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PubMed1984

"Race related illness in Vietnamese refugees".

The author worked for six weeks in September 1982, as a Medical Practitioner and Psychiatrist at the first Asylum Centre Puerto-Princessa, Palawan, Philippines. This paper relates relevant aspects of Mental Health needs of Vietnamese refugees related to racism, aftermath of war, leaving home-land without preparation, perilous escape, prolonged stay in cramped refugee camps, and move on to unsettled, unsure future in another country with alien culture and environment. Changes of life situation, loss of business, property or occupation, loss of loved ones, separation from friends, disruption of family relationships are related to racism and persecution elements in 'Boat People'. The most frequent psychiatric illnesses among the refugees are: depression, anxiety state, psychosomatic disease and psychosis. A special mental health project is needed to train health workers, provide service and consultation and to organising research activities. On the preventive aspects, primary prevention may be achieved by less stress on rapid assimilation and the reduced likelihood of discrimination, hostility and prejudice. Secondary prevention consists of early detection of the disease and early initiation of treatment and tertiary prevention consists of the elimination or reduction of residual disability after an illness.

Adult↗

PubMed1984

Corporate reported sick leave and its relationship with education, responsibility and blood pressure.

The investigation group included all 1313 employees of SAAB-SCANIA, Linköping, in the age group 50-59 years. In 1975 they were called during their working hours to the company's Physical Training Centre to be assessed. This investigation included measurements such as systolic blood pressure, height, weight and certain anthropometric measurements. Other information was obtained from the personnel records about sex, age, type of employment, educational grade, degree of responsibility, and reported sick leave in 1974 and 1975 for the workers, and between 1970 and 1975 for the salaried employees. The total number of drop-outs was 238, or 18%. Sick leave is mainly a problem of the long-term absence of a minority of employees with an ever-increasing rate of absence. Sick leave among the salaried employees decreases in relation to higher education and increased responsibility. A high level of responsibility and education characterizes a low-risk group, whereas little responsibility and a low level of education denote a high-risk group with regard to blood pressure and sick leave. A disparity--low education and medium responsibility--has earlier been described as denoting a high risk of psychosomatic diseases. In this study they showed a rate of absence lower than the average at the same time as the blood pressure is above the average.

Absenteeism↗

PubMed2005

A topological model of biofeedback based on catecholamine interactions.

BACKGROUND: The present paper describes a topological model of biofeedback. This model incorporates input from a sensory organ and a transduction phase mediated through catecholamine production in the feedback path. The transduction phase comprises both conservative and dissipative systems, from which the appropriate output is combined in a closed loop. RESULTS: The model has been simulated in MATLAB 6.0 R12 in order to facilitate a comprehensive understanding of the complex biofeedback phenomena concomitant with the transduction phases associated with migraine and with psychosomatic diseases involving digestive disorders. CONCLUSION: The complexity of the biological system influences the transduction phase and nature of the system response, which is consequent on the activation of smooth muscles by sympathetic and parasympathetic stimulation.

Aging↗

PubMed1991

Reassessing the validity and reliability of the MMPI Alexithymia Scale.

In the past decade, alexithymia has emerged as a heuristically useful personality construct used to explain the pathogenesis of a variety of physical illnesses, including classical psychosomatic diseases, somatization disorders, hypochondriasis, and somatoform pain disorders. Unfortunately, research evaluating the alexithymia construct has been conducted with little attention to assessing the psychometric properties of various scales used to measure it. In two separate studies, we examined various scale and item properties as well as the factor structure and validity of the Minnesota Multiphasic Personality Inventory Alexithymia Scale (MMPI-A), one of the most commonly used scales to assess alexithymia. In Study 1, the 22 items that comprise the MMPI-A were extracted from a computerized MMPI data bank which included separate samples of psychiatric inpatients and outpatients. Poor item-to-scale characteristics and only moderate levels of internal reliability were found for both samples. Factor analysis produced factors that were poorly related to the theoretical domains of the alexithymia construct. In Study 2, we found little support for validity of the scale as those patients identified as alexithymic and nonalexithymic by the MMPI-A did not differ on several theoretically relevant scales. These results question seriously the value of the MMPI-A in investigating the alexithymia construct.

Adult↗

PubMed1986

Changes in the hypothalamic-pituitary-thyroid axis during acute starvation in non-obese patients.

