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[The psychiatric problems raised by cystalgias in the female].
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[Psychosomatic research and psychotherapeutic methods in dermatology].
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[INSIDON IN UROLOGICAL PSYCHOSOMATIC DISTURBANCES].
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Psychosomatic methods of investigation in the recognition of organic disease.
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[Conditions of psychosomatic nature in otorhinolaryngology].
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[DISEASE AND OCCUPATION FROM THE VIEWPOINT OF THE INTERNIST].
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[The problem of genuine mental causation of physical diseases].
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Alexithymia may influence the diagnosis of coronary heart disease.
A number of psychosomatic studies have suggested that alexithymia, impairment in identifying and expressing inner feelings, might somehow affect the course of various illnesses. However, none of these studies have distinguished between an impact of alexithymia on actual pathophysiological change versus an impact only on illness behavior. In the present study, a population-based random sample of 2297 middle-aged men from Eastern Finland was evaluated for alexithymia using the Finnish version of the self-report Toronto Alexithymia Scale (TAS). Although high TAS scores were associated with prior diagnosis of coronary heart disease (CHD), they were not associated with greater prevalence of ischemia on an exercise tolerance test. The results of B-mode ultrasonography of the carotid artery for those who had a CHD diagnosis showed that carotid atherosclerosis actually decreased significantly as alexithymia increased. An interaction analysis indicated that alexithymia was related to increased probability of being diagnosed with CHD only among those who had mildly or moderately progressed carotid atherosclerosis, and not among those with the most severe progression. Alexithymia was associated with higher perceived exertion, and to some extent, with more self-reported symptoms during the exercise tolerance test. The findings support the hypothesis that alexithymia relates to increased symptom reporting rather than pathophysiological changes in CHD. The results also suggest that alexithymic men may get diagnosed earlier, perhaps because of their different illness behavior.
[Basis disturbances in depressive neuroses and psychosomatic disorders].
Applying the concept of the "basic fault" (Balint) to depressive neuroses and psychosomatic disorders the author reports some analogies in the dynamic processes of both diseases. Both are based on a pre-verbel deficiency in communication which has an influence on further conflict-organisation. In the case of psychosomatic diseases this leads to a fixation on the pre-verbel, vegetative object-relation. At the stage of the re-activated psychovegetative basic fault only somatic reactions and satisfactions may be accepted by the patients. This impedes the working alliance, consolidates somatisation as a resistance mechanism, and may require discontinuation of psychoanalytic treatment. In the case of depressive neuroses the stage of the basic fault is characterised by a paradox form of sell-object-relationship which is both object-relation and narcistic isolation as well. Though at this stage verbal communication is less important the analist may advance dissolving of this paradox relationship by means of empathetic interventions.
[What modifies the course of Crohn disease?].
This paper presents empirical results concerning the interdependency of somatic and psychological factors in the course of Crohn's disease. Data derived from the Heidelberg psychosomatic study on Crohn's disease are explored with the help of canonical correlation analysis. Somatic data recorded in the acute stage of Crohn's disease were not empirically found to be predictive of the psychological status after convalescence empirically. On the other hand, we did find psychological data that allowed prediction of the somatic status when the patients were in remission. Of these psychological data, coping resources are the most important predictors of the course of the disease. In particular, depressive forms of coping are correlated with personality factors, whereas active coping forms are not. The results have implications for scientific theory as well as for clinical practice.
[DISEASE AND PAIN. THE 2 FACES OF PAIN].
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Depersonalization, vertigo and Ménière's disease.
Ménière's disease is generally accepted to be a consequence of distention of the endolymphatic sac of the inner ear. Although the exact etiology is unclear, there is a body of research suggesting that Ménière's disease is of psychosomatic origin. While we do not intend to review the literature exhaustively, we briefly review several frequently cited studies. Even though this literature is so severely flawed that no solid conclusions may be drawn from it, certain questions about the psychological aspect of this disorder continue to surface. Our limited access to patients with vertigo has not allowed us to undertake a carefully designed study. However, in clinical practice we have noted that many persons who complain of vertigo (whether due to Ménière's disease or other causes) also report symptoms of depersonalization and derealization. In this paper we present the cases of two women with Ménière's disease who also experienced concurrent feelings of unreality. It appears likely that feelings of unreality may occur regularly in association with syndromes causing vertigo, presumably as a consequence of vestibular dysfunction. We argue that emotional disturbances previously identified as predisposing causes of Ménière's disease are more likely effects of the disease. Although the discussion of two uncontrolled cases can do little to help solve nagging questions about a psychosomatic component to this disorder, we believe it may suggest a different perspective from which to investigate these complex phenomena.
European evidence based consensus on the diagnosis and management of Crohn's disease: special situations.
This third section of the European Crohn's and Colitis Organisation (ECCO) Consensus on the management of Crohn's disease concerns postoperative recurrence, fistulating disease, paediatrics, pregnancy, psychosomatics, extraintestinal manifestations, and alternative therapy. The first section on definitions and diagnosis reports on the aims and methods of the consensus, as well as sections on diagnosis, pathology, and classification of Crohn's disease. The second section on current management addresses treatment of active disease, maintenance of medically induced remission, and surgery of Crohn's disease.
Socio-economic and school factors of psychological and physical health in Siberian schoolchildren.
Cultural influences on psychological and physical health were examined in a sample of Russian schoolchildren in Novosibirsk. To evaluate the children's behaviour the translated short form of the Child Behaviour Checklist was given out to mothers. A School Adjustment Scale and the Rutter Teacher Questionnaire were completed by teachers and one total score was derived from the Rutter Health Questionnaire for children. Children from disturbed families had worse school adjustment and more behavioural problems. Acute respiratory diseases were more frequent in children from large families, while the mother's education level was a protective factor. Academic attainment was positively related to parents' education, CBCL Somatic Complaints and the occurrence of psychosomatic and inflammatory diseases, and negatively related to Externalising Problems. The CBCL Somatic complaints score was the key variable in the prediction of most physical health variables. Overall, the findings show the significance of academic attainment for a child's physical and psychological health. Low academic attainment tends to be connected with Externalising Problems, while higher attainment could be connected with somatisation and physical illness.
[PSYCHOSOMATIC PERSPECTIVES IN GASTROENTEROLOGY].
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[Juvenile ischemic type of moyamoya disease: a case report].
Moyamoya disease is a rare, chronic cerebrovascular disorder characterized by progressive stenosis of the arteries composing the circle of Willis. The ischemic type of Moyamoya disease progresses insidiously. To prevent irreversible cerebral damage and psychomotor deterioration, early surgical treatment is considered indispensable. The patient may present with nonspecific symptoms and no specific abnormalities on brain MRI, and might be erroneously suspected as having psychosomatic disorder. The disease must be diagnosed as early as possible. Electroencephalography (EEG) is of little value in the diagnosis of the juvenile type of Moyamoya disease, except for the demonstration of "re-build up" after hyperventilation. Half of the children with Moyamoya disease have been demonstrated to exhibit "re-build up" after hyperventilation. Our patient showed normal background activities, no spike discharges and no slowing during hyperventilation. Nonetheless, we emphasize the appearance of irregular high voltage slow waves de novo after hyperventilation. The findings may be potentially useful for the screening of patients with the juvenile type of Moyamoya disease.