Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 86
Filtrar
1.
Brain Topogr ; 29(4): 524-38, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26936595

RESUMEN

Relaxation and meditation techniques are generally characterized by focusing attention, which is associated with an increase of frontal EEG Theta. Some studies on music perception suggest an activation of Frontal Midline Theta during emotionally positive attribution, others display a lateralization of electrocortical processes in the attribution of music induced emotion of different valence. The present study examined the effects of vibroacoustic stimulation using a Body Monochord and the conventional relaxation music from an audio CD on the spontaneous EEG of patients suffering from psychosomatic disorders (N = 60). Each treatment took about 20 min and was presented to the patients in random order. Subjective experience was recorded via self-rating scale. EEG power spectra of the Theta, Alpha-1 and Alpha-2 bands were analysed and compard between the two treatment conditions. There was no lateralization of electrocortical activity in terms of the emotional experience of the musical pieces. A reduction in Alpha-2 power occurred during both treatments. An emotionally positive attribution of the experience of the vibroacoustically induced relaxation state is characterized by a more pronounced release of control. In the context of focused attention this is interpreted as flow experience. The spontaneous EEG showed an increase in Theta power, particularly in the frontal medial and central medial area, and a greater reduction in Alpha-2 power. The intensity of positive emotional feelings during the CD music showed no significant effect on the increase in Theta power.


Asunto(s)
Estimulación Acústica/métodos , Ritmo alfa , Emociones , Música/psicología , Trastornos Psicofisiológicos/psicología , Ritmo Teta , Adulto , Anciano , Electroencefalografía , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Vibración , Adulto Joven
2.
Qual Life Res ; 22(8): 2095-104, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23292277

RESUMEN

PURPOSE: Known association between tinnitus and psychological distress prompted us to examine patients with chronic tinnitus by using the Composite International Diagnostic Interview (CIDI), which is a standardized and reliable method used for the diagnosis of mental disorders. METHODS: One hundred patients with chronic tinnitus admitted to the Tinnitus Center, Charité-Universitätsmedizin Berlin, were included in this study. Data were collected between February 2008 and February 2009. Besides CIDI, the Tinnitus Questionnaire according to Goebel and Hiller, the Hospital Anxiety Depression Scale, and the General Anxiety Disorder-7 were used. RESULTS: Using CIDI, we have identified one or more mental disorders in 46 tinnitus patients. In that group, we found persistent affective disorders (37 %), anxiety disorders (32 %), and somatoform disorders (27 %). Those patients who had affective or anxiety disorders were more distressed by tinnitus and were more anxious and more depressed than tinnitus patients without mental disorders. Psychological impairment positively correlated with tinnitus distress: Patients with decompensated tinnitus had significantly more affective and anxiety disorders than patients with compensated tinnitus. CONCLUSIONS: In the present study, we have detected a high rate (almost half of the cases) of psychological disorders occurring in patients with chronic tinnitus. The patients diagnosed with psychological disorders were predominantly affected by affective and anxiety disorders. Psychological disorders were associated with severity of tinnitus distress. Our findings imply a need for routine comprehensive screening of mental disorders in patients with chronic tinnitus.


Asunto(s)
Ansiedad/diagnóstico , Depresión/diagnóstico , Trastornos Mentales/diagnóstico , Calidad de Vida , Acúfeno/psicología , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Audiometría , Depresión/epidemiología , Depresión/psicología , Femenino , Alemania/epidemiología , Humanos , Incidencia , Entrevista Psicológica , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Psicometría/estadística & datos numéricos , Índice de Severidad de la Enfermedad , Factores Socioeconómicos , Encuestas y Cuestionarios , Acúfeno/diagnóstico , Acúfeno/epidemiología
3.
Schmerz ; 26(1): 77-9, 2012 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-22366936

RESUMEN

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.


