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Objective: The study examined whether psychiatric/psychosomatic rehabilitation continues to have a better course of treatment for women than men., Methods: We compared the course of global symptom severity, health-related quality of life and functioning between admission and discharge in patients (848 men, 1412 women) at an Austrian psychiatric/psychosomatic rehabilitation clinic., Results: Gender-specific differences in the course of treatment were all too small to be clinically relevant. The differences were smallest in the middle-aged cohort. However, at the time of admission, women reported a slightly higher symptom burden., Conclusion: Overall, the results show a gender-fair effectiveness of the rehabilitation. The new findings could be explained by changes in living conditions, gender roles, or better treatment methods., Competing Interests: Prof. Dr. Manuel Sprung is the scientific director of the University Clinic for Psychosomatic Medicine Eggenburg, PSZW (Eggenburg and Gars). Chief physician Dr. Riffer is the medical director of the PSZW. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

4,4'-Dimethylaminorex (4,4'-DMAR) is a new synthetic stimulant, and only a little information has been made available so far regarding its pharmaco-toxicological effects. The aim of this study was to investigate the effects of the systemic administration of both the single (±) cis (0.1-60 mg/kg) and (±) trans (30 and 60 mg/kg) stereoisomers and their co-administration (e.g., (±) cis at 1, 10 or 60 mg/kg + (±) trans at 30 mg/kg) in mice. Moreover, we investigated the effect of 4,4'-DMAR on the expression of markers of oxidative/nitrosative stress (8-OHdG, iNOS, NT and NOX2), apoptosis (Smac/DIABLO and NF-κB), and heat shock proteins (HSP27, HSP70, HSP90) in the cerebral cortex. Our study demonstrated that the (±) cis stereoisomer dose-dependently induced psychomotor agitation, sweating, salivation, hyperthermia, stimulated aggression, convulsions and death. Conversely, the (±) trans stereoisomer was ineffective whilst the stereoisomers' co-administration resulted in a worsening of the toxic (±) cis stereoisomer effects. This trend of responses was confirmed by immunohistochemical analysis on the cortex. Finally, we investigated the potentially toxic effects of stereoisomer co-administration by studying urinary excretion. The excretion study showed that the (±) trans stereoisomer reduced the metabolism of the (±) cis form and increased its amount in the urine, possibly reflecting its increased plasma levels and, therefore, the worsening of its toxicity.

Objectives: We assessed the relationship between the clinical features of patients with psychogenic nonepileptic seizures (PNES) and referrals for brain imaging tests. We also hypothesized that some clinical factors might be associated with structural brain imaging abnormalities in these patients., Methods: In this retrospective study, patients with PNES, who were investigated at Shiraz Comprehensive Epilepsy Center, Iran, from 2008 until 2019, were studied., Results: One hundred thirty-two patients had a brain magnetic resonance imaging (MRI) study available. Forty-seven patients (36%) had abnormal finding(s) in their MRI. Age (odds ratio = 1.040, p = 0.02), and comorbid epilepsy (odds ratio = 3.006, p = 0.005) were significantly associated with having an abnormal brain MRI. In a subanalysis, we excluded the patients with comorbid epilepsy (46 patients). From the remaining 86 patients (with PNES only), 23 patients (26.7%) had abnormal findings on their MRIs. Common epileptogenic structural brain abnormalities (e.g., tumors, mesial temporal sclerosis, encephalomalacia, and developmental anomalies) were common in patients with comorbid PNES and epilepsy (in 19 out of 46 patients; 41%), but not in those with PNES only (in 4 out of 86 patients; 5%) (p = 0.00001)., Conclusion: While the evidence is convergent on the relatively high prevalence of structural brain abnormalities in patients with PNES, the data so far is suboptimal. In order to investigate the significance of structural brain abnormalities in the development of PNES, future well-designed multicenter studies, which include a large number of patients with a unified methodology of imaging, are desirable.

