[PSYCHOSOMATIC ASPECTS OF VARIOUS INTERNAL DISEASES].
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[Psychosomatic aspects of psoriasis: affectivity and conflict].
With a sample of 32 patients with psoriasis--compared with 22 control-persons--possible disturbances of the development of affectivity in the childhood of the patients were investigated (cluster- and factor-analysis). By this an essential point in psychosomatic theories could be explained: the inhibition of an immediate psychic discharge of affects. Further investigation concerned the question--, of how far conflict-coping-behavior of psoriatic patients is characterized by denial of reality, excessive repression and over-adjustment. Disturbed affective development and pathological conflict-behavior together may result in a chronic overstrain of psychic structures--as a correlate of the psychosomatic illness. Our results show a pathological conflict-behavior and a disturbed development of affectivity in the genesis of psoriasis. We found two subtypes of psoriatic patients with specific character-traits--whereas a typical personality could not be found.
Adaptation, Psychological↗
[Psychosomatic aspects of rheumatic diseases].
The spectrum of rheumatic diseases includes syndromes characterized solely by musculoskeletal pain and discomfort. Indeed, muskuloskeletal pain and dysfunction are experienced by almost everyone in the course of a lifetime. The rheumatic syndromes are diverse and often of unclear etiology. For many years, psychosomatic theories have been advanced as an attempt at explanation, especially in the case of chronic polyarthritis. This article discusses the meaning of risk factors viewed as relevant to the course of back pain syndromes in particular. Therapeutic and rehabilitative-psychological interventions for comprehensive treatment of chronic rheumatic pain-patients are presented, and the necessity for a well-coordinated psychosomatic-interdisciplinary approach is emphasized.
Adaptation, Psychological↗
[Psychosomatic aspects of growth retardation].
Emotional deprivation is one of the possible causes of failure to thrive. Deprivation dwarfism is also associated with growth hormone deficiency, which disappears when the child is removed from his harmful environment. This phenomenon may constitute a pertinent model for etiopathogenic studies in child psychosomatics with particular emphasis on exploration of the linkage between biological, environmental and psychic factors.
Child↗
[Psychosomatic aspects of the chronic pelvic pain syndrome].
Epidemiologic data have demonstrated the significance of chronic prostatitis/chronic pelvic pain syndrome (CP/CPSS) for the urological practice. Apart from the rare cases of bacterial prostatitis numerous somatic models have failed to completely explain pathogenetic interrelations; therapeutic attempts frequently have produced unsatisfactory results. Additionally, psychosomatic factors have often been neglected. A number of personality variables have turned out to play an important role in questionnaire-based studies, namely somatization and depression, as well as anxiety, hypochondriasis, and weak masculine identity. However, these preliminary results need further evaluation. In the future, diagnostic and therapeutic strategies should pay attention to the complex interweavement of somatic and psychogenic factors in the pathogenesis of CP/CPSS.
Humans↗
Psychosomatic aspects of children's consultations in primary care.
Family doctors identified psychological factors associated with the presenting complaint in 17% of children aged 7 to 12 years attending their care. When compared with other children attending within the same age group, children said by their doctors to show associated psychological factors tended to present with psychosomatic-type symptoms (bed-wetting, asthma, skin rashes, abdominal pains, blackouts and headaches) and to make more use of medical services (both hospital and primary care). Our findings suggest that the families from which these children came had relatively high surgery attendance rates and more mothers with health problems. More of these families were regarded by the doctors as being under stress, and there were indications that concern about the children and their schooling was particularly common amongst the parents. Exploration of parental concerns about their children's health and about educational expectations would appear specially indicated in these cases.
Child↗
[Psychosomatic aspects of the patients with stomatognathic dysfunction. 2].
Various kinds of mind stress are prevalent in our society today. Especially, in the current society, number of patients who suffered from mind stress have been increased. And to our interest, many of them tended to show dysfunction in stomatognathic system. We have reported in the previous report that psychosomatic factors not only occlusal factors played an important role in the function of stomatognathic system. If the stomatognathic dysfunction patients were treated without the care of psychosomatic factors, effect of the treatment may sometimes be resulted in slow or uncertain cure. So we must analyze the psychosomatic condition of the patients in order to diagnose and treat them effectively. Therefore we studied the relationship between the psychosomatic factors and the social condition such as age, sex, type of job, marital status. The personality test was done among the general patients, who belonged to three different companies, using a questionnaire such as CMI test in regard to general patients. The results indicated that the difference of social condition developed different tendency in psychosomatic condition. This suggestion that psychosomatic factors must be taken care in order to diagnose and treat the patients.
