Positive Emotional Experience: Induced by Vibroacoustic Stimulation Using a Body Monochord in Patients with Psychosomatic Disorders: Is Associated with an Increase in EEG-Theta and a Decrease in EEG-Alpha Power.

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.

[Integrated intensive treatment of tinnitus: decrease of the tinnitus-related distress during a one-year follow-up study]. / Integrierte Tinnitusintensivbehandlung: Verringerung der tinnitusbedingten Belastung während einer 1-Jahres-Katamnese.

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.

[Integrated intensive treatment of tinnitus: method and initial results]. / Integrierte Tinnitusintensivbehandlung: Konzept und erste praktische Erfahrungen.

In recent years, no major advances have been made in understanding the mechanisms underlying the development of tinnitus. Hence, the present therapeutic strategies aim at decoupling the subconscious from the perception of tinnitus. Mindful of the lessons drawn from existing tinnitus retraining and desensitisation therapies, a new integrated day hospital strategy of treatment lasting 7-14 days has been developed at the Charité Hospital and is presented in the present paper. The strategy for treating tinnitus in the proximity of patient domicile is designed for patients who feel disturbed in their world of perception and their efficiency due to tinnitus and give evidence of mental and physical strain. In view of the etiologically non-uniform and multiple events connected with tinnitus, consideration was also given to the fact that somatic and psychosocial factors are equally involved. Therefore, therapy should aim at diagnosing and therapeutically influencing those psychosocial factors that reduce the hearing impression to such an extent that the affected persons suffer from strain. The first results of therapy-dependent changes of 46 patients suffering from chronic tinnitus are presented. The data were evaluated before and after 7 days of treatment and 6 months after the end of treatment. Immediately after the treatment, the scores of both the tinnitus questionnaire (Goebel and Hiller) and the subscales improved significantly. These results were maintained during the 6-month post-treatment period and even improved.

[Kurt Goldstein's understanding of amnesic aphasia and its underlying disorder - an early model of the pensée opératoire of the French psychosomatic school?]. / Kurt Goldsteins Verständnis der amnestischen Aphasie und der Grundstörung - ein frühes Modell der Pensée opératoire der französischen psychosomatischen Schule?

Kurt Goldstein's understanding of amnesic aphasia in some regards anticipated the model of the pensée opératoire, a concept developed during the 60's and 70's by the French psychoanalytical school of psychosomatics. Goldstein interpreted amnesic aphasia within the framework of a "basic disorder". Closely following the philosopher Ernst Cassirer, Goldstein described amnesic aphasia as an expression of a general alteration following localized or generalised brain damage. Due to various historical events (world war, fascism, the holocaust) as well as developments during the 20(th) century (dominance of the English language in many areas of science), these connections were forgotten or were no longer recognised as such. Without wanting to determine the extent to which the concept of pensée opératoire possesses validity, one can interpret Goldstein's reflections on aphasia as a heretofore unreceived preliminary model of the psychosomatic concept of the French School.

Indications for a 'brain-hair follicle axis (BHA)': inhibition of keratinocyte proliferation and up-regulation of keratinocyte apoptosis in telogen hair follicles by stress and substance P.

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.

Patients' expressions of complaints as a predictor of the course of acute hepatitis A.

OBJECTIVE: Physical complaints, emotional states, liver, and immune parameters were investigated as possible indicators of the course of hepatitis A. METHODS: Forty-seven patients with hepatitis A were studied by means of the Giessen-Complaint-Inventory (GBB) and the Berlin Mood Questionnaire (BSF), as well as by taking into account their typical liver parameters and the following immune parameters: alphaInterferon (alphaIFN), soluble Interleukin 2 receptor (sIL-2R), Interleukin 6 (IL-6), Interleukin 1 receptor antagonist (IL-1Ra), and Immunoglobulin M or G (IgM, IgG). Two hundred twenty-nine medical students and a representative German sample (n = 1557, Braehler et al.) served as controls. RESULTS: We found that the initial degree of change in permeability of the liver cells, complaints about abdominal symptoms, and extent of depressive mood were able to predict the length of hospital stay. Patients with the initial, more pronounced liver damage, as well as patients who articulated less subjective impairment proved to have a longer course of illness. Those patients who needed a significantly longer time for recovery report, at admission, very few complaints-fewer than even the normal population. We were not, however, able to demonstrate a significant difference in the investigated immune parameters. CONCLUSION: A certain denial tendency seems to be harmful with respect to the recovery process and the immunological competence in the course of hepatitis A.

[Pictures by pregnant patients with premature labor. Initial experiences with art therapy]. / Bilder von Schwangeren mit vorzeitigen Wehen. Erste Erfahrungen eines maltherapeutischen Angebots.

Patients with preterm labor not only suffer from anxiety and uncertainty regarding the healthy development of their child but, especially as inpatients, in part severely from loss of autonomy and feelings of insufficiency. By the creative therapeutic means of art therapy it is aimed at influencing the disturbed emotional state and strengthening self-esteem. During the sessions patients experience challenge, success and relaxation with endurance some time after the sessions. Paintings produced by hospitalized patients in art therapeutic sessions are presented. Further psychophysiological investigations are in process for controlling the effects on preterm labor. Paintings of inpatients are discussed.