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At least 19 recordsLinked to original sources

[A role of psychosomatic cycles in genesis of psychosomatic diseases].

900 patients with different psychosomatic diseases were observed. A leading mechanism of the pathology development was found to be formation (through the period of psychosomatic reactions) of mono- and polysystemic psychosomatic cycles responsible for the development of both primary and secondary psychosomatoses in context of a single psychosomatic continuum. On the basis of neurotic depression, at first, primary psychosomatosis developed. Besides, quantitative increase of psychosomatic pathology was observed within a damaged system. As far as monosystemic psychosomatic cycle transformed into polysystemic one, secondary psychosomatosis formed including psychosomatic pathology of some other organs and systems.

Affect↗

[Psychosomatic disorders in dermatology--incidence and need for added psychosomatic treatment].

In a cooperative study involving the Department of Dermatology and the Department of Psychosomatic Medicine/Psychotherapy of the University of Düsseldorf, 187 patients were evaluated for psychosomatic disease and indenient psychological testing. The distribution of skin diseases and psychosomatic ICD 10 diagnoses are presented. It was found that patient evaluation-(symptom-complaint-questionnaire) and expert evaluation correlate positive. It therefore seems worthwhile examining dermatology in-patient's for psychosomatic problems in order to facilitate combined dermatological and psychosomatic approach not only in the hospital but also during the post-discharge ambulatory treatment.

Adaptation, Psychological↗

Psychosomatic disorder: a treatment problem more difficult than neurosis? A comparative clinical study of psychosomatic and neurotic patients of the psychiatric policlinic of a general hospital.

Two patient groups from the psychiatric policlinic of a general hospital were compared, the first comprised 93 patients with severe psychosomatic disorders who were not diagnosed as neurotic, and the second, 133 neurotic patients without psychosomatic symptoms. The aim of the study was to clarify anamnestic and personality differences between the groups and investigate their treatment motivation. The psychosomatic patients showed less motivation for psychiatric treatment, even though their psychiatric impairment was more severe than that of the neurotics and although the extent of their psychological symptoms was equally great. Compared with the neurotic patients, the ability to tolerate stress was poorer and the attitude toward the interview and the interviewer was more defensive in the psychosomatic patients. Compared with the neurotics, medical services were utilized to a greater extent by the psychosomatic patients, and their childhood environment and background development were characterized by somewhat more psychological disturbance.

Adolescent↗

[Psychosomatic complaints and utilisation of psychosomatic consultation services in gynecology and obstetrics].

The aim of this study was to identify symptoms of depression, anxiety and somatization disorder in gynecological and obstetrical inpatients by screening questionnaires and to compare this findings with utilisation of a psychosomatic consultation service. 517 patients were screened with HADS (anxiety and depression) and GBB-24 (somatic complaints). 28.7% had pathological and, in addition, 19.8% borderline scores in at least one scale. More than 40% had pathological or borderline scores even in a 4-week follow-up and emphasised that they would have preferred having psychosomatic support in hospital. In only 2.9% psychosomatic consultation service was requested. Physicians in the gynecology department rated anxiety depression and the patients' acceptance of psychological factors of their illness significantly lower than the patients themselves. Our results demonstrate that anxiety and depression in gynecological and obstetric patients are not only a momentary phenomenon. Physicians underestimate the need of psychosomatic consultation.

Adult↗

Studies on the psychosomatic functioning of ill-health according to Eastern and Western medicine 5. Psychosomatic characteristics of anxiety and anxiety-affinitive constitution.

