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Background: Anorexia nervosa is a psychosomatic disorder and is commonly associated with impaired oral health. Dentists can play a relevant role in the early diagnosis of anorexia nervosa. With the help of intra- and extraoral examinations and anamnesis, the dentist can detect characteristic signs and symptoms of this eating disorder. The purpose of this study was to determine the knowledge regarding the oral and physical manifestations of anorexia nervosa among general dental practitioners and specialist dentists of Poland.Material and Methods: A pretested online questionnaire consisting of a first part asking for the characteristics of the participant and a second part with 22 specific questions on their general knowledge of anorexia nervosa and knowledge of physical and oral manifestations of this eating disorder was used.Results: A total of 369 dentists completed the questionnaire. The Polish dentists in this study reported sufficient knowledge regarding anorexia nervosa. However, younger dentists and general dental practitioners had relatively lower knowledge scores than other groups. The dentists mainly had difficulties with the oral symptoms of anorexia nervosa.Conclusion: Despite Polish dentists having sufficient knowledge about anorexia nervosa in relation to the general symptoms of anorexia, there are deficits with regard to oral manifestations. Therefore, there is a need to increase continuing education in this field, which can improve early diagnosis of this disease by dental practitioners and referral to specialists for treatment.

Migraine is one of the most frequent complaints in children and adolescents and it can have a significant impact on quality of life. There are several factors underlying the onset and the maintenance of this disorder and there is still no a clear etiopathogenesis common to all subjects suffering from migraine. Psychological factors such as individual characteristics, psychiatric comorbidities, and temperament are strictly related to psychosomatic disorders and to migraine. Also, the environmental influence is very relevant and studied: socio-economic status, family dysfunctions, attachment style, or psychiatric disease in parents can influence the onset of migraine in children. Finally, many studies are trying to find out any alteration in genetics or in cerebral areas or networks that can explain migraine vulnerability. In this review, we analyze the most recent findings on neurological, psychological, and environmental factors that may potentially cause migraine.

Background: Anorexia nervosa (AN) is a serious psychosomatic disorder with unclear pathomechanisms. Metabolic dysregulation is associated with disruption of redox homeostasis that might play a pivotal role in the development of AN. The aim of our study was to assess oxidative status and carbonyl stress in plasma, urine and saliva of patients with AN and healthy controls. Methods: Plasma, spot urine, and saliva were collected from 111 girls with AN (aged from 10 to 18 years) and from 29 age-matched controls. Markers of oxidative stress and antioxidant status were measured using spectrophotometric and fluorometric methods. Results: Plasma advanced oxidation protein products (AOPP) and advanced glycation end products (AGEs) were significantly higher in patients with AN than in healthy controls (by 96, and 82%, respectively). Accordingly, urinary concentrations of AOPP and fructosamines and salivary concentrations of AGEs were higher in girls with AN compared with controls (by 250, and 41% in urine; by 92% in saliva, respectively). Concentrations of thiobarbituric acid reactive substances (TBARS) in saliva were 3-times higher in the patients with AN than in the controls. Overall antioxidants were lower in plasma of girls with AN compared to the controls, as shown by total antioxidant capacity and ratio of reduced and oxidized glutathione (by 43, and 31%, respectively). Conclusions: This is the first study assessing wide range of markers of oxidative status in plasma, urine and saliva of the patients with AN. We showed that both, higher levels of markers of oxidative stress and lower antioxidants play a role in redox disruption. Restoration of redox homeostasis might be of the clinical relevance © 2021, The Author(s)., 2018/36-LFUK-10 Ministerstvo školstva, vedy, v?skumu a športu Slovenskej republiky: 1/0613/17, This study was supported by the Grant of Ministry of Health of the Slovak republic 2018/36-LFUK-10 and by the Grant Agency of Ministry of Education, Science, Research and Sport of the Slovak Republic VEGA 1/0613/17.

Unnmad is one type of mansik-vyadhi which is most common form of mental disorder. Unnmad can be co –related with Attention deficit hyperactivity disorder (ADHD). Today’s modern era day to day psychosomatic disorder affected children are increased in pediatric clinics, out of that Attention deficit hyperactivity disorder (ADHD) one of them. Due to increased distractibility and difficulty sustaining attention; poor impulse control and decreased self-inhibitory capacity; and motor over activity and motor restlessness. etc leads to this disease. Attention Deficit Hyperactivity Disorder (ADHD) neurobehavioral disorder of childhood and one of among the most prevalent chronic health conditions affecting school-age children. In modern medicine except presynaptic dopaminergic agonists, there is no other treatment for this disease While traditional life science Ayurveda has most effective solution over this. The present article is an attempt to highlighting on details of unnmada with co-relating with ADHD.

Social problems in primary care Objectives: Social problems appear in clinical work as well as in expert opinions for courts and insurances as a major factor in frequently chronic psychosomatic diseases, both in the professional and private environment. On the assumption that unemployed individuals show a higher risk for the development of mental and psychosomatic diseases, we investigated our hypothesis that mostly social issues lie at the center of patients' motivation for consultations. METHODS Our questionnaire was dispatched by the Medical Association of Mecklenburg-Vorpommern (MV) to all established general practitioners in that state (n = 1025). It collected information on how social problems were handled in primary-care practices. RESULTS The large majority of social problems in MV arise from unemployment and job-related conflicts. Doctors often evaluate these problems using pathological dimensions (medicalization) and provide certificates of disability as a "dysfunctional" approach to the problem. CONCLUSIONS The medicalization of social problems indicates a lack of alternatives in our medical system and highlights the inadequate handling up to early retirement based on dysfunctional behavior (incorrect diagnosis, certificate of disability).

