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[Psychotherapy of irritable colon].

16 patients with an irritable colon were examined psychologically and independent of the result of the diagnostics of neuroses additionally distributed to two groups of treatment. One group was treated symptomatically, the other additionally psychotherapeutically (above all with autogenous training). Two thirds of the patients showed a neurosis. Psychotherapy was very useful only in those patients with a neurosis, measured as the result of the treatment one year after the beginning of the therapy. When an obstinate irritable colon is present, a diagnostics of neuroses is indicated. If a neurosis is proved, an individual psychotherapy is indicated, in which case the autogenous training as basis therapy apparently stood the test.

Adult↗

[Psychological nondrug treatment of hypertension and the criteria of its effectiveness].

Eighty patients with essential hypertension, stages IIA-IIB, were examined three times: on admission to hospital, and 1 and 12 months later. All patients were subjected to clinical, psychological (brief multifactorial questionnaire for examination of a personality and the interpersonal relationships test) and psychophysiological investigation. The patients were allocated to 3 groups by random selection: 30 patients practicing autogenic training (group 1), 30 patients on relaxation therapy making use of biological feedback (BFB) (group 2), and 20 patients exposed to no psychological influences (group 3, or the controls). In the presence of psychological treatment, the BP decline, the increase in stress tolerance and the improvement of the psychological status were significantly more marked in the former two groups, as compared to the controls. Comparative assessment of the efficiency of autogenic training and BFB showed no basic differences between the two treatment methods. In cases where treatment proved inefficient, the patients exhibited a negative attitude to treatment and markedly demonstrative character.

Adult↗

Systematic review of relaxation interventions for pain.

PURPOSE: To review randomized trials of relaxation interventions used for the treatment of pain in adults and to synthesize evidence regarding the efficacy of specific techniques. DESIGN: Integrative review. METHODS: A literature search was conducted using the terms "relaxation" and "pain" in CINAHL, Medline, and PsychInfo from 1996 to March 2005. Studies were reviewed and categorized based on the type of relaxation intervention (progressive muscle relaxation [PMR], autogenic training, jaw relaxation, rhythmic breathing, and other relaxation exercises), and summarized with respect to various study characteristics and results. FINDINGS: Researchers reported support for relaxation interventions in 8 of the 15 studies reviewed. The most frequently supported technique was progressive muscle relaxation, particularly for arthritis pain. Investigators reported support for jaw relaxation and a systematic relaxation intervention for relieving postoperative pain. Little evidence was found for autogenic training, and no support for rhythmic breathing or other relaxation techniques. CONCLUSIONS: Most of the studies reviewed had weaknesses in methodology, which limited the ability to draw conclusions about interventions. Further research is needed to confirm positive findings related to PMR, jaw relaxation, and systematic relaxation, to address questions related to the dose-response relationship and the individual differences that might influence response to relaxation interventions. These and other relaxation techniques require testing in carefully designed and conducted trials.

Adult↗

Application of the relaxation technique in general hospital psychiatry.

The present article demonstrates the clinical application and the efficacy of relaxation techniques in general hospital psychiatry in Japan. During April to December 1993, 20 patients were treated with progressive muscle relaxation and "modified' autogenic training therapies. The targeted symptoms were anxiety attacks (or panic attacks), neurotic insomnia, hyperventilation syndrome, agoraphobia, chronic pain, and distress. Most patients (18/20) improved rapidly with the use of these techniques and their excellence encourages increased use in general hospital psychiatry for the following reasons. First, physically ill patients are likely to show unexpected reactions to psychotropic medications. Second, some patients prefer these treatment methods rather than medications because they feel that they are participating voluntarily in their own treatment and also because they are fearful of being addicted to tranquilizers. Third, these treatments have produced rapid improvement especially for patients with panic attacks and/or hyperventilation. This study strongly suggests that progressive muscle relaxation and "modified' autogenic training are simple and useful methods which can be easily employed in the clinical practice of general hospital psychiatry.

Adaptation, Psychological↗

Quantitative measurements of finger blood flow during behavioral treatments for Raynaud's disease.

