Using hypnoanalysis and guided imagery to identify and manage emotional aspects of multiple sclerosis.

BACKGROUND: To date, no studies have used hypnosis to examine and manage the potential emotional causes of multiple sclerosis (MS) in the scientific field; therefore, we decided to compare the effectiveness of hypnoanalysis and guided imagery for determining and manage these emotional causes. METHODS: Fifteen participants with severe MS were included and assigned into 2 groups: hypnoanalysis and guided imagery. In the hypnoanalysis group, the participants underwent 10 hypnotic sessions to understand events related to the cause of the disease, which were restructured (the events were modified by adding the psychological resources that each involved person needed); in addition, other techniques were used to investigate the causes and solutions according to the participants' unconscious. The guided imagery group received 10 group sessions of body relaxation and guided imagery, which were recorded for practice at home. Outcome measures, namely, disability (the Expanded Disability Status Scale, EDSS), quality of life (QoL, measured with the SF-36) and number of relapses, were evaluated 4 months previous the intervention, at baseline, post-intervention, and 3 months later. RESULTS: Hypnoanalysis revealed that stressful events and psychoemotional maladaptive patterns acted as causal, detonating, or aggravating factors of disease, and psychoemotional changes were the most frequent and varied solutions. No changes were observed in disability between the two groups. The guided imagery group showed an improvement in 2 subscales of QoL when compared with the hypnoanalysis group (which disappeared at the follow-up); this difference is probably due to the increased number of sessions and probably due to psychoemotional maladaptive patterns being more frequently mentioned than difficult circumstances in life and/or unsolved past events. However, the techniques used in hypnoanalysis were effective in understanding the potential emotional causes of MS, which showed high intra- and inter-participant consistency. CONCLUSIONS: The daily use of guided imagery overcame the restructuring of negative past events to improve QoL in patients with MS. TRIAL REGISTRATION: ACTRN12618002024224 (retrospectively registered).

Relaxation with heat and procedural information to diminish anxiety in presurgical patients of hernia surgery.

Presurgical anxiety has been associated with postsurgical pain and complications, therefore we decided to compare two psychological interventions in order to reduce presurgical anxiety-state and pain in patients undergoing hernia surgery. Patients undergoing the presurgical consultation for hernia repair (umbilical or inguinal), were invited. The group of procedural information consisted in administering an informative brochure after the presurgical consultation, while the relaxation with heat group (RWH) consisted in giving a heat pack to the patients while asking them to think in the benefits of the surgery and instructions of relaxation were given, this was performed at the operating theater before surgery. Anxiety-state and pain levels were measured after presurgical consultation and a day after just before surgery. Ninety-five patients were included in 3 groups of study (control = 36, procedural information = 31 and RWH = 28); when we included only those individuals with moderate or high anxiety at the presurgical consultation, we found that procedural information (-4.72 ± 6.10) and RWH diminished anxiety (-9.29 ± 6.91) but only RWH group reached statistical significance when compared with control group (-9.29 ± 6.91 vs -0.56 ± 9.82, p = 0.007). In conclusion, RWH produced a significantly higher reduction of anxiety-state before hernia surgery.

Association between personal, medical and positive psychological variables with somatization in university health sciences students.

OBJECTIVE: To measure personal, medical and psychological positive and negative variables and to determine their relation with somatization in a sample of health sciences students. Subjects and methods: A total of 594 (34.43%) of the 1725 health science students of a public university answered an online survey with personal and medical information as well as the following psychological variables: phsychological well-being, five facets mindfulness questionnaire (FFMQ), life satisfaction, depression, and academic stress. Additionally, the presence of 11 somatic symptoms and 11 diseases during the last year was measured. Results: Most students were women (74.06%) who were 19.96 ± 4.28 years old. The global frequency of somatization in the previous year was 66.59%, and the presence of any measured disease 14.75%. With the multivariate analysis, self-acceptance was the most related variable (negatively) with somatization, followed by the sum of diseases, female gender, academic stress, smoking, and depression, in a model with an R-value of 0.634, self-acceptance was also the most related variable (negatively) with depression, being this last the most related variable with academic stress. Conclusions: After analyzing all variables considered in this study, self-acceptance was the most related variable with somatization and depression; this highlights the importance of strengthening the acceptance of the self in the student population in order to prevent these conditions and their consequences.

Attitudes, Knowledge, Use, and Recommendation of Complementary and Alternative Medicine by Health Professionals in Western Mexico.

BACKGROUND: The use of complementary and alternative medicine (CAM) has increased in many countries, and this has altered the knowledge, attitudes, and treatment recommendations of health professionals in regard to CAM. METHODS: Considering Mexican health professionals׳ lack of knowledge of CAM, in this report we surveyed 100 biomedical researchers and Ph.D. students and 107 specialized physicians and residents of a medical specialty in Guadalajara, México (Western Mexico) with a questionnaire to address their attitudes, knowledge, use, and recommendation of CAM. RESULTS: We observed that significantly more researchers had ever used CAM than physicians (83% vs. 69.2%, P = .023) and that only 36.4% of physicians had ever recommended CAM. Female researchers tended to have ever used CAM more than male researchers, but CAM use did not differ between genders in the physician group or by age in either group. Homeopathy, herbal medicine, and massage therapy were the most commonly used CAMs in both the groups. Physicians more frequently recommended homeopathy, massage therapy, and yoga to their patients than other forms of CAM, and physicians had the highest perception of safety and had taken the most courses in homeopathy. All CAMs were perceived to have high efficacy (>60%) in both the groups. The attitude questionnaire reported favorable attitudes toward CAM in both the groups. CONCLUSIONS: We observed a high rate of Mexican health professionals that had ever used CAM, and they had mainly used homeopathy, massage therapy, and herbal medicine. However, the recommendation rate of CAM by Mexican physicians was significantly lower than that in other countries, which is probably due to the lack of CAM training in most Mexican medical schools.

MTHFR C677T, MTHFR A1298C, and OPG A163G polymorphisms in Mexican patients with rheumatoid arthritis and osteoporosis.

MTHFR polymorphisms C677T and A1298C are associated with reduced MTHFR enzyme activity and hyperhomocysteinemia, which has been associated with osteoporosis. The A163G polymorphism in osteoprotegerin (OPG) has been studied in osteoporosis with controversial results. The objective of the present study was to investigate the association(s) among MTHFR C677T, MTHFR A1298C, and OPG A163G polymorphisms in Mexican patients with rheumatoid arthritis and osteoporosis. The femoral neck and lumbar spine bone mineral densities (BMDs) were measured in 71 RA patients, and genotyping for the three polymorphisms was performed via restriction fragment length polymorphism analysis. Patients with osteoporosis/osteopenia exhibited statistically significant differences in the genotype frequencies of MTHFR C677T as well as an association with femoral neck BMD; TT homozygotes had lower BMDs than patients with the CT genotype, and both of these groups had lower BMDs than patients with the CC genotype. The associations of the MTHFR C677T polymorphism with osteoporosis/osteopenia and femoral neck BMD suggest that these polymorphisms confer a risk of developing osteoporosis in patients with rheumatoid arthritis, a risk that may be reduced with folate and B complex supplementation.