Psychosomatic disorder is a condition in which psychological stresses adversely affect physiological (somatic) functioning to the point of distress. It is a condition of dysfunction or structural damage in physical organs through inappropriate activation of the involuntary nervous system and the biochemical response. In this framework, this review will consider anxiety disorders, from the perspective of the psychobiological mechanisms of vulnerability to extreme stress in severe chronic illnesses. Psychosomatic medicine is a field of behavioral medicine and a part of the practice of consultation-liaison psychiatry. Psychosomatic medicine in palliative care, integrates interdisciplinary evaluation and management involving diverse clinical specialties including psychiatry, psychology, neurology, internal medicine, allergy, dermatology, psychoneuroimmunology, psychosocial oncology and spiritual care. Clinical conditions where psychological processes act as a major factor affecting medical outcomes are areas where psychosomatic medicine has competence. Thus, the psychosomatic symptom develops as a physiological connected of an emotional state. In a state of rage or fear, for example, the stressed person's blood pressure is likely to be elevated and his pulse and respiratory rate to be increased. When the fear passes, the heightened physiologic processes usually subside. If the person has a persistent fear (chronic anxiety), however, which he is unable to express overtly, the emotional state remains unchanged, though unexpressed in the overt behavior, and the physiological symptoms associated with the anxiety state persist. This paper wants highlight how clinical hypnosis and meditative states can be important psychosocial and spiritual care, for the symptom management on neuro-psychobiological response to stress.

Background - Psychosomatic health of adolescent girls at crossroads of childhood and mature adulthood, may lead to various health problems in future. To measure the prevalence and identify factors associated with psychiatric morbidity & psychosomatic symptoms among adolescent secondary school girls in Khartoum. Methods - This ‘Study’ was conducted, in three secondary schools of Khartoum North. The Simple Random Sampling Technique was applied to select three schools from the spot map of Khartoum North for this study, and 491 girl students in the adolescent age group were selected from the completed updated list of students from the enrollment registers in these schools. Results - according to the cut-off point (≥ 24 in the G.H.Q -28) findings showed that the prevalence of psychiatric morbidity (severe depression and anxiety) was 60.89% among the adolescent secondary school girls while the psychosomatic disorder was 34.62%. The psychosomatic disorder was found to be significant (P0.05) relation between the fathers' level of education and the occurrence of psychosomatic however, the odds ratio of disease is 28% higher among the girls whose fathers were illiterate in comparison to the girls whose fathers were of high level of education. among adolescent school girls.

Stress, depression, mental illness are serious problems but the most often overlooked problems. Ironically, the number of mental problems is greater than health services. The purpose of this study is to develop a system consisting of Admin Webpage and Android Application which analyze mental illness with artificial intelligence that can diagnose and carry out therapy for people with mental disorders which has the types of psychoneurosis and psychosomatic disorders. This research used the methodology of Modified Backward Chaining which works backward towards the initial condition of the patient. Moreover, the system used the Expert System as reference data from the expert, in this case, psychologist. Results could be diagnosed via smartphone by a doctor or expert so they could provide faster and easier treatment in accordance with the application of this Psychological PPD (Psychoneurosis and Psychosomatic Disorders). Finally, the application was successfully implemented to give diagnoses and treatments. The system's ability to deal with mental illness was carried out at Raden Mataher General Hospital, Jambi, Indonesia. This study consisted of 21 respondents consisting of 13 men and 8 women. The result showed that the application was tested Usability Testing which had score 4.22 of 5.

Background Seborrheic dermatitis is a skin disease in which psychological factors play a central role in its onset, exacerbation and remission. Objective The aim of this study was to investigate personality traits and common psychiatric conditions in patients with SD. Methods Outpatients who were admitted to the Bozok School of Medicine Department of Dermatology complaining of SD and who volunteered for study were included. Symptom Checklist 90 – Revised (SCL-90-R) and Eysenck Personality Questionnaire – Revised Short Form (EPQ-RSF) were administered before treatment to 50 patients who fulfilled the criteria for inclusion in the study. Results compiled from the 50 subjects were compared to a control group that was comprised of 50 healthy volunteers. Results Of the 50 patients that were included in the study, 25 were female and 25 were male. The Global Symptom Index (GSI; Z = -6.96, P < 0.001), Somatization (Z = -6.59, P < 0.001), Depression (Z = -7.11, P < 0.001), and Anxiety (Z = -6.64, P < 0.001) subscales of the SCL-90-R were evaluated. Statistically significantly higher scores were obtained from patients with SD in comparison with the control group on all of these subscales. In addition, the EPQ-RSF Neuroticism subscale was statistically significantly higher (Z = -4.99, P < 0.001) in patients with SD. Discussion Our results showed that common psychiatric conditions are considerably frequent in SD patients. More importantly, neurotic personality characteristics were much more frequent in these patients. These findings suggest SD to be a psychosomatic disorder that requires a multi-disciplinary approach.

This study is investigating the impact of “Philosophy for Children” Program on the reduction of the symptoms of psychosomatic disorders in children aged 9 to 11 years in Iran. The sample of the study consists of 45 primary school boy students who were randomly selected using multistage random cluster sampling from among 19 districts of Education. This is a Quasi-experimental method research with experimental and control groups. Research tool in this study was Achenbach questionnaire form YSR (Youth Self-report). At first, using this questionnaire, all third and forth graders in two schools were selected by screening in which 45 ones got a score which showed psychosomatic disorders that all of them were eager to take part in the study. The test group, during a 12 sessions in a week, for 1 hour, participated in community of philosophical inquiry-the method of “Philosophy for Children” Program-with a training coach. After the end of the sessions, Achenbach’s re-test, on both control and test groups, was taken to determine the effect of holding the “Philosophy for Children” Program on psychosomatic disorders. The results of this study showed that the implementation of this program has a significant effect in reducing symptoms of psychosomatic disorder of test group.

Background: Adolescent age group needs special attention because this period is very crucial since these are the formative years in the life of an individual when major physical, psychological and behavioral changes take place. This study was undertaken to understand the different issues relating to sexual, reproductive and mental health among adolescent health in South Goa. The aim and objective of the study was to know the pattern of menstruation among adolescent girls, to study reproductive health issues among adolescent girl and to study their selected mental health issues. Methods: This cross sectional study was conducted among adolescent girls from higher secondary schools in South Goa. The students selected by simple random sampling method were interviewed by using a pre-planned, pretested and structured questionnaire. Results: Mean age of menarche of study participants was 12.73 years. 36.7% had moderate to severe dysmenorrhea. Among the study participants 18.7% had burning sensation during urination, 27.9% had itching in the groin or vulva and 19.1% had abnormal vaginal discharge. 44.4% of the adolescents had feelings of anxiety, sadness, anger, irritability or stress. The most common symptom suggestive of psychosomatic disorder was significantly less or more sleep. 48 to 72% of study participants had different symptoms suggestive of depression. Conclusions: The study brings to focus various problems faced by adolescent girls in Goa. These problems need to be addressed urgently and in systematic manner so that these adolescents can have a healthy life as adults, free from reproductive and mental health issues.