Research with predominantly male samples supports primary and secondary developmental pathways to psychopathy that are phenotypically indistinguishable on aggressive and antisocial behavior. The aim of this study was to examine whether female variants of psychopathy show divergent endocrine (i.e., cortisol, dehydroepiandrosterone [DHEA], testosterone, and their ratios) and psychophysiological (i.e., heart rate variability [HRV]) reactivity to social provocation. We also tested whether variants differed on reactive aggression when performing a competitive reaction time task against the fictitious participant who previously insulted them. Latent profile analyses on 101 undergraduate women oversampled for high psychopathic traits identified a high-anxious, maltreated secondary variant (n=64) and a low-anxious primary variant (n=37). Although variants did not differ on aggression, secondary variants showed higher cortisol, testosterone, cortisol-to-DHEA ratios, and HRV following social provocation relative to primary variants. Findings suggest that the neurobiological mechanisms underpinning aggression in psychopathy may differ between women on primary versus secondary developmental pathways., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

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.

The purpose of this study was to conduct a preliminary investigation of the white matter characteristics in patients with psychogenic non-epileptic seizures (PNES). Diffusion Tensor Imaging (DTI) data were collected at 3T in 16 patients with PNES and 16 age- and sex-matched healthy controls (HC). All patients with PNES had their diagnosis confirmed via video/EEG monitoring; HCs had no comorbid neurological or psychiatric conditions. DTI indices including fractional anisotropy (FA), and mean diffusivity (MD) were calculated and compared between patients with PNES and HCs using Tract-Based Spatial Statistics (TBSS). Significantly higher FA values were observed in patients with PNES in the left corona radiata, left internal and external capsules, left superior temporal gyrus, as well as left uncinate fasciculus (UF) (P<0.05; corrected for multiple comparisons). There was no significant change in other indices between patients with PNES and HCs. These findings suggest that patients with PNES have significantly altered white matter structural connectivity when compared to age- and sex-matched HCs. These abnormalities are present in left hemispheric regions associated with emotion regulation and motor pathways. While the relationship between the pathophysiology of PNES and these abnormalities is not entirely clear, this work provides an initial basis to guide future prospective studies., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Purpose: There has been a rapid increase in the rate of publications about psychogenic nonepileptic seizures (PNES). This review summarises insights from the 50 most important original articles about PNES published since 2011 and describes the advances made in the understanding of PNES over the last 3 years., Method: We carried out a systematic literature search of all English language publications about PNES published between October 2011 and October 2014 on Scopus, Ovid Medline and Web of Knowledge, and inspected all abstracts. Having excluded all review articles, case reports, conference abstracts, articles exploring PNES in children, and articles not actually focussing on PNES, we considered 150 papers for inclusion in this review. We assessed the quality of the identified studies and used expert judgement to identify the 50 most important publications from the review period and composed a narrative review based on these original papers., Results: Almost one half of the studies initially identified only provided Class 4 evidence. Recent work has provided more support for a biopsychosocial account of PNES. It has illustrated the heterogeneity of PNES, identifying varying and distinct psychological profiles of individuals with this disorder. These findings suggest that intervention needs to be flexible or adaptive if it is appropriately to target the different mechanisms which may give rise to PNES. Several educational and psychotherapeutic interventions for PNES have been described, but sufficiently powered randomised controlled trials are yet to be undertaken. Recent research using social, economic and quality of life indicators has provided further evidence of the societal and individual burden of PNES., Conclusion: The research into PNES published over the last 3 years has deepened our understanding of the condition as a biopsychosocial disorder which is neither a "physical" nor a "psychological" condition. A number of small studies have demonstrated the potential of educational and psychotherapeutic treatments, but rigorous and sufficiently large trials still need to be conducted to determine the effectiveness of these interventions., (Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Objective: To determine cortical thickness (CTh), cortical surface area (CSA), curvature and sulcal depth (SD) in patients with psychogenic nonepileptic seizures (PNES)., Methods: Freesurfer software was used to identify differences between active and control group in Cth, CSA, curvature, and SD. Neuropsychological tests intending to document possible frontal lobe deficit were applied., Results: We included 37 patients with PNES (age 37.3±13.8; female/male 31/6; age of disease onset 26.1±10.6; age of disease duration 11.1±11.1), and 37 healthy controls (age 38.4; ±12.7; female/male 26/11). No difference in CSA and curvature was detected between groups. Patients with PNES had increased CTh in the left insula, left and right medial-orbitofrontal, and left lateral-orbitofrontal, and decreased CTh in the left and right precentral, right enthorinal, and right lateral-occipital region than healthy controls. SD was increased at the level of the left and right insula, right rostral anterior cingulate, right posterior cingulate, and left cuneus, and reduced at the level of the right and left medial-orbitofrontal sulci in patients with PNES compared to healthy controls., Conclusion: Individuals with PNES display a distinct profile of changes in CTh, in association with increase in SD in both insula as compared to controls. Our results may contribute to the understanding of the neurobiological background of PNES. Further research, to include replication of the findings and directed to understand the role of insula is needed., (Copyright © 2015 Elsevier B.V. All rights reserved.)

