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PubMed1976

[Comparative studies of the psychosomatic aspects of liver diseases].

Connections between disturbed functions of liver and mental diseases at all times have been generally supposed as existent and have been discussed in the literature; they should be clarified by means of questionnaire-tests: MPI-test and MMQ-test of Eysenck combined with neurotizism-depression-questionnaire of Hoffmann-La Roche allowed to comprehend the dimensions of personality "neurotizism" and "depressivity". Concerning "neurotizism" statistically significant differences could be found between liver-patients and healthy persons in a tendency to a significant increase among liver-patients, but not between liver-patients with other diseases. The tendency to "depressivity" of healthy persons could be statistically evaluated as being much greater than that of liver-patients; there were no differences between liver-patients and patients with other diseases. That is why liver-patients do not differ psychically from patients suffering from other diseases; they share their reaction to the occurrence of disease - in various degrees until a neurotic lack of active realization of the fact of illness. Liver-diseases apparently are not triggered or caused by special pre-morbid alterations.

Depression↗
PubMed1980

Psychosomatic factors in duodenal ulcer disease.

Psychological factors may play an important role in peptic ulcer disease, but this has not yet been proven. The psychosomatic theory suggests than an unconscious conflict, by some yet unknown route, results in an increase in acid-pepsin secretion or a decrease in resistance of the duodenal mucosa, thereby upsetting the normal balance between injurious and defensive factors. At least some ulcer patients have a conflict over an exaggerated need for dependency and a desire to be a self-sufficient adult. In a prospective study [13] aimed at predicting individuals predisposed to ulcer disease, the presence of this dependent-independent conflict was confirmed. Since this personality profile was found to be associated with hyperpepsinogenemia which has since been shown to be genetically determined, the intriguing possibility exists that the psychological traits are also genetically determined. This personality profile may be associated with a predisposition to ulcer disease, but so far there is no clearcut evidence showing that the psychological factor actually influences the gastrointestinal disorder. Clinical experience suggests that "stress" is frequently a contributory factor to exacerbations of the ulcer disease. We are coming to recognize that a number of different pathophysiological mechanisms may lead to a duodenal ulcer. It seems that psychological factors may be found to be important in some forms of the disease and not in others. Consideration of psychiatric treatment should be based on the individual's psychological characteristics and not solely on the presence of ulcer disease.

Duodenal Ulcer↗
PubMed1999

[Crohn's disease from the viewpoint of psychosomatic and behavioral medicine].

In a group of patients suffering from Crohn's disease increased incidence of affective symptoms, mainly high degree of neurosis and depressions, was detected with the use of psychological methods. Social relations and status may influence the course of the disease. Social support, information on the disease and patients higher educational degree have positive effects on the acceptation and compliance of the disease. Surprisingly negatively is the disease influenced by stable partnership and parenthood. Affective symptoms can be managed with the use of psychological methods. We proved it on reconditioning stays with structured programme. Their application led to reduction of neurotic and depressive symptoms, improvement of physical condition, better ability to relax physically and emotionally, the ability to harmonize psychical and physical functions, to cope with stress and the patients have established social contacts with other persons suffering from the same disease with the aim to promote conscious care of one's own health condition. Psycho-educational programme is extraordinary important in new diagnosed patients, for their ability to cope with the disease, and as a help for their future life arrangement. The techniques used to deal with stress can be helpful for prolonging the remission period. It was confirmed that psychological methods may contribute to life quality improvement in Crohn's disease patients. Self-help activities in the form of clubs and reconditioning stays reveal as very useful. Psycho-social intervention should become a part of complex care of patients with Crohn's disease. (Tab. 1, Fig. 1, Ref. 22.)

Adult↗