In successive studies of the psychosomatic functioning of ill-health according to Oriental and Western medicine in medical students, we established the existence of the psychosomatic characteristics we have provisionally termed the anxiety-affinitve constitution at the core of ill-health. Therefore, we conducted this research because our previous investigation showed this constitution included a high complexity of respiratory movement and eye movement with a significant correlation to the State Trait Anxiety Inventory (STAI). We examined the correlation between the STAI and somatic function of 88 medical students to identify the psychosomatic characteristics of anxiety and the anxiety-affinitive constitution. These tests included STAI, fractal (EEG, EOG, plethysmogram, respiratory curves, and EMG) and non-fractal (accelerated plethysmogram) dimension analyses, and malocclusion (based on Angle's classification). In particular, EOG, plethysmogram, and respiratory curves are known to have close association with trait anxiety. We were able to discover the correlation between (1) trait anxiety and thoracic and abdominal respiratory movements, and malocclusion (Class III), and (2) the correlation of state anxiety with thoracic respiratory movement, horizontal eye movement, a plethysmogram and an EEG-Pz (in males only). In subsequent study the relation between thoracic dominance and state-trait anxiety and between abdominal dominance and state-trait anxiety should be assessed to develop this research regarding the psychosomatic characteristics of anxiety and the anxiety-affinitive constitution. Further, it is essential to create an anxiety-affinitve constitution index based on multi-regression analysis.

Adult↗

Socialization and psychosomatic disease: an empirical study of the educational style of parents with psychosomatic children.

Starting from the assumption that psychosomatic diseases are distinct from neuroses and different kinds of socialization tend to predispose to the two disorders, the educational style of parents with psychosomatic children (n = 79, 30 bronchial asthma, 19 ulcerative colitis, 30 atopic dermatitis) and with neurotic children (n = 51) was studied. Children and parents were given questionnaires on parental educational attitudes, techniques and goals. Significant differences were found on various dimensions, which indicate for example closer mother-child ties as well as father-child ties in the psychosomatic families. The results from this study are consistent with the concept of a restrictive socialization in psychosomatic families.

Asthma↗

Learning to have psychosomatic complaints: conditioning of respiratory behavior and somatic complaints in psychosomatic patients.

OBJECTIVE: Assuming a subjective similarity between the experience of a hyperventilation episode and inhaling CO2-enriched air, we tested whether a respiratory challenge in association with a particular stimulus could result in altered respiratory behavior and associated somatic complaints upon presenting the stimulus only. METHOD: Psychosomatic patients (N = 28) reporting hyperventilation complaints participated in a differential conditioning paradigm using odors with a positive or negative valence as conditioned stimuli (CS+ or CS-) and 7.4% CO2-enriched air as the unconditioned stimulus (US). Three CS+ and three CS-acquisition trials were run. During the test phase, two CS(+)- and two CS(-)-only trials were run, followed by two new test odors (with a positive or negative valence). Respiratory frequency, tidal volume, end-tidal fractional concentration of CO2, and heart rate were measured throughout the experiment. Somatic complaints were registered after each trial. RESULTS: We observed a) increased respiratory frequency and an elevated level of somatic complaints upon presenting the CS+ only; b) a selective association effect: conditioning was only apparent with the negatively valenced CS+ odor; (c) no generalization of respiratory responses and complaints to the new odors; (d) no conditioning effect on dummy complaints that are usually not reported when inhaling CO2; (e) in exploratory comparisons with normal subjects, stronger conditioning effects on typical hyperventilation complaints in patients, and, in female subjects, on respiratory frequency. CONCLUSION: Respiratory responses and psychosomatic complaints can be elicited by conditioned stimuli in a highly specific way. The findings are relevant for disorders in which respiratory abnormalities and/or psychosomatic complaints may play a role and for multiple chemical sensitivity.

Adult↗

Studies on the psychosomatic functioning of ill-health according to Eastern and Western medicine 6. Psychosomatic characteristics of anxiety and depression.