This resting-state functional magnetic resonance imaging study found that nine patients with somatoform pain disorder exhibited atypical precentral gyrus activation compared with 20 healthy controls. The role of the precentral gyrus in pain-related processing is discussed., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

The objective of this article was to study individual capabilities of intrapsychic processing psycho-traumatic events and their impact on somatic health. Clinical characteristics of bronchial asthma patients and those with ulcerous disease were compared. General pathological background for development of psihosomatic pathology was identified.

Objective: Indolent low-grade temporal lobe tumors may present with ictal panic that may be difficult to differentiate from psychogenic panic attacks. The current study aims to demonstrate the differences between the two disorders and help physicians generate a diagnostic paradigm., Method: This was a retrospective study of 43 patients who underwent a temporal lobectomy between 1981 and 2008 for the treatment of intractable temporal lobe epilepsy secondary to low-grade neoplasms at Rush University Medical Center. A total of 10 patients in this group presented with ictal panic who were previously being treated for psychogenic panic attacks. Medical records were reviewed for age at seizure onset, duration of symptoms, lateralization of the epileptogenic zone, pathological diagnosis, and postsurgical seizure outcome according to the modified Engel classification., Results: Neuropathologic findings of the 10 tumors were pleomorphic xanthoastrocytoma, ganglioglioma, oligodendroglioma, and dysembryoplastic neuroepithelial. The mean age of the patients undergoing surgery was 28 years (range, 15-49). The mean duration of panic symptoms prior to surgery was 9.8 years (range, 3-23). All patients had unprovoked ictal panic. None had symptoms suggestive of a brain tumor, such as signs of increased intracranial pressure or any focal neurologic deficit. In 5 of the patients, other symptoms associated with the ictal panic, including unusual sounds, nausea, automatism, uprising gastric sensation, and déjà vu were identified. Gross total resection of the lesion resulted in improved seizure outcome in all patients undergoing surgery. Patient follow-up was, on average, 7.4 years (range, 2-14) from time of surgery., Conclusions: Although similar, ictal panic from epilepsy and classic panic attacks are clinically distinguishable entities with different modalities of treatment. A careful history may help differentiate patients with ictal panic from those with psychogenic panic attacks and determine for which patients to obtain neuroimaging studies., (© Copyright 2013 Physicians Postgraduate Press, Inc.)

Background: Voice disorders have a multifactorial genesis and may be present in various ways. They can cause a significant communication handicap and impaired quality of life., Objective: To assess the effect of vocal fold lesions and voice quality on voice handicap and psychosomatic well-being., Methods: Female patients, aged 18-65 years, who were referred to the outpatient clinic with voice problems were subsequently assessed. Laryngostroboscopic examination and acoustic voice analysis were carried out, and the patients were asked to fill in the Voice Handicap Index (VHI) and Symptom Check List-90 questionnaires., Results: Eighty-two patients were included. In 43 patients (52.4%), a vocal fold lesion was observed. The VHI and psychosomatic well-being did not differ significantly between patients with and without a vocal fold lesion. The patients with a vocal fold lesion showed lower scores on the Dysphonia Severity Index (DSI) compared with those without a vocal fold lesion. However, the DSI was not correlated with voice handicap and psychosomatic well-being, except for the VHI physical subscale., Conclusion: Objective measurement does not necessarily correlate with the subjective appraisal of the patient's voice handicap and psychosomatic well-being. Furthermore, the criterion of the presence of a vocal fold lesion as the base of indemnity that is applied by health insurance institutions should be questioned., (Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)

Chronic somatic pain disorders with somatic and mental factors (ICD-10: F45.41) are common among psychosomatic patients. In the present case, due to the close temporal association with a trauma and the subsequent development of symptoms including depressive symptoms, a chronic pain disorder with a relevant somatoform component was suspected. However, after a period of several months without significant somatic findings, targeted diagnostic approaches resulted in the diagnoses of primary hyperparathyroidism and a papillary thyroid carcinoma. Surgical therapy resulted in an almost complete decline of symptoms within a short period of time.