Asunto(s)
Adenocarcinoma/diagnóstico , Adenocarcinoma/psicología , Adenoma/diagnóstico , Adenoma/psicología , Hiperparatiroidismo Primario/diagnóstico , Hiperparatiroidismo Primario/psicología , Dolor Musculoesquelético/diagnóstico , Dolor Musculoesquelético/psicología , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Primarias Múltiples/psicología , Neoplasias de las Paratiroides/diagnóstico , Neoplasias de las Paratiroides/psicología , Trastornos Psicofisiológicos/diagnóstico , Trastornos Psicofisiológicos/psicología , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/psicología , Adenoma/patología , Adenoma/cirugía , Adulto , Calcio/sangre , Conducta Cooperativa , Errores Diagnósticos , Humanos , Hiperparatiroidismo Primario/patología , Hiperparatiroidismo Primario/cirugía , Comunicación Interdisciplinaria , Escisión del Ganglio Linfático , Masculino , Dolor Musculoesquelético/patología , Dolor Musculoesquelético/cirugía , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Dimensión del Dolor , Hormona Paratiroidea/sangre , Neoplasias de las Paratiroides/patología , Neoplasias de las Paratiroides/cirugía , Grupo de Atención al Paciente , Determinación de la Personalidad , Trastornos Psicofisiológicos/patología , Trastornos Psicofisiológicos/cirugía , Cintigrafía , Glándula Tiroides/patología , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Ultrasonografía
4.
Gesundheitswesen ; 73(12): 829-34, 2011 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-21181645

RESUMEN

AIM: The aim of the present study was to define, besides prevalence data, regional and individual factors of stress experience in a representative sample of the German general population. METHODS: Regional factors were examined separately by federal state and the size of the political location. Individual factors were defined according to the severity of the stress experience as well as on the basis of central social factors such as family state, profession and earnings. The Perceived Stress Questionnaire (PSQ), a validated, self-evaluation process for recording a subjective representation of frequency estimates of stress experiences was used. Data acquisition was carried out by a market research institute in a multi-topic questionnaire (N=2,552). Households were selected by the random route procedure, target persons were also selected at random. RESULTS: The prevalence rate for an elevated stress experience was 14.5%, that for a very high stress experience 3.1% of the sample. People without education exhibited the highest rates of stress experience (36.8%), followed by the unemployed (30.6%). Individual and social factors that favour an increased stress experience are a subjectively poor state of health (OR: 3.42) or belonging to the lower social economic status (OR: 1.30). Furthermore, there are indications of regional factors such as size of the location as well as differences between the individual federal states. An east-west comparion did not show any significant differences with regard to stress experiences. CONCLUSION: In the light of the illness burden associated with chronic stress situations, preventative measures in cases of unemployment or low level of education should be given priority.


Asunto(s)
Indicadores de Salud , Estrés Psicológico/diagnóstico , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , Adulto , Anciano , Escolaridad , Empleo/estadística & datos numéricos , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Factores de Riesgo , Adulto Joven
5.
Psychopathology ; 43(3): 150-8, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20197708

RESUMEN

BACKGROUND: Narcissism is seen as a normal but heterogeneously formed personality variable, ranging from 'grandiosity-exhibitionism' to 'vulnerability-sensitivity'. This article reports the development and factorial validation of a short version of a narcissism inventory. SAMPLING AND METHODS: The sample includes data of 4,509 consecutive psychosomatic inpatients. The overall sample was divided in 2 equally sized randomized subsamples. One sample (n = 2,262) was used for exploratory factor analysis (principal component analysis). The other sample (n = 2,265) was used for confirmatory tests of the model fit of the newly built NI-20 version, and to analyze the model fit separately for men and women using structural equation modeling with AMOS software. RESULTS: The short version (NI-20) consists of 20 items, with items representing almost all of the original 18 subscales and 4 second-order dimensions. The NI-20 possesses properties similar to the NI-90, with a considerable gain in test economy. The 4-factor structure of the NI-20 was confirmed, and reaches good fit indices. CONCLUSIONS: The NI-20 is an economical instrument with acceptable psychometric characteristics that reflects the heterogeneous aspects of narcissism. A methodological limitation is that the interactions between sociodemographic variables were not included as potential predictors.


