[Significance of (patho)-psychology of family life in the etiology of psychosomatic diseases].
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Harmful effects that result from psychic influences on the organic control of tissues are known as psychosomatic disorders. Psychologically, the oral cavity is related directly or symbolically to the major human instincts and passions. In this article, before treating two patients, who have gingival recession and itching, the importance and necessity of their treatment of psychiatric disorders were mentioned and the relationship between psychiatry and dentistry is explained.
The authors, after having considered the close likeness between the collateral clinical picture described by others in regard to the irritable colon syndrome and the outstanding one pointed out by them in many cases of psychosomatic disorders, have analyzed again a large number of personal cases diagnosed as "psychosomatic" in order to find possible relations between these two unwholesome conditions. At the end of their examination, after having ascertained that the "Irritable colon" has not to be considered an isolated disease but a syndrome caused by many factors, hinged on a predisposing condition likely of constitutional nature, the authors remark how it may nest in the folds of a psychosomatic disorder and sometimes be its outbreaking feature. The authors by this way, don't want to conclude identifying the I.C. with a psychosomatic disorder and suggest that in such cases one may take this syndrome as the main manifestation of a condition marked by an impairment of the digestive tract motility inside a psychosomatic disorder with a somatic expression of this apparatus.
Despite its impressive rate of growth in the past decades, an increasing amount if dissatisfaction with the area of psychosomatic medicine is reflected in recent literature. The discipline's failures relate to concepts of pathogenesis and therapeutic application of research findings. These failures are explained as a necessary consequence of the philosophical tenet of mind-body dualism which underlies medical theory. It is urged that advocates of psychosomatic medicine give the concept of "holism" meaning at the most fundamental level by establishing a rational basis for theory, or else forsake this line of research for others which yield causal relationships conductive to effective therapy.
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Despite the considerable consequences, school teachers treated in psychosomatic in-patient settings, have not yet been the subject of investigations. Whether, for whom and which kind of job related treatment can be helpful for teachers returning to work can only be discussed if the specific stress and the social situation of teachers as public officials ("Beamtenstatus") are taken into consideration. On this point of view a systematic evaluation of 63 psychosomatically ill teachers consecutively admitted in a psychosomatic hospital was performed. The average age was 50, suffering mostly from depression or/and tinnitus. Most teachers rated job related stress as influencing their symptomatologies. A program focusing on discrepancies between personal ideals versus real situations in school, problems in social interactions and time management, should be a valuable part of the teachers' psychosomatic inpatient treatment. This approach was affected by a strong desire for early retirement in about half of the teachers.
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Various stresses are considered to be involved in the development of gastric and duodenal ulcers. We interviewed patients of either gastric ulcer group (GU) or duodenal ulcer group (DU) with regular occupation who were admitted to our Psychosomatic Illness Department in order to examine the differences in the characteristics of their stress and developmental factors of their diseases between the two groups. Developmental factors were scored for comparison. The following results were obtained. Though group DU was generally younger than group GU, it tended to have a greater number of episodes. No significant difference was found between the two groups in living habits, life history, or familial, social and physical environments. However, group DU had greater stress than group GU in the working environment. A significantly greater number of patients in group DU smoked and had problems in personal relations as compared with GU. There was a significant correlation between smoking habit and stressfulness of the working environment in both groups. In group DU, there was a significant correlation between the father-child relationship and personal relations. In group DU, a significant number of those who had problems in the relation with their superiors at work had problems in the father-child relation. These findings show that patients with duodenal ulcer had more problems in the working environment, particularly in personal relations, than those with gastric ulcer, and smoking habit appears to accelerate the development of the diseases. Also, a possible association was suggested between problems of personal relations at work and the history of growth.
The affective process is described as governing at least three different subsystems, expression, cognition and physiology. Different forms of interconnections between them are considered as substantial for two different psychosomatic subgroups. Patients with colitis ulcerosa should have a deficiency of the experienced and expressed affectivity. In contrast patients with functional psychosomatic disturbances should show signs of inhibition with measurable indicators of the repressed affective impulse. 20 male psychosomatic patients suffering from colitis ulcerosa (10) or functional spine disturbances (10) interacted with healthy same sex subjects unknown to them. 20 healthy subjects served as a control group. The affective behavior was analyzed using EMFACS, an emotional facial action cording system, as well as DES, the differential emotion scale. For patients with ulcerative colitis a significant reduction of facial activity is characteristic. Whereas patients with functional spine disturbances are excessive in the same behavior. The observable reduction is however centered around affective arousal indicators not the primary affects per se. The observable differences between expressed affectivity and the experience did not reach significance mainly, because the great variability of the patients with functional spine disturbances. Clinical impressions are confirmed however not with exactly the phenomena the clinicians thought.
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