[On the manner of development of psychosomatic diseases].
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The presented work provides a review of literature dealing with dermatoses (dermatitis atopica, eczemas, allergies, urticaria, pruritus, etc.) from the psychosomatic point of view. The presented work attracts attention to the association of psychical state with the skin; it indicates the necessity to comprehend each patient from the bio-psycho-social aspect and to take into account the multifactorial etiopathogenesis of each disease. The author recommends cooperation between dermatologists, clinical psychologists and psychiatrists. The aim of the cooperation is to supplement local therapy by psychotherapy in psychosomatic disorders, and the field of psychodermatology by psychopharmacology.
A history intrafamilial sexual child abuse was dicited from 33 patients (20%), admitted to the Psychiatric Department (Psychosomatic Unit) of the University Clinics of Innsbruck in 1989. They exhibited quite different psychopathologies, with no typical incest syndrome, however, self-destructive behaviours of different kinds appeared to be characteristic of sexually abused patients. Experiences of separation and loss could be seen as the most frequent trigger for mental and psychosomatic disorders. The importance of child sexual abuse as a vulnerability factor, the necessity to consider the possibility of sexual abuse during childhood in all cases of mental disorder and the importance of the therapist's empathy as a precondition for the patient's ability to speak about the traumatic experience are discussed.
There are empirical indications that the well-known weaknesses of the different psychosomatic specificity theorems are linked to their presupposition of a one-to-one relationship between one specific psychosocial configuration and one definite disease entity. An alternative conceptualization is offered: The majority of the psychosocial phenomena found within a definite disease entity fall into a small group of perhaps half a dozen different patterns. Only a minority of cases show a high variation with many different patterns - some even individually unique. This alternative concept demands different research strategies and methods which are provided by taxometrics. This is illustrated with examples from a follow-up study of anorexia nervosa.
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Twenty patients with a chief complaint of a lump in the throat, were examined otolacyngologically, radiographically, and psychiatrically with special attention directed to psychosomatic aspects. The control material consisted of matched sample persons of the general population, and of the total patient material treated at a general hospital.