Asunto(s)
Narcisismo , Inventario de Personalidad/normas , Encuestas y Cuestionarios/normas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Distribución de Chi-Cuadrado , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Componente Principal , Valores de Referencia
6.
HNO ; 58(10): 973-82, 2010 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-20811868

RESUMEN

Peripheral and central structures are involved in the onset of tinnitus. Neuronal plasticity is of special importance for the occurrence of central tinnitus and its persistent form. Neuronal plasticity is the ability of the brain to adapt its own structure (synapses, nerve cells, or even whole areas of the brain) and its organization to modified biological requirements. Neuroplasticity is an ongoing dynamic process. Generally speaking, there are two types of plasticity: synaptic and cortical. Cortical plasticity involves activity-dependent changes in size, connectivity, or in the activation pattern of cortical networks. Synaptic plasticity refers to the activity-dependent change in the strength of synaptic transmission and can affect both the morphology and physiology of the synapse. The stimulation of afferent fibers leads to long-lasting changes in synaptic transmission. This phenomenon is called long-term potentiation (LTP) or long-term depression (LTD). From the perspective of molecular biology, synaptic plasticity is of particular importance for the development of tinnitus and its persistence. Ultimately, the damage to the hair cells, auditory nerve, and excitotoxicity results in an imbalance between LTP and LTD and thus in changes of synaptic plasticity. After excessive acoustic stimulation, LTP can be induced by the increase of afferent inputs, whereas decreased afferent inputs generate LTD. The imbalance between LTP and LTD leads to changes in gene expression and involves changes in neurotransmission, in the expression of the receptors, ion channels, regulatory enzymes, and in direct changes on the synapses. This causes an increase of activity on the cellular level. As a result, the imbalance can lead to hyperactivity in the dorsal cochlear nucleus, inferior colliculus, and in the auditory cortex and, later on, to changes in cortical plasticity leading to tinnitus.


Asunto(s)
Encéfalo/fisiopatología , Modelos Neurológicos , Red Nerviosa/fisiopatología , Plasticidad Neuronal , Transmisión Sináptica , Acúfeno/fisiopatología , Acúfeno/terapia , Animales , Humanos
7.
HNO ; 58(2): 162-72, 2010 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-19795102

RESUMEN

Emotional stress is often associated with auditory phenomena such as hyperacusis, tinnitus, Ménière's disease and vertigo. Stress develops as a result of a person's attempts to come to terms with the increased or unexpected demands of his or her environment. Stress serves to protect one from physical danger and to temporarily increase one's performance in order to increase the probability of survival. Sleep and appetite are particularly reduced, while anxiety increases. The mental changes induced by stress may contribute to the onset or exacerbation of tinnitus. The following links exist between the auditory and stress systems: the limbic system, which regulates instinctive behavior and emotions, is linked to the auditory system via the medial geniculate body (amygdala). The hypothalamus, which is the integrative center of the endocrine and autonomic systems, is linked to the auditory system via the inferior colliculus. The reticular system, which is focused on the behavior pattern of attention and excitement, projects serotonergic fibers to all pathways of the auditory system, ranging from the cochlea to the auditory cortex.


Asunto(s)
Ansiedad/fisiopatología , Nivel de Alerta/fisiología , Estrés Psicológico/complicaciones , Estrés Psicológico/fisiopatología , Acúfeno/psicología , Amígdala del Cerebelo/fisiopatología , Animales , Ansiedad/complicaciones , Ansiedad/diagnóstico , Ansiedad/psicología , Corteza Auditiva/fisiopatología , Vías Auditivas/fisiopatología , Cóclea/inervación , Hormona Liberadora de Corticotropina/sangre , Dopamina/sangre , Cuerpos Geniculados/fisiopatología , Humanos , Hidrocortisona/sangre , Sistema Hipotálamo-Hipofisario/fisiopatología , Colículos Inferiores/fisiopatología , Sistema Límbico/fisiopatología , Ratones , Red Nerviosa/fisiopatología , Sistema Hipófiso-Suprarrenal/fisiopatología , Serotonina/sangre , Acúfeno/fisiopatología
8.
Clin Transplant ; 23(3): 382-91, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19537301

RESUMEN

An important aspect in the preoperative evaluation and a legal precondition for an living donor liver transplantation (LDLT) is a family or emotionally close relationship between donor and recipient. We investigated the development of the donor-recipient relationship after LDLT. We conducted semi-structured clinical interviews with 18 donors as part of a regular postoperative follow-up and analyzed them using the method of Grounded Theory. The donation does not lead to any major changes in the donor-recipient relationship, probably due to careful pre-selection. It does however enhance the existing positive or conflicting character of the relationship. Donors sometimes downplay negative aspects in the relationship and emphasize the improvement as a way of dealing with a major life event. A donation cannot fulfill expectations linked to it and it is unfavorable to be used to improve the relationship. Potential misuse or instrumentalization of the donation by the donor are possible. Postoperative feelings of gratitude are an issue after surgery. A good relationship enhances a better management of the postoperative course. The preoperative donor-recipient relationship should be as free of conflict as possible. A thorough preoperative evaluation of the donor-recipient relationship is particularly important to assess the donors' suitability and clarify conflicts and unrealistic expectations.