A psychosomatic disorder involves both the body and mind. These diseases have physical symptoms originating from mental or emotional causes. Most common causes are stress, anxiety, and depression. When these psychological entities are not perceived properly, it may result in somatic disease due to conversion hysteria. Even the oral and paraoral structures show manifestations of these psychosomatic disorders. The present review has been done from text books and articles relevant to psychosomatic disorders. Relevant articles have been selected and filtered from databases using MeSH terms psychosomatic diseases, oral mucosal diseases, stress, etc., with boolean operators from 1990 till date. This review highlights the important aspects of the psychosomatic diseases affecting oral cavity.

In an effort to improve school performance, we have examined the effect of sleep–wake patterns, particularly time in bed, and morning psychosomatic conditions in adolescents. A psychosomatic disorder questionnaire was administered to 135 physically healthy students, who were divided into four groups according to time they went to bed: 23–24, 24–01, 01–02 and 02–03 h. (1) The 23–24 and 24–01 h groups had significantly higher grade point averages than the 02–03 h group. (2) Partial correlations, controlling for sleep quality, revealed significant associations between time to bed and psychosomatic disorder, with regard to whole-body fatigue, lack of motivation and the desire to rest. Our results suggest that the sleep–wake pattern, especially the time of retiring, may predict academic performance and psychosomatic disorder.

Objectives There is evidence that menopausal symptoms manifested at peri-menopause occur less frequently when compared to the symptoms experienced at post-menopause. The aim of this study was to investigate this and to test the hypothesis that depressive symptomatology mediates the relationship between menopausal stage and symptom frequency. Methods This cross-sectional study included 213 women (M age = 52 years), of whom 125 were peri- and 88 post-menopausal. Measures comprised the Center for Epidemiologic Studies-Depression scale (CES-D) and the Women's Health Questionnaire (WHQ) vasomotor symptoms and somatic symptoms subscales. Results Multiple mediated regression analyses provided evidence that somatic symptoms and vasomotor symptoms were less frequent at post- compared to peri-menopause, and that these differences were mediated by depressive symptomatology. Multivariate effect sizes ranged from small to moderate, and univariate effect sizes were uniformly small with wide confidence intervals. Conclusions The frequency of vasomotor and somatic symptoms appears to increase with depressed affect. The management of symptoms could include interventions of a psychotherapeutic nature, which may offset this effect, particularly in women for whom depressive symptoms are a feature of the climacteric syndrome. The extent to which depression and the climacteric syndrome may be causally related to one another remains unclear and longitudinal research should further examine the mechanisms of this association.

Objective The authors review the literature on two dramatic psychosomatic disorders of reproduction and offer a potential classification of pregnancy denial. Method Information on false and denied pregnancies is summarized by comparing the descriptions, differential diagnoses, epidemiology, patient characteristics, psychological factors, abdominal tone, and neuroendocrinology. Pregnancy denial's association with neonaticide is reviewed. Results False and denied pregnancies have fooled women, families, and doctors for centuries as the body obscures her true condition. Improvements in pregnancy testing have decreased reports of false pregnancy. However, recent data suggests 1/475 pregnancies are denied to 20 weeks, and 1/2455 may go undiagnosed to delivery. Factors that may contribute to the unconscious deception include abdominal muscle tone, persistent corpus luteum function, and reduced availability of biogenic amines in false pregnancy, and posture, fetal position, and corpus luteum insufficiency in denied pregnancy. For each condition, there are multiple reports in which the body reveals her true pregnancy status as soon as the woman is convinced of her diagnosis. Forensic literature on denied pregnancy focused on the woman's rejection of motherhood, while psychiatric studies have revealed that trauma and dissociation drive her denial. Conclusions False pregnancy has firm grounding as a classic psychosomatic disorder. Pregnancy denial's association with neonaticide has led to misleading forensic data, which obscures the central role of trauma and dissociation. A reappraisal of pregnancy denial confirms it as the somatic inverse of false pregnancy. With that perspective, clinicians can help women understand their pregnancy status to avoid unexpected deliveries with tragic outcomes.

Podría decirse que una de las pocas cualidades comunes a todos los seres humanos es la capacidad de apreciar la belleza. Si bien, es cierto que el objeto considerado como bello cambia de una persona a otra, la admiración y profunda emoción que experimenta un espectador en trance, es la misma. En ocasiones, esta experiencia puede llevar una persona hasta el borde mismo de la existencia. Una condición muy rara, conocida como síndrome estético, y en algunos casos, síndrome de Stendhal, comprende un cuadro clínico en el que la presencia de una magnífica y bella pieza de arte o arquitectura, produce síntomas disautonómicos como taquicardia, diaforesis, dolor torácico y pérdida de la consciencia. Presentamos aquí una revisión clínica e histórica de esta condición. It could be argued that one of the few unifying qualities all human beings share is the ability to appreciate beauty. While the object of beauty may change from one person to another, the awe and the thrill experienced by an enthralled beholder remains the same. Sometimes, this experience can be so overwhelming it can bring someone to the edge of existence. A very rare condition, known as aesthetic syndrome and, more commonly, Stendhal syndrome, entails a clinical phenomenon in which the presence of a beautiful piece of work or architecture causes dysautonomic symptoms such as tachycardia, diaphoresis, chest pains and loss of consciousness. We present an historical and clinical review of this condition. © 2018, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.

New research has brought to light thatis a psychological disorder as well as an organic affliction. Indeed, it would now seem that it is an extremely psychosomatic disorder with psychological aspects weighing heavily in conditioning the onset of the pathology, with sudden restrictions in consumption and a rapid decrease in weight. Over time, this will end in a state of malnutrition and loss of personal control over the situation, together with the onset of phobic fears and the exacerbation of obsessive-compulsive disorders relating to food and the possibility of getting fat.

