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Psychosomatic aspects of defecation and its disturbances.

Constipation and diarrhea are usually defined in terms of frequency of defecation and consistency of stool. However, the subjective component in these symptoms is so great that the objective criteria cannot be satisfactory. An important additional aspect is provided by the analysis of sensations and postures in the three phases of the act of defecation (announcing, emptying, subsequent phase). Taking account of the subjective aspects may contribute to a better differentiation and classification not only of constipation and diarrhea but also of such disturbances as organic rectal disease and irritable colon.

Constipation↗

Psoriasis: psychosomatic aspects.

On the basis of the findings of this study it could be concluded that the hereditary proneness alone is not sufficient to cause the breakout of psoriasis. Only when additional causes intervene, the disease breaks out. The importance of stress and emotional factors in causation and precipitation of the disease is discussed. The traumatic emotional experience and the aggravation of disease as result of improper approach of the society towards the patient's illness is reviewed. The impact of the disease on the treating doctor and the doctor-patient relationship is reported. Means of prevention of the breakout of the disease and the proper approach of the doctor in treating his patient is suggested and specified.

Attitude of Health Personnel↗

Psychosomatic aspects of liver transplantation.

Forty patients received orthotopic liver transplants at Massachusetts General Hospital between May 21, 1983 and July 21, 1987 (mean follow-up: 64 weeks, range: 2-186 weeks). Twenty-seven patients (68%) were living as of July 21. Among survivors, 15 (56%) returned to full activity; and 7 (26%) were partially rehabilitated. Five patients were rehospitalized or recently transplanted. Successful outcome occurred most often among those who came to transplant early in the course of illness. All adults experienced preoperative anxiety and 17 (50%) of adults had some degree of hepatic encephalopathy. Following operation, 8 adults (24%) were referred for treatment of depressive disorder typically associated with deterioration of hepatic status, infectious complication or recurrence of cancer. Medical noncompliance required psychiatric intervention in 3 cases. Other psychiatric events an increasingly successful intervention of major scope and affords meaningful survival to many patients whose liver disease allow less than a year of life. Psychiatric consultation is an essential support to the transplant program.

Adjustment Disorders↗

Psychosomatic aspects of patients on hemodialysis. 4. The relationship between quality of life and alexithymia.

The relationship between quality of life (QOL) and alexithymia was examined in dialysis patients. Hemodialysis (HD) patients with diabetic nephropathy had poor QOL in medical dimension. Although they had good QOL in psychological and social dimensions, a high prevalence of alexithymia associated with self-control ability was observed. These results suggest that their inability to care for themselves was reflected in poor medical dimension, and that good psychological and social dimensions were merely an outward appearance. Therefore, identification of alexithymia in dialysis patients is important along with a three-dimensional evaluation of QOL. Multidisciplinary comprehensive assessment of QOL including alexithymia will lead to a real improvement of dialysis patients' QOL.

Activities of Daily Living↗