We investigated changes in the hypothalamic-pituitary-thyroid axis before, during, and after fasting in twenty-one non-obese euthyroid patients with psychosomatic diseases. Blood samples for free T3 (FT3), T3, free T4 (FT4), T4, reverse T3 (rT3), and TSH were obtained from all patients before and on the 5th day of fasting, and in 11 of the same individuals on the 5th day of refeeding. Serum TSH and T3 responses to TRH were also evaluated in 10 patients before and on the 5th day of fasting. During the fast, FT3, T3 and TSH levels decreased significantly and rT3 levels increased significantly whereas FT4 and T4 levels remained within the normal range. Maximal delta TSH, peak TSH levels, max delta T3, peak T3 levels, and net secretory responses to TRH decreased significantly. Peak TSH levels and max delta TSH to TRH correlated well with basal levels of TSH. A statistically significant negative correlation between basal levels of FT4 and TSH was observed. After refeeding, there was a significant increase only in TSH which returned to prefasting values. These results demonstrated that in a state of "low T3" during acute starvation a reduction in serum T3 might depend partly on TSH-mediated thyroidal secretion.

Adolescent↗

PubMed1986

[Application of health questionnaires for health management in small- and medium-sized enterprises].

Two kinds of health questionnaires, the Todai Health Index (THI) and Cumulative Fatigue Index (CFI), were applied as a screening device for health management of workers belonging to small-medium sized enterprises. A total of 495 workers composed of 452 male workers of a glass-bottle manufacturing factory and 43 male workers of a soft-drink bottling factory were the subjects of the present study. It was found that the two kinds of health questionnaires were different from each other and have their own characteristics. Twelve scales of THI were grouped into two, the first consisting of ten scales (SUSY, RESP, EYSK, MOUT, DIGE, IMPU, MENT, DEPR, NERV, and LIFE) and the second consisting of two scales (AGGR and LISC). Nine categories of CFI were grouped into one by using principal factor analysis. It was confirmed that the twelve scale scores of THI obtained at small-medium sized factories differed from those scale scores of a reference group investigated at a large-sized enterprise. It is on the basis of the scales of aggressiveness and lies and also of the scale of mental unstability which characterizes workers, locality, job (clerical or field work), and size of industry (large or small sized) that the difference could be evaluated. Urban life characterized by a life style of staying up late at night and waking up late in the morning has been reflected on the scale of life irregularity. Irregularity of life induced by transformation of working schedule, such as two or three shifts of work and overtime, was also reflected on this scale. Two scales of THI test, i.e., many subjective symptoms and digestive organ complaints, seemed to be the representative scales indicating a close relation between work load and health level. The discriminant score for diagnosis of psychosomatic diseases is considered to be one of the most useful assessments of the individual's health condition. As mentioned above, THI is recommended as a convenient assessment method for health management of workers and for screening individuals or groups requiring health management from the total respondents belonging to small-medium sized enterprises where health administrators or professionals for health services are not available. A combined use of THI and CFI is more effective in evaluating health status of field workers than the independent use of one of these two tests, because the causal relationship between work load and health status cannot be satisfactorily observed, only through THI.

Adult↗

PubMedDate not supplied

Treating the untreatables: identifying the somaticizing borderline patient.

Both medical and psychiatric services have long been challenged by patients with either clear psychosomatic disease or disease complicated by functional elements. Not only are these patients unresponsive to the usual medical management, but they seem to derive little benefit from the usual psychotherapeutic approach. This paper is intended as an examination of this group of difficult patients for the purpose of: 1. creating a suggestive profile to aid in the identification of such patients; 2. anticipating some of the difficulties experienced by clinicians and institutions responsible for their care; and 3. formulating a framework for understanding the basic difficulty experienced by some of these patients as an expression of borderline personality phenomena.

Adult↗

PubMed1983

Abdominal ultrasonography in patients with uncharacteristic abdominal symptoms.

Ultrasonography (US) was performed in a prospective study of 48 patients with uncharacteristic abdominal symptoms. All patients had been examined in other hospitals, but no diagnosis had been established. Pathologic US findings were encountered in five patients: fatty liver in two patients, gallstones in one patient, ovarian cyst in one, and liver metastases in another patient. US may be used as a diagnostic approach in patients with uncharacteristic abdominal complaints when conventional X-ray examinations are negative. In patients with psychosomatic disease a negative US result may be of importance in the psychiatric approach to these patients' disease.

Abdomen↗

PubMed2004

[Clinical and fundamental investigations on recurrent glossodynia].