Psychosomatic health of adolescent girls at crossroads of childhood and mature adulthood, may lead to various health problems in future. To measure the prevalence and identify factors associated with psychiatric morbidity and psychosomatic symptoms among adolescent secondary school girls in Khartoum. This ‘Study’ was conducted, in three secondary schools of Khartoum North. The Simple Random Sampling Technique was applied to select three schools from the spot map of Khartoum North for this study, and 491 girl students in the adolescent age group were selected from the completed updated list of students from the enrollment registers in these schools. according to the cut-off point (≥ 24 in the G.H.Q-28) findings showed that the prevalence of psychiatric morbidity (severe depression and anxiety) was 60.89% among the adolescent secondary school girls while the psychosomatic disorder was 34.62%. The psychosomatic disorder was found to be significant (P 0.05) relation between the fathers' level of education and the occurrence of psychosomatic however, the odds ratio of disease is 28% higher among the girls whose fathers were illiterate in comparison to the girls whose fathers were of high level of education. among adolescent school girls.

ADHD is a complex neurobehavioral psychosomatic disorder, which affects millions of children and often persists into adulthood. According to the 4th edition, American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV criteria), the core symptoms of ADHD are 1) inattention 2) hyperactivity and 3) impulsivity. In Ayurveda it occurs due to vibramsha of Dhee (rational thinking), Dhriti (intellect / retaining power of the mind), Smriti (memory) which results into improper contact of the senses with their objectives and give rise to inattention, hyperactivity and impulsivity. In modern sciences, treatment predominantly relies on prescribing stimu­lant medications and psychosocial therapy. Stimulant drugs used to treat ADHD are associated with side effects like cardiovascular events etc. Therefore Ayurvedic literature explains many treatment modalities which are safe and effective in various disorders, among which Shirodhara (Takra processed with Brahmi, Jatamamsi, Vacha and Aswagandha) is a procedure which is widely used in psychosomatic disorders and there is a need to standardize this procedure as a safest treatment in children. Hence an effort is made to study the effect of Takradhara in Attention- Deficit Hyperactivity Disorder.So to evaluate the effect of Takradhara in ADHD, 40 children aged 7 – 12years who were fulfilling the inclusion criteria and diagnostic criteria were selected from Kaumarabhritya OPD and IPD of S.V.Ayurvedic College & Hospital, Tirupati. Takradhara was done for 14 days and then again repeated after every two months for 3 consecutive sittings. The cases were recorded as per the case sheet and observations were recorded. Symptoms were scored and statistically analyzed for any change before and after treatment. In the group statistically highly significant change (p =

Due to civil wars, violence and persecutions, between 2015 and 2016, more than 1.4 million people, from the Middle East and Africa, fled their counties and migrated to Europe. The vast majority of migrants, who have already experienced enormous level of stressors, are faced with dangerous, often lethal, migratory journeys. Those who survive are exposed to adaptation stressors such as different languages, isolation, lack of work opportunities, diminished social status and a sense of failure in the new countries of residence. These are stressors that go far beyond the usual adaptation stresses to new cultures and migrants experience permanent crises with an imminent risk of developing the "Ulysses syndrome". As a consequence, many individuals often develop symptoms such as irritability, nervousness, migraine, tension headache, insomnia, tiredness, fear, loss of appetite and generalized ill-defined discomfort. If left untreated these symptoms, originally described by Hofer in the 17th century, may degenerate into a severe psychosomatic disorder leading to reactive depression. Here we expand the concept of Ulysses' syndrome and illustrate new initiatives aimed at reducing the level of stressors in migrants and at promoting their successful integration in their new countries.

SummaryAccording to population-based studies, the prevalence of feelings of heaviness, swelling and pain in the legs is around 50 %. These feelings are often not accompanied by clinically detectable changes, but are the inevitable and generally unrecognised consequences of the increase in leg volume caused by standing still. We assume that the physiological change is detected as part of the constant information about the internal milieu that is sent to the corresponding centres in the brain. This information is modified by many factors, including emotion and – depending on the situation – is either appropriately perceived as an unpleasant sensation of swelling or not even noticed. These feelings can result in an impairment of vitality and depression. In some cases, a thorough phlebological work-up can reveal an occult organic venous disease, so that the feelings can be traced to a somatic cause. Feelings have a psychological and a somatic component; they are not imaginary. It is up to the doctor to discern the individual importance of the two components and to draw the appropriate conclusions regarding treatment.

See related article, pp 824–832 Hypertension has long been suspected of being, in some patients, a psychosomatic disorder. The impact of daily exposure to life stresses, to anger, or to anxiety on high blood pressure has been studied for decades, but these works showed inconsistent results and, as such, mostly failed to confirm the underlying hypotheses.1 Nevertheless, the role of 2 specific psychological impairments in the development of hypertension is supported by stronger evidence and, as such, deserves further investigation: the repression of the expression of affects2 and the exposure to intensely traumatic life events.1 In particular, posttraumatic stress disorder (PTSD) has been associated with an increased risk of hypertension in a nationally representative US population sample of 4008 subjects (odds ratio, 2.6–2.9 according to the model),3 and cohorts of 303 223 (odds ratio, 1.6–2.9)4 and 194 319 (hazard ratio, 1.1–1.3) US veterans deployed in Iraq and Afghanistan.5 On the other hand, in 3846 wounded US military service members, Stewart et al6 reported increased incidence rates of hypertension (from 6% to 15%) according to the degree of severity of the initial injury. In the current issue of Hypertension , Howard et al7 provide further insights into the …

Psychosomatic or somatoform disorders are among the most common psychiatric disorders found in general practice. A psychosomatic disorder involves both body and mind. These diseases have physical symptoms originating from mental or emotional causes. Most common ones are stress, anxiety and depression. A wide spectrum of psychiatric disorders may influence the orofacial region, where unfortunately they remain unrecognized due to limited nature of their presenting features. We here present a case report of atypical odontalgia in an elderly male secondary to underlying psychological distress.

