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[Clinical and fundamental investigations on recurrent glossodynia].

A type of oral lesion, so-called glossodynia has been on the increase recently. Glossodynia is a kind of psychosomatic disease in which the patient experiences chronic pain on the surface of the tongue. It has never been diagnosed as coming from organic or functional pain. Although glossodynia can be cured by antianxiety drugs, antidepressants, or autogenic training and so on, usually. These are not a desirable solution. We initially tried to administer the antifungal drug, ITCZ, to 65 glossodynia patients. Sixty-four of them were cured of tongue pain after 1-3 weeks. The effective rate of recovery was 98.5%. Only two patients experienced recurrence of pain after 15 and 17 weeks, respectively, and Candida albicans was isolated from the surface of their tongues. The nature of the recurrent strains was investigated by MICs against 4 antifungal drugs, ITCZ, MCZ, AMPH-B, and NYS, as well as by the API 20C Auxanogram biochemically, and a molecular epidemiologic study by PFGE. Each case of Candida albicans was almost the same before and after the administration of ITCZ. Above all, it is important to carefully inspect the candidiasis of the tongue and to initially administer antifungal drugs when the diagnosis is glossodynia.

Adult↗

[Free from stress by autogenic therapy. Relaxation technique yielding peace of mind and self-insight].

The utilisation of self-regulatory capacity is one of the purposes of autogenic therapy, a method consisting of exercises focused on the limbs, lungs, heart, diaphragm and head. The physiological response is muscle relaxation, increased peripheral blood flow, lower heart rate and blood pressure, slower and deeper breathing, and reduced oxygen consumption. Autogenic training is applicable in most pathological conditions associated with stress, and can be used preventively or as a complement to conventional treatment.

Autosuggestion↗

[Effectiveness of different methods of treating sleep disorders according to electropolygraphic findings].

The authors report of an electropolygraphical study of 111 patients with different forms of neurotical sleep disorders. For therapeutical purposes different pharmacological methods (Ca cyclobarbital, eunoctin, elenium, difenisid) and psychotherapeutical (hypnosuggestion, autogenic training) treatment was used. The achieved data permit to conclude that there is an increased activity of the awakening and activizing systems in patients with neurotic disorders of sleep. A decrease of the activating changes evoked under the influence of pharmacological and psychotherapeutical methods is accompanied by an improvement of the objective indices and as a rule correlates with a subjective personal feeling of sleep by the patient. The authors studied the optimal conditions for using different methods of treatment and based their principles for a differentiated therapy of different disorders of sleep in neuroses.

Adult↗

Rehabilitation needs psychotherapy.

The rehabilitation patient by his permanent disablement comes into an important crisis which makes psychotherapy as reasonable and necessary as other human crisis situations do. Especially the more senior patient must be regarded within this rank. There is a broad rank of known psychotherapeutic methods which however we propose to classify in six groups with the following main factors: Verbal communication Sociodynamics Representational means The hypnoid Behaviouristic means Physical means as entrance to psychotherapy We recommend 'renaissance of conversation culture' and give further hints on conversion therapy. The hypnoid can by no means only act in functional disturbances, however, its action is directly somatotropic. We could show this in paralysed patients. Conversation with the uncurably ill needs special emphasis schooling, and mainly taking the caregivers into the conversation (systemic approach). We have with good success used a combination model, combining autogenic training with analytically orientated group psychotherapy.

Persons with Disabilities↗

The viability of external electrical stimulation as a therapeutic modality.

This study indicates that external electrical stimulation is a valuable tool for control of acute pain in about 80 percent of patients but, for significant relief of pain, in only about 25 percent of patients with chronic pain. The author recognizes that in order to increase its use, a system for delivery of this therapy under a doctor's prescription, rather than having to teach each individual practitioner the technique for using the device, must be developed. In chronic-pain patients when external electrical stimulation is inadequate, a more aggressive and comprehensive program of operant conditioning, progressive physical exercise, drug withdrawal, autogenic training, and biofeedback is advised.

Acute Disease↗

[Type A botulinum toxin: a new methods in treating focal hyperhidrosis. A summary of various possibilities in hyperhidrosis therapy with special emphasis type A botulinum toxin injections].

