Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.076
Filtrar
1.
Artigo em Russo | MEDLINE | ID: mdl-32929942

RESUMO

The authors consider current views on and approaches to trauma and posttraumatic stress disorder (PTSD). There are doubts about the correctness and validity of allocation of PTSD entirely according to psychogenesis of the disease. The authors consider the «post-traumatic¼ as a type of response to extreme stress. PTSD is characterized as a nonspecific pathological form of disease, which can occur in the structure of different mental disorders. Based on considering two approaches (cerebrotraumatic and psychosomatic) in solving the current issue, the authors suggest that PTSD is a psychogenic-organic disorder.


Assuntos
Intolerância Ortostática , Transtornos de Estresse Pós-Traumáticos , Veteranos , Humanos , Transtornos Psicofisiológicos , Transtornos Somatoformes
2.
Soc Sci Med ; 262: 113261, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32758794

RESUMO

RATIONALE: Psychological resilience is characterized as the ability to respond to extreme stress or trauma or adverse experience successfully. While the relation between public emergencies and psychological distress is well known, research on therelationship between psychological resilience and mental health is very limited during the outbreak of public health emergencies. OBJECTIVE: This research investigated the relationship between psychological resilience and mental health (depression, anxiety, somatization symptoms) among the general population in China. METHOD: Psychological resilience, depression, anxiety, and somatization symptoms of 1770 Chinese citizens were investigated during the epidemic peak of coronavirus disease 2019 (COVID-19) (23rd February 2020 to 2nd March 2020). The analyses were done through the Connor-Davidson Resilience Scale (CD-RISC), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) scale, and the Patient Health Questionnaire-15 (PHQ-15) scale. RESULTS: The prevalence of depression, anxiety, somatization symptoms was found to be 47.1%, 31.9%, 45.9%, respectively, among all participants. From them, 18.2% showed moderate to severe symptoms of depression, 8.8% showed moderate to severe symptoms of anxiety, and 16.6% showed moderate to severe symptoms of somatization. Psychological resilience was negatively correlated with depression (standardized ß = -0.490, P < 0.001), anxiety (standardized ß = -0.443, P < 0.001), and somatization symptom scores (standardized ß = -0.358, P < 0.001), while controlling for confounding factors. Analysis of the three-factor resilience structure showed that strength and tenacity were correlated with depression (standardized ß = -0.256, P < 0.001; standardized ß = -0.217, P < 0.001), anxiety (standardized ß = -0.268, P < 0.001; standardized ß = -0.147, P < 0.001), and somatization symptoms (standardized ß = -0.236, P < 0.001; standardized ß = -0.126, P < 0.01). CONCLUSIONS: Our results suggest that there is a high prevalence of psychological distresses among the general population at the peak of the COVID-19 epidemic in China, which is negatively correlated with resilience. Psychological resilience represents an essential target for psychological intervention in a public health emergency.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Epidemias , Pneumonia Viral/psicologia , Resiliência Psicológica , Transtornos Somatoformes/epidemiologia , Adulto , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/epidemiologia
3.
Georgian Med News ; (303): 142-148, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32841196