Human ejaculation happens in the orgasmic phase of the human sexual response cycle. Among psychosomatic ejaculatory disorders that may happen before ejaculation, we present two cases of preejaculatory illness syndrome. The two cases shared common symptoms of sympathetic over activity, the sensation of impending death, and muscle atonia with subsequent failure to ejaculate. Depression, anxiety disorders, and family histories of psychiatric problems were noticed as risk factors. Medical conditions that may lead to panic attack type symptoms were eliminated before the final diagnosis. After the failure of empirical medications, symptoms became controlled with fluoxetine. Patients reported a recurrence of the symptoms on trying to stop the prescribed medication. On the last follow-up, they still take fluoxetine on a regular base with satisfactory sexual life.

Pain has several causes. It can be caused not only by operative trauma or cancer. Some patients suffer from pain as a result of being victims of violence. The aim of the study was to introduce diagnosis and treatment of pain problems in patients who are victims of violence, from a physician’s and a psychologist’s common perspective. Physical pain-related primary effects experienced by the victims of domestic violence go far beyond the results which are noticeable directly and confirmed visually in a forensic examination. In the present paper we introduce an ‘invisible’ group of secondary effects of violence. They appear in time, often after several years, in the form of a variety of psychosomatic disorders. The body is devastated insidiously and the secondary effects are visible as vegetative symptoms, a variety of psychosomatic disorders and pain, difficult to diagnose and treat.

During the past one to two decades, practicing physicians and clinical researchers have shown an increasing interest in the psychogenic factors (especially chronic anxiety) that contribute to the development of emotional behavior disorders and anthropogenic occupational malfunctions. A comprehensive medical psychological assessment of 80 patients with high levels of predominantly deep-seated anxiety who had various (mainly indirect) complaints of the overall state of health and inadequate professional capacity was conducted. It has been found that the pathogenic effect of anxiety on the neuropsychological function increases with age and leads to professional failures and arterial hypertension and other psychosomatic dysfunctions (mainly in men prone to psychological suppression and ignoring anxiety). From a psychoprophylactic perspective (considering Leonhard’s personality accentuations), chronic anxiety demands comprehensive medical-psychological care in a timely manner.

Students suffering from subjective psychosomatic disorder often have basic lifestyle problems. We examined 30 healthy students aged 21–22 years old. Salivary samples were collected from the subjects at home five times per day (20:00, 24:00, 04:00, 08:00 and 12:00 h). We assessed melatonin secretion patterns by fluorescence enzyme immunoassay and cortisol secretion by ELISA. We assigned the subjects to regular, semi-regular and irregular circadian rhythm groups based on whether melatonin secretion was high until midnight. A self-assessment questionnaire addressing psychosomatic disorder was completed by the same students. The subjects rated their psychosomatic symptoms twice per day (08:00 and 20:00 h). The irregular group showed lower cortisol awakening response, but high cortisol concentrations at 12:00 h; this group also reported more subjective health complaints related to psychosomatic stress compared with the regular group. Our findings suggest that psychosomatic disorder is associated with circadian...

Postdoctoral Researcher, Finnish Centre of Excellence in Philosophy of the Social Sciences, Department of Politics and Economic Studies, Helsinki University, Helsinki, Finland Research and Teaching Associate, Department of History and Philosophy of Science, University of Cambridge, Cambridge, UK Socrates Professor in Philosophy and Technology and the Humanist Tradition, Technical University Eindhoven, Eindhoven, The Netherlands

The incidence of mental health disorders is significantly higher in individuals with a rare disease, compared to the general population. This letter considers the possible reasons for this in terms of the many ways in which a rare disease impacts on an individual’s life, and how these impacts can be strongly related to factors which predispose to mental health difficulties. Furthermore, issues surrounding mental health can also play a significant role in the process of diagnosing a rare disease. The unusual nature of such diseases intrinsically predisposes an individual to obtain an inaccurate diagnosis of a psychosomatic disorder, a diagnosis which can often be further complicated by the presence of genuine psychiatric symptoms. This letter argues that these common experiences of rare disease patients have impacts upon the way in which their psychiatric care should be offered and managed, and that sensitivity and understanding surrounding these issues should be considered a necessary part of effective care for rare disease patients.

It is well documented that headache is a multifactorial disorder which includes not only genetic, biological, medical and neuropsychological factor but also psychological and personality traits. The close relationship between stress and migraine attacks and the significant psychiatric comorbidities in migraine provide evidence of a "paradigm" of tight interaction between somatic and psychological aspects in paediatric migraine. In particular in younger children, an uncomfortable situation, a psychological problem or an emotional distress is rarely expressed directly but usually through physical symptoms. So migraine may be considered as a disorder of psychobiological adaptation in which genetic predisposition interplays with internal and/or external environmental influences such as psycho-emotional, climatic, hormonal, dietary or other factors.

To determine whether obstructive sleep apnea mediates the relationship between posttraumatic stress disorder (PTSD) and psychosomatic and somatic disorders and its implications for self-rated health (SRH) among Iraqi immigrants in the United States.A random sample of immigrants who had left Iraq before the 1991 Gulf War (n = 145) or after (n = 205) and are residing in metropolitan Detroit responded to a structured interview covering questions on sociodemographics, premigration trauma, SRH, physician-diagnosed and -treated obstructive sleep apnea, somatic disorders, and psychosomatic disorders. Structural equation modeling was used to evaluate the relationship between premigration trauma scores and health, as well as to explore mediating pathways between PTSD, obstructive sleep apnea, and health.The prevalence of obstructive sleep apnea among post-Gulf Warimmigrants (30.2%) was significantly higher than among pre-Gulf War immigrants (0.7%; p.001). Premigration trauma scores were positively associated with depression and PTSD. Structural equation modeling supported a model in which obstructive sleep apnea mediated the relationship between PTSD and psychosomatic and somatic disorders. Premigration trauma also related directly to SRH.Part of the PTSD-associated adverse health effects observed in Iraqi immigrants is mediated by obstructive sleep apnea. Because sleep apnea in the current study is based on medical history and current treatment, there is a need for future confirmatory polysomnographic studies.

