1/65. 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 = 1keywords = anxiety (Clic here for more details about this article) |
2/65. 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 = 0.37118103398072keywords = neurotic (Clic here for more details about this article) |
3/65. 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 = 0.00020575190737002keywords = state (Clic here for more details about this article) |
4/65. 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 = 0.00010287595368501keywords = state (Clic here for more details about this article) |
5/65. 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 = 0.00010287595368501keywords = state (Clic here for more details about this article) |
6/65. Psychosomatic disorders in pediatrics.Psychosomatic symptoms are by definition clinical symptoms with no underlying organic pathology. Common symptoms seen in pediatric age group include abdominal pain, headaches, chest pain, fatigue, limb pain, back pain, worry about health and difficulty breathing. These, more frequently seen symptoms should be differentiated from somatoform or neurotic disorders seen mainly in adults. The prevalence of psychosomatic complaints in children and adolescents has been reported to be between 10 and 25%. These symptoms are theorized to be a response to stress. Potential sources of stress in children and adolescents include schoolwork, family problems, peer pressure, chronic disease or disability in parents, family moves, psychiatric disorder in parents and poor coping abilities. Characteristics that favour psychosomatic basis for symptoms include vagueness of symptoms, varying intensity, inconsistent nature and pattern of symptoms, presence of multiple symptoms at the same time, chronic course with apparent good health, delay in seeking medical care, and lack of concern on the part of the patient. A thorough medical and psychosocial history and physical examination are the most valuable aspects of diagnostic evaluation. Organic etiology for the symptoms must be ruled out. Appropriate mental health consultation should be considered for further evaluation and treatment.- - - - - - - - - - ranking = 0.18559051699036keywords = neurotic (Clic here for more details about this article) |
7/65. A case study of neurosis secondary to trauma in an eight-year-old girl. Comments on the tendency for psychogenic illness to become chronic.This case study deals with an eight-year-old girl who developed persistent abdominal pain and vomiting for which no physiological cause could be discovered. After two months of unsuccessful treatment for her illness, the girl was referred for a psychiatric consultation. During the psychiatric interview, the psychogenic nature of the girl's illness became readily apparent, as did the nature of the conflict which had produced it. The tendency is strong for psychogenic illness, such as this, to become chronic without psychiatric treatment. Many physicians are reluctant to apply clinically basic psychiatric techniques to the treatment of physical illness. A suggestion is made that closer collaboration between psychiatry and other medical specialties could be of great value in preventive medicine.- - - - - - - - - - ranking = 0.88058708628086keywords = neurosis (Clic here for more details about this article) |
8/65. dermatitis artefacta. case reports.patients who seek care for foot problems may present to the podiatrist with concurrent problems, such as anxiety, depression, phobias, personality disorders, and psychoses. These may or may not have any direct relationship to the pathogenesis of the foot problem. The podiatrist may learn of the presence of an emotional problem directly from the patient or from a family member. In many cases, the patient may be unaware or deny the presence of an emotional problem, leaving the podiatric physician in the dark about the patient's mental health state or its implications for the management of the skin problem. In a review of the psychosomatic aspects of dermatology, Koblenzer offered a working classification of the psychodermatoses. This is helpful to the podiatrist in recognizing those dermatologic disease states in which the various aspects of the individual participate in the disease, signs and symptoms of the disease, and the potential psychological value of the disease for the patient. It is also helpful to the podiatrist for recognizing those dermatoses in which psychiatric consultation may be useful so that recognition, treatment, improvement, and perhaps cure may be effected quickly.- - - - - - - - - - ranking = 0.3335390852407keywords = anxiety, state (Clic here for more details about this article) |
9/65. psychophysiologic disorders in children and adolescents.Psychosomatic disorders in children and and adolescents is a topic that covers a wide variety of illnesses and one which is difficult if not impossible to define accurately. In general, chronic emotional states, often nonspecific, serve as strong contributors to the development of a physical illness. The particular illness is often dictated by varying degrees of biological predisposition in one physiological system-i.e., such a predisposition in the respiratory system may lead to asthma or in the gastrointestinal system to ulcerative colitis. In some cases the biological factor is large and the emotional factor minimal, while in other cases the reverse is true. In the early days of research in psychosomatic disorders it was widely believed that each disorder was accompanied by certain specific emotional problems. Further study has shown this is not true. It was also felt that many, if not most of these disorders could be cured by psychotherapy, and this also has proven to be a fallacy. we have moved more and more to the team approach. Since both psyche and soma are involved, more than one specialist is usually required. In children and adolescents this may involve a child psychiatrist, a pediatrician, an allergist or gastroenterologist, a social worker and a psychologist. It requires time and patience to form an effective and smoothly functioning team in which all members respect one another's potential contribution. Some examples of team operation are presented and some of the problems outlined. In addition, there is attention given to the special problems of the adolescent and also the child with chronic nonspecific physical complaints as well as the child who requires hospitalization.- - - - - - - - - - ranking = 0.00010287595368501keywords = state (Clic here for more details about this article) |
10/65. Central neurological abnormalities and multiple chemical sensitivity caused by chronic toluene exposure.multiple chemical sensitivity (MCS) is a syndrome in which multiple symptoms occur with low-level chemical exposure; whether it is an organic disease initiated by environmental exposure or a psychological disorder is still controversial. We report a 38-year-old male worker with chronic toluene exposure who developed symptoms such as palpitation, insomnia, dizziness with headache, memory impairment, euphoria while working, and depression during the weekend. Upon cessation of exposure, follow-up neurobehavioural tests, including the cognitive ability screening instrument and the mini-mental state examination, gradually improved and eventually became normal. Although no further toluene exposure was noted, non-specific symptoms reappeared whenever the subject smelled automotive exhaust fumes or paint, or visited a petrol station, followed by anxiety with sleep disturbance. During hospitalization for a toluene provocation test, there was no difference between pre-challenge and post-challenge PaCO(2), PaO(2), SaO(2) or pulmonary function tests, except some elevation of pulse rate. The clinical manifestations suggested that MCS was more relevant to psychophysiological than pathophysiological factors.- - - - - - - - - - ranking = 0.33343620928702keywords = anxiety, state (Clic here for more details about this article) |
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