RESUMO

The aim of the study - is to investigate the presence of depressive disorders and their manifestation in children with somatoform disorders (SD) from different organs and systems and to establish the role of disorders of serotonin and tryptophan metabolism in their occurrence. 111 children were diagnosed with SD. The average age of children was 13,6±2,3 years, among them boys were 42 (37,8%) and girls - 69 (62,2%). The patients were divided into two groups: children with SD without depression 63 (56,8%) and children with SD with depression 48 (43,2%). For diagnosing of depression it was used a questionnaire for childhood depression of M. Kovacs. The determination of blood serum concentration of serotonin was carried out by biochemical method, tryptophan - by chromatographic. The depression was diagnosed in 48 (43,2%) children of which it was mild - in 14 (29,2%), moderate - in 27 (56,2%) and severe depression - in 7 (14,6%) children. Depression was more common in girls - 34 (70,8%), in relation to boys 2,4:1. The serotonin level in children with depression was 1,03 ± 0,37 µmol/L, and it was lower to compare with children without depression (1,30 ± 0,27 µmol/L) (95% CI, 0,15 - 0,39 µmol/L, p<0,0001). The level of tryptophan in children with depression was 0,035 ± 0,031 mmol/L and it was higher to compare with children without depression (0,026 ± 0,026 mmol/L) (p>0,05). Low levels of serotonin were associated with a negative mood (95% CI, 0,02 - 0,30 µmol/L, p<0,02), anhedonia (95% CI, 0,11 - 0,36 µmol/L, p<0,0003). It was found the moderate and inverse correlation between serotonin and tryptophan in SD in children with depression (r = -0,342; 95% CI for r, -0,65 to -0,034, p<0,05). A low serotonin level was associated with depression and it was not associated with SD without depression. With a decrease in serotonin concentration the level of tryptophan increases which can indicate about the violation of the chain of tryptophan-serotonin and its involvement in the development of depression in SD.


Assuntos
Serotonina , Triptofano , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Transtornos Somatoformes
4.
Wiad Lek ; 73(6): 1114-1118, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32723936

RESUMO

OBJECTIVE: The aim: Study of somatoform vegetative dysfunction' clinical features at adolescent age with a chronic pain (HA syndrome and AP syndrome), and also socially-psychological factors of its formation too. PATIENTS AND METHODS: Materials and methods: There are 82 teenagers have been examined in this research: 48 girls (58,5 %) and 34 young men (41,5 %) at the age of 16 - 17 years. Research will be done according to diagnostic criteria of ICD-10. RESULTS: Results: An aetiological basis of HAS and APS are various somatoform disorder mostly at teenage age (70,8 % cases at girls and in 58,8 % - at young men). 32,2 % of the patients had various neurotic disturbances with anxiety-depressive symptoms in a genesis of HAS and APS. Somatoform vegetative dysfunction - the most widespread reason of HAS and APS development among teenagers. Among teenagers HAS cases (68,8 % - at girls, 58,8 % - at young men) essentially prevail over APS (31,2 and 41,2 % cases accordingly). All adolescents had combine negative life events in their life. Girls felt psychotraumatic experience more strongly than young man. The greatest combine negative life experience has been revealed in a subgroup of girls with HAS. The least influence of psychotraumatic factors was observed at young men with APS. Consequently, SVD, accompanied by severe pain in adolescence - is pathogenic complex and combined mental disorders, requiring adequate psychopharmacological and psychotherapeutic intervention. CONCLUSION: Conclusions: Chronic stressful situations were experienced by each of the examined patients. Each of the teens noted combination of stress problems in their lives. The widespread common problem among the examined adolescents was a sense of being overprotected by parents. Consequently, SVD, accompanied by severe pain in adolescence -is pathogenic complex and combined mental disorders, requiring adequate psychopharmacological and psychotherapeutic intervention.


Assuntos
Dor Crônica , Pediatria , Adolescente , Criança , Feminino , Humanos , Masculino , Transtornos Somatoformes , Síndrome
5.
Medicine (Baltimore) ; 99(29): e21338, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702931

RESUMO

Anophthalmic patients not only cause obvious functional deficits and facial deformities, but lead to poor psychological outcomes, although prosthesis wearing can offer improvements in psychological well-being to some extent. The study aimed to comprehensively evaluate the psychological symptoms and analyze related factors in anophthalmic patients wearing ocular prosthesis.Total of 150 anophthalmic patients and 120 control subjects were included in this cross-sectional study. Baseline characteristics survey and the symptom checklist-90 scale were completed by all participants to assess the psychological symptoms and analyze their related factors by multivariate analysis.The anophthalmic patients exhibited the increased levels of somatization, depression, anxiety, and hostility compared with control subjects. The most prominent symptom was hostility with the median score of 1.20. Female patients presented with higher somatization, depression, anxiety, and hostility. Marital status single was positively associated with depression, anxiety, and hostility symptoms. Lower education and cause of enucleation were related to higher levels of hostility.Anophthalmic patients wearing ocular prosthesis presented with more prominent hostility and somatization besides its higher depression and anxiety symptoms. The findings suggest that for female single anophthalmic patients with low education, especially caused by trauma, timely psychological assessment and intervention should be provided to avoid undesirable consequences.