Asunto(s)
Relaciones Familiares , Relaciones Interpersonales , Trasplante de Hígado , Donadores Vivos , Adulto , Anciano , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad
9.
Z Gastroenterol ; 47(9): 814-8, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19750428

RESUMEN

BACKGROUND: In recent years, data from questionnaires have demonstrated increasing criticism from junior physicians regarding their work conditions. Ideally, such subjective statements should be compared to accurate objective data regarding workload. However, such data is not available in the research literature. Therefore the aim of the current study is to deliver exact data about physicians' work in different gastroenterology departments to analyze and to optimize work routines. METHOD: An observational real-time study was conducted by shadowing 21 gastroenterologists individually during weekday shifts at three hospitals in urban German settings. A total of 585 hours of observations were recorded by using an ultra mobile computer. RESULTS: The observation results have shown that a gastroenterologist's working day lasted on an average 9 hours 16 min (SD = 1:11:18 h). The following amount of time was given to varying tasks within this time period: 30.21 % for meetings (SD = 8.54 %), 13.42 % for documentation duties (SD = 7.74 %), 15.53 % for indirect patient care (SD = 6.32 %), 7.98 % for hospital admissions and ward rounds (SD = 5.49 %). Doctor patient communication was restricted to 4.05 % of the working day (SD = 2.71 %). CONCLUSION: This is the first real time analysis on how hospital gastroenterologists spend their working hours. Some of the problems with work routine reported by the doctors themselves were partly confirmed. With regard to the study results a rearrangement of job tasks coupled with technological solutions may prove helpful in reducing the burden on gastroenterologists and thereby improving the quality of medical care.


Asunto(s)
Gastroenterología/estadística & datos numéricos , Cuerpo Médico de Hospitales/estadística & datos numéricos , Estudios de Tiempo y Movimiento , Carga de Trabajo/estadística & datos numéricos , Sistemas de Computación , Alemania , Recursos Humanos
10.
Gesundheitswesen ; 71(1): 35-40, 2009 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-19173149

RESUMEN

AIM OF THE STUDY: The therapy of the chronic tinnitus is aimed at improving the way patients cope with their tinnitus and at reducing the tinnitus-related distress. The present study investigated the changes of psychometric parameters that occurred in patients with chronic tinnitus after 7-days outpatient multidisciplinary therapy. The changes were monitored for up to 1 year in order to evaluate the long-term efficiency. METHODS: Main emphasis of the intensive tinnitus therapy applied was placed on tinnitus habituation and on teaching the patients how to apply coping strategies. The main elements of the multimodal concept included progressive muscle relaxation according to Jacobson, physiotherapy, educative seminars, training of selective attention and, lastly, the change of judgment, attitude and behaviour towards tinnitus. Psychometric parameters and tinnitus-related distress were assessed prior to and after the therapy (at 3, 6 and 12 months) using the tinnitus questionnaire (TQ) according to Goebel and Hiller. Furthermore, subjects waiting for therapy (waiting list) were recruited to the control group and compared with the therapy group which had received therapy 3 months earlier. RESULTS: The therapy group showed a significant reduction of the TQ total score after 3 months as compared to the control group. Moreover, we observed a long-term, progressive positive outcome during the one-year follow-up. The TQ total score was reduced by 10.9 points. There was an obvious decrease of the emotional and cognitive distress as well as of the intrusiveness of tinnitus, as per evaluation of TQ subscales. CONCLUSIONS: The outpatient intensive multidisciplinary tinnitus therapy with long-term aftercare has proved to be an effective method in the treatment of patients with chronic tinnitus. The outpatient setting enables the instant implementation of strategies learned during therapy in the patients' everyday life.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Prestación Integrada de Atención de Salud , Psicoterapia/métodos , Psicoterapia/estadística & datos numéricos , Estrés Psicológico/prevención & control , Acúfeno/terapia , Adulto , Anciano , Enfermedad Crónica , Comorbilidad , Femenino , Estudios de Seguimiento , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estrés Psicológico/epidemiología , Acúfeno/epidemiología , Resultado del Tratamiento
11.
Clin Exp Allergy ; 38(2): 283-90, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18070153