Aim. To identify the features of etiopathogenesis of somatoform and psychosomatic disorders in adolescents. Methods. Examined were 426 adolescents and their families. The main group - 321 patients of the Kirov City Children’s Clinical Hospital, which included two subgroups: 117 adolescents with somatoform autonomic dysfunction, and 204 - with psychosomatic disorders; the mean age was 15.1±1 years. The control group consisted of 105 adolescents who were students of secondary schools in the city of Kirov with the first group of health; the mean age was 15.1±1 years. The clinical-psychopathological method of investigation, questionnaire surveys, and experimental psychological tests were used in order to perform the study. Results. The conducted study confirms the multifactor nature of the pathogenesis of psychosomatic disorders (identified was the importance of biological, psychological and social factors) and makes it possible to suggest that the onset of symptoms of psychosomatic disorders is formed according to the main stages of the nonspecific response to stress, from the autonomic neurotic reactions during somatoform autonomic dysfunction (at the stage of resistance) to the development of the psychosomatosis picture - during the development of psychosomatic disorders (at the exhaustion stage). The level of disease development is determined by both the individual predisposition and the spectrum of adaptive responses to stress. All this confirms the need for earliest detection of somatoform autonomic dysfunction in order to prevent the development into a chronic process and its progression. Conclusion. Complex treatment is of great importance, including the personal-oriented psychotherapy aimed at the development of adaptive mechanisms for coping with stress.

Stress has long been recognised to be associated with asthma. Hippocrates stated that to prevent an asthma attack “the asthmatic should guard himself against his own anger” 1. Maimonides in his treatise of asthma suggested that “mental anguish, fear, mourning or distress” may cause asthma whereas “gaiety and joy” which “gladden the heart and stimulate the blood and mental activity” may have the opposite effect 2. In his treatise, H.H. Salter wrote that “asthma is essentially, and with perhaps the exception of a single class of cases, exclusively a nervous disease; the nervous system is the seat of the essential pathological condition” 3, and W. Osler referred to asthma as “a neurotic affection” 4. Thus, until the second half of the 20th century, asthma was predominantly viewed as a psychosomatic disorder in which emotional stress and imbalances in the nervous system were key factors in its aetiology. As a result, relief of anxiety was considered the main therapeutic intervention for “asthma nervosa”; as it has been referred to historically. Although the increased awareness in the second half of the 20th century of other triggers of asthma (allergens and air pollution) has shifted the focus away from psychosocial factors, these old concepts are going through a renaissance, with an increasing number of publications reporting consistent positive associations between psychosocial stress and asthma. Associations with asthma have been shown for a wide range of stressors including: post-traumatic stress disorder (PTSD) 5, 6; psychiatric disorders 7, 8; community violence 9; stressful life events 10; partner violence and housing quality 11; war-related stress 12; neuroticism and relational problems 13; perceived safety 14; social depravity and high crime rates 15; anxiety and attention disorders 16; psychological distress 17; …

Objective The development of somatoform illnesses is often associated with prior psychiatric illness and life stress. Broken heart syndrome has been associated with a range of stressors and we aimed to investigate if psychiatric illnesses are risk factors for developing broken heart syndrome. Methods We systematically assessed for antecedent psychiatric risk factors in two groups of cases (people who developed sporadic and earthquake-related broken heart syndrome) and compared them to a control group of healthy volunteers. Results We found that of the ten psychiatric risk factors examined, only ‘neuroticism’ significantly differed between participants with broken heart syndrome and healthy volunteers. Conclusion There was no association between previous psychiatric illness and development of broken heart syndrome in this study. Clinical assessment of psychiatric risk factors may not identify patients at increased risk of broken heart syndrome.

PURPOSE: The purpose of this study was to explore status and relationships of anger and its expression type to biopsychosocial health in Korean adolescents. METHODS: This cross-sectional study used four reliable survey questionnaires that measure anger, depression, resilience, and psychosomatic symptoms. Data were collected from 18,752 students of 36 middle schools and 23 high schools located in 23 administrative districts in Seoul, Korea. RESULTS: The Korean adolescents who completed the questionnaires indicated moderate level of trait anger. 45% of them demonstrated using one of three undesirable types of anger expression such as dysfunctional anger-in and anger-out, high level anger-in, or high level anger-out. Also, level of trait anger and types of anger expression were significantly associated with resilience, depression, and psychosomatic health status. CONCLUSION: School-based mental health education such as anger management programs for Korean adolescents might be necessary to help them develop desirable and effective coping skills and strategies.

Fibromyalgia syndrome (FMS) is now understood as a chronic pain syndrome, and recent evidence indicates it is not a pure psychosomatic disorder. We review the current knowledge in FMS pain pathways, focusing on the central system sensitization phenomenon and the abnormalities in the inhibitory pain systems. Chronic headache is one of the most common symptoms in FMS, and better knowledge of their common pathophysiologic features can help us understand both conditions better. These features include the nerve growth factor actions and failure of the endocannabinoid system. In addition, we review new immunological aspects of FMS, both in their humoral (autoantibodies, antipolymer antibodies) and cytokine (interleukin-2) aspects.

Objective: : The effectiveness of use of migrant health educators in the general practitioners' care for female migrants with psychosomatic problems was evaluated to contribute to the improvement of the care for these patients. Methods: : A randomised controlled trial (RCT) design was used. A total of 104 patients (75%) agreed to take part in the intervention study. The patients were from Turkish and Moroccan immigrant groups living in The Netherlands. The intervention group received counselling and education from the migrant health educators as adjuncts to the GPs' care. Special attention was given to the patient's cultural background, supporting the communication between GP and patient. The control group received regular treatment from their GPs. Results: : A significant improvement of perceived general health, psychological health and reported ability to cope with pain was observed among the intervention group. No effects were found for social support and the perceived burden of stressful life-events. Conclusion: : The patients' perceived health and coping abilities improved through the intervention as a whole. Not all outcome measures had been affected due to among others the diversity of physical and psychological complaints the patients suffered from, non-compliance and a perceived decrease of disability over time. Practice implications: : The intervention methods should be integrated in the patient care delivery for migrants in general practice. Further development of intervention methods to address the patients' social support is recommended. © 2007 Elsevier Ireland Ltd. All rights reserved.