Assuntos
Anoftalmia/psicologia , Olho Artificial/psicologia , Adulto , Anoftalmia/complicações , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos de Casos e Controles , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Fatores de Risco , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/etiologia , Inquéritos e Questionários , Adulto Jovem
6.
PLoS One ; 15(6): e0233153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32492037

RESUMO

Body dysmorphic disorder (BDD), together with its subtype muscle dysmorphia (MD), has been relocated from the Somatoform Disorders category in the DSM-IV to the newly created Obsessive-Compulsive and Related Disorders category in the DSM-5. Both categorizations have been criticized, and an empirically derived classification of BDD is lacking. A community sample of N = 736 participants completed an online survey assessing different psychopathologies. Using a structural equation modeling approach, six theoretically derived models, which differed in their allocation of BDD symptoms to various factors (i.e. general psychopathology, somatoform, obsessive-compulsive and related disorders, affective, body image, and BDD model) were tested in the full sample and in a restricted sample (n = 465) which indicated primary concerns other than shape and weight. Furthermore, measurement invariance across gender was examined. Of the six models, only the body image model showed a good fit (CFI = 0.972, RMSEA = 0.049, SRMR = 0.027, TLI = 0.959), and yielded better AIC and BIC indices than the competing models. Analyses in the restricted sample replicated these findings. Analyses of measurement invariance of the body image model showed partial metric invariance across gender. The findings suggest that a body image model provides the best fit for the classification of BDD and MD. This is in line with previous studies showing strong similarities between eating disorders and BDD, including MD. Measurement invariance across gender indicates a comparable presentation and comorbid structure of BDD in males and females, which also corresponds to the equal prevalence rates of BDD across gender.


Assuntos
Transtornos Dismórficos Corporais/classificação , Adolescente , Adulto , Idoso , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Imagem Corporal , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Alemanha/epidemiologia , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Transtornos do Humor/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Prevalência , Psicopatologia , Transtornos Somatoformes/psicologia , Inquéritos e Questionários , Adulto Jovem
7.
Orv Hetil ; 161(25): 1050-1058, 2020 06.
Artigo em Húngaro | MEDLINE | ID: mdl-32516123

RESUMO

INTRODUCTION: About 25-30% of patients present themselves in general practice and specialized healthcare with medically unexplained somatic symptoms. The prevalence of these symptoms is the highest among the elderly, children and adolescents. Approximately 20% of patients in primary care and 47% of them in specialized clinics are children between the age of 7-12 who seem to have somatic symptom disorder (SSD). Somatization disorder most frequently occur with symptoms of headache, stomach ache or various kinds of pain in the limbs that show high comorbidity with other mental disorders, predominantly with anxiety. SSDs are always multicausal issues where biological, social-environmental and psychological factors are interconnected in a complex manner. According to our experience, somaziting patients are often drifting in the healthcare system for years, and instead of getting adequate treatment, they only receive medication, thus their symptoms may easily become chronic. Aim, method: Our aim was to review the current literature and guidelines concerning evidence-based treatments for SSD in childhood. Furthermore, to underline the importance of psychotherapy in SSD, we present the cognitive behavior therapy of a 16-year-old adolescent with vertigo, gastrointestinal symptoms and insomnia over a 8-month period. DISCUSSION: The results of effectiveness studies unequivocally recommend cognitive behavioral therapy in the treatment of SSD patients, accompained by family therapy or family consultation. The therapy should focus on reducing psychosocial stressors, health anxiety and catastrophizing thinking style in the family, while developing adequate coping and communication skills as well as maintaining the patient's age-appropriate activity level. CONCLUSION: Cognitive behavior therapy is the treatment of choice in SSD for children and young people. Applying the biopsychosocial approach is a key issue in the assessment of predisposing and maintaining factors, ensuring that only methods based on scientific evidence will be applied to help these children. Orv Hetil. 2020; 161(25): 1050-1058.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Sintomas Inexplicáveis , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/terapia , Adolescente , Idoso , Transtornos de Ansiedade/terapia , Medicina Baseada em Evidências , Humanos , Psicoterapia , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/terapia , Transtornos Somatoformes/diagnóstico , Resultado do Tratamento , Vertigem/diagnóstico , Vertigem/terapia
8.
J Oral Rehabil ; 47(8): 923-929, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32433776