RESUMEN

BACKGROUND: Asthma is a chronic disease defined by airway inflammation, increased airway hyperresponsiveness and episodes of airway obstruction. Although there are abundant clinical and experimental data showing that stress may worsen asthma, the mechanisms linking stress to asthma are not well understood. By inducing a pro-inflammatory cytokine milieu, stress might enhance airway inflammation in bronchial asthma. We therefore investigated the correlation of stress perception and the cytokine profile of circulating lymphocytes in humans. METHODS: Allergic asthmatic patients and healthy controls were evaluated for perceived level of stress, demographic and lung function data. Whole blood cells were obtained and stimulated by mitogen to assess intracellular IL-4, IFN-gamma and TNF-alpha by flow cytometry. Neurotrophins nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were measured in serum. RESULTS: Asthmatic patients showed significantly higher percentages of TNF-alpha-producing T cells than healthy controls. Only in asthmatic patients was stress perception correlated with percentages of TNF-alpha-producing T cells and serum BDNF levels, while forced expiratory volume in 1 s (% predicted) was negatively correlated to BDNF. CONCLUSION: The results of our study support the hypothesis that stress deteriorates bronchial asthma by inducing a pro-inflammatory cytokine profile in allergic asthmatics. Stress management might provide a supplement therapy of allergic asthma.


Asunto(s)
Asma/inmunología , Citocinas/sangre , Factores de Crecimiento Nervioso/sangre , Hipersensibilidad Respiratoria/inmunología , Estrés Fisiológico/complicaciones , Adulto , Anciano , Asma/diagnóstico , Factor Neurotrófico Derivado del Encéfalo/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factor de Crecimiento Nervioso/sangre , Hipersensibilidad Respiratoria/diagnóstico , Estrés Fisiológico/diagnóstico , Linfocitos T/inmunología
12.
Clin Exp Allergy ; 38(7): 1203-11, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18307524

RESUMEN

BACKGROUND: Nerve growth factor (NGF) has been found to induce substance-P biosynthesis in large-diameter A-fibres vagal airway neurons. However, the effect of NGF on trigeminal neurons innervating the nasal mucosa of the mouse has not been investigated so far. OBJECTIVE: NGF has been implicated in allergic diseases by modulating sensory nerves. Therefore, the present study investigated the effect of NGF on neuropeptides expression such as substance-P and glutamate in nasal trigeminal neurons. METHODS: Using neuronal tracing in combination with double labelling immunohistochemistry the expression of substance-P, glutamate and neurofilament protein 68-kDa expression was examined in nasal-specific trigeminal neurons of BALB/c-mice. RESULTS: The numbers of Fast blue-labelled trigeminal neurons expressing substance-P were significantly increased after NGF exposure (NGF-treated ganglia: 16.4 +/- 0.6% vs. control: 7.0 +/- 0.4%, P

Asunto(s)
Mucosa Nasal/inervación , Factor de Crecimiento Nervioso/metabolismo , Neuronas/metabolismo , Sustancia P/biosíntesis , Nervio Trigémino/citología , Animales , Femenino , Ácido Glutámico/biosíntesis , Ratones , Ratones Endogámicos BALB C , Proteínas de Neurofilamentos/biosíntesis , Neuronas/citología , Nervio Trigémino/metabolismo
13.
J Psychosom Obstet Gynaecol ; 29(3): 164-72, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18821266

RESUMEN

OBJECTIVE: The study aims to describe the prevalence of violent physical and sexual experiences in female outpatients and to identify specific gynaecological symptoms that are associated with a history of abuse. STUDY DESIGN: We performed a cross-sectional study among native German women. The confidential self-administered questionnaire included items on physical and sexual abuse and on the patient's medical history. Of a total of 1941 eligible women, 730 (37.6%) participated in the survey. We calculated prevalence rates of physical and sexual abuse and compared victims and non-victims of violence with respect to specific symptoms and complaints. We developed multivariate models for pelvic pain and vaginal infection. RESULTS: The lifetime prevalence of severe physical violence by any kind of perpetrator was 35.5%. 13.5% of participants reported a completed rape. The lifetime prevalence of physical and/or sexual intimate partner violence (IPV) was 28.3%. Physical and sexual abuse is significantly associated with irregular menstrual cycle, urinary tract infections and pelvic pain independent of menses. CONCLUSIONS: Physical and sexual violence are associated with many gynecological symptoms. Especially gynecologists and general practitioners have to be aware that their patients might be victims of violence. This is important for adequate diagnosis and therapy and to avoid retraumatization in affected women.