In the accompanying paper "Psychosomatic Characteristics of Anxiety and the Anxiety-Affinitive Constitution (Provisional Term) in Medical Students," we suggest that an assessment of the relationship between anxiety and the state of thoracic-abdominal balance of breathing, and the creation of an anxiety-affinitive constitution index (AACI) derived from that assessment, will be indispensable for furthering research in the future. Using the tenets of Oriental psychosomatic medicine, we examined in this research medical students (N=104) from whom we had received fully-informed consent for the research in writing, and patients who met the DSM-IV diagnostic criteria for anxiety disorders (N=18) and major depressive episodes (N=20). We then identified their anxiety and depressive psychosomatic traits in accordance with an assessment of the relationship between anxiety and the state of their thoracic-abdominal balance of breathing, and the AACI derived from that assessment. We performed a multiple regression analysis with the STAI trait anxiety as the dependent variable, and the parameters of the somatic tests as the independent variables. We obtained the formula that AACI=-62.9 + 72.9 x the thoracic/abdominal respiratory movement ratio (the fractal dimension value for the thoracic respiratory curve/the fractal dimension value for the abdominal respiratory curve) + 22.5 x the horizontal eye movement (the fractal dimension value) + 2.4 x the dental indentation of the tongue (existence, 1; none 0). We then obtained data regarding a symptomatological, constitutional, and nosological, diagnosis of anxiety and depression based on the AACI values of the Student's t test calculated for the medical students and the anxiety disorder patients and patients with major depressive episodes, and a statistical analysis using ANOVA. We believe the AACI we created in this research will be very important and significant for the preventive treatment of lifestyle illnesses and stress-related diseases.

Abdominal Muscles↗

A concept of analytical treatment for patients with psychosomatic disorders. Report on the psychosomatic phenomenon and its consequence for therapy.

With the Paris school the author holds the view that the 'pensée opératoire' is pathognomic for the psychosomatic patient. This archaic, 'automatistisch-mechanistisch' thinking is a consequence of defects in the sphere of the physiological pre-ego. Certain typical findings, such as reduplication and mechanized object relations are seen as correlates of disturbances in the patient's early identification processes. Analytical therapy must thus aim at shifting the all but inaccessible psychosomatic phenomenon into a historical perspective. The psychological event can set in only when the patient has discovered the connexion between his somatic reaction patterns and the emotions he is beginning to feel for the security-giving therapist. An account of the development of the treatment of one patient (Birgit) illustrates the author's concept of analytical therapy in psychosomatics. The 'facilitating environment' helped the patient Birgit to differentiate herself from her dual object and thus to be able to cathect the level of the triangular relationship. The concept of the model ward led on to the development of an ambulatory method of therapy, 'relaxation analytique', which is based on investigations into the concept of the holding function. 'Taking care' of the patient is function of the therapist's own inner attitude, of his being prepared to do everything to encourage the therapeutic regression. The correlate of this attitude, on the side of the patient, is the sense of security which is an essential condition for the 'new beginning' to set in.

Adult↗

Psychosomatic symptoms in adolescent twins. Longitudinal twin study with special reference to psychosomatic symptoms.

In a cohort study of 234 twin pairs followed from pregnancy to 12-20 years of age the psychosomatic symptoms of adolescents were inquired from their parents. Girls had symptoms more often than boys. Intrapair concordances were high. The mothers' favorite children had psychosomatic complaints more often than the father's favorites or those who were equally close to each parent. Psychosomatic complaints were more frequent in the submissive members of twin pairs and nervous symptoms in the dominant ones.

Adolescent↗

[Psychosomatic pain in the field of gynecology. Stages of the formation of psychosomatic reactions and symptoms with examples of cases (author's transl)].

