Terpsichoretrancetherapy: a new hypnopsychotherapeutic method.
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Many "problem" patients seen in primary care settings cannot be easily classified as "masked depressives" or seekers of secondary gain. Rather, they fit into a third category--those with the "tired person" syndrome. The essential feature of this syndrome is the decrease in self-esteem that follows the real or perceived loss of the ability to work productively. The decrease in self-esteem triggers anxiety, which may be so severe as to approach a panic state. The patient then becomes increasingly disabled or has increasing physical symptoms and enters a vicious cycle culminating in debility. Treatment is aimed at the physician's accepting and legitimizing the very real loss that the patient perceives in order to help him or her become comfortably dependent.
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Lack of intimacy in the marital relationship is hypothesized to be associated with the presence of symptoms of nonpsychotic emotional illness in one or both spouses. The development of the Waring Intimacy Questionnaire (WIQ) has furthered the understanding of the relationship between intimacy and illness. A clinical sample (n = 184) was compared to a nonclinical sample (n = 188) on both the quality and quantity of intimacy. The clinical sample reports significantly lower intimacy [F (1, 370) = 37.5, p less than .001] and is deficient on almost all aspects of intimacy described, except sexuality. The results suggest that the WIQ is a useful assessment tool which may identify marital relationships that are not close, marital assessment may be useful in formulating a comprehensive treatment plan, and the sexual quality of marriage may operate independently of marital intimacy.
The folk-illness of susto has long captured the interest of anthropologists. A review of the literature reveals a multitude of competing ideas as to its biological basis, its epidemiological patterning, and why it persists as it does. The present essay offers not only a summation of much of the research done on fright-sickness to date, but also suggests a number of new lines of inquiry that, when completed, will advance our understanding of this widely spread, yet still to be fully understood, ethnomedical disease category.
BACKGROUND: The impact of a chronic disease on the emotional well-being of children and adolescents is controversial in the literature. This study tested the hypotheses that 1) a specific approach is required to assess emotional deviations in adolescents with chronic diseases and 2) specific anxiety symptoms are predictive of excessive somatic symptoms. METHODS: Emotional and somatic symptoms were measured in four groups, selected from a community sample of 897 adolescents: 32 with asthma, 20 with other severe chronic diseases, 30 with median scores (the true comparison group), and 29 with minimal scores on common measures of trait anxiety and depression. RESULTS: The asthma and chronic disease groups scored not significantly higher than the true comparison group on trait anxiety, depression, negative affectivity, five anxiety syndromes, anxiety-related physical, and miscellaneous somatic symptoms. The asthma and chronic disease groups scored only higher than the true comparison group on panic attacks and respiration symptoms. Regression analyses showed that severity of asthma was no significant factor, and the minimal group scored consistently lower than the other groups, except on physical injury fears. There were no group differences in positive affect. Girls scored higher than boys on specific anxiety syndromes (except on obsessive-compulsive disorder) and also on respiration symptoms. CONCLUSION: Adolescents with severe chronic diseases deviated from a true comparison control group on panic attacks, but not on other negative and positive emotions.
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UNLABELLED: Paediatricians and other professionals in Sweden note that the amount of children with psychiatric and psychosomatic symptoms is growing in number. Suicide attempts among the young (15-24 y) increased by more than 30% from 1998-2003. The Swedish National Board for Health and Welfare's 2004 guidelines for school healthcare shed light on this increasing problem among schoolchildren. An article in this issue of Acta Paediatrica, "Living conditions and psychosomatic complaints in Swedish schoolchildren", analyses economic stress as a causative factor leading to psychosomatic symptoms such as headache, abdominal pain and difficulty in falling asleep. Living conditions, however, most likely include other factors related to our modern and ever-changing society that also have an impact on the growing child. CONCLUSION: Psychiatric health is changing for the worse among Swedish schoolchildren. The cause is multifactorial. Economic stress is one factor, but there are also other possible causes related to modern society that correlate to the increase of psychosomatic problems among schoolchildren. Three major problems are among those suspected: impaired education and deficient working environment in Swedish schools, a general lack of adult contact and guidance, and excessive computer and TV use.
To clarify the mechanisms of gender-related mind/body relationships, the authors analyzed the characteristics of 1,132 outpatients (848 women and 284 men) attending a mind/body medicine clinic. At entry in the program, the patients completed the Medical Symptom Checklist, Symptom Checklist-90 revised (SCL-90R), and Stress Perception Scale. Women reported 9 out of 12 symptoms (fatigue, insomnia, headache, back pain, joint or limb pain, palpitations, constipation, nausea, and dizziness) more frequently than the men did. Being a woman was a predictor of the total number of somatic symptoms endorsed. SCL-90R somatization scores were significantly higher in nonmarried women than in married women. Perceived stress ratings of family and health were higher in women than in men, despite the lower degree of perceived stress concerning work. Women, especially nonmarried women, were more likely to report somatic discomfort. Gender appears to be an important factor in relation to the report of somatic symptoms in stress-related conditions.
Telecommunications technology is dramatically changing our world, allowing healthcare professionals to offer medical healthcare, in the form of consultation, assessment, and treatment, through the use of new communications media. In behavioral medicine, advances in telecommunications have brought about new ways of offering services by expanding healthcare to patients located all over the world and simultaneously reducing costs and improving outcome efficacy. This article describes the use of biofeedback to treat various pain and psychophysiological disorders through telemedicine technology. The authors provide a description of "off-the-shelf," low-cost, and low-bandwidth telemedicine equipment used to deliver clinical biofeedback treatment when the patient and provider are in two different locations. In addition, the authors discuss practical issues of behavioral telehealth.
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A study on psychotropic drug monitoring was carried out in Verona over a 2-week period using information obtained during consultation with 3 GPs. Psychotropic drugs accounted for 23.4% and 24.3% of all prescriptions in men and women respectively. Benzodiazepines were the most frequently prescribed: 76% and 72% of all psychotropic prescriptions respectively in women and in men. No significant association between psychotropic drug prescription and age, sex, marital status and occupation was found in the present survey. In men only, those patients with higher educational level were more likely to receive a prescription for psychotropic drugs than those with a lower educational level. About 70% of men and 60.4% of women diagnosed by the GP as having a psychiatric problem were prescribed a psychotropic drug. However, the probability of a psychotropic being prescribed, when a psychiatric problem is identified by the GP, was significantly higher (p less than 0.05) in men than in women: odds ratio 39.37 and 16.33 respectively. Psychotropic drugs were prescribed in 35% of men and in about 48% of women in which a social problem was identified by the GP. Women were about 5 times more likely to receive a prescription than men: odds ratio 12 and 2.75 respectively. A significant influence of physical ill-health and educational level on psychotropic prescription emerged: both effects were independent of sex, psychiatric morbidity and social problems. Using a logistic regression analysis, an interactive effect between sex and conspicuous psychiatric morbidity and between sex and social problems was also found.