Quantitative measurements of finger blood flow have not been performed during temperature biofeedback or other treatments for Raynaud's disease. In the present investigation, finger blood flow was determined with venous occlusion plethysmography, in addition to measurements of finger temperature, heart rate, blood pressure, and skin conductance level. After a maximum vasodilation test, subjects received 10 sessions of finger temperature biofeedback or autogenic training. There were no group differences during the maximum vasodilation test. During training, temperature feedback subjects showed significant elevations in finger blood flow, finger temperature, and skin conductance level, whereas those who received autogenic training did not. These findings could not be explained by group differences in other cardiovascular measures and are consistent with previous studies suggesting the involvement of an active vasodilating mechanism in temperature feedback.

Adult↗

[Medical students and alternative medicine--a survey].

In the last decade, the growing interest and use of alternative healing methods among practitioners and patients has been documented in many empirical studies. The present inquiry of n = 140 undergraduate medical students at the University of Düsseldorf reveals a continually increasing knowledge of methods, self-experience as patients or lay persons, and an interest in learning one or more techniques. The highest interest in acquiring a working knowledge of a method is for acupuncture (55.7%), homoeopathy (42.1%), autogenous training (24.9%), and reflex-zonetherapies (11.4%). On a five-point-rating scale (3 = no effect) for estimated effectiveness, acupuncture, music therapy, autogenous training, massage, chiropractics (each 1.7) and homoeopathy (1.9) ranked high, whereas esoteric methods like laying-on-of-hands (3.3), hypnosis (2.5) and ozone and oxygen therapies (2.9) were low. The average score of 2.1 for all alternative methods indicates that they are generally considered more effective than not. A shift from a bio-medical "paradigm" towards psychosomatic and biopsychosocial thinking can be hypothesized, since (body-) psychotherapies (2.0) and body therapies (1.7) are rated highly effective.

Adult↗

Regulation of mental states and biofeedback techniques: effects on breathing pattern.

The purpose of the present study was to examine whether breathing pattern may be used as a reliable index for the effectiveness of techniques applied for the regulation of mental states. Heart rate (HR), breathing pattern, galvanic skin response (GSR), and electromyogram (EMG) of the frontalis muscle were measured in 39 male and female subjects aged 18-25 years during 10-minute treatment with relaxation technique (autogenic training and/or music) followed by 10 minutes of imagery training. In the first 7 sessions biofeedback (BFB) was not included, while during the last 6 sessions BFB was introduced and utilized by the subjects. Relaxation (music or autogenic training) led to a decrease in breathing frequency, attributed to lengthening of expiration time, as well as reduced HR, GSR, and frontalis EMG response. In most instances imagery training was related to an increase in these indices. Specifically, significant tachypnea was observed during imagery of sprint running. In most cases BFB substantially augmented the physiological responses. In conclusion, our data suggest that, compared with HR, GSR, and EMG responses, the breathing pattern is at least as sensitive to the mental techniques employed, and may be useful as a psychophysiological index for diagnosis and testing, especially in sport practice.

Adult↗

Stress reactivity to and recovery from a standardised exercise bout: a study of 31 runners practising relaxation techniques.

OBJECTIVE: To compare the efficacy in runners of two relaxation techniques with regard to exercise reactivity and recovery after exercise. METHODS: Thirty one adult male runners were studied prospectively for six months in three groups practising either meditation (n = 11) or autogenic training (n = 11) or serving as controls (n = 10). Before and after the six months relaxation intervention, indicators of reactivity to exercise and metabolism after exercise (blood lactate concentration, heart rate (HR), and oxygen consumption (VO2)), were tested immediately after and 10 minutes after exercise. Resting HR was also assessed weekly at home during the trial. State anxiety was measured before and after the intervention. RESULTS: After the relaxation training, blood lactate concentration after exercise was significantly (p<0.01) decreased in the meditation group compared with the control group. No difference was observed in lactate responses between the autogenic training group and the control group. There were no significant differences among the groups with regard to HR, VO2, or levels of anxiety. CONCLUSION: Meditation training may reduce the lactate response to a standardised exercise bout.

Adult↗

Complementary/alternative medicine in dermatology: evidence-assessed efficacy of two diseases and two treatments.