RESUMO

OBJECTIVE: To compare the smallest thickness that can be perceived between occluding teeth (occlusal tactile acuity, OTA) of temporomandibular disorder pain (TMD-P) patients with that of control (CTR) individuals. METHODS: Twenty TMD-P patients (17 women and 3 men, mean age: 31.3 ± 10.4 years) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol and 20 age- and gender-matched controls (17 women and 3 men, mean age: 31.4 ± 10.5 years) were enrolled. The OTA was tested with 10 different thicknesses: 9 aluminium foils (8 µm-72 µm with a constant increment of 8 µm) and 1 sham test (without foil), each thickness being tested 10 times in random order (100 tests in total). The participants were instructed to close their mouth once and to report whether they felt the foil between their molar teeth. A between-group comparison (TMD-P vs CTR) was performed for each testing thickness (analysis of variance for repeated measurements, with Bonferroni multiple correction) (P < .005). RESULTS: Significantly increased OTA was observed in the TMD-P group for the thicknesses between 8 µm and 40 µm, while no significant differences were found for the sham test and for the larger thicknesses tested (from 48 µm to 72 µm). CONCLUSIONS: TMD-pain subjects presented an increased OTA as compared to controls.


Assuntos
Transtornos da Articulação Temporomandibular , Adulto , Estudos de Casos e Controles , Dor Facial , Feminino , Humanos , Masculino , Dor , Transtornos Somatoformes , Tato , Adulto Jovem
9.
Praxis (Bern 1994) ; 109(7): 499-503, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-32456576

RESUMO

Body Dysmorphic Disorder - Balance between Beauty Mania and Illness Abstract. The body dysmorphic disorder (BDD) belongs to the somatoform disorders and is characterized by an excessive concern about a slight or not apparent defect in appearance. Typical areas of concern include the face, for example the skin texture or form and symmetry of a particular feature. Besides behavioral pecularities such as excessive checking of the defect in a mirror, the preoccupation causes clinically significant distress and impairment in social functioning. Given a prevalence of up to 20 % among patients seeking plastic surgery, it is perhaps the most relevant psychiatric condition for plastic surgeons. Moreover, aesthetic treatments might even lead to a worsening of symptoms. Thus, we recommend close observation of all patients seeking aesthetic operations cautiously with regard to typical symptoms and behavior. Particular questions from well-known screening questionnaires might further help to identify patients with BDD.


Assuntos
Transtorno Bipolar , Transtornos Dismórficos Corporais , Cirurgia Plástica , Beleza , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/terapia , Imagem Corporal , Estética , Humanos , Transtornos Somatoformes
10.
Dtsch Arztebl Int ; 116(8): 134-135, 2020 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-32181737
12.
Int J Prosthodont ; 33(2): 155-159, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32069339