Hyperhidrosis is defined as an excess of sweating over the amount necessary for thermoregulation. Essential focal hyperhidrosis is a overactivity of the sweat glands of the axilla, palms and soles probably due to a disorder of the sympathetic nervous system. The therapy is difficult, even though there are many therapeutic options. Beside the effort to treat the psychovegetative disorder (autogenic training or acupuncture), there are efforts to seal the lumen of terminal sweat ducts using aluminiumchlorhydroxide application or iontophoresis. Surgery has the aim to eliminate sweat glands either by excision or by denervation. It is also possible to use chemical denervation with systemic anticholinergics. Only recently the local chemodenervation with injections of botulinum toxin (BTX) was added to the therapeutic tools of focal hyperhidrosis. We present an overview of several therapeutic options in consideration of BTX.

Botulinum Toxins, Type A↗

Medical rehabilitation of chronic progressive disseminated encephalomyelitis (MS).

Eight years after diagnosis, 40% of MS patients develop a chronically progressive form. Annually we treat approximately 200 patients with progressive MS. Treatment consists of medication, i.e. agents that help to prevent future impairment, or interferon-beta injections, and intervals of mitoxantrone infusions (Novantrone(R)), and in some cases cyclic cyclophosphamide (Endoxan(R)) or nucleoside analogue cladribin (Leustatin(R)). Without clear scientific evidence, we recommend unsaturated fatty acids (thistle or sunflower oil), sufficient protein, and freshly prepared fruits and vegetables as a sound basis for remyelination. Remyelination profits from general prophylaxis in the use of ascorbic acid to help prevent urinary infections via acidification, autogenic training to reduce fatigue, improve ventilation of deeper airways, and stimulate vagotonic regeneration, and prevention of unnecessary immune stimulation caused by insects and some food. We recommend the use of sun hats and disencourage blood donation (Allain 1998). Physiotherapy can improve strength, reduce spasticity, and train the patient to compensate for dysbalance and ataxia; supported by beta blockers and good antispastics, tremor and gait disturbances can be positively influenced. Music and motion, speech therapy, realistic training of daily activities, and prudent psychotherapy complete the range of measurements to reconstitute as much as possible of the patient's individual freedom. In the individual, we eventually provide prudent technical aids and careful prognostic estimations. Cooperating with local and regional patient networks, we reinforce long-term disease management and spread up-to-date medical research results, and finally gather valuable contextual information and clinical data on an increasingly frequent idiopathic disease of the human central nervous system.

Adult↗

[The effects of a health promotion program on physical, mental, and dietetic health status in climacteric women].

PURPOSES: The purpose of this study was to evaluate the effects of a six months health promotion program on physical and mental health status assessments in climacteric women. METHODS: Seventy-two women, with a mean (+/- SD) age of 51.3 (+/- 3.1 yr.), body weight of 51.5 (+/- 6.3 kg), and Body Mass Index of 22.4 (+/- 2.4 kg/m2), residing in Tokyo Metropolitan area, participated as subjects in a health promotion program, completing health status assessments. Health promotion was performed once a week, two hours per session, sixteen times. The lecture and exercise program, in the first half, included basic information on diet, exercise and relaxation, and prevention of life-style related disease, and instructions for walking exercise, dancing, and dumbbell exercise. In the latter half, they performed extended walking, stretching, and autogenic training for relaxation. Healthy foods were also supplied. Before and after the program, health status was assessed, with a general medical health check, a questionnaire regarding nutrition, exercise and relaxation activities, and determination of dietary intake based on food records, eating behavior, complaints (CMI, Nichidai stress score) and physical activity levels. RESULTS: After the six months of the program: 1) Total cholesterol levels had decreased significantly, along with both systolic and diastolic blood pressure, body weight and BMI; 2) Major nutrient intake, density of nutrients and eating behavior were improved, with decrease in daily salt intake, and increase significant in daily energy expenditure; 3) Stress scores by the Nichidai stress check were decreased significantly, subjects with higher stress scores at the beginning of programs having marked change, and neurotic tendencies were decreased in CMI categories II-IV. CONCLUSION: These results suggest that, in order to maintain and/or improve the QOL of climacteric women, good dietary habits and physical activities, such as walking, and psychological support are essential. Further long-term investigations of larger populations (middle-aged to elderly) are now necessary.

Climacteric↗

[Childbirth preparation courses: obstetrical and neonatal evaluation].

From 1997, R.A.T. (Respiratory Autogenous Training) and "Stretching" training have been performed into the Department of Obstetrics and Gynecology University of Parma, for childbirth preparation. The aim of this study is to evaluate the obstetric characteristics of these women during labor and delivery. We compared the labour and delivery characteristics of 200 women who have completed antepartum R.A.T. and stretching training with 100 matched controls who have not. Preparation is significantly related to reduction in dystocic deliveries (operative vaginal delivery and cesarean section) and emergency cesarean section. Epidural analgesia (an obstetric procedure that is not routinely offered in the department of Parma) is more frequently performed in women prepared with ante-partum training. The neonatal outcome is good in all the three groups. "Prepared-childbirth" courses offer measurable clinical, obstetrical and neonatal advantages and psychological support, providing a useful link between prenatal ambulatory care and hospital labor and delivery care.