The objective of this article is to provide a brief, but critical, overview of the evidence related to complementary/alternative medicine (CAM) use, and to offer valid and useful information for dermatologists in clinical practice. Systematic literature searches were conducted on these databases: Medline, EMBASE, The Cochrane Library, CISCOM and AMED (until October 2000). Where appropriate, the evaluation of the published literature was based on systematic reviews and randomized controlled trials. After scanning the literature it was decided to focus on a selection of two conditions (atopic dermatitis and chronic venous insufficiency) and two treatment modalities (aloe vera gel and tea tree oil). Data for the life-time prevalence of CAM use by patients with dermatological disease ranges between 35 to 69%. The most popular modalities include herablism and (other) dietary supplements, while atopic dermatitis is one of the conditions most frequently treated with CAM. For patients with atopic dermatitis the evidence relates to autogenic training, hypnotherapy, diet, herbal medicine, and dietary supplements. Compelling evidence of effectiveness exists for none of these therapies. However, some promising data have been reported for those with a psychological component: autogenic training, biofeedback and hypnotherapy. For chronic venous insufficiency there is relatively convincing evidence for the effectiveness of oral horse chestnut seed extract. The data for aloe vera gel and tea tree oil indicate that for neither is there compelling evidence of effectiveness. The use of CAM treatments is not free of risk; direct and indirect risks associated with CAM must be considered.

Chronic Disease↗

What treatments do patients with panic disorder and agoraphobia get?

In a retrospective study 100 patients with DSM-III-R/ICD-10 panic disorder and agoraphobia (PDA) were interviewed about the psychopharmacological, psychological and 'alternative' treatments they had received in the course of their illness. Patients gave global statements about how satisfied they were with the various treatments they had experienced. Many patients received treatments that have never been investigated under controlled conditions. The most common drug treatments, in descending order, were: 48% benzodiazepines, 42% tricyclic antidepressants, 32% herbal preparations, 29% neuroleptics, 7% selective serotonin reuptake inhibitors and 6% beta blockers. Of the drug prescriptions, 63% were according to international standards. Of the neuroleptics, two-thirds (63.3%) were prescribed by nonpsychiatric physicians, and only one-third by psychiatrists (33.3%). Tricyclic antidepressants were prescribed more often by psychiatrists (64.7%) than by non-psychiatrists (31.4%). Among psychological treatments, autogenic training (43% of the patients) and psychodynamic therapy (33%) were used far more frequently than behavioural/cognitive therapy (20%). These results confirm the underutilisation of available effective treatments for panic disorder (e.g. tricyclic antidepressants or behavioural therapy) and the overutilisation of treatments without proven efficacy (e.g. herbal preparations or autogenic training). Patients were most satisfied with treatments that have been proven effective in controlled studies. Among drug treatments, benzodiazepines, selective serotonin inhibitors and tricyclic antidepressants were favoured (mean on a 0-4 scale indicating effectiveness: 2.6, 2.6 and 2.4). Neuroleptics (1.4), beta-blockers (1.0) and herbal preparations (0.9) were not rated highly effective by the patients. Among psychological treatments, patients were more satisfied with behavioural/cognitive therapy (2.6) than with psychodynamic therapies (1.5).(ABSTRACT TRUNCATED AT 250 WORDS)

Agoraphobia↗

Liaison psychiatry and HIV infection (II): Application of relaxation in HIV positive patients.

We examined the efficacy of relaxation techniques in a sample of HIV patients without AIDS in the early stages after infection, by comparing the three groups: relaxation group (progressive muscle relaxation and modified autogenic training); ordinary supportive psychotherapy group, and finally no psychiatric treatment group. Scores for anxiety, fatigue, depression and confusion, as measured by the profile of mood states (POMS), were significantly lower after relaxation than before. There were no significant differences in the POMS scores (except for anger) among the three groups. These two results suggest that a combination of progressive muscle relaxation and modified autogenic training is a useful method, which can be easily employed in HIV patients without AIDS.

Adaptation, Psychological↗

[Rehabilitation and psychotherapy].