1. Understanding disease in the context of a hermeneutic of the ill person's life history forces us to abandon the old understanding of causality which is represented by the model of body-soul polarity. The real onset of an illness has a biographic pre-history. Long latent periods may occur before and between "functio laesa" and actual damage to the involved organ. On the basis of psychosomatic case histories, we can conclude that the future-orientation of an individual's life, that for which man must make decisions, is also that which causes the crises situation for those who are suffering. 2. Psychosomatic medicine cannot simply be included in an already existing medical discipline such as, for example, perinatology can be included in gynecology or pediatrics. It implies a whole new understanding of illness and, above all, it requires a new attitude on the part of the physician. The patient must be allowed to cooperate in his self-realization; the physician himself becomes the medicine. 3. An attempt was made to illustrate the concept of "organ language" on the basis of 6 brief examples from psychosomatic gynecology. Here only the most important information was presented. According to the concept of "organ language", the soma and psyche of the suffering person can represent and interpret each other reciprocally. It also becomes obvious that conflicts at various strata of being can use one and the same physical symptom if a common denominator is present (e.g., defence overagainst a danger, a disease or a role). This type of teleological nosology implies a new dimension for the consideration a disease, namely, the question of the meaning of suffering. 4. The examples cited are almost exclusively found in the understanding of sexuality in the broadest sense of the word. The threat of individuation as the final personality organization resulting from inadequate realization of the individual's own sex determination (Friedrichs) is present. 5. The sixth example clearly illustrates that sexuality is not what it is commonly considered to be. Rather, it permeates all state of personality and extends beyond them into areas of cultural and intellectual life. Whether or not a woman engages in sexual activity is not important (as had originally been thought). What is important is her attitude toward her own sex, toware her sexual activity and, therefore, also toward her partner and the environment. True sexual activity means infinitely more than just the automatic physiological act. In total self-abandonment to the "Thou", perfect sexual love becomes a knowing penetration of being. Genesis 4:1 states: "Now Adam knew Eve his wife...". The Hebrew word for "know" (yada') means both to know and to beget. Through the mystery of this word, something of the perfection, of the "participation mystique" in the work of creation becomes transparent in the perfect sexual union of two human beings!

Coitus↗

[Psychosomatic rehabilitation: inpatient integrated brief psychotherapy in neuro-orthopedic psychosomatic medicine].

Presented is a brief in-patient psychotherapy concept practiced in the framework of psychosomatic rehabilitation. The clinic's main focus is the treatment of patients with subjective health problems and disorders of the musculoskeletal system and sense organs ("neuroorthopaedic psychosomatics"). The conceptual development has been geared both to the specific requirements of the patient population and to the time-limiting and structural factors in psychosomatic rehabilitation. The structural conditions as well as the elements of the integrative therapy approach are set out, with group psychotherapy combining verbal and body-oriented therapy elements the central emphasis. The concept also accommodates the various stages of motivation among our patients. The entire range of supportive therapies, in particular physiotherapy, form an integral part of this concept. This integration of verbal and body-oriented therapy is hoped to enable the fragmentations and compartmentalizations, both with our patients and in the therapeutic team, to be overcome.

Adult↗

[Changes in the psychosomatic status following operative augmentation and reduction of the female breast. Catamnestic study from the operative-gynecologic and psychosomatic viewpoints].

We performed preoperatively a psychiatric and psychosomatic exploration of women who came to us with a request for performing breast-corrective surgery. 18 months after the operation, these women were again examined both gynaecologically and psychosomatically. Subsequent to a postoperative course without complications and with primary wound healing, 88% of the surgically treated women considered the result to be in accordance with their expectations, and the size of their breast as adequate. Analysis of variance of the personality data reveals that patients with hypoplasia or hyperplasia of the breast do not differ from each other in respect of their personality characteristics. Preoperatively, the patients assessed themselves on the average very negatively with regard to social resonance, and proved to be very depressive. After plastic surgery of the breast, i.e. after anatomic correction, definite changes are seen in the mental field. A significant improvement is noticeable in the way the patients experience themselves, their body, and their self-value. The same also applies to the experience of their sexuality, to social relationships and social resonance, social potency, and partner relationship. All these were assessed by the patients as considerably improved (significant on the 1% level).

Adaptation, Psychological↗

Overcoming 'psychosomatic' illness: lay attributions of cure for five possible psychosomatic illnesses.

