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Results for “Psychophysiologic Disorders”

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At least 505 records · Page 28Linked to original sources
PubMed1987

Integration of DSM-III and ICD-8 to be used in a consultation-liaison psychiatric service. Preliminary experiences.

In 1983 a total of 405 patients received psychiatric supervision in somatic departments in the general hospital. At this supervision, these patients were registered by means of a five-axial diagnostic coding according to the DMS III principle, and this was combined with a quantitative global assessment of the severity of the condition. Reliability testing was undertaken by five supervising physicians with a total of 15 patients. The total number of supervisions constituted one supervision per somatic bed per annum. Women were overrepresented, and medical departments made the greatest use of psychiatric supervision. Reactive conditions dominated parallel with a high relative incidence of alcohol-related conditions. In patients with diagnoses of psychoses, only slight to moderate psychiatric symptoms were encountered. This held true also for personality deviations. 50% of the patients had experienced significant psychosocial stress, but 10% of these were diagnosed as having non-reactive psychoses, 52% of the patients had moderate to pronounced disturbances of social function. Half of the patients supervised in this manner could be investigated or treated in the referring departments. Approximately half of the patients in whom referral to private psychiatric specialists was made did not keep these appointments. Reliability testing in the material shows the employability of the diagnostic armamentarium. All in all, the investigation suggests that extension of the liaison psychiatric service in somatic departments would result in a relative increase in the number of patients who could be treated in the referring department and an increase in the number of psychiatric conditions diagnosed. Establishment of a psychiatric outpatient clinic in the somatic environment appears to be indicated.

Alcoholism↗
PubMed1989

The influence of consensus on the assessment of physical disease in chronic community psychiatric patients.

Physical disease is a frequent concomitant of mental disease. The majority of chronic psychiatric patients have physical complaints. Screening physical disease on a regular basis in an ambulatory setting for chronic psychiatric patients is often impossible if only for lack of medical manpower and facilities. Especially for the nonmedical personnel of a community psychiatric unit (CPU) for chronic patients, approaching and handling physical complaints and diseases poses a formidable problem. This paper addresses the issue of screening physical disease from a completely different viewpoint than that of the often advocated but just as often infeasible routine physical examination and laboratory workup. It is argued that consensus (i.e., agreement and mutual understanding) between patient and therapist on the physical well-being of the patient may increase the accuracy with which a CPU therapist, irrespective of his/her discipline, assesses physical disease. This hypothesis was tested in a sample of 156 chronic ambulatory psychiatric patients. Consensus between patient and CPU therapist was measured by means of a questionnaire. The CPU therapist assessment on physical disease in both the consensus and no consensus group was compared with those of two external medical observers; the patients' general practitioner and a specialist in internal medicine, who followed a protocolized physical screening procedure. The results tend to support the proposed hypothesis. Replication of this study using a larger samples is recommended in order to confirm the value of consensus in the assessment of physical disease in at least some subgroups of chronic ambulatory psychiatric patients and for the implications that consensus could have for daily community psychiatric practice.

Adult↗
PubMed1990

Therapy expectation in different groups of patients with chronic diseases.

In a questionnaire study on 865 patients suffering from different psychosomatic and somatopsychic disorders their therapy expectations were analyzed. The complete scale of the test holds 47 items (Cronbach's alpha = 0.91) grouped into for subscales: subjective experience of the disease (subscale 1, ii items, alpha = 0.76), lay concept (subscale 2, 8 items, alpha = 0.71), general attitudes and expectations concerning treatment (subscale 3, 8 items, alpha = 0.81) and previous experiences with psychotherapeutic concepts of treatment (20 items, alpha = 0.86). The results of the study show that patients with a prominent somatopsychic disorder have a significantly lower motivation for psychotherapy than typical psychosomatic and psychiatric patients. Therefore characteristically neurotic patients with predominant psychic symptoms present the highest motivation for psychotherapy. The results for the different subgroups of patients were discussed with regard to the different factors of therapy expectations and to the indication for psychotherapy.

Adult↗
PubMed1990

Psychological distress and quality of life in endocrine disease.

Despite an upsurge of research in psychoneuroendocrinology, there has been very little interest in the psychological aspects of clinical care in endocrine disease. The clinical and research implications of quality of life in endocrinology (life events preceding disease onset, psychological distress associated with acute illness and convalescence, abnormal illness behavior) are discussed.

Adaptation, Psychological↗
PubMed1991

Study of the work of a community medical emergency service with psychosomatic and psychiatric patients.

The study aims to: (a) assess the incidence of functional/psychosomatic (FP) and psychiatric (P) calls to the Community Emergency Medical Service (during the night, week-ends, public holidays, when the primary care physicians are not on duty) and to determine the type of response provided; (b) highlight the diagnostic, relational, therapy and assistance problems involved in an approach to these patients at an emergency call level by a young, nonspecialist physician. The study data show that the quantitative importance of FP and P patients, as noted in the literature, is equally valid for emergency. But the study also highlights the numerous difficulties these patients cause to nonspecialist physicians. Liaison psychiatrist activity should find excellent growth potential in this new direction.

Adult↗
PubMed1992

Physical illnesses underlying psychiatric symptoms.

The authors reviewed 21 studies dealing with the rate of diagnosed and undiagnosed physical illnesses in the psychiatric patient population. These studies performed by different authors in variable clinical settings with diverse methodology in different locations over a period of 45 years yielded a close concordance. Approximately half of the patients (50.1%) suffered from significant physical illnesses, of these 58.2% were previously undiagnosed. A substantial portion of the physical illnesses (27.1%) produced symptoms showing direct relation to the psychopathology of the patient. These numbers are quite close to those found by authors in earlier research.

Age Factors↗
PubMed1993

Psychosomatic view of endocrine disorders.

This review is concerned with the clinical and research implications of psychosomatic research in endocrinology. A possible role of life events in the pathogenesis of endocrine disease, the psychological distress associated with acute illness, and the issue of quality of life in clinical endocrinology are surveyed. In particular, the psychosomatic aspects of Cushing's syndrome, Addison's disease, hyperthyroidism, hypothyroidism, hyperprolactinemia, acromegaly, growth hormone deficiency, and hirsutism are considered.

Arousal↗