Psychosomatic grand rounds: Graves' disease.
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Gastrointestinal diseases are notoriously protean in their modes of expression. The patient's description of symptoms is particularly important, but psychologic, physiologic, and social factors can cause data-base unreliability. Many of the patients termed crocks have symptoms referable to the gastrointestinal system, and they are at considerable health risk, since they usually alienate health care personnel. Patients with pancreatitis usually have a history of heavy alcohol intake which also needs treatment. Behavioral disturbances are related to toxic psychosis. Pancreatic carcinoma has a higher incidence of associated psychiatric symptoms than other types of cancer. Biologic, psychologic, and environmental factors all interact dynamically to cause peptic ulcer disease. There is a high correlation between the severity of inflammatory bowel disease and degree of emotional disturbances.
Most therapists recognize that emotional factors influence the course of neurodermitis (ND). Most studies concerning the influence of experimental, acute stressors brought only inconsistent results in ND. Most likely, the experimental stressors chosen thus far were only able to poorly simulate the reactions to real stressors in neurodermitis patients. More recent articles, however, were able to demonstrate changes in psychoimmunological parameters under experimental stress conditions in ND in comparison with a control group of persons with healthy skin. Retrospective studies, serial analyses over time and psychotherapeutic evaluation studies were able to demonstrate even more clearly that emotional factors influence the course of ND.
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