Asunto(s)
Mujeres Maltratadas/psicología , Enfermedades de los Genitales Femeninos/diagnóstico , Enfermedades de los Genitales Femeninos/epidemiología , Violación/psicología , Violación/estadística & datos numéricos , Violencia/psicología , Violencia/estadística & datos numéricos , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios
14.
HNO ; 56(3): 332-9, 2008 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-18066513

RESUMEN

The aim of this article is to show an established group therapeutic concept for chronic tinnitus. The treatment of chronic tinnitus is intended to improve the way patients cope with tinnitus but it does not eliminate it. It means that patients learn how to reduce the impairment they are experiencing. Patients with tinnitus are supported in the process of habituation through the treatment. Multimodal cognitive behavioral therapeutic interventions in a group setting are particularly helpful because they may demonstrate differences in the influence of cognitive processes on the emotional perception of the tinnitus between the patients. Psychological factors like emotional support through other patients and learning from other examples can ease the process of internalizing coping strategies. Psychological processes seem to be of particular importance. Those processes can have an effect on concentration, appraisal, and coping with the tinnitus. Progressive muscle relaxation using Jacobson's technique, physical therapy, education via lectures, training of selective attention and change of appraisal, mental attitude and behavior concerning the tinnitus are the main factors in tinnitus therapy and can enable tinnitus patients to decrease their psychological strain.


Asunto(s)
Guías de Práctica Clínica como Asunto , Psicoterapia de Grupo/métodos , Psicoterapia de Grupo/tendencias , Acúfeno/psicología , Acúfeno/rehabilitación , Alemania , Humanos , Pautas de la Práctica en Medicina , Resultado del Tratamiento
15.
J Physiol Pharmacol ; 67(2): 195-203, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27226179

RESUMEN

Irisin has recently been proposed to act as a myokine secreted from skeletal muscle following exercise and to exert several health-beneficial effects, although its role is far from being established. In contrast to the growing body of literature on the biological regulation and function of irisin, there is no evidence on potential associations with mental functions. Since physical activity has been reported to have favorable impact on mental functions, we investigated the association of irisin with depressiveness, perceived stress, and anxiety as well as eating disorder symptoms in obese women. We included 98 female obese inpatients (age: mean ± S.D. 43.9 ± 12.5 years; body mass index 49.2 ± 8.3 kg/m(2)) covering a broad spectrum of psychopathology. Depressiveness (PHQ-9), perceived stress (PSQ-20), anxiety (GAD-7), and eating disorder symptoms (EDI-2) were assessed psychometrically. Plasma irisin obtained at the same time was determined by ELISA. Irisin did not correlate with depressiveness (r = -0.03, P = 0.80), anxiety (r = 0.14, P = 0.17) and perceived stress (r = -0.14, P = 0.18) as well as eating disorder symptoms in general (r = -0.09, P = 0.39). No correlation of irisin was observed with any subscales of the PSQ-20 and EDI-2 (after Bonferroni correction). In conclusion, irisin is not associated with depressiveness, anxiety and perceived stress in female obese patients. These results do not support the assumption of irisin being involved in psychoendocrine pathways of the regulation of depression or other mental functions such as anxiety and perceived stress.


Asunto(s)
Ejercicio Físico , Fibronectinas/sangre , Obesidad/sangre , Adulto , Ansiedad/sangre , Índice de Masa Corporal , Depresión/sangre , Trastornos de Alimentación y de la Ingestión de Alimentos/sangre , Femenino , Humanos , Persona de Mediana Edad , Estrés Psicológico/sangre
16.
FASEB J ; 15(13): 2536-8, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11641256

RESUMEN

It has long been suspected that stress can cause hair loss, although convincing evidence of this has been unavailable. Here, we show that in mice sonic stress significantly increased the number of hair follicles containing apoptotic cells and inhibited intrafollicular keratinocyte proliferation in situ. Sonic stress also significantly increased the number of activated perifollicular macrophage clusters and the number of degranulated mast cells, whereas it down-regulated the number of intraepithelial gd T lymphocytes. These stress-induced immune changes could be mimicked by injection of the neuropeptide substance P in nonstressed mice and were abrogated by a selective substance P receptor antagonist in stressed mice. We conclude that stress can indeed inhibit hair growth in vivo, probably via a substance P-dependent activation of macrophages and/or mast cells in the context of a brain-hair follicle axis.