Introduction: psychodynamics disorders result in inabilities and abnormality of social and individual activities; which in fact lead to incoherency with the environment. In addition to physical symptoms, the disorders are featured with mental aspects that have great effects on personal life. Therefore, along with diagnosing and treating the disorders, a need to deal with the problems caused by the disorder through adopting proper treatments is felt. Methodology: the study was conducted by comparing the impact of hypnotism therapy, psychodynamics, and cognitive-behavioral treatments on some of the cognitive parameters such as anxiety and depression among women suffering from psychosomatic disorder (Migraine headache – vascular dilation). The study design was semi-experimental (pretest and posttest) with control group. Results: the results revealed that anxiety and depression level in the two treatment groups in posttest and follow up stages were significantly lower than those of the control group. In addition, in comparing the two treatment methods, hypnotism therapy psychodynamics led to more reduction in the psychological parameters after the treatments. Conclusion: both treatment methods led to reduction of depression and anxiety among women suffering from migraine headache. Moreover, hypnotism therapy psychodynamics were more influential in reducing the psychological parameters compared with cognitive-behavioral treatment. Results from follow up stage also uncovered that the two treatment methods had favored effects three months after the treatments. DOI: 10.5901/mjss.2015.v6n2s1p220

Phantom bite syndrome is characterized by an uncomfortable sensation mainly affecting corrected dentition in which no abnormality is clinically detectable. Despite repeated failures of dental surgery, sufferers persist in seeking bite correction from a succession of dentists. The etiology–pathogenesis of phantom bite is unknown but some consider the syndrome to be a psychosomatic disorder. Seven patients with this syndrome were treated with the serotonin and norepinephrine reuptake inhibitor milnacipran for 4 weeks. One patient withdrew after 2 weeks because he was feeling “well”. At the end of the study, 5 of the 6 patients completing the study reported significant improvements, with a mean decrease in occlusal discomfort of 55.3%, as indicated by a visual analogue scale. This result appeared to be independent of any antidepressant effect. Only minor and transient side-effects were observed. It is suggested that milnacipran may be a helpful treatment for phantom bite but this needs to be confirmed by further and longer term studies.

Psychosomatic diseases are the pathological expression of biological, psychic and social parameters of health and illness, whereas yogic approaches are ways to bind closely the normal interrelationship of above. Thus, the yoga, a mystic way of life, originated 2800 years ago in India and compiled comprehensively by Patanjali in the fourth century is remarkably vibrant, unique and successful in the management of psychosomatic diseases. Yoga therapy emphasizes self-regulation by patients and stresses the importance of somatopsychic functioning of the individual. The spiritual itinerary of yoga is discussed and emphasis is given to its use in these psychosomatic diseases where therapeutic effectiveness can be demonstrated logically and scientifically. Besides reviewing the recent researches of yoga therapy, particular effort is made to discuss its relationship to other therapies of psychosomatic diseases. Yogic approaches have been successfully used in the management of bronchial asthma, essential hypertension, mucous colitis, peptic ulcer, cervical spondylosis, chronic sinusitis, intractable pain, personality disorder, anxiety reaction, anxiety depression, gastritis and rheumatism.

Psychosomatic medicine is a way of approaching problem and health, and psychosomatic disorders in general are pathological expression of biological, psychological and socioecological parameters of human health and illness. Psychopharmacology, on the other hand, is one of the youngest and rapidly developing disciplines of treating agents and has become a widely used tool on psychosomatic medicine. The antecedents of psychopharmacology are many, such as biochemical, physiological, biophysical, psychological and, of course, clinical. These antecedents combine and run through the psychiatry and psychosomatic medicine to bind them, just like the psychosomatic medicine has become the binding force of biopsychosocioecological antecedents. Psychopharmacological agents most used in psychosomatic medicine are antidepressants, anxiolytic agents, hypnotics, antipsychotics, beta-blockers and mood stabilizers. As psychopharmacology is moving rapidly from empirical to rational, it is reflecting the path of understanding the mechanism of many psychosomatic disorders and a symbiosis is taking place between these two for bringing successful control or for curing psychosomatic sufferings. The holistic management of psychosomatic medicine requires the need to bring back suffering patients free from disorder, but with multiple modalities, including psychopharmacology, to enhance the quality of life to what it was before the illness started. Non-specific, more curative these agents will be, the more control over the abnormal biopsychosocioecological process will occur in human sufferers and the symbiosis of present will bind more firmly to psychosomatic disorder in future.