Pain is emotionally detrimental and consciously avoided; however, it is absolutely crucial for our survival. Pain perception is one of the most complicated measurable traits because it is an aggregate of several phenotypes associated with peripheral and central nervous system dynamics, stress responsiveness and inflammatory state. As a complex trait, it is expected to have a polygenic nature shaped by environmental pressures. Here we discuss what is known about these contributing genetic variants, including recent discoveries that show a crucial role of voltage-gated sodium channel Nav1.7 in pain perception and how we can advance our understanding of the pain genetic network. We propose how both rare deleterious genetic variants and common genetic polymorphisms are mediators of human pain perception and clinical pain phenotypes.

We studied a case of psychogenic amnesia by means of a functional magnetic resonance imaging (fMRI) experiment involving the retrieval of autobiographical memories. The 38-year-old patient was unable to access most of her autobiographical memories from her childhood up to 16 years of age. Compared with the forgotten period, evocation of the normally retrieved memories elicited increased activity in medial temporal and dorso-lateral frontal regions. Evocation of the preserved scattered recollections was associated with bilaterally distributed temporo-parieto-occipital loci of activations. These functional changes seem to support the idea of common mechanisms involved in both organic and psychogenic amnesias.

Objective: The purpose of this study was to analyze the psychological characteristics of patients with vocal nodules and to establish the relationship between these characteristics and the development of vocal nodules., Setting: A tertiary medical centre., Design and Method: The patient group consisted of 41 housewives with vocal nodules, and the control group consisted of 35 housewives who did not have any vocal pathology. The subjects completed questionnaires related to the voice disorder and the Symptom Checklist-90-Revision., Outcome Measures: The scores of the patient group with less than 1 year of symptom duration (acute) and more than 1 year of symptom duration (chronic) were also compared with those of the controls., Results and Conclusion: The total patient group differed statistically from the control group on seven neurotic dimensions (p < .001) and one psychotic dimension (p < .05). The acute group differed on two neurotic dimensions (p < .05). We suggest that the neurotic traits found in the acute group may play a role in the development of vocal nodules. The dimensions in which the total patient group differed significantly from the control group may indicate the changes that occur in the psychological characteristics following voice change. The collective results indicate that psychological characteristics play an important role in the pathogenesis of vocal nodules. Hence, greater attention should be given to the psychological and emotional aspects of patients for the treatment and prevention of vocal nodules.

Objective: To examine the current approach to classifying bodily symptoms in both psychiatry and medicine and to suggest better alternatives., Methods: Theoretical analysis, narrative review, and theoretical proposal., Results: The assumptions that (a) bodily pathology can always explain bodily symptoms, (b) psychopathology can always explain bodily symptoms in the absence of bodily pathology, and (c) dichotomizing bodily symptoms into "medical" and "psychiatric" types is clinically useful were all found to have questionable validity and utility., Conclusion: Alternative multiaxial diagnostic approaches for the classification of bodily symptoms are proposed. These are intended to (a) give greater prominence to bodily symptoms in their own right, (b) allow etiology to be conceptualized in terms of multiple factors, and (c) provide the basis for integrating medical and psychiatric approaches to patient care.