Asunto(s)
Encéfalo/fisiología , Folículo Piloso/crecimiento & desarrollo , Estimulación Acústica , Animales , Apoptosis/efectos de los fármacos , Degranulación de la Célula , División Celular/efectos de los fármacos , Citocinas/biosíntesis , Folículo Piloso/química , Folículo Piloso/efectos de los fármacos , Antígenos de Histocompatibilidad Clase II/biosíntesis , Inmunohistoquímica , Etiquetado Corte-Fin in Situ , Indoles/farmacología , Isoindoles , Queratinocitos/química , Queratinocitos/citología , Queratinocitos/efectos de los fármacos , Antígeno Ki-67/análisis , Macrófagos/metabolismo , Macrófagos/patología , Mastocitos/fisiología , Ratones , Receptores de Antígenos de Linfocitos T gamma-delta/biosíntesis , Piel/metabolismo , Piel/patología , Estrés Fisiológico/fisiopatología , Sustancia P/farmacología , Linfocitos T/citología , Linfocitos T/metabolismo , Regulación hacia Arriba
17.
Diabetes Care ; 21(11): 1876-85, 1998 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-9802736

RESUMEN

OBJECTIVE: The concept of quality of life (QOL) is understood as a multidimensional construct made up of physiological, psychological, and social aspects, but their particular weightings for the global QOL are rarely investigated. We examined 1) the general QOL of patients with diabetes, 2) the significance of the individual QOL aspects for the overall assessment of QOL, and 3) the modulating function of coping mechanism and particular personality traits. RESEARCH DESIGN AND METHODS: A total of 116 diabetes patients under intensified insulin therapy were studied, as were 107 patients with inflammatory bowel disease, 66 patients with chronic hepatitis C, and 229 students who served as control subjects. The examination was based on eight standardized QOL and personality questionnaires (354 items) and assessed by means of linear structural regression models (AMOS 3.6). RESULTS: The QOL of diabetes patients appears to be higher than the QOL of other chronically ill patients. Social, psychological, and physical aspects contribute to the overall QOL, although physical complaints receive a comparatively low weighting. Coping behavior and particular personality traits covary with all QOL aspects, giving these variables greater significance for the QOL than the existence of secondary illnesses. CONCLUSIONS: The hypothesis that the various factors involved in the multidimensional construct QOL receive different weightings was confirmed, making a simple summary score for the general QOL appear unjustifiable. In addition, all aspects that are commonly understood as parameters of QOL are influenced by external factors, such as coping behavior, based on individual personality characteristics.


Asunto(s)
Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/psicología , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Calidad de Vida , Actividades Cotidianas , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Apoyo Social , Encuestas y Cuestionarios
18.
J Physiol Pharmacol ; 66(4): 493-503, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26348074

RESUMEN

The ghrelin acylating enzyme ghrelin-O-acyltransferase (GOAT) was recently identified and implicated in several biological functions. However, the effects on food intake warrant further investigation. While several genetic GOAT mouse models showed normal food intake, acute blockade using a GOAT inhibitor resulted in reduced food intake. The underlying food intake microstructure remains to be established. In the present study we used an automated feeding monitoring system to assess food intake and the food intake microstructure. First, we validated the basal food intake and feeding behavior in rats using the automated monitoring system. Afterwards, we assessed the food intake microstructure following intraperitoneal injection of the GOAT inhibitor, GO-CoA-Tat (32, 96 and 288 µg/kg) in freely fed male Sprague-Dawley rats. Rats showed a rapid habituation to the automated food intake monitoring system and food intake levels were similar compared to manual monitoring (P = 0.43). Rats housed under these conditions showed a physiological behavioral satiety sequence. Injection of the GOAT inhibitor resulted in a dose-dependent reduction of food intake with a maximum effect observed after 96 mg/kg (-27%, P = 0.03) compared to vehicle. This effect was delayed in onset as the first meal was not altered and lasted for a period of 2 h. Analysis of the food intake microstructure showed that the anorexigenic effect was due to a reduction of meal frequency (-15%, P = 0.04), whereas meal size (P = 0.29) was not altered compared to vehicle. In summary, pharmacological blockade of GOAT reduces dark phase food intake by an increase of satiety while satiation is not affected.