Female↗
Psychosomatic aspects of coronary artery bypass graft surgery. A prospective study of 101 male patients.
101 consecutive male patients were examined by means of clinical interviews and depression, anxiety, personality, psychometric and life stress tests. The examinations took place preoperatively, on the 9th postoperative day (average) and 7.5 months after surgery. The mean age of the patients was 52.2 years and the mean duration of CHD was 6.7 years. Prior to surgery 77% had experienced myocardial infarction and 85% belonged to NYHA class III or IV. 74% had a 3-vessel disease. When the NYHA classification was used as criterion for rehabilitation the result was excellent. Postoperatively 80% belonged to NYHA class I or II. Hospital mortality rate was 4% and one patient died from myocardial infarction prior to the final follow-up. Preoperatively 17% of the study group were working. 87% of the patients experienced negative effects on work life, caused by CHD. Postoperatively 33% worked regularly. The postoperative work situation correlated with the duration of preoperative unemployment (p less than 0.0001), the patient's own opinion about work return (willingness/unwillingness to return to work) (p less than 0.01), as well as with the amount of negative life stress experienced preoperatively (p less than 0.01). Only 13% of the series experienced positive effects on work life, caused by CABG surgery. The majority of the patients had experienced negative effects on social and economic life (51%), as well as on sexual life (70%), caused by CHD. After surgery improvements were noted by 36% on social life and by 27% on sexual life. 15% experienced impairment of sexual life postoperatively. According to the Beck Depression Inventory 29% showed depression preoperatively, and 10% postoperatively. The difference is significant (p less than 0.0001). Clinically the figures tended to be higher. The same tendency holds for anxiety scores as measured by the Hamilton anxiety scale. The incidence of postoperative psychoses was 35%. Higher age (p less than 0.01) and/or absence of psychosomatic diseases (p less than 0.05) correlated with higher frequency of psychoses. Even though cardiological rehabilitation according to the NYHA classification was excellent, 22% of the series did not think their expectations were fulfilled. Psychic and social rehabilitation was in several aspects unsatisfactory, and the patients did not seem prepared for this. The importance to consider rehabilitation from a psychosomatic standpoint is clearly shown. To predict the result of rehabilitation preoperatively is not possible.
Adaptation, Psychological↗
Psychosomatic aspects of chronic pain: a new way of description based on MMPI item analysis.
Certain psychic structures which are represented in special configurations of MMPI scale values--the 'neurotic triad' and the 'conversion V'--are said to be typical of chronic pain patients. But considering the problems of reliability and validity of MMPI scales and new theoretical reflections regarding psychosomatic disorders, the diagnostic information given by these scale-based descriptions seems to be low. The present study examines the MMPI patterns of patients suffering from chronic headaches (N = 45) and chronic low back pain (N = 45) in comparison with a control group (N = 33) to obtain more relevant diagnostic information. Both pain groups claim to have strange bodily sensations accompanied by anxiety. Headache patients as well as low back pain patients tend to deny feelings of anger and aggressiveness. In comparison with the control group all pain patients adapt themselves to their immediate social environment to a much higher degree.
Adaptation, Psychological↗
[Psychosomatic aspects of emesis gravidarum: somatic and psychosocial status of females in early pregnancy].
81 women were tested in early pregnancy with a personality questionnaire (FPI), a bodily symptoms checklist and a structured questionnaire with respect to various psychosocial events. Women with and without Emesis in early pregnancy differ significantly according to the following characteristics: Quality and quantity of past and present bodily symptoms, psychosomatic affect-resonance, calmness, occupational attitudes, description of family-relationship and expectancy to vomit. Results are interpreted that vomiting in early pregnancy seems to be a psychosomatic reaction, based on a extenuated perception of reality, in combination with difficulties "leaving home" as well an expectancy to vomit in pregnancy.
Attitude to Health↗
[Steps in the recovery from severe depression. On the psychosomatic aspects of a convalescent process].
In retrospect, several phases of the healing process are easily distinguishable: Initiated with a terminal inpatient antidepressant therapy, continued by a tranquilizer-hypnotic withdrawal treatment, the psychotherapeutic mastering of the life-crises which provoked the mental disturbance in the first place, then the patient's going back to work, and, finally, the total mental stabilization on a mature level. The psychopathologic and psychosomatic symptoms appearing in the process are interpreted as expressions of spontaneous healing and not to be confounded with symptoms of withdrawal and/or relapse. The transition of the disturbance suffered and vanquished into a new self-image terminates the process of healing and recovery.
Adaptation, Psychological↗
[Modern psychosomatic aspects of dermatology].
Concerning their origin most diseases are multifactorial and that goes for skin diseases too. Emphasizing just one must not exclude further research and other aspects of etiopathogenetic mechanisms. It has been known for along time that psychological factors have a certain influence on the start, aggravation and maintenance on skin changes and that cosmetic defects of this kind disturb the psychological peace of the sick person and his capacity of establishing satisfactory social relations. Psychosomatic approach in dermatology cannot be reduced to investigation of specific etiology in the field of psyche without physical or social spheres. It unites all of them and in that way the old question what cause and what the consequence is has no importance, because there is no time or distance limit among them. They act simultaneously, holistically.
Humans↗
Psychosomatic aspects of arterial hypertension in women.
Arterial hypertension is one of the most widespread diseases in the world, both in women and men. In Poland, about 45% of the adult population suffers from arterial hypertension--it afflicts 45% of men and 36-38% of women. Arterial hypertension is a set of regulatory disorders of a complicated, multifactor etiology encompassing genetic conditions, the influence of the environment and some individual factors. Being also psychosomatic disorder it is strongly linked with improper adaptation to stress, personality traits and behavioural conditions esspecially with the type A behaviour pattern. This type of behaviour includes a strong need of achievement a tendency to dominate, and aggressiveness. The type A women--impatient, aggressive, hostile to their environment, committed to work and competitive--have a higher CVR (cardiovascular reactivity) coefficient and higher arterial blood pressure than type B. Some authors suggest that the lowering of estrogen levels in women over the age of 50 increases the frequency of occurrence of arterial hypertension. In spite of the fact that we do not have a full knowledge of the mechanisms starting the reaction chain, the awareness of these factors can help us decrease the risk of the development of the disease or hinder its progression.
Adaptation, Psychological↗
[Psychosomatic aspects of asymptomatic hirsutismus (author's transl)].
In a statistical study the somatic and psychic variables of 42 unselected women were evaluated who were seen with the presenting symptom of hirsutismus at a medical out-patient department. An organic source for the hirsutismus was excluded. The mean 17-ketosteroid values and the plasma testosterone values were normal. The following results were obtained: Patients with hirsutismus do not have specific personality traits. Hirsutismus is not a psychosomatic disease. There is not endocrine psycho-syndrome in hirsutismus. The suffering from hirsutismus is independent of the objective degree of hirsutismus. Women with the presenting symptom of hirsutismus regard their male type of body hair as a scapegoat and as the cause for their problems which in reality are neurotic problems. Unless contraception is desirable, we do not suggest treatment of hirsutismus with Cyproteronacetate.
17-Ketosteroids↗
[Psychosomatic aspects of neuroleptic side effects].
Using four clinical examples it is demonstrated that the neuroleptic induced side effects occasionally occur due to an interplay of pharmacological and psychological factors. On the one hand, psychic conflicts can in a more or less specific way foster the occurrence of certain side effects; on the other hand, the presence of side effects can enable the patients' psychic problems to become manifest. The clinician should always be on the alert regarding the possible psychosomatic nature of neuroleptic side effects and intervene psychotherapeutically if appropriate.
Adult↗
[Psychosomatic aspects of females with placental insufficiency].
Significant differences occurred on various scales by comparing 30 pregnant women who suffered from dysfunction of placenta chosen at random. Comparison was made by means t-tests and cross tables in GT, FPI, SSG sociological and medical data. Additionally a controlled experiment was performed. Dominating parts on a body level are the masochistic and the rigid one, both high charged structures. They seem to be more frequent than schizoid, oral and psychopathic parts. Looking to psychosomatics of dysfunction of placenta aggressive wishes against the child could be found.
Female↗
Some psychosomatic aspects of neoplasia.
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Adolescent↗
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.
Adult↗