RESUMO

PURPOSE: To assess the correlation between RDC/TMD Axis I and Axis II diagnoses and whether pain could mediate a possible correlation between these two variables. MATERIALS AND METHODS: Data of both RDC/TMD axes were collected from 737 consecutive patients who sought TMD advice at the University of Padova, Italy. A descriptive analysis was used to report the frequencies of Axis I and II diagnoses, and Spearman test was performed to assess the correlation between the axes. Subsequently, the sample was divided into two groups (painful vs nonpainful TMD). Frequencies were reported using descriptive analysis, and chi-square test was used to compare groups. The painful TMD group was then divided based on the level of pain-related impairment (low = Groups I and II; high = Groups III and IV). Then, frequencies of depression and somatization were reported using descriptive analysis for each disability group, and chi-square test was used to compare groups. RESULTS: No correlation levels were found between Axis I and any of the Axis II findings (Graded Chronic Pain Scale, depression, and somatization). The painful TMD group presented higher levels of depression and somatization (P < .05). Comparisons of depression and somatization frequencies between pain-impairment groups showed a significantly higher prevalence of abnormal scores for the severe pain-impairment group. CONCLUSION: There is no correlation between specific Axis I and Axis II findings. The presence of pain, independent of the muscle or joint location, is correlated with Axis II findings, and higher levels of pain-related impairment are associated with the most severe scores of depression and somatization.


Assuntos
Transtornos Somatoformes , Transtornos da Articulação Temporomandibular , Depressão , Dor Facial , Humanos , Dor , Medição da Dor
14.
Scand J Public Health ; 48(2): 214-223, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29741125

RESUMO

Aims: Earlier studies on the associations between parental somatic illnesses and children's psychological wellbeing have focused on the most common somatic illnesses or on specific groups of illnesses. In this study, we aimed to systematically examine whether parental somatic illnesses, diagnosed during an offspring's childhood, are associated with later mental disorders of the offspring and, if so, identify which parental somatic illnesses in particular increase the likelihood for later mental disorders among the offspring. Methods: The 1987 Finnish Birth Cohort study yields longitudinal nationwide follow-up data that include a complete census of children born in a single year. Children have been followed over time through to the year 2012 using official registers maintained by the Finnish authorities. Parental diagnoses of specialised hospital inpatient care were identified from the Hospital Discharge Register after children's birth and followed up until the end of 1995. Children's psychiatric diagnoses from specialised hospital care were identified from the same register for the periods 1996/1998-2012. Logistic regression analyses were used to calculate sex-specific odds ratios for associations of mental disorders with maternal and paternal somatic illnesses using parental death, education, social assistance and psychiatric inpatient care as covariates. Results: Parental somatic illnesses during an offspring's childhood seem to increase the risk for later mental disorders. Several previously unreported somatic parental illnesses were found to be significantly associated with offspring's later mental health. Conclusions: Parental somatic illnesses should be considered as a significant adverse childhood life event, calling for preventive actions and child-centred support in adult healthcare.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/epidemiologia , Transtornos Somatoformes , Adolescente , Experiências Adversas da Infância , Criança , Filho de Pais Incapacitados/estatística & dados numéricos , Estudos de Coortes , Feminino , Finlândia/epidemiologia , Hospitalização , Humanos , Masculino , Fatores de Risco , Adulto Jovem
15.
Nord J Psychiatry ; 74(1): 1-8, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31509059