Asunto(s)
Aciltransferasas/antagonistas & inhibidores , Depresores del Apetito/farmacología , Ingestión de Alimentos/efectos de los fármacos , Inhibidores Enzimáticos/farmacología , Péptidos/farmacología , Animales , Depresores del Apetito/administración & dosificación , Relación Dosis-Respuesta a Droga , Conducta Alimentaria/efectos de los fármacos , Ghrelina/metabolismo , Inyecciones Intraperitoneales , Masculino , Péptidos/administración & dosificación , Ratas , Ratas Sprague-Dawley , Respuesta de Saciedad/efectos de los fármacos
19.
Transplantation ; 56(3): 561-7, 1993 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8212150

RESUMEN

In a cross-sectional survey of the quality of life of 45 liver transplant recipients, physical and psychological status, physical complaints, capability to participate in daily life, social support, and global quality of life were assessed. The average time of follow-up was 9 months after transplantation. Nine patients had moderate liver damage, 12 suffered from drug side effects, and 10 had extrahepatic diseases. Physical complaints, especially rheumatism, exhaustion, and gastric complaints, were higher than in the general population. Most patients were able to participate in daily life (do housework, take part in family life, etc.). Apart from the complex "health" (use of body), they did not differ in this respect from healthy individuals. Eighty percent of the patients reported having very good social support. The psychological status was generally good, with only 5% complaining of anxiety and nervousness. Sixty percent regarded their quality of life to be very high, 31% reported medium quality of life, and 9% felt very bad. No relationship was found between low quality of life and transplant malfunction; patients with extrahepatic diseases had the lowest quality of life. Among all subgroups, the individuals who were actively working again felt best. Psychological qualities necessary for coping with daily life (self-assurance, self-realization, satisfaction, and happiness) correlated most with the global quality of life (r = 0.80), whereas no relationship was found between quality of life and complaints in total (r = -0.32). This survey shows that during the first year after transplantation, transplant recipients report a high quality of life in important areas of living, despite many physical complaints, and even display an almost euphoric mood.


Asunto(s)
Trasplante de Hígado/psicología , Calidad de Vida , Adulto , Anciano , Análisis de Varianza , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Escalas de Valoración Psiquiátrica , Apoyo Social , Factores Socioeconómicos
20.
Neurogastroenterol Motil ; 15(5): 467-73, 2003 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-14507348

RESUMEN

Several pathophysiological mechanisms have been proposed in functional gastrointestinal (GI) disorders, e.g. altered GI motility and sensitivity. The aim of this study was to investigate gastric electrical activity (GEA) in patients with functional dyspepsia (FD) or irritable bowel syndrome (IBS) compared with healthy controls (HC), and to assess if abdominal symptoms and delayed gastric emptying are associated with alterations in GEA, as determined by electrogastrography (EGG). Forty patients with FD, IBS or both were compared with 22 HC. EGG was performed before and after a standard meal. Frequencies and amplitudes pre- and post-prandially were analysed. Furthermore, gastric emptying and symptom scores were assessed. Eight of 40 patients (20%; three FD, three IBS, two FD and IBS) had delayed gastric emptying. Disturbed gastric emptying and lack of a postprandial increase in the EGG amplitude were significantly correlated (r = 0.8; P < 0.005). No differences between controls and patients were observed in the distribution of EGG frequencies. Treatment with the prokinetically active macrolide erythromycin improved gastric emptying, GEA and symptoms (n = 4). The data suggest that EGG could be useful as a diagnostic tool in patients with FD and IBS to identify a subgroup of patients with delayed gastric emptying.


Asunto(s)
Dispepsia/diagnóstico , Electrodiagnóstico/métodos , Vaciamiento Gástrico/fisiología , Síndrome del Colon Irritable/diagnóstico , Adolescente , Adulto , Anciano , Dispepsia/tratamiento farmacológico , Dispepsia/fisiopatología , Eritromicina/uso terapéutico , Femenino , Humanos , Síndrome del Colon Irritable/tratamiento farmacológico , Síndrome del Colon Irritable/fisiopatología , Masculino , Persona de Mediana Edad
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA