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PubMed1990

[Acne vulgaris: morphologic, endocrinologic and psychosomatic aspects].

25 male patients suffering from acne vulgaris were examined by means of endocrinological, morphological, and 5 psychometric procedures in order to check the correlations and interactions between the psychological and dermatological aspects of the disease. In comparison with a control group, the acne patients did not show any striking endocrinological abnormalities; we found no correlation between the extensiveness of the lesions and the level of DHEA sulphate. All the psychological tests yielded results deviating from those achieved by the representative controls, but they were comparable with those of other patients suffering from psychosomatic diseases. The individual feeling of being "disfigured" found its expression in self-consciousness, lack of trust in his/her own body, as well as the clinically relevant difference between his/her conception of self and the ideal of self. During times of enhanced psychosocial strains subjectively assumed by the patients, the lesions increased and the patients were disturbed in social interaction and communication. Surprisingly, we did not find any correlation between the clinical status and significant psychometric findings. Our results show that in acne vulgaris, the individual experience of wanting physical attractiveness, associated with a predominantly neurotic depressive personal structure, may play a central part in a disturbed process of interaction with the environment and suggest the influence of psychic factors in the pathogenesis of acne vulgaris.

Acne Vulgaris↗
PubMed1978

[Psychosomatic aspects of pregnancy, parturition and puerperium (author's transl)].

Pregnancy, delivery and post-partum period represent not only a special physical strain, but also an extra-ordinary psychic stress. Defective developments and neuroses, especially in the sexual field, as well as improperly adjusted current conflicts, can lead to somatic disturbances. The present-day situation is particularly characterized by the dual role played by the modern woman in society, and the resulting ambivalence of her attitude toward maternity. Over and above this, the technicalization of modern medicine can be associated with a loss of the human relationship between the patient and the physician, so that the patient gets the impression of being at the mercy of an inhuman apparatus. Hence, it is one of the fundamental problems of modern obstetrics not to transgress the limits where technicalization defeats its own purpose and becomes more harmful than useful. Although it cannot be the aim of psychosomatic training in obstetrics and gynecology to train the gynecologist in such a manner that he can also practise formal psychotherapy, it will become more and more important in future to expand our traditionally biologically oriented method of working by the aspect of the interactional and psychosocial fields of life.

Female↗
PubMed1991

[Psychosomatic aspects of oral contraception].

Oral contraceptive use is influenced by multiple emotional factors. Physiological and psychological effects are closely correlated. Contraception may assist women in pursuing important psychosocial goals, on the other hand, it may cause a number of problems. Many unconscious wishes or fears may interfere with the clear separation of sexuality from fertility. Ambivalence about pregnancy, neurotic personalities and problems in partner relationship may cause psychic conflicts with regard to contraception. Anxiety, side effects, misuse of contraceptives or problems in the relationship between doctor and patient may result. As a further development psychosomatic symptoms such as discomfort, nervousness, sleep disturbance, fatigue, nausea and sexual disorders may appear. The physician must take contradictory feelings of the patient into consideration, including her anxiety and her possible ambivalence with respect to pregnancy.

Contraceptives, Oral↗
PubMed2004

[Psychosomatic aspects of urogynaecology: model considerations on the pathogenesis, diagnosis and therapy].

Disorders of micturition and other symptoms in the area of the lower urinary tract are frequent in gynaecological consultation. The uro-gynaecological clinical symptoms and diseases refer to the following syndromes: irritable bladder, recurrent cystitis, interstitial cystitis, urinary retention and forms of incontinence. In view of the great aetiological importance of depression and its psycho-neuroendocrine associations with urge symptoms correlating with oestrogen deficiency, the option of employing newer approaches, and also psychopharmacological approaches, must be considered. In the pathogenesis, the stress and conflict model offers approaches to explanation and treatment. The psychosomatically oriented diagnosis and treatment of symptoms and disorders of the lower urinary tract in women is primarily the task of the gynaecologist, who has to go beyond investigations for organic diseases and must also clarify and treat the psychological dimensions. If there is major psychiatric comorbidity, referral to a doctor specialising in psychotherapeutic medicine and psychotherapy is required, or to a specialist in psychiatry and psychotherapy in the case of clinical and neurophysiological implications and symptoms from the depressive spectrum.