A type of oral lesion, so-called glossodynia has been on the increase recently. Glossodynia is a kind of psychosomatic disease in which the patient experiences chronic pain on the surface of the tongue. It has never been diagnosed as coming from organic or functional pain. Although glossodynia can be cured by antianxiety drugs, antidepressants, or autogenic training and so on, usually. These are not a desirable solution. We initially tried to administer the antifungal drug, ITCZ, to 65 glossodynia patients. Sixty-four of them were cured of tongue pain after 1-3 weeks. The effective rate of recovery was 98.5%. Only two patients experienced recurrence of pain after 15 and 17 weeks, respectively, and Candida albicans was isolated from the surface of their tongues. The nature of the recurrent strains was investigated by MICs against 4 antifungal drugs, ITCZ, MCZ, AMPH-B, and NYS, as well as by the API 20C Auxanogram biochemically, and a molecular epidemiologic study by PFGE. Each case of Candida albicans was almost the same before and after the administration of ITCZ. Above all, it is important to carefully inspect the candidiasis of the tongue and to initially administer antifungal drugs when the diagnosis is glossodynia.

Adult↗

PubMed1975

A model of psychosomatic illness.

An attempt is made to provide a general theoretical framework for psychosomatic disease. It is suggested that the convergence of a number of factors is necessary for the production of the illness. These factors include an individual's control or repression of emotional discharge over a long period. In addition, the affected person may show personality characteristics consistent with such control, and may live in a situation of unresolved conflict. The choice of illness might be determined by organ "weakness". The persistence of symptoms after resolution of the conflict is explained in terms of conditioning.

Adult↗

PubMed1999

[The hospital at Ilebu prison. From sentences 1945-50].

Ilebu Prison held the majority of men sentenced for treason in Norway after the Second World War. About one third of all prisoners convicted of treason served their sentence at Ilebu, which was one of the few prisons or camps which had a well organised hospital with a patient registration protocol. The protocols were recently (1995) brought to light; complete case records are stored in the National Archive. We have gone through a number of the case records and compared them with the protocols. The typical patient at Ilebu in 1945 was below 39 years of age, whereas in 1949 those over 40 were in majority. Average age and length of stay increased over the years as the oldest convicts also got the longest sentences. High age and long sentences contributed to increased morbidity, mental and psychosomatic disease as well as functional illness. The most common reason for admission was infectious disease. Ilebu Prison escaped serious epidemics, most likely because of good facilities for isolation as well as vaccination. However, the large number of prisoners suffering from tuberculosis was a cause for concern.

Adult↗

PubMed1999

[The combined effect of psychotherapy and fluoxetine on obesity].

Obesity as psychosomatic disease is a mass phenomenon. The number of obese males (BMI > 30) became doubled in the last ten years. In the etiology of obesity play an important role the reactive obesity. In the background of "yo-yo syndrome" often could be found depression, or other psychotic disorder. The low self-esteem, body dissatisfaction, tension, anxiety disorders is well-known in a slimming diet. Obese subjects (n = 29) who were admitted on their request with a view to losing weight were examined (Hamilton Depressive Scala, Hamilton Anxietas Scala, Eating Attitude Test) Physical Conditioning and internal Medicine Department of National Sports Medicine Institute, Budapest. Among obesities with mild and severe depression as treatment of somatic complications was used fluoxetine, in severe cases and depression with severe anxiety was associated with supportive or cognitive-behavioral treatment. The prevalence of binge eating disorders were at 57% and bulimia nervosa was at 3% in using population (n = 29). Decreasing of anxiety and grade of depression significantly correlated with body mass index (p < 0.023, F = 1.997, p < 0.034, F = 3.131). The treatment of fluoxetine significantly correlated with body mass index (T1: p < 0.023, T2: p < 0.03, T3: p < 0.004). The patients indicated their well being as fluoxetine reduced eating, satiety and lower binges.

Adult↗

PubMed2000

[Aspects of occupational disability in psychosomatic disorders].

In 1997, 30% of the persons going into early retirement because of occupational disability and received pensions were psychosomatically ill. An additional large number of retirees suffered from untreatable pain such as chronic low back pain, some of them might as well have a chronic somatoform pain disorder. The article describes frequent psychosomatic diseases like somatization disorder, fibromyalgia and chronic fatigue syndrome with respect to their pathophysiology and psychological aspects as well as therapeutic advancements. It is postulated that an interdisciplinary access to these patients early in the course of their illness involving both somatic medical and psychiatric competence is the most promising means to tackle this enormous medical and health protection problem.

Disability Evaluation↗

PubMedDate not supplied

[Insomnia in the elderly: cognitive involvement and therapeutic attitudes].

INTRODUCTION: Sleep is an important biological function, which greatly affects the quality of life at all ages. Sleep influences the alertness and stress levels, psychosomatic diseases and health in general. DEVELOPMENT: The predisposition to insomnia increases with age, illnesses such as heart disease, breathing disorders, cancer, strokes, pain and polyuria often disturb sleep patterns. In addition, the aging process, which directly alters sleep-wake cycles and other cerebral functions, affects the elderly. All the above points can lead to an increase in sleep latency, less total sleep time, increases in early awakening and a greater frequency of daytime naps. In an attempt to improve sleep in the elderly, and thus their quality of life, we can try to prevent stress and psychiatric symptoms by altering life-styles and improve the patients' awareness of the problem. Hypnotic drugs are useful for short periods but for longer ones we prefer techniques which attempt to modify behavior. In chronic patients who need treatment with hypnotic drugs for a long time, therapy must be individualized.

Aged↗

PubMed2001

[Dynamics and prognosis of mental disorders incidence in elderly patients].

Mental disorders incidence grows constantly in patients of 60 and older. It has grown by 9.8% in 1998 as compared with 1993 and by 21.2% as compared with 1991. In 1998 psychoses and mental retardation incidence was 117.1, while nonpsychotic forms of the disorders--136.4 per 100 thousands of population at the age of 60 and older. The main increase of the incidence was found in the group with disorders characteristic for the late age. A number of the new patients with senile psychoses and dementias increased in 1998 by 21.3% as compared with 1993, while a number of patients with nonpsychotic disorders of vascular nature during the same period increased by 61.2% and with the disorders of the other organic nature--by 35.3%. From 1995 the individuals of the old age had high incidence of reactive states--by 58.9%, of neuroses--by 71.8% and of psychosomatic diseases--by 72.2%. The paper predicts further increase of mental disorders incidence in the population of elderly and old age.

Aged↗

PubMed2002

[Alexithymia and alcohol dependence].

Alexithymia is a term introduced by Sifneos in 1973 to describe, initially in psychosomatic patients, the inability to recognize and to express emotions. Since 1973, alexithymia has been also described in alcohol dependence. A review of these studies is proposed with the results of our study from the INSERM network "Dependence". Prevalence of alexithymia is high in alcoholic patients, between 40 and 60%. Some authors have found that alexithymia predicted poor outcome in these patients. The distinction between primary and secondary alexithymia and the relationships between depression and alexithymia are complex. The psychodynamic hypothesis that alexithymia could hold a central position secondary to early dysfunction in the construction of the psychic and somatic self can be put forward. In some circumstances, regression to this position, even after transient addictive filling-in, could lead to essential depression and to psychosomatic disease.

Affective Symptoms↗

PubMedDate not supplied

[Normoplastic interventions in conflict-oriented brief therapy].

A method of brief psychotherapy developed in the clinic for psychogenic and psychosomatic diseases Tiefenbrunn, and suited for patients unable to deal with interpretations is presented. From focal psychotherapy inaugurated by Balint, to which it constitutes a counterpart, the method differs as to mutative interventions, which are specifically directed at the norms determining patient behaviour. The interventions are derived from an analytically oriented assessment of psychodynamics. Their mode of functioning is explained within a psychoanalytic model of psychic functioning. Indications, especially in comparison to Balint's focal therapy are stated. Technique is described.

Conflict, Psychological↗

PubMedDate not supplied

[Psychological aspects of ulcerative rectocolitis (author's transl)].

Ulcerative rectocolitis has been known for quite some time as a psychosomatic disease, it is an organic disease occurring in people with a particular personality rendering them susceptible to certain conflicts or stress which would be able to play a causing role in the appearance or exacerbations of the disease. Insofar as the psychological study is concerned, there are two important points to keep in mind: the role of psychological trauma as a stimulating factor and the basic personality. In 90% of the cases observed, psychological factors are found as provoking the hemorrage, as found by Groen and confirmed by the author. The basic personality is generally the obsessional type with a hypersensibility to rejection and hostility, sometimes of a paranoid dimension. The aggressivity is almost always repressed. The doctor-patient relationship indicates an important dependency as well as a passivity on the part of the patient. Furthermore, these patients rarely express their feelings, even if their behavior is indicative of experiencing intense emotion. By further experimentation, it has been established that these patients have a greater neuro-vegetative fragility than controls, thus demonstrating a greater vulnerability to stress. A pathological relationship between mother and child has almost always been proven. Finally, the principal causal psychological factor in this disease seems to be a relational conflict unresolved between specific figures. The role of psychotherapy influences greatly the disease evolution. the author recounts an interesting research of 900 ulcerative colitis patients, undertaken by O'Connor. In order to insure favorable therapeutic results in ulcerative rectocolitis, one must carefully coordinate a psychological and somatic treatment.

Colectomy↗