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Psychorehabilitation aspects in older age groups.

Throughout medical history, suggestion is the oldest and most common method of relieving human distress and treating physical disease. One of the oldest Egyptian documents, the Ebers Papyrus (1552 BC) states, "Lay your hands upon him to quiet the pain in the arms and say that the pain will disappear." The psychogenic and therapeutic potency of Native American trance dances are also well documented. In a North American tribe practicing ancient traditions, such dances were found to produce an altered feeling for time, loss of conscious control, drastic emotional outbreaks, illusions, hypersuggestibility, and a deep feeling of restored youthfulness (Jilek, 1982). These and other historical documents show the deep historical connection between somatic and mental processes. From the viewpoint of a neurologist or a psychiatrist, a combination of somatic illness, depressive syndromes, organic psychosyndromes, and multimorbidity is frequent in elderly patients (Kortus, 1992). Thus, integrated psychotherapy in geriatric rehabilitation is necessary and useful. Practical psychotherapeutic methods are discussed in this manuscript.

Autogenic Training↗

Cue-elicited cocaine craving and autogenic relaxation. Association with treatment outcome.

Prior to entering a pharmacotherapy trial for the treatment of cocaine dependence, 19 patients participated in a pretreatment cue-reactivity protocol that concluded with a relaxation exercise. Measures included self-reported craving and skin conductance level (SCL). Post hoc exploratory analyses suggest that neither craving nor change in SCL in response to cocaine cues differentiated patients who subsequently achieved abstinence from those who did not. Craving following the relaxation procedure did differentiate the two groups: patients who subsequently initiated abstinence in treatment reported a reduction in cue-elicited craving to below baseline levels; craving reported by patients who did not successfully complete treatment remained elevated.

Adult↗

Psychological aspects of cardiac arrhythmia.

A review of data from a wide spectrum of research studies suggests that psychological-emotional factors can significantly influence and alter the incidence of cardiac arrhythmia. While the existing data are, in many cases, difficult to interpret because of theoretical and methodological problems, sufficient evidence does exist to warrant a concerted investigation into the total involvement of psychological factors in cardiac arrhythmia.

Animals↗

Imagery content during nonpharmacologic analgesia in the procedure suite: where your patients would rather be.

RATIONALE AND OBJECTIVES: Imagery as a hypnotic technique can produce analgesia and anxiolysis, but effective use may be restricted to select, highly hypnotizable individuals. This study assessed (a) whether patients not selected for hypnotizability can produce imagery during interventional radiologic procedures and (b) the type of imagery produced. A secondary goal of the study was to familiarize health care providers with a simple, time-efficient technique for imagery. MATERIALS AND METHODS: Fifty-six nonselected patients referred for interventional procedures were guided to a state of self-hypnotic relaxation by a health care provider according to a standardized protocol and script. Patient hypnotizability was assessed according to the Hypnotic Induction Profile test. RESULTS: Patients as a group had average distribution of hypnotizability. The induction script was started in all patients and completed in 53. All patients developed an imagery scenario. Chosen imagery was highly individual, but common trends were nature and travel, family and home, and personal skills. Being with loved ones was an important element of imagery for 14 patients. Thirty-two patients chose passive contemplation, and 24 were action oriented. CONCLUSION: Average patients who present for interventional radiologic procedures and are not preselected for hypnotizability can engage in imagery. Topics chosen are highly individual, thus making prerecorded tapes or provider-directed imagery unlikely to be equally successful.

Adult↗

Outcome of biofeedback-assisted relaxation for neurocardiogenic syncope and headache: a clinical replication series.

Preliminary evidence exists through single case reports that psychophysiological interventions may be useful in the treatment of syncope (fainting). To explore this possibility, a case series of ten patients with histories of recurrent unexplained syncope or near syncope, headache, and a poor response to or tolerance for medication was performed. All patients were treated with electromyographic, thermal, biofeedback as well as progressive and autogenic relaxation. Six of the ten patients showed a major decrease in symptoms at the end of treatment. Descriptive comparisons between the improved and unimproved group were made and a detailed case study of one improved patient is presented. The results suggested that biofeedback-assisted relaxation treatment was most effective in younger patients whose syncope was associated with a strong psychophysiological response and whose headaches were intermittent, not daily occurrences.

Adolescent↗

[Algorithm for diagnosis and therapy of pain].

Certain basic principles are applicable to all forms of pain treatment when the aims are pain relief and the avoidance of chronicety. Such algorithms, as guidelines are even more important when pain is becoming chronic. The use of the described algorithms is necessary in the diagnosis and therapy of acute pain and also to avoid the establishment of chronic pain due to the changes of neuroplasticity in the central nervous system. The most important basic principles in the form of algorithms are first of all that therapies should be simultaneously applied and not sequentially. Secondly, the challenge should be met to create a concept where by various therapies can be preformed in a parallel fashion, without compete one another and being effective on different aspects and causes of the pain.

Administration, Oral↗

[Management of treatment-resistant depression (author's transl)].

An intensive course of drug treatment--combination of a major tranquilliser with two antidepressants--was used in 46 patients with endogenous depression and 31 with exhaustion depression, all of which had proved refractory to other forms of treatment. After one week intramuscular injection of the major tranquilliser, in order to relax the patient, intravenous infusion of the two antidepressants, clomipramine and maprotiline, was performed daily for 10-20 days, while the major tranquilliser was given orally during this period. Complete remission after 4-6 weeks was achieved in 70% of patients with endogenous depression and 48% with exhaustive depression. It is stressed that careful diagnosis and treatment by drug and psychotherapy are preconditions for the successful management of otherwise resistant depressions.

Administration, Oral↗

[Hypnosis in gastroenterology].

Hypnosis is one of the oldest remedies against physical diseases and mental disorders of mankind. The term hypnosis is used for the description of a technique as well as for the description of an altered state of consciousness which is induced by this technique. Hypnosis is a scientific tool in psychophysiological studies of gastrointestinal functions (secretion, motility, visceral sensitivity) and their processing in the central nervous system. Hypnosis is an empirically validated treatment of the irritable bowel syndrome even refractory to medical treatment which is recommended by international expert groups (Rome II) and the British Society of Gastroenterology. In diagnostic upper gastrointestinal endoscopy the relevance of hypnosis as an alternative of intravenous sedation needs to be clarified. Hypnosis cannot be recommended as an alternative for intravenous analgosedation in painful endoscopic therapeutic procedures of the gastrointestinal tract.

Autogenic Training↗