Objective: The main objective of this work was to study plasma oxytocin concentration of children with psychosomatic recurrent abdominal pain and children with organic abdominal disease producing pain. Another objective was to study plasma oxytocin in children with psychosomatic recurrent pain over time and its relationship to other associated symptoms such as somatic pains and appetite., Design: The concentration of oxytocin in plasma (fasting morning sample) was measured by radioimmunoassay in 48 children with abdominal pain, 32 of whom had psychosomatic recurrent abdominal pain according to previously defined criteria. Oxytocin levels were assessed in a separate group of 15 children with inflammatory bowel disease with abdominal pain and in a control group of 79 healthy school children., Results: Plasma oxytocin concentration was significantly lower in children with recurrent abdominal pain of psychosomatic origin (P < 0.0001) and in the group of children with inflammatory bowel disease (P < 0.001) compared to controls. There was no difference between oxytocin levels of children with psychosomatic abdominal pain and those with inflammatory bowel disease. When repeated after one year, children with psychosomatic abdominal pain had an increase in mean plasma oxytocin level (P < 0.05). No relationship was found between specific symptoms and plasma oxytocin., Conclusions: Plasma oxytocin level is low in patients with abdominal pain of psychosomatic origin and inflammatory bowel disease. Measurement of plasma oxytocin may be of some help in the differential diagnosis of recurrent abdominal pain, but does not differentiate between psychosomatic abdominal pain and pain associated with inflammatory bowel disease.

The authors suggest extending the list of conventionally studied general pathological processes with psychosomatic and mental variants of pathology. These variants are relatively new in respect to evolution, are characteristic only for man and, in much lesser degree, for higher animals and have gained recognition in the last 50-100 years by defining the modern specificity of the nosological principle in medicine. The analysis of psychosomatic and psychic aspects of diseases may be of key importance for further development of general human pathology as a science.

The sympathetic-related regions of the cerebral cortex were identified in rats after pseudorabies virus injections were made in functionally different targets: adrenal gland, stellate ganglion which regulates the heart, or celiac ganglion which innervates the gastrointestinal tract. Extensive transneuronal labeling was found in limbic system areas: (1) extended amygdaloid complex, (2) lateral septum, and (3) infralimbic, insular, and ventromedial temporal cortical regions (viz., ectorhinal cortex=Brodmann's area 36, perirhinal cortex=area 35, lateral entorhinal=area 28, and ventral temporal association cortex=Te3 region). Deep temporal lobe structures were prominently labeled, including the amygdalopiriform and amygdalohippocampal transition areas, ventral hippocampus and ventral subiculum. The cortical circuits mediating emotional-autonomic changes (i.e., mind-body control) are discussed.

Because of the controversy concerning the manner in which the sympathetic nervous system is involved in reflex sympathetic dystrophy (RSD), its name was changed to one having no mechanistic connotations. This article reviews the relevant literature in support of not only the taxonomical changes to complex regional pain syndrome (CRPS) but also provides evidence of sympathetic dysfunction demonstrated in animal models of neuropathic pain.

Fibromyalgia and other chronic pain and fatigue syndromes constitute an increasingly greater societal burden that currently is not being approached effectively by traditional Western medicine. Although the hallmarks of fibromyalgia--chronic widespread pain, fatigue, and multiple other somatic symptoms--have neurophysiologic and endocrinologic underpinnings, these biological aspects derive primarily from psychological variables. Female gender, adverse experiences during childhood, psychological vulnerability to stress, and a stressful, often frightening environment and culture are important antecedents of fibromyalgia. To understand fibromyalgia and related syndromes and to provide optimum care requires a biopsychosocial, not a biomedical, viewpoint.

Background: Both psychological and physiological disturbances have been implicated in the aetiopathogenesis of irritable bowel syndrome (IBS)., Aims: To investigate how the psychological factors act, and the involvement of infective and physiological factors., Methods: Consecutive patients hospitalised for gastroenteritis reported life events for the previous 12 months, and past illness experiences on standardised questionnaires. They also completed psychometric questionnaires for anxiety, neuroticism, somatisation, and hypochondriasis. In some patients, rectal biopsy specimens were obtained during the acute illness and at three months postinfection., Results: Ninety four patients completed all questionnaires: 22 patients were diagnosed with IBS after their gastroenteritis (IBS+), and 72 patients returned to normal bowel habits (IBS-). IBS+ patients reported more life events and had higher hypochondriasis scores than IBS- patients. The predictive value of the life event and hypochondriasis measures was highly significant and independent of anxiety, neuroticism, and somatisation scores, which were also elevated in IBS+ patients. Rectal biopsy specimens from 29 patients showed a chronic inflammatory response in both IBS+ and IBS- patients. Three months later, specimens from IBS+ patients continued to show increased chronic inflammatory cell counts but those from IBS- patients had returned to normal levels. IBS+ and IBS- patients exhibited rectal hypersensitivity and hyper-reactivity and rapid colonic transit compared with normal controls, but there were no significant differences between IBS+ and IBS- patients for these physiological measurements., Conclusion: Psychological factors most clearly predict the development of IBS symptoms after gastroenteritis but biological mechanisms also contribute towards the expression of symptoms.

