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[Psychological approach to disease].
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[Asthma, allergy and psychosomatic medicine].
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[Psychosomatics is "expensive"].
Experience shoves that number of diseases where recognition and treatment is without limits of classical medicine is rising, however it is fully within the competence of psychosomatic approach. It does not concern the classical classification into organic and functional defects, but it concerns the possibility of complex approach. The theorem of "diagnosis per exclusionem" is still valid, as well as it is true that the means of medicine end at its biological limitations. We consider stressing in our article that psychosomatic diseases or psychosomatic patients do not exist and psychosomatics is not and independent specialization. Psychosomatics is, as inseparable unity of psychic and somatic activities, each human being. Complex biopsychosocial (psychosomatic) approach is the way of thinking and work, which considers human in unrepeatable oneness and context of his life. It does not mean to underestimate objective biological findings and results of instrumentally investigation, but their implanting into the complex network of consequences of the patient's life in order to choose the most appropriate methods of the care of the individual in healthiness and disease.
[Psychosomatic correlations of sympathetic reflex dystrophy (Sudeck's disease). Review of the literature and initial clinical results].
The present state of the art in psychosomatic research on reflex sympathetic dystrophy or Sudeck's atrophy (also known as Sudeck's disease) is reviewed. The survey confirms the impression prevailing with surgeons and orthopaedists that patients suffering from this disease are "psychically peculiar", i.e. they appear strange or odd. Psychometric examinations show that they suffer from enhanced anxiety, are emotionally rather unstable and display a tendency to depressiveness associated with a marked self-esteem rating problem complex. Basing upon these criteria the occurrence of reflex sympathetic dystrophy in the postoperative course of patients with Dupuytren's contracture could be correctly predicted in 43 of 47 patients, the remaining 4 patients being forecast with a false-positive prediction (Zachariae 1964). Studies on Children with reflex sympathetic dystrophy likewise confirmed these characteristic features. In a study of our own we examined in 12 patients their biographical development as well as life events that had happened 6 months before onset of the disease. We obtained a surprisingly uniform result: In all patients we found that at least one or in most cases several severely stressful life events had occurred; all patients had been suffering from chronic headache and/or pain in the lumbar vertebral column for many years; and all of them had shown signs in the course of their development in childhood and adolescence that have been described by Engel as "pain proneness". Over and above this, the anamnesis of most patients revealed other psychogenic and psychosomatic diseases or signs and symptoms. The case reports of all the 12 patients served as basis for initial approaches to a psychosomatic disease concept of reflex sympathetic dystrophy.
[Application of psychosomatic medicine to allergy].
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[Psychosomatic aspects of allergy].
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[Allergy and psychosomatic medicine].
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Psychosomatic aspects of dentistry.
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[Neuropsychiatric disorders of the diseases of exocrine pancreas (author's transl)].
Neuropsychiatric and psychosomatic disorders occurring the exocrine pancreatic diseases are not rare, nevertheless didn't it seem to be very interesting in research and there exists no summarizing work of this disorders. Therefore we tried to give a comprehensive representation of those neuropsychiatric problems which are connected with the function of this organ. At first we give a description of psychopathology and pathogenesis of the functional pancreatic psychosis. The problematic of the reciprocal relationship of nervous system and pancreatitis, alcoholism and pancreatitis are demonstrated as well as the psychic disorders occurring the pancreas insufficiency, cystes of pancreas and congenital pancreatic diseases. Psychosomatic and mental disorders of pancreas carcinoma and mucoviscidosis are shown in detail. The question of the interrelation between pancreatic function and amyotrophic lateral sclerosis or parathyreotic diseases are discussed just as themes of neuropsychiatric pharmacotherapie and pancreatic function and mental disorders in pancreatic treatment.
[Psychosomatic reactions comorbid with ischemic heart disease: psychogenically provoked infarctions and myocardial ischemia].
Ischemic heart disease (IHD) with psychogenic provoked myocardial infarctions (MI) and myocardial ischemic disease (MID) is considered as a psychosomatic disorder. Seventy patients, 17 female and 53 male, aged between 39-77 years, mean age 61.2 +/- 9.9 years, were observed. The presence of both somatic (prolonged atherosclerotic lesion of coronary arteries) and mental (personality disorders with symptoms of reactive lability under psychic trauma influence) predisposition is obligate for manifestation or exacerbation of this IHD type. It is suggested that atherosclerotic coronary vessels affection of heterogeneity may exist. Two types of vulnerability are described. In type 1 cardiovascular system exhibits selective sensitivity to the influence of obligate and of great personality significance cathatymic affect. A strict condition of its realization is amplification of negative emotions up to a level of pathological affective outbursts in the spectrum of paranoiac or explosive reactions. In these cases, IHD is characterized by a stable course (angina of high tensions, without instable anginal episodes etc). In type 2 cardiovascular system reveals vulnerability to negative emotions, the continuum of which is ended by polar pathological affects-cathatymic and anxiety. In contrast to cathatymic affect, a common feature of anxiety affect is a fast, like short-term emotional outburst, manifestation of instable, labile, dramatic external appearances (with tears, converse disorders etc). IHD symptom complex is distinguished by pronounced clinical manifestations (stenocardia of tension with progressive impairment of tolerability to loadings).
[Diseases of civilization and a nosological principle of medicine in terms of general pathology].
The last 100-150 years are marked by the spread of so-called "diseases of civilization" (primarily psychosomatic and mental diseases) which earlier have been encountered rarely. These diseases present quite novel pathogenic factors, adaptation to which in the course of evolution is lacking. Development of civilization constantly stimulates the emergence of numerous qualitatively new pathogenic factors, on the one hand, and changes the conditions for impact of conventional factors, on the other hand. This process is becoming more and more intensive and makes the sequence "cause-specific pathogenesis-clinical symptoms-nosological unity-relevant etiotropic and pathogenetic treatment" less obvious. From this follow difficulties in application of routine methods of diagnosis, etiotropic and pathogenetic therapy based on the nosological principle as well as interest to methods of "alternative' (complementary) medicine which are nonspecific and, therefore, in some cases effective against some "diseases of civilization".
Psychosomatic aspects of cerebral vascular disease.
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[Psychosomatic medicine and allergy].
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[The psychosomatic approach to the collagen disease scleroderma].
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Immunity and stress.
The relationship between stress and immunity is not a hot topic of psychoneuroimmunology. The review outlines the main aspects of these interrelations; stress sensitive immunological markers, experimental research and studies on humans which underline the prevailing immunosuppressive effects of stress are discussed. A classification of stress-related diseases comprises autoimmune, acute, psychosomatic and neuroendocrine diseases. Besides the hypothalamopituitary-adrenocortical axis and the symparthoadrenal system, newer information points to the role of cytokines, opioids and other mediators in the complex mechanisms involved. Several data from the physiological laboratory in Cluj are included. The final consideration outlines some unclarified aspects and new research directions.
Psychosomatic aspects of Menière's disease.
The author presents a study of the personality structure, youth development and the role of interhuman conflicts in the work situation and the family, in the causation and course of Menière's disease, the somatopsychic reactions of the patients to the illness, and the principles of a form of psychotherapy which was combined with the regular E.N.T. check-ups and treatment. The results confirm and extend previous work by other researchers. A testable hypothesis about the specific psychosomatic etiology of Menière's disease is formulated and presented.
[PSYCHOSOMATIC ASPECTS OF VARIOUS INTERNAL DISEASES].
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