Adult↗

[Report on professional workshops "Aging and psychotherapy"].

Since 1989, annual scientific meetings "Age and psychotherapy" have been held in Erlangen, and since 1991, in Bonn. For each meeting a special topic has been selected such as, "Multimorbidity and Psychotherapeutic Implications," "Dementia and Psychotherapy," "Sexuality and Partnership." In addition to scientific papers related to the topic, courses, seminars and workshops have been offered since 1992 to exchange practical knowledge about psychotherapy with the elderly (e.g., autogenic training, family work, Balint-group, family therapy, art therapy, psychotherapy in psychogeriatrics, self-experience workshop, assertiveness-training, supervision). In addition to advanced training and continuous education, the main objective of these meetings has been to offer a forum to share knowledge and experience with professionals working in psychotherapy with the elderly.

Aged↗

The Italian Air Force rehabilitation programme for air-sickness.

Motion Sickness, or kinetosis, is a complex clinical syndrome usually classified according to the environmental situation evoking the symptoms. Among the various forms of motion sickness, air sickness has a significant impact on aircrew readiness and is often a cause for the grounding of aircrew. Unfortunately, standards for clinical testing to accurately predict the sensitivity of each individual to air-sickness are currently lacking. Furthermore, pharmacological prevention is contraindicated for aircrews, whose cognitive tasks involve a high level of vigilance. Therefore, a number of Air Forces have developed their own rehabilitation programmes to counteract air-sickness effects on flight personnel. These programmes may differ in several aspects, such as their duration, instruments used, costs and the technical characteristics of the rehabilitation team. However, reports in the specialized literature, refer to high rates of success, despite the above-mentioned differences. In the autumn of 2000, the Italian Air Force (ITAF) also began its own rehabilitation programme for air-sickness desensitisation. The programme was developed at the Aerospace Medicine Department of the ITAF Flight Test Centre, at the Pratica di Mare Air Force Base, Italy. The ITAF rehabilitation course lasts two weeks, and candidates are first classified according to their clinical history and to their reaction to the Coriolis Stress Test. Thereafter, subjects undergo a personalized desensitisation programme, involving increasingly more intense nauseogenic stimuli by means of various devices. At the same time, a psychological approach, based on autogenous training and cognitive-behavioural therapy, is adopted. The present report refers to data from 17 subjects treated from January 2001. The current clinical outcome is extremely encouraging, with a success rate of 88%. Nevertheless, several aspects of motion sickness rehabilitation are still under investigation, and further research programmes, aimed at improving the final clinical outcome and prolonging the benefits of rehabilitation, are needed.

Adolescent↗

Integrative medical therapy: examination of meditation's therapeutic and global medicinal outcomes via nitric oxide (review).

Relaxation techniques are part of the integrative medicine movement that is of growing importance for mainstream medicine. Complementary medical therapies have the potential to affect many physiological systems. Repeatedly studies show the benefits of the placebo response and relaxation techniques in the treatment of hypertension, cardiac arrhythmias, chronic pain, insomnia, anxiety and mild and moderate depression, premenstrual syndrome, and infertility. In itself, relaxation is characterized by a decreased metabolism, heart rate, blood pressure, and rate of breathing as well as an increase in skin temperature. Relaxation approaches, such as progressive muscle relaxation, autogenic training, meditation and biofeedback, are effective in lowering systolic and diastolic blood pressure in hypertensive patients by a significant margin. Given this association with changes in vascular tone, we have hypothesized that nitric oxide, a demonstrated vasodilator substance, contribute to physiological activity of relaxation approaches. We examined the scientific literature concerning the disorders noted earlier for their nitric oxide involvement in an attempt to provide a molecular rationale for the positive effects of relaxation approaches, which are physiological and cognitive process. We conclude that constitutive nitric oxide may crucially contribute to potentially beneficial outcomes and effects in diverse pathologies, exerting a global healing effect.

Anxiety↗

[Psychotherapy of relaxation or does relaxation have its place in psychotherapy?].

