1/123. The management of medically unexplained symptoms.Medically unexplained symptoms occur in up to 50% of new medical out-patients. Health care seeking may not be related to the presence of physical disease but may reflect social problems, psychological disturbance, or frank psychiatric disorder. Management of unexplained physical symptoms depends on the duration of symptoms. If acute, exclusion of physical disease, as well as providing symptomatic care, is a priority. The patient's fears of illness need to be addressed and an explanation in simple terms of the symptoms provided. Adverse life situations should be identified and, where possible, rectified. Psychiatric disorders require appropriate treatment. When symptoms are chronic, conservative management is required to contain the symptoms and avoid iatrogenic problems.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
2/123. Psychogenic vomiting: report of two cases.Two patients were admitted to our hospital with the diagnosis of psychogenic vomiting of more than 9 months' duration. Both were treated with a combination of pharmacotherapy, relaxation training, cognitive therapy and supportive psychotherapy. Behavioral therapy and verbal catharsis were also used in one of the cases involving bereavement. The intervention was not directly aimed at the vomiting, but at the aspects of the patients' stress and emotional problems. Change in condition was assessed on basis of the frequency of vomiting and the severity of anxiety and depression. vomiting was found to be positively related to anxiety but not to depression. These 2 patients improved to the extent that the disturbance caused by vomiting was significantly reduced, and the reduction was closely related to the severity of anxiety. Both were also found to have similar personality traits and family types, which have been reported to be related to psychogenic vomiting. We review the characteristics of psychogenic vomiting and relate some important considerations for treating Chinese psychogenic vomiting cases.- - - - - - - - - - ranking = 0.73559950936344keywords = person (Clic here for more details about this article) |
3/123. Psychiatric patients presenting with primarily somatic symptoms: report of two cases.Two recent cases of psychiatric disorders, presenting primarily with physical symptoms are described, which suggest that both psychotic and psychoneurotic disorders can present with somatic symptoms for which no adequate physical cause could be defined. It is emphasised that such cases require specialist psychiatric evaluation and assessment for the appropriate management to be initiated. Recent studies have stressed the frequency with which psychiatric illness or psychological distress is presented in most African patients as somatic illness, especially in depressive illness, psychotic disorders and psychoneurotic disorders (1). Two such cases of different diagnoses are presented here.- - - - - - - - - - ranking = 3keywords = illness (Clic here for more details about this article) |
4/123. Psychological factors in the etiology of ulcerative colitis: objectlessness and rage.In this second investigation of psychological factors in the etiology of ulcerative colitis, the author again utilizes unusual cases characterized by limited variables preceding illness. The first investigation involved several patients whose partial deafness antedated their illness. A significant point was that prior to developing their illness, all these patients had arrived at a state of objectlessness which was abetted by the deafness. This report presents four ulcerative colitis patients with pre-existing organic problems affecting their mental status. Two of the patients are severely mentally retarded. A third patient has rapidly advancing multiple sclerosis, and a fourth--actually an addition to the earlier study--has long-standing partial deafness. Aside from the objectlessness which was also prominent in the earlier group, all four patients demonstrate a consistent pattern of vicious self-directed rage. This paper takes into account the interaction between the rage and the state of objectlessness in the production of illness.- - - - - - - - - - ranking = 4keywords = illness (Clic here for more details about this article) |
5/123. Possible sequelae of trauma and somatic disorder in early life.All children experience trauma. The age, state of development and constitutional factors will determine whether some children will have a traumatic effect. Trauma occurring before the age of three, at a time when the ego has not developed its synthetic and integrative functions, may be reproduced in later life as an isolated symptom, by selected sensations involved in a sensory imprint or screen sensation of the trauma as a simple recording. After the age of three, under the influence of a more mature ego, excessive traumatic stimuli will be integrated and elaborated in symptom formations as phobias or other conditions and extended as part of the total personality. recurrence in later life is triggered by events related not only to the original experience, but also to the content of its elaboration. The earlier in life the trauma occurs, the more likely that somatic imprints of primitive physiological symptoms would result as an archaic, biological defense or screen sensations. Recurrent sensory imprints or screens may appear as organic illness or functional somatic symptoms. Diagnostically, a detailed early life history is necessary to uncover the presence of a sensory screen memory of a trauma and so avoid diagnostic medical search for organic causation. Case material illustrating the two groups are presented. Indications for psychoanalysis and for supportive psychotherapy are discussed from our theoretical framework as well as from the literature.- - - - - - - - - - ranking = 1.7355995093634keywords = illness, person (Clic here for more details about this article) |