Although it has been fairly well established that symptoms of anxiety are often present in patients with irritable bowel syndrome (IBS), less is known about the role of worry and intolerance of uncertainty in this population. This study investigates the relations among these variables in a sample of treatment-seeking IBS patients. Although the results are preliminary, worry does seem to predict gastrointestinal symptom severity and, when combined with a measure of current anxiety, accounts for almost 30% of the variance. Intolerance of uncertainty differentiated diarrhea-predominant IBS patients from constipation-predominant IBS patients. Earlier research has taken a psychiatric perspective on anxiety in IBS patients-the current study may provide some support for shifting our focus to the cognitive biases that may be operating in IBS patients, regardless of the presence of an anxiety disorder. Implications for a cognitive therapy approach to IBS treatment are discussed. Keywords: irritable bowel syndrome; anxiety; worry; intolerance of uncertainty; cognitive treatment Anxiety is believed to play some role in the onset and/or maintenance (see Sykes, Blanchard, Lackner, Keefer, & Krasner, 2003) of irritable bowel syndrome (IBS), a functional disorder of the lower gastrointestinal (GI) tract. Patients with IBS experience recurrent abdominal pain and/or cramping that is accompanied by altered bowel habit (diarrhea, constipation, or both); these symptoms can create marked impairment in functioning and quality of life (Drossman, Corrazziari, Taller, Thompson, & Whitehead, 2000). Although GI symptoms have a high degree of instability, physicians can often classify their patients into one of three IBS subtypes: diarrheapredominant, constipation-predominant, and mixed type. Research studies rarely examine differences among these three groups of patients, which may partially explain the marked variability seen in IBS assessment and treatment outcome research. As IBS is a GI illness that has no known organic cause (and is therefore considered functional), it has commonly been thought of as a psychosomatic disorder. In support of this hypothesis are several studies that have shown that between 33% and 94% of IBS patients have a diagnosable psychiatric disorder (Blewett et al, 1996; Jarret et al, 1998; Lydiard, Fosset, Marsh, & Ballenger, 1993; for a summary see Blanchard, 2001). Further, although depression and somatization were also commonly diagnosed conditions within IBS patients, it is likely that between 4% and 60% of IBS patients meet criteria for a current anxiety disorder (Blanchard, 1990; Lydiard et al.; Folks & Kinney, 1992; Blanchard et al, 1990). Unfortunately, although most clinicians would agree that anxiety is an important component of an IBS patient's presentation, the measurement of such anxiety has resulted in inconsistent findings. When measured categorically (i.e., through DSM-III-R or DSM-IV diagnoses), IBS patients exhibit significantly higher rates of anxiety disorders than normal controls or individuals with inflammatory bowel disease (Blanchard, Scharff, Schwatz, Suis, & Barlow, 1990). On the other hand, when measured dimensionally, IBS patients, on average, suffer from only mild to moderate anxiety when measured by the State-Trait Anxiety Inventory (STAI; Speilberger, 1983; see Blanchard & Keefer, 2003). This is somewhat surprising, given the high rate of anxiety disorders seen in IBS patients. It is possible that measurement of anxiety by the STAI excludes some of the other components of anxiety that IBS patients may manifest. The most commonly diagnosed anxiety disorder among our IBS treatment-seeking population is Generalized Anxiety Disorder (GAD). GAD, a disorder characterized by chronic, uncontrollable worry and multiple CNS-mediated complaints, was found in 37% of our population in earlier research (Blanchard et al., 1990) and between 26% and 32% of our population more recently (Blanchard & Keefer, 2003; Sykes et al. …

Epilepsy is the most important neurological disorder which can produce psychiatric symptoms. Conventional antiepileptic drugs in the management of epilepsy intend to reduce the seizures but have no role in the management of psychiatric aspects of the disease. In Ayurvedic literature, ‘Apasmara’ has been mentioned as a psychosomatic disorder and ghrta has been held in high esteem for its beneficial effects in apasmara. Hence the present study was undertaken to estimate the prevalence of psychiatric symptoms in patients of apasmara and also to assess the effect of ‘Maha Kalyanaka Ghrta’ on those psychiatric symptoms. A total of 20 cases of apasmara were registered, among them 8 patients had symptoms related to one or more psychiatric components. To those 8 patients ‘Maha Kalyanaka Ghrta’ was administered for 90 days. The study showed that personality impairment was most predominant psychiatric symptom observed in patients of apasmara followed by symptoms related to anxiety. ‘Maha Kalyanaka Ghrta’ had very good effect in reducing the psychiatric symptoms by 57.22 % and 60.69 % at the end of 45 and 90 days of treatment respectively.

Bernardo Dell’Osso,1,2,* Umberto Albert,3,* Anna Rita Atti,4 Claudia Carmassi,5 Giuseppe Carrà,6 Fiammetta Cosci,7 Valeria Del Vecchio,8 Marco Di Nicola,9 Silvia Ferrari,10 Arianna Goracci,11 Felice Iasevoli,12 Mario Luciano,8 Giovanni Martinotti,13 Maria Giulia Nanni,14 Alessandra Nivoli,15,16 Federica Pinna,17 Nicola Poloni,18 Maurizio Pompili,19 Gaia Sampogna,8 Ilaria Tarricone,20 Sarah Tosato,21 Umberto Volpe,8 Andrea Fiorillo8 1Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy; 2Bipolar Disorders Clinic, Stanford Medical School, Stanford University, CA, USA; 3Rita Levi Montalcini Department of Neuroscience, University of Turin, Torino, 4Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, 5Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 6Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; 7Department of Health Sciences, University of Florence, Florence, 8Department of Psychiatry, University of Naples SUN, Naples, 9Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, Rome, 10Department of Diagnostic-Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, 11Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, 12Department of Neuroscience, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, 13Department of Neuroscience, Imaging, and Clinical Science, University G.d Annunzio, Chieti-Pescara, 14Section of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 15Psychiatric Institute, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy; 16Bipolar Disorder Unit, CIBERSAM, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain; 17Department of Public Health, Clinical and Molecular Medicine, Unit of Psychiatry, University of Cagliari, Cagliari, 18Department of Clinical and Experimental Medicine, Psychiatric Division, University of Insubria, Varese, 19Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’ Andrea Hospital, Sapienza University of Rome, Rome, 20Department of Medical and Surgical Sciences, Bologna University, Bologna, 21Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, Verona, Italy *These authors contributed equally as first authors Abstract: More than half a century after their discovery, benzodiazepines (BDZs) still represent one of the largest and most widely prescribed groups of psychotropic compounds, not only in clinical psychiatry but also in the entire medical field. Over the last two decades, however, there has been an increased focus on the development of antidepressants and antipsychotics on the part of the pharmaceutical industry, clinicians, and researchers, with a reduced interest in BDZs, in spite of their widespread clinical use. As a consequence, many psychiatric residents, medical students, nurses, and other mental health professionals might receive poor academic teaching and training regarding these agents, and have the false impression that BDZs represent an outdated chapter in clinical psychopharmacology. However, recent advances in the field, including findings concerning epidemiology, addiction risk, and drug interactions, as well as the introduction of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition with related diagnostic changes, strongly encourage an updated appraisal of the use of BDZs in clinical practice. During a recent thematic event convened with the aim of approaching this topic in a critical manner, a group of young Italian psychiatrists attempted to highlight possible flaws in current teaching pathways, identify the main clinical pros and cons regarding current use of BDZs in clinical practice, and provide an updated overview of their use across specific clinical areas and patient populations. The main results are presented and discussed in this review. Keywords: benzodiazepines, psychiatric clinical practice, teaching issues, risks and benefits