This semi-replicative study was concerned with lay people's beliefs about the importance of 24 different contributors towards overcoming five relatively common illnesses: hypertension, peptic ulcers, asthma, dermatitis and migraine. These illnesses have frequently been regarded as psychosomatic although there is considerable debate as to whether this is so. One hundred subjects completed a 5-page questionnaire indicating how effective 24 factors were to overcoming the five specified illnesses. Factor analysis revealed almost identical clusters for each problem. These were labelled inner control, social consequences, fate, understanding and receiving help. Items clustering on the first and latter two factors were thought of as generally important and those on fate and, to a lesser extent, understanding, less important, although the perceived relevance of the second and third factors differed significantly between problems. Regressional analysis showed that various individual difference factors, age and sex in particular, were related to perceived relevance of the different contributors. The results were discussed in terms of subjects' beliefs concerning the value of self reliance as opposed to professional help, and the importance of understanding lay beliefs about the efficacy of different cures. Comparisons are made with four other studies using basically the same methodology.

Attitude to Health↗

[Psychosomatic gynaecology or gynaecology and psychosomatics?].

Such an interrogation might well seem vain or even absurd, although one cannot deny that it does mean a different vision of medicine, if not an entirely different conception of it. Considering the sick person as a whole and not only the sickness of one organ means practicing a true holistic approach, far from a limited somatic medicine addressing the psyche only in case of failure, as a last resort. Rather than artificially applying to the soma some would-be psychological recipes, let us try and take up that bet: a simultaneous use, in time and space, of body and mind medicine. Psychosomatic gynaecology certainly requires will and training, disponibility and curiosity, but it might well be the best protection against boredom and routine, as well as a true source of pleasure. Can such a satisfying way of practicing our art be anything else than a bonus for our patients?

Female↗

The Academy of Psychosomatic Medicine practice guidelines for psychiatric consultation in the general medical setting. The Academy of Psychosomatic Medicine.

This practice guideline seeks to provide guidance to psychiatrists who regularly evaluate and manage patients with medical illnesses. The guideline is intended to delineate the knowledge base, professional expertise, and integrated clinical approach necessary to effectively manage this complex and diverse patient population. This guideline was drafted by a work group consisting of psychiatrists with clinical and research expertise in the field, who undertook a comprehensive review of the literature. The guideline was reviewed by the executive council of the Academy of Psychosomatic Medicine and revised prior to final approval. Some of the topics discussed include qualifications of C-L consultants, patient assessment, psychiatric interventions (e.g., psychotherapy, pharmacotherapy), medicolegal issues, and child and adolescent consultations.

Adolescent↗

[Psychosomatic aspects of females in the climacteric. The climacteric--psychosomatics--personality structure].

In this experimental study, the feelings of climacterium in two groups of menopausal women were compared (a test group with climacteric complaints vs a control group without complaints). 70 patients were given a questionnaire: EWL by Janke and Debus, FPI and Giessen-test. The evaluation of the socio-economic data exhibited the fact, that patients in the group with complaints took more drugs than the other group and were more inclined to weight gain. Gynecological data showed significant differences in the beginning and the experience of menstruation. Psychological tests of the group with complaints showed a lack of self-assurance and increased anxiety. These women had also a tendency toward psychosomatic disorders and were less assertive in their social contacts. The discriminant analysis of menopausal and personality variables classified the women equally into the group with complaints compared to the control group.

Adaptation, Psychological↗

[Integration of psychosomatics with internal medicine. A diagnostic and therapeutic strategy for psychosomatic-internal medicine patients].

The high incidence of contributory psychosocial factors in developmental aspects of internal diseases makes it necessary to give up traditional forms of cooperation between internal and psychosomatic medicine, such as consultations, in favour of more intensive cooperation, in the course of which psychosocial aspects would be taken more into account in diagnosis and therapy of all patients in medical wards and clinics. A new method of treatment integrated into the medical department is presented, which favours not only patients, but also team-centered approach. The referral frequency of the new service, the diagnostic distribution and the therapeutic management of the first 270 patients is discussed. Special staff training, the key function of the first interview, the attainable cooperation and pre-selection of referred patients and the importance of the referral talk are emphasized.

Humans↗