Intracavernous PO2 (mm Hg) was measured during flaccidity in 5 psychogenic impotent patients (control), in 9 patients with venous leak and in 10 patients with arterial disease. No significant difference was observed in the mean PO2 value between the control group 36.2 +/- 5.8 and patients with venous leak 35.6 +/- 6.9 or with arterial disease 34.1 +/- 6.5 at flaccidity. Ten minutes after injection of Prostaglandin E1 (PGE1), the mean value of cavernous PO2 in the control group 83.8 +/- 6.8 was significantly different (p < 0.01) from that in the venous group 67.8 +/- 8.2 and the arterial group 57.8 +/- 10.7 (p < 0.01). Using the computerized analysis and the immunohistochemical staining actin anti-actin, the mean percentage of cavernous smooth fibers was 43.3 +/- 3.6, 34.1 +/- 4.6, and 29.3 +/- 3.4 in the three groups of patients respectively. At flaccidity, the higher the PO2 value, the higher the percentage of cavernous smooth muscle fibers was detected (p < 0.05). A high correlation was observed between the increase in PO2 value after injection of PGE1 and the increase in cavernous smooth muscle content. On the other hand, the mean value of penile brachial index in the psychogenic 0.87 +/- 0.07 was significant different (p < 0.01) from the venogenic group 0.68 +/- 0.06 and the arteriogenic group 0.64 +/- 0.09 (p < 0.01). Similarly, a high correlation was detected between the increase in penile brachial index ratio and the increase in cavernous smooth muscle content. A decrease in the percentage of the intracavernous smooth muscle fibers could be explained by the low oxygen tension at flaccidity and therefore could be responsible for insufficient rigidity during erection.

Epilepsy is a well-documented consequence of about 150 rare genetic syndromes and malformations of the central nervous system. These syndromes are generally associated with fairly gross defects within the central nervous system and they were thought to be responsible for a small minority of cases. However, improved methods of neuropathological investigations and extensive magnetic resonance imaging studies have revealed a range of disturbances in cortical cytoarchitecture in patients with epileptic seizures previously considered as idiopathic (up to 70% of epilepsy). Structural abnormalities have also been demonstrated in the brain in schizophrenia. These consist of disturbed cortical cytoarchitecture (best described in the temporal lobe) and a diffuse loss of grey matter. The absence of the pathological stigma characteristic of degenerative processes indicates that these structural changes are the result of an abnormal pattern of brain development. The relationship between the type and location of developmental abnormality and the subsequent clinical syndrome (e.g. generalized or localized epilepsy) and the effects of aberrant cortical development on the functional integrity of the adult brain require definition.

A case of autoerythrocyte sensitization syndrome is reported. This syndrome most often appears in young women who have an underlying emotional disorder; features include bizarre, tender ecchymotic lesions, which are most commonly located on the arms and legs. Systemic symptoms often accompany the onset of these lesions. A diagnosis of autoerythrocyte sensitization syndrome may be made in a patient who has the typical history and clinical picture of the syndrome and in whom a skin test with use of the patient's blood reveals a positive reaction.

Of all partial seizures, those of frontal lobe origin (FLPS) are most bizarre and are often mistaken for psychogenic seizures (PS). The reverse can also be true. To clarify the confusing clinical presentation of these different seizure types, we compared the clinical ictal characteristics of 63 FLPS in 11 patients with 29 PS in 12 patients. Patients with PS had significantly later age at onset and longer ictal duration. There was no statistically significant difference between the two groups with respect to history of psychiatric disorder, ictal pelvic thrusting, rocking of body, side-to-side head movements, or rapid postictal recovery, all of which previously have been reported as characteristic features of PS. Turning to a prone position during the seizure occurred only in FLPS. Nocturnal occurrence, short ictal duration, younger age at onset, stereotyped patterns of movements, and MRI and EEG abnormality suggested FLPS.

