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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study reports lifetime prevalence of certain "psychosomatic disorders" in psychiatric patients in India. The "psychosomatic disorders" studied were peptic ulcer, bronchial asthma, rheumatoid arthritis, ischemic heart disease and irritable bowel syndrome. One percent of psychiatric patients had these psychosomatic illnesses. Ten of the fifteen cases had two psychosomatic illnesses. Patients with psychosomatic disorders were significantly more often older in age (p = 0.003) and from an urban background (p = 0.05) as compared to other psychiatric patients. Depression was the commonest diagnosis, and was significantly (p = 0.01) more often diagnosed in the psychosomatic patients. Psychosis was not diagnosed in patients with psychosomatic disorders. This article emphasizes the need for identifying concomitant psychosomatic problems in psychiatric patients for their appropriate management.
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PMID:Psychosomatic patients in a psychiatric clinic. 326 96

The history of psychosomatic medicine in the 20th century is predominantly marked by a concern with studies of major diseases (e.g., angina pectoris, bronchial asthma, diabetes mellitus, essential hypertension, neurodermatitis, rheumatoid arthritis, etc.). Traditional physicians also narrowly focus on disease--a trend that began with Morgagni in the 18th century. But disease (defined by structural alterations) is not the only cause of illness and disability. In fact, most persons seeking health care are ill without having a disease. It is only recently that this distinction has been fully made. The various manifestations of ill-health go by a variety of descriptive names--the functional or irritable bowel and hyperventilation syndromes, fibromyositis, psychophysiological, functional and somatoform or somatization disorders. They lead to loss of productivity, cost the health care system excessively, produce negative reactions in physicians, and are fertile ground for iatrogenic disease. They do not constitute discrete syndromes but overlap, each also being closely associated with anxiety and depression, sleep disturbances or marital disruption. They are the manifestations of sick persons not only of disturbances of bodily systems. They may be precipitated by unemployment, marital discord, bereavement, and job dissatisfaction. Curiously, ill-health has not been the major area of investigative interest of psychosomatic medicine. This presentation will emphasize why it should be, and why proper interventions may radically reduce the cost of medical care, prevent iatrogenic disease, and reduce the use of ill-advised procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Some unexplored regions of psychosomatic medicine. 333 83

Starting from a prior study, in which cognitive and coping variables proved to be related to well-being, the use of medical resources and the absence from work in asthmatic patients, the authors constructed a cognitive-educational (a combination of health education and rational emotive behaviour modification) intervention programme aiming at altering coping behaviour in asthmatic patients in order to influence emotional distress and use of medical resources. The effects of the programme were assessed by means of a pre-test-post-test control group design. The programme was offered to ten patients and their partners. Both before and after the intervention cognitive attitudes (optimism, locus of control, and shame or stigma), coping behaviour in attack situations (minimizing the seriousness of the attack, rational action and reacting emotionally), coping in daily life (maintaining a restrictive life-style, focussing on asthma and hiding asthma), emotional distress (anxiety, anger, and depression), and the use of medication were measured in the experimental and control group. It was found that patients who received the programme became less preoccupied with their asthma and reported significantly less emotional distress (anxiety and anger) in daily life. In addition, they used less maintenance medication (corticosteroids). The authors wish to stress the importance of using medical variables such as the number of attacks as covariates in this type of research.
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PMID:Changing health behaviour outcomes in asthmatic patients: a pilot intervention study. 334 56

The purpose of this study was to evaluate the relationship between neuroendocrine function and the beta receptor activity of the lung in a group of 47 pediatric patients with bronchial asthma. It is postulated that since hypothalamic norepinephrine (NE) is known to inhibit corticotropin-releasing hormone (CRH), an increase in brain NE as measured by its metabolite 3-methoxy-4-hydroxy-phenylglycol (MHPG) could reflect the depression of the hypothalamic-pituitary-adrenal (HPA) axis as measured by urinary cortisol levels. Further, since cortisol influences epinephrine formation in the adrenal medulla and since cortisol and epinephrine contribute to beta receptor function, it is further postulated that an increase in brain NE by depressing the HPA axis could thereby, cause a relative decrease in both cortisol and epinephrine with resultant beta receptor dysfunction. In both age groups, the 3- to 11-year-olds and the adolescents, differences in NE were found among the three subgroups (P = .003) with the difference observed only between the wheezing (decreased NE) and control groups (P less than .05). There was a similar difference in MHPG (elevated) among these groups. In a similar manner, the MHPG/NE ratios (elevated) were statistically different in comparing the three groups in the 3- to 11-year-old range. In the adolescent group both the wheezing and nonwheezing groups were comparably elevated and showed statistically significant differences from their controls. The results of this study appear to support the hypothesis and suggests that brain NE may play a pivotal role in the beta-adrenergic dysfunction characteristic of bronchial asthma.
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PMID:Brain norepinephrine: a possible role in bronchial asthma. 335 38