6/123. "Short and long-term therapies in psychosomatic disorders".Narcoanalysis (narcosynthesis) as well as psychoanalytically oriented psychotherapy (psychoanalytic psychotherapy) are both, in my opinion, practical and useful short-term methods of therapy in psychosomatic disorders. Psychoanalytic psychoterapy may also be used as an alternative to narcoanalysis when the latter method decisively fails the therapist. In selecting candidates for psychotherapy in psychosomatic practice, 3 essential factors should be taken into consideration, viz. the time of onset of the illness, the patient's personality structure and his intellectual capacities.- - - - - - - - - - ranking = 1.7355995093634keywords = illness, person (Clic here for more details about this article) |
7/123. Sense, symbol, and soma: illness experience in the soundscape of everyday life.This article explores the lived experience of women suffering from an illness prevalent in the Kui communities of Northeast thailand. The symptoms, ranging from loss of appetite to chronic fatigue, were typically triggered by being exposed to certain kinds of sounds, such as motorcycles, quarrelling neighbors, or carousing drunkards. I examine the illness experience as it was constituted in the soundscape of everyday life to reveal how the meaning-endowed sounds aggravated the feeling of being vulnerable and defenseless. The felt immediacies created by the audio-somatic experience were reconceptualized within the indigenous somato-psychic framework as a form of illness. By examining the life histories and illness experiences of individuals who were rendered vulnerable and defenseless, the study reveals how symbols that carry political significance, the body as a cultural form of memory, and the senses combine to create a specific mode of being-in-the-world. Sense, symbols, and somatic processes combined to create an illness experience out of the felt immediacies of the Kui's socio-political predicament of marginality.- - - - - - - - - - ranking = 9keywords = illness (Clic here for more details about this article) |
8/123. The stiff man syndrome: a psychiatric disease?Although the Stiff Man syndrome has been traditionally viewed as a neurologic disorder, a number of recent articles have documented a pattern of familial, interpersonal, and intrapsychic stress which suggests that this disease may be, to a considerable degree, psychosomatic in origin. The present paper reviews several recent articles and focuses on a single case study. Although the medical diagnosis was earlier confirmed, an in-depth psychiatric evaluation and extensive psychological assessment showed many psychopathological concomitants associated with the severe muscle spasm and stiffness. A follow-up after about a year of group and individual psychotherapy showed that the symptoms were still in remission, and that the patient was functioning personally and occupationally on a significantly improved level.- - - - - - - - - - ranking = 1.4711990187269keywords = person (Clic here for more details about this article) |
9/123. work-related posttraumatic upper limb disorder. A case report.In this paper we describe a patient with mor-sensory loss in the right forearm and hand, which persisted more than 2 years after work-related crush trauma of the left hand. Radiographic and electromyographic investigations, somatosensory evoked potentials, CT scans of the encephalus as well as the minnesota Multiphasic personality inventory and the Roarschach test have been performed. On the basis of these investigations, we think this represents a case of conversion disorder with somatic features. Included is a brief overview of other psychological illness with physical findings involving the upper limb.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
10/123. Respiratory diseases with a psychosomatic component in adolescents.Adolescence is often a time of emotional upheaval and it is no wonder that many respiratory diseases with a psychosomatic component find their origins or time of exacerbation during this time of life. Adolescents who present with unexplained respiratory diseases may also suffer from some form of psychosomatic illness. Recognition of the psychological contributions to symptoms related to the respiratory tract is essential for practitioners who care for adolescents. This article includes some of the more common respiratory or related conditions that have psychological etiologies or components and are encountered in the adolescent patient. These include psychogenic cough, sighing dyspnea, hyperventilation, vocal cord dysfunction, and emotional state as a trigger for asthma. This review provides a general discussion of these conditions and an overview of issues related to psychological/psychiatric evaluation and the reluctance of patients and their parents to access mental health treatment.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
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