25 male patients suffering from acne vulgaris were examined by means of endocrinological, morphological, and 5 psychometric procedures in order to check the correlations and interactions between the psychological and dermatological aspects of the disease. In comparison with a control group, the acne patients did not show any striking endocrinological abnormalities; we found no correlation between the extensiveness of the lesions and the level of DHEA sulphate. All the psychological tests yielded results deviating from those achieved by the representative controls, but they were comparable with those of other patients suffering from psychosomatic diseases. The individual feeling of being "disfigured" found its expression in self-consciousness, lack of trust in his/her own body, as well as the clinically relevant difference between his/her conception of self and the ideal of self. During times of enhanced psychosocial strains subjectively assumed by the patients, the lesions increased and the patients were disturbed in social interaction and communication. Surprisingly, we did not find any correlation between the clinical status and significant psychometric findings. Our results show that in acne vulgaris, the individual experience of wanting physical attractiveness, associated with a predominantly neurotic depressive personal structure, may play a central part in a disturbed process of interaction with the environment and suggest the influence of psychic factors in the pathogenesis of acne vulgaris.

Functional state of the adrenals and structural organization of the thymus and lymph nodes in the rats with hereditary stress-induced arterial hypertension (HSIAH) have been investigated in the control and against the background of a prolonged staying under conditions of a moderate cold. In comparison with the initial population of Wistar rats, the test animals demonstrate an elevated level of corticosterone, decreased mass and size of the thymus, the size of the popliteal lymph nodes is increased at the expense of the structural components of the medulla. In 7 weeks of living in cold secretion of adrenal steroids in Wistar rats increases greatly and it is noticeably less in the HSIAH rats. Structural changes in the thymus are also insignificant, but reaction of the lymph nodes is important. Their size sharply diminishes at the expense of certain structural components of the medulla. A shift towards mature forms of the plasmocytic line cells takes place.

A 27 year old women revealed chronic relapsing, spontaneously developing hematomas without coagulopathy. The lesions were reproducible by intradermal injection of erythrocyte membranes as well as DNA. Positive test reactions could be elicited or suppressed by psychological influences on the patient. This case and similar reports in the literature raise the question whether Gardner-Diamond syndrome and the autosensitization to DNA are different entities.

Had markedly anarchic dietary behaviour with alternating anorexia and bulimia, or even self-induced vomiting. These disturbances in dietary behaviour fall within the context of an unusual neurotic syndrome, predominantly hysterical. There were also menstrual problems, most often amenorrhoea. The physiopathological relations between these symptoms and signs may be envisaged as follows: the initial psychological problems explain the dysorexia; the menstrual difficulties are related at one and the same time to the psychological problems and the dysorexia; the latter is responsible for the parotidomegaly and for disturbances in carbohydrate and lipid metabolism.

After a brief introduction regarding the nosography of psychosomatic disorders and the main reasons that have little by little discouraged non-psychiatric physicians to deal with this type of pathology, considering its high incidence among all the areas of general practice, the Authors go on discussing the diagnostic problems and pointing out the most important aspects concerned with these. The Authors conclude by warning not to over-value the effects obtained with an antidepressant especially when it is set up only on the basis of the ex-juvantibus principle. The Authors also invite their colleagues general practitioners to take greater care in the fight for prevention and treatment of these disorders, side by side with the psychiatrist.

One hundred thirty-two atopic patients have been investigated for coincidental tongue lesions. There was a significantly increased frequency of exfoliatio linguae areata (35.7%) amongst the patients when compared to a control group. These results let suggest that exfoliatio linguae areata is a possible manifestation of atopy. Psychosomatic factors which probably contribute to both exfoliatio linguae areata and atopy are suggested to explain the high incidence of this anomaly of the tongue in atopics.

The importance of psychiatric factors in Crohn's disease and ulcerative colitis is well recognized. This fact is demonstrated with two characteristic medical histories based on the psychoanalytic interview. The question of vicissitudes of symptoms following proctocolectomy is discussed on the basis of own investigations. The last part of the paper shows problems of patients with permanent colo- and ileostomy.

In summary, automated perimetry and other psychophysical tests currently provide the most sensitive, reliable and reproducible means of clinically detecting early glaucomatous changes. Compared to optic disk and nerve fiber layer evaluation, such procedures provide a consistent, quantitative method of distinguishing between early abnormalities and normal variations.