After giving a brief historical outline of relaxation methods, from Freud to Ajuriaguerra, the author attempts to define relaxation. Then he describes the principal methods of relaxation according to three approaches: the neurophysiological which includes Jacob-son's progressive relaxation; the hypnotic in which can be classed Schultz's autogenous training; and the psychodynamic with the psycho-tonic reeducation of Ajuriaguerra and Cohen. This completed, he focusses on the different therapeutic indicators somatic, psychiatric and prophylatic. In conclusion the author underlines the common points of these methods such as detente, the regressive phase, the use of suggestion; mentions that all of the methods lead to a similar state, whatever name may be given to it, and that these methods can be placed on a progressive continuum.

English Abstract↗

[A case of conversion disorder analyzed from a psychodynamic, psychophysiologic, and morphodynamic perspective].

This paper presents a case of conversion disorder characterized by sensory paralysis that involved the right half of the body, a motor deficit consisting of permanent contracture in flexion of fingers 2-5 of the right hand (clenched fist syndrome), and a visual alteration compatible with homonymous hemianopia and amblyopia. The patient initially presented a clinical picture of depression as well as frequent gynecological disorders. The author evaluates important aspects of the psychogenesis of the clinical picture and emphasizes the identifying aspects and primary and secondary gains. Consideration is given to the distinct therapeutic strategies used (psychotherapy, autogenous training, hypnosis), and the case is analyzed from a morphodynamic point of view. The author concludes that the organic basis of the clinical picture would be localized in the posterior nuclei of the thalamus.

Adult↗

[Psychosomatic dermatology].

An appreciative cooperation among dermatology, clinical psychology and psychology and psychiatry is necessary and useful. By selected facts interactions between central and autonomous nervous system on one side and the immune system on the other side were described. As far as the neutrocutaneous interrelations are concerned the cutaneous stimulation appears to be an important factor for the physical and physiologic development. In addition, the skin communicates to the environment and other people. Therefore, it plays a role in the social integration. Psychiatric diseases can affect the skin (e.g. delusions of parasitosis in schizophrenia). On the other hand primary skin diseases such as psoriasis, atopic dermatitis, acune vulgaris, chronic idiopathic urticaria and alopecia areata may induce psychologic features. The characteristics of the personalities of dermatological patients are discussed. The psychodiagnostics (personal interview, questionaires) is followed by psychotherapeutic procedures such as personal consultations, treatment in groups, hypnosis and autogenous training. Our experiences in the psychodiagnostics and treatment are briefly reported. Finally, psychotropic drugs-antipsychotic, anti-depressant, antianxiety, and hypnotic agents - may be useful as an adjunct in the management of dermatologic disorders, if applied under precautious indications.

Combined Modality Therapy↗

[The state of professional psychological guidance for patients with multiple sclerosis].

Over a period of two years, a total of 847 patients with multiple sclerosis (283 male and 564 female aged 18 to 79 years) were interviewed relative to the psychological care provided. Two patients currently participated in regular client-centered group therapy, 11 patients had regularly attended individual or group psychotherapy in previous years, and one patient had undergone family therapy several years ago. Another 26 patients reported occasional supportive counselling by their neurologist or family doctor in the framework of outpatient care. Ten patients used relaxation techniques such as autogenic training, and 42 patients reported emotional benefit from contacts within an MS self-help group. The findings of our study show that professional psychological care of persons with MS is extremely sparse, substantiating the call for better psychological services in coping with MS.

Adaptation, Psychological↗

[Psychotherapy of patients with a history of craniocerebral trauma].

The management of patients in the early period of craniocerebral trauma according to a psychotherapeutic program comprising reasonable psychotherapy, prolonged hypnotic sleep, psychotherapeutic passes, a mental hygiene complex, and a special variant of autogenous training increases essentially the efficacy of treatment of patients and the possibility of their return to work. The bordering neuropsychic disorders and inadequate personal reactions to the disease are deactualized.

Adolescent↗

[A psychotherapist's experience with conducting emotional and psychological relaxation].

As industrial development intensified over the past decades, the loads suffered by both central nervous system and psychoemotional sphere raised drastically, especially in industrial workers. This often leads to reducing the labor productivity and its qualitative indices with tiredness increasing toward the second half of the working day. This trend is especially marked in subjects with weak type of the nervous system. The author has designed a technique optimally using the work time-outs approved by the management for group or individual psychotherapeutic sessions (autogenic training, hypnosuggestive and musc therapies) in medically selected worker population at a plant. The therapeutic efficiency was permanently controlled and substantional positive results were achieved judging by subjective (medical) and objective (economic-production) parameters.

Electronics↗