Female↗
PubMed1976

[The psychosomatic aspects of complaints of varicose veins during pregnancy. A psychosometric investigation in 345 antenatal patients (author's transl)].

A discrepancy between complaints of varicose veins of the legs such as stabbing in the legs, pain in the legs, tiredness of the legs, heaviness of the legs, feeling of swelling in the legs and nocturnal cramps in the calves, and anatomical signs of varicose veins in the legs was observed. Therefore these complaints were analyzed in 345 antenatal patients regarding their psychological aspects. No complaints of venous insufficiency were found in 47% of the pregnant women. Of the 53% antenatal patients with complaints, 24% had mild, 18% had moderate and 11% had severe complaints. Antenatal patients with well noticable neurotic personality traits in the MPI had complaints twice as often as women without neurotic traits (p smaller than 0.05). Introverted antenatal patients (according to the MPI) had more venous leg complaints than expected (p smaller than 0.05). Pregnant women with frequent psychosomatic complaints and altered general well being had the highest incidence of varicose veins complaints (p smaller than 0.001) or p smaller than 0.05). In addition to these psychometric data, there was also a correlation of the gynaecological history with complaints of venous insufficiency in the legs during pregnancy. Pregnant women with a very painful menarche had more varicose vein complaints than expected (p smaller than 0.05). The incidence was also higher with a history of abortion (p smaller than 0.05), marked dysmenorrhea (p smaller than 0.01) and side effects from oral contraception (p smaller than 0.01) and in primigravida (p smaller than 0.05). Age was only correlated to the symptom of stabbing pain in the legs in a statistically significant correlation (p smaller than 0.05). The results were tested statistically for significance with the X2-method.

Abortion, Spontaneous↗
PubMed1985

Psychosomatic aspects of changes in body weight during a long sea voyage.

The author, on the basis of his investigations, have shown the relationship between body weight changes and mental disease morbidity and other mechanism of adaptation to conditions of a long sea voyage. In author's opinion changes in body weight are an important adaptational mechanisms in conditions of long sea voyage. This mechanism is based on feedbacks in which dominated psychic mechanisms in the form of changes in personality dimensions. If the free regulation of the body homeostasis is disturbed and cannot be corrected by the body weight changes and personality dimensions then a further escalation of disturbances in homeostasis will lead to psychic or psychosomatic diseases.

Anxiety↗
PubMed1992

[Psychosomatic aspects of stress].

We established the Bromocriptine test for the dopaminergic function of the hypothalamopituitary gland. The secretion patterns of plasma GH and PRL to 2.5 mg Bromocriptine, a dopamine receptor agonist, were classified into two types; a response type and a non-response type. The former showed an increase in plasma GH levels and suppression of PRL secretion; the latter showed no change in GH after Bromocriptine administration. The response type cases corresponded to psychosocial stress by neurotic and maladaptive behavior. The non-response type cases corresponded to psychosocial stress by alexithymic and over adaptive behaviors. Case Presentation 1. Essential Hypertension: a. 56-year old male, response type, blood pressure elevated by stress in daily life. Psychosomatic treatment: advice about blood pressure measurement at his home, brief psychotherapy and drug therapy. b. 53-year-old male, non-response type, type A behavior. Psychosomatic treatment: advice to increase awareness of body-mind relationships of his disorder, self-control training and drug therapy. 2. Gastric ulcers: a. 40-year-old male, response type, CMI IV region (Neurotic tendencies). Psychosomatic treatment: autogenic training and drug therapy. b. 28-year-old male, non-response type, high JAS scores(Over adaptative behavior). Psychosomatic treatment: advice to increase awareness of body-mind relationships of occurrence of his ulcers, to induce change in his perceptions of way of life, to encourage taking rest. 3. Technostress syndrome: a. 23-year-old female, response type, technoanxiety. Psychosomatic treatment: advice to make her take rest, and change in arrangements at her working place. b. 27-year-old male, non-response type, technodependent. Psychosomatic treatment: Fasting therapy. This therapy changed the non-response pattern to normal.

Adult↗
PubMedDate not supplied

[Psychosomatic aspects of gallstones. A test psychological study of female gallstone patients with clinical symptoms in comparison with a psychoanalytic study of gallstones].

In a comparison of 51 women suffering from biliary calculi and 74 women chosen at random by means of T-tests in GT, FAF and FPI, significant differences occurred in various scales. The test group differed from the control group in respect to aggressiveness, propensity toward depression and emotional instability. The test subjects suffering from biliary calculi were also given a 16 PF as well as a questionnaire on afflictions and risk factors, obesity dominating among the latter. With the help of discriminant analysis four-fifth of the participants could be correctly associated with their group. A conclusion concerning psychosomatic and psychodynamic correlations could only be reached by means of comparison with a psychoanalytical study.

Aggression↗
PubMedDate not supplied

[Assessing psychosomatic aspects of chronic orofacial pain syndrome].

BACKGROUND: The diagnosis of COS is often formulated when classification fails for the lack of clear symptoms or persisting complaints in spite of evidence-based dental care. PATIENTS AND METHODS: Eight patients suffering from COS and referred to us by the Dental Clinic of the Munich University were invited to complete the self-rating SASB-Intrex questionnaire. In addition, the patients were examined in a clinical psychodynamic interview. RESULTS: All patients suffered from undefined, very often bizarre, complaints of the teeth, oral cavity, and face. These dysesthetic syndromes occurred after previous dental interventions. However, the complaints surpass symptomatic pain due to local aetiologies or neurological causes. There was clinical evidence of underlying unconscious conflicts, e. g., concerning control vs. submission. All patients showed clinically-relevant psychosomatic co-morbidity which could be formulated as cyclic maladaptive interpersonal patterns. CONCLUSION: COS patients are often not sufficiently examined and undergo multiple, sometimes irreversible and invalidating dental or surgical interventions. Given their exclusively somatic attribution style, referral to psychotherapy is frequently unsuccessful. Characteristic cyclic maladaptive interaction patterns may contribute to the chronification process. This study shows the difficulties and chances of an interdisciplinary diagnosis and treatment program.

Adaptation, Psychological↗
PubMed1992

[A study of the psychosomatic aspects of endometriosis].

Based upon existing psychological studies of endometriosis, the hypothesis was tested if patients suffering from this disorder differ from other infertile females with respect to psychological characteristics. Using questionnaires as well as a semi-structured psychotherapeutic interview 38 patients with endometriosis and 18 females with tubal sterility were investigated. A comparison of both groups indicated a higher level of anxiety and some evidence for a somatic preoccupation in the endometriotic patients. The analysis of the interviews (which were judged by several independent raters) confirmed the hypothesis of gender role conflicts in combination with endometriosis. This conflict seemed to be characterized by a negative experience of menarche and puberty, early gynecological problems and negative sexual experiences. This constellation is illustrated using a typical case. Based upon these results, further studies of endometriosis using a psychosomatic perspective seem to be promising.

Adaptation, Psychological↗
PubMed2006

[Psychosomatic aspects of bowel diseases].

Functional gastrointestinal disorders (FGID) and inflammatory bowel diseases (IBD) are the most frequently studied bowel disorders in the context of a bio psycho-social model. FGID are associated with significant work absenteeism, impaired quality of life, and increased medical costs. Many patients also suffer from psychosocial problems. Most of the research in FGID to date has focused on the irritable bowel syndrome. Randomised controlled studies have shown that psychotherapy is superior to conventional medical therapy. The gut-focussed hypnotherapy seems to be very successful. For IBD it is increasingly recognized that the psycho-neuro-endocrine network can modulate inflammation and pain perception and that psychosocial factors are related to exacerbation of and coping with IBD. The psychosocial consequences of the illness become more significant with increasing severity of the disease. Therefore integrated psychosomatic care should be provided, the patient's psychosocial status and the demand for additional psychological care should be assessed and offered, if indicated.

Adaptation, Psychological↗
PubMed1994

[Psychosomatic aspects of focal dystonia: two case reports].

Dystonic movements and other dyskinesias often cause diagnostic difficulties due to their complex symptomatology. Namely focal dystonias are frequently misdiagnosed as conversion reactions. Idiopathic dystonias are generally considered a nonstructural (neurobiochemical) disorder of the basal ganglia. Many case reports, however, have dealt with patients presenting with "atypical" dystonia whose symptoms were relieved by psychotherapy or hypnosis. We present the histories of two young women exhibiting focal dystonia emerging for the first time under circumstances of profound emotional trouble. We discuss the general difficulties in the diagnosis of dystonic movement disorders and review the criteria for the diagnosis of "psychogenic dystonia". The basal ganglia integrate limbic, proprioceptive and sensorimotor inputs to create emotionally and functionally appropriate voluntary movements. Therefore, the traditional dichotomy "psychogenic-somatogenic" appears to be inappropriate when applied to extrapyramidal movement disorders. In a psychosomatic understanding, the assumption of a psychogenic "trigger" for a somatic movement disorder does not mean a contradiction.

Adolescent↗
PubMed1987

Psychosomatic aspects in dermatoses.

The purpose of this presentation is to offer a classification of psychocutaneous disease and to examinine factors which result in itching and scratching becoming chronic. Pruritus is a very common sensation in dermatoses. All forms of itching, whatever the cause, may be intensified by emotional stress. The patient sample of my own study consisted of seven diagnostic groups, giving a total of 99 patients. The dermatoses were: dermatitis herpetiformis, lichen ruber planus, chronic eczema, atopic eczema, neurodermatitis circumscripta, lichen corneus obtusus and pruritus psychogenes. The principal findings were as follows: 1. Many of the different mechanisms by which skin diseases became chronic had a psychological background. 2. Psychiatric disturbances were clearly more common than in the average population. Possibilities of psychiatric treatment were evaluated. The results confirm the hypothesis that in those skin diseases in which the disease mechanism is not yet sufficiently understood, psychosomatics is of considerable importance or offers an easier way to explain the mechanism.

Humans↗
PubMed1996

Psychosomatic aspects of healthy young women with orthostatic dysregulation.

The Japanese Edition of the Cornell Medical Index-Health Questionnaire and the Yatabe-Guilford personality test (Y-G Test) was given to 56 young women (mean age 19.2 years) who were identified as having orthostatic dysregulation among a total of 280 healthy young women. The percentage classed as types III (possible neurotic) and IV (probable neurotic) according to the Health Questionnaire was 37.5% in the 56 with orthostatic dysregulation and 9.2% in the controls (n = 65). The percentage classed as types B and E, suggestive of emotional or psychological disturbance according to the personality test, was 59.0% in those with orthostatic dysregulation and 23.1% in the controls. These differences were statistically significant (P < 0.01). Furthermore, there was a significant correlation (P < 0.01) between the two test results for the frequency distribution of the 280 women. These results suggest a possibility that psychosomatic factors influence the occurrence of orthostatic dysregulation in young women, even if these subjects have not sought treatment for dizziness or vertigo, nor for psychosomatic disorders.

Adult↗
PubMed1986

[Psychosomatic aspects of protein-calorie malnutrition in early childhood in a tropical environment. Facts and hypotheses].

After a brief look at the clinical descriptions of marasmus and kwashiorkor, and a summary of the physiopathological concepts of these protein calorie malnutritions (PCM), the author looks at arguments which suggest there is a change in the mother-child relationship at the onset of PCM, excluding, however, those malnutritions which appear in conditions of famine or catastrophe. These arguments are drawn principally from studies done in Africa, and are based on clinical, sociological, and ethnopsychiatric data. The contributing factor of maternal depression and that of relational characteristics of the child are considered, and an analysis is made of how these factors might converge at the onset of PCM. The author attempts to demonstrate the important role of a psychomotor retardation in the tableau of psychological troubles which present themselves during the course of Kwashiorkor. The role and importance of weaning, of the separation and the psychomotor retardation in the genesis of the "situation of malnutrition" are discussed. Finally, a parallel is established between PCM and early psychosomatic syndromes observed in the west, principally the anorexias and insomnias during the first year of life. The point in common between these situations and PCM is perhaps the onset of conditions having an upsetting and distorting effect on the mother-child relationship. The family and the entourage use certain collective representations in Africa ("Nit-KuBon", "Tjid-a-Paxer") to try and explain the onset of PCM. The description of these traditional representations is utilized as a materialization, by the mother and the social group, of an alteration of the mother-child relationship, and can be compared to representations which play the same role in the west.