Especially the chronically ill and disabled deserve to benefit from "socially integrated psychotherapy" in view of their specific situation of distress, which has often arisen without warning and unexpectedly. Dealing with bodily impairments, there are the so-called "organismic" methods using the hypnoid state as major component that have proven to be highly efficient. Dealt with are autogenic training, guided affective imagery, respiratory feedback and hypnosis. Hypnoid states can be regarded as a third basic state of consciousness in humans (besides waking and sleep). They play a major role in many forms of psychotherapy. The knowledge and selective use of underlying mechanisms enhance the potentialities of psychotherapy. The psychotherapeutic basic dialogue stays in constant accompanying function. We are opposed to a widespread misconception that psychotherapy is a method for the treatment of psychogenic disorders only. We obtained good results in the treatment of palsied patients of extrapyramidal and pyramidal type with hypnosis or autohypnosis as well as with our own model of group psychotherapy (autogenic training with concomitant analytic discussion, over a period of up to nine months). In this set-up we successfully mix patients with psychogenic and with somatogenic disorders. Although not a primarily psychotherapeutic method, respiratory feedback also makes use of the hypnoid state. Good results have been achieved with patients in rehabilitation and chronic pain sufferers. Occasional experience with guided affective imagery have been encouraging. We can conclude that psychotherapy with organically ill patients is indicated and promising. We need more appropriate training, supervision and concomitant scientific research.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

Group therapy for asthma patients: a concept for the psychosomatic treatment of patients in a medical clinic--a controlled study.

Asthma patients pose special problems as far as the medical supervision, danger of symptoms and the course of the disease are concerned. Some 90 asthma patients were registered for the treatment in the Heidelberg Medical Clinic. 31 patients who were interested in taking part were randomized into 3 groups: two treatment group consisted of the exchange of information, discussion sessions on the illness as well as 'autogenic training' or 'functional relaxation'. The third group was the control group. Before and after treatment the patients were submitted to a thorough examination both of lungs and other internal organs as well as from the psychodiagnostical point of view. The average age of the patients was 43.5 years and the average duration of illness 16.8 years. Nevertheless, the treatment group's sympathomimetics use was significantly reduced by 1 year of treatment (p less than 0.05); the use of steroids decreased as well. The number of visits of the general practitioner also decreased. These results support the conclusion that psychosomatic group therapy can make an important contribution to the treatment of asthma patients. Body therapy practised in 'autogenic training' and 'functional relaxation' seems to be another important healing factor for the treatment in addition to the discussion sessions and the exchange of information.

Adolescent↗

[Effectiveness of combined relaxation exercises for children with bronchial asthma].

In the framework of a pilot study, 15 children having bronchial asthma (4 female, 11 male; age 5-11; 6) participated, over a period of 8 weeks, in two weekly sessions of combined relaxation, respiratory and sports exercises. The present article in particular focuses on the relaxation exercises, made up of Progressive Muscle Relaxation and Autogenic Training elements as well as of phantasy travels, mantras, and periodic music. Ongoing observation of the children during training, the findings of subsequent semi-structured interviews with them, topical instances of coping with impending asthma attacks by using the techniques learnt, as well as the result of a catamnestic inquiry some three years later--all indicate a positive impact of the relaxation exercises. Statistical analysis of the data at hand revealed significant improvements in a number of pulmonary function parameters (airway resistance, forced expiratory volume for 1 s, forced vital capacity, peak expiratory flow rate). Interpretation of these findings must however take into account the entirety of the training provided.

Asthma↗

[Efficacy of combined relaxation exercises for children with bronchial asthma].

In the framework of a pilot study, 15 children having bronchial asthma (4 female, 11 male; age 5-11;6) participated, over a period of 8 weeks, in two weekly sessions of combined relaxation, respiratory and sports exercises. The present article in particular focuses on the relaxation exercises, made up of Progressive Muscle Relaxation and Autogenic Training elements as well as of phantasy travels, mantras, and periodic music. Ongoing observation of the children during training, the findings of subsequent semi-structured interviews with them, topical instances of coping with impending asthma attacks by using the techniques learned, as well as the results of a catamnestic inquiry some three years later--all indicate a positive impact of the relaxation exercises. Statistical analysis of the data at hand revealed significant improvements in a number of pulmonary function parameters (airway resistance, forced expiratory volume for 1 s, forced vital capacity, peak expiratory flow rate). Interpretation of these findings must however take into account the entirety of the training provided.

Asthma↗