Although high rates of psychopathology in children and adolescents suffering from temporal lobe epilepsy (TLE) have been reported in the literature, the subject remains controversial. In this investigation we made a psychiatric study of 26 adolescents with TLE using a detailed structure interview and rigorous diagnostic criteria. These were compared to 26 matched controls suffering from chronic bronchial asthma (BA). In neither group was there a high rate of specific psychiatric illness, although many adolescents in both samples showed moderate to severe depression. We conclude that TLE may not be a specific cause of psychopathology in adolescence, and that the depression might result from the suffering involved in chronic illness.
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PMID:Psychopathology and temporal lobe epilepsy in adolescents. 340 33

This paper reports studies of patients with the following disorders: peptic ulcer, hypertension, bronchial asthma, irritable bowel syndrome (IBS), ulcerative colitis (UC), urticaria, psoriasis and alopecia. The investigations focused on dysthymic states, measured by Foulds' Scale of Anxiety and Depression (SAD) and--except for the first three disorders--the Present State Examination (PSE). On the SAD, all the above groups scored significantly higher than somatically ill controls in anxiety, and all except ulcer patients scored significantly higher in depression. The PSE designated more than half of these patients as cases, except in the psoriasis group. Most patients were assigned to the PSE syndromes of anxiety states or neurotic depression, with the former being more common in UC and urticaria, and the latter more common in IBS, alopecia and rheumatoid arthritis. The variation within skin diseases and within gastrointestinal diseases suggests that neurotic symptoms are typical of each disease rather than of the system involved in the disturbance.
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PMID:Dysthymic states and depressive syndromes in physical conditions of presumably psychogenic origin. 343 24

One hundred consecutive patients, 74 women and 26 men, aged between 18 and 83 years (mean = 54.8 years), referred with complaints related to oral galvanism were investigated and treated and the treatment results were evaluated after 2-3 years. Forty of the patients reported facial pain, pain from the teeth, temporomandibular joints (TMJ) and masticatory muscles and TMJ clicking and locking and 26 reported headache. Smarting in the oral mucosa, smarting of the tongue and xerostomia were reported by 26, 21 and 24 patients, respectively, and 30 patients reported an unpleasant taste, a metallic taste or a battery taste. The same patient often reported several symptoms. The patients also reported various general symptoms, above all joint symptoms, pain in the back, neck and shoulders and general muscular pain but also tiredness, weakness, difficulty in concentrating, depression and insomnia. After clinical and radiological examination, salivary tests, determination of the maximum galvanic current at metallic contacts and screening for contact allergy to dental materials, various oral diagnoses could be established. Most of the patients exhibited functional disturbances of the masticatory system, periodontitis, smarting of the oral mucosa, xerostomia, pulpitis and pulpal necrosis and mucosal lesions. The medical illnesses the patients reported themselves to be suffering from or had been treated for included cardiovascular disorders, high and low blood pressure, asthma, rheumatic disorders, diabetes, pernicious anaemia, gastritis and peptic ulcer. Seventy-six patients took drugs regularly. In most cases there were several oral, dental and medical explanations for the symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Results obtained from patients referred for the investigation of complaints related to oral galvanism. 345 16

There has been an increase in mortality from asthma in the adolescent age group in the past several years. Although the exact cause of this is not known, a number of factors probably contribute. We have identified four areas of major concern which we believe place adolescents with asthma at high risk. These include physiological factors such as night-time worsening of disease (or "dipping"), non-compliance with the medical regimen, stress associated with daily living and parental expectation, and depression/suicide with asthma as the modality. Identification of those individuals who are at risk and intervention into the contributory factors may reduce asthma deaths.
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PMID:Sudden death in adolescent asthma. 350 4

Tracheal mucociliary clearance is governed by the interplay between ciliary activity and secretory functions of the epithelium. These functions are altered transiently by various physiologic and injurious stimuli, and chronically in asthma, chronic bronchitis, cystic fibrosis, and other forms of airway disease. In general, these conditions are associated with a depression in mucociliary clearance that may predispose to respiratory infections and the accumulation of secretions.
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PMID:Mucociliary clearance in the trachea. 352 72

Mechanisms which disturb mucociliary transport may act on the mucus, the ciliary action or both. Inflammation of the airways almost invariably induces reversible functional disturbances but can, in chronic diseases, also lead to irreversible morphological lesions. Infectious inflammation acts mainly through ciliostatic or cytotoxic effects on ciliated cells. Infections with rhinovirus, influenza virus A and M. pneumoniae may induce profound disturbances of the mucociliary system, with effects lasting up to 1 year. In non-infectious inflammation, the mucociliary system might be influenced by serum factors leaking through the bronchial wall, by inflammatory cells such as granulocytes and eosinophils, and by mediators released from mast cells. In a very early phase of the acute allergic reaction in bronchial asthma, these mediators are responsible for an acceleration of mucus transport, which is followed by a long-standing depression mainly due to the production of highly viscous mucus. Any positive therapeutic effects resulting from drug administration can only be achieved in early phases of the disease, before irreversible morphological lesions have occurred.
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PMID:Mucus transport and inflammation. 353 95


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