Africa↗
PubMedDate not supplied

Gender and psychosomatic aspects of ischemic heart disease.

While women and their doctors have traditionally worried about mortality from breast and gynecological malignancies, over the past 5 years they have come to realize that ischemic cardiac disease (IHD) is the number one killer of women in most Western countries. This has led to public and professional education campaigns and a new emphasis on gender and gender-specific research in IHD. Unfortunately, this literature remains poorly developed and much work remains to be done. Even in samples in which there may be sufficient numbers to allow for the evaluation of gender and gender differences, these important analyses have often been overlooked. This article provides a review of what is known about gender and gender differences in psychosocial and behavioral issues in IHD.

Adult↗
PubMedDate not supplied

[Psychosomatic aspects of treated testicular neoplasm patients].

We examined 26 patients who were semicastrated, lymphadenectomied and cytostatic treated because of a maligne testicular tumor to find out the secondary psychic manifestation of this organic illness. Somatic caused consequences of operation were a unilateral loss of testis and a loss of ejaculation and therefore a generative impotency. We found no evidence for a primary psychic influence on the origin of tumor illness. We could subdivide the secondary psychic manifestation in two stages: 1. The psychodynamik at the time of diagnostic and operation, 2. the specific personal mechanism of conflictmanagement in the following time, the phase of rehabilitation. In the first stage we subdivided three different states during the acute crisis with regard to regression, to mobilisation of infantil drives and to defence: 1. Disavowal, 2. Helplessness, 3. Fight. We discussed the psychodynamic and the attachment of these affective states to the psychology of neurosis. In the second stage of the secondary psychic manifestation we could find different more or less durable strategies of conflictmanagement: So called normal conflictmanagement, conflictmanagement by disavowal, by different mechanism of compensation as oral symbiotic dependences, narcissistic increasing of potency, intensified productivity, forming of religious ideal and by secondary hypochondric processes. The sexual disorders which we could state in about 1/3 of the patients existed mostly in an avoid of sexual partnership because of anxiety concerning narcissistic grief and injury of selfesteem. In older patients with special liability to crisis we found also an erective impotency. All patients with sexual disorders showed also psychoneurotic and psychosocial disorders. We discussed the results with regard to forming of hypothesis in psychosomatics, to personal and interpersonal conflictmanagement and to supportive psychotherapeutic possibilities.

Adaptation, Psychological↗
PubMedDate not supplied

[Psychosomatic aspects of obesity].

Overweight and obesity are widespread in industrial countries and are considered to be serious health problems in these countries. Population-based studies in Germany have shown that between 12 and 18 % of the adult population is obese. Overweight and obesity are accompanied by a large spectrum of health disorders and extreme psychosocial burdens. Besides the hereditary disposition, the life style including both intra- and inter-individual aspects determines the complex etiology of obesity. Within the collective sample of the obese, one sub-sample is the "psychogenic obese" i. e. in which psychiatric disorders lead to a change in both eating and exercise behavior, the result then being a continuous positive energy reserve in the form of overweight and obesity. The paper describes the psychosocial problems of obese persons; especially the controverse question with regard to psychiatric morbidity in general and eating disorders in particular are emphasized. The results of past, mainly behavioral oriented treatment concepts are presented and various concepts beyond single school orientation are discussed. Finally, the problems with psychiatric psychological diagnostics in those obese patients with the request for surgical weight reduction within the context of insurance coverage and the surgeons are presented.

Animals↗