RESUMO

Objective: This study analyzed the prevalence of psychoform and somatoform dissociation among individuals with the whole spectrum of eating disorder diagnoses and compared it with ratings from a non-clinical group. The relationship between dissociation and severity of eating disturbance was examined as well as differences between the eating disorder diagnosis groups in extent of dissociation. The validity of a new structural dissociation interview suitable for eating disorder patients was analyzed.Method: Sixty individuals with eating disorder completed three self-report questionnaires: Dissociation Questionnaire Sweden, Somatoform Dissociation Questionnaire and Eating Disorder Examination Questionnaire. The ratings were compared with the scores in a female non-clinical group (N = 245). Twenty patients with eating disorder diagnoses were interviewed with the Interview for Dissociative Disorders and Trauma Related Symptoms. The validity of the interview was tested by comparing the ratings on the interview subscales with the scores on the Dissociation questionnaires and the Somatoform Dissociation Questionnaire.Results: Participants with eating disorders reported a higher extent of both psychoform and somatoform dissociation compared with the non-clinical individuals. Analyses also showed a correlation between degree of dissociation and severity of eating disorder symptoms. No differences in dissociation were found between the ED subgroups. Participants reporting more dissociation got higher ratings on the interview, indicating convergent validity.Discussion: Eating disorders seem to be associated with presence and severity of dissociative symptoms. The extent of dissociation needs to be assessed for these individuals as treatment may benefit from a focus on such symptoms in order to increase its effect.


Assuntos
Transtornos Dissociativos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos Somatoformes/epidemiologia , Adolescente , Adulto , Comorbidade , Feminino , Humanos , Prevalência , Autorrelato , Inquéritos e Questionários , Suécia , Adulto Jovem
16.
Clin Child Psychol Psychiatry ; 25(1): 62-77, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30818976

RESUMO

BACKGROUND: Medically unexplained symptoms (MUS) are common among children and adolescents and may be highly impairing. Even after long diagnostic and/or therapeutic trajectories, many of these children and their parents feel dissatisfied with the advice and therapies they were given. OBJECTIVES: After a 2-week hospitalisation for somatic and psychiatric reassessment, children and their families were given recommendations for further treatment. This study evaluates which of these recommendations were carried out (primary outcome measure) and which factors influenced the (non-)adherence to therapeutic advice. METHODS: Parents of 27 children aged 7-17 with impairing MUS took part in a structured telephone survey to assess adherence to and perceived effectiveness of therapeutic recommendations (cross-sectional study). Influencing factors were analysed retrospectively. RESULTS: Psychotherapy was recommended to all 27 patients and their families; 19 of them (70.4%) carried out this advice. When physiotherapy was recommended, adherence proved lower (6/22 children; 27.3%). No influencing factors were found to have a statistically significant correlation with adherence. Effect sizes may be indicative of clinically relevant influential factors, but should be considered cautiously. CONCLUSION: Results suggest that more efforts need to be made to ensure adherence to therapeutic recommendations. Known risk factors for non-adherence to treatments for chronic somatic disorders may not apply for children with somatoform disorders.


Assuntos
Sintomas Inexplicáveis , Cooperação do Paciente/psicologia , Satisfação do Paciente , Transtornos Somatoformes/terapia , Adolescente , Criança , Estudos Transversais , Terapia Familiar , Feminino , Humanos , Masculino , Pais , Psicoterapia/métodos , Estudos Retrospectivos , Transtornos Somatoformes/psicologia , Resultado do Tratamento
17.
Clin Child Psychol Psychiatry ; 25(1): 45-61, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31079473

RESUMO

BACKGROUND: Functional disorders, defined as disorders with no clear medical explanation, are common and impose a significant burden on youths, their families, healthcare services and society as a whole. Currently, the literature describes resistance among patients and their families towards psychological symptom explanations and treatments. More knowledge about the thoughts and understandings of youths with functional disorders and their parents is needed. The aim of this study was to explore the illness perceptions of youths with severe functional disorders and their parents. METHODS: A qualitative interview study using interpretative phenomenological analyses. The study included 11 youths aged 11-15 years with functional disorders and their parents, where interviews were performed at the point of referral from a somatic to a psychiatric treatment setting. RESULTS: Analyses identified three main themes. Themes 1(Ascribing identity to the disorder) and 2 (Monocausal explanations) explore key elements of the participants' illness perceptions, and theme 3 (Mutable illness perceptions) explores how illness perceptions are influenced by experiences from healthcare encounters. CONCLUSIONS: The label 'functional disorder' was poorly integrated in the illness perceptions of the youths and their parents. Participants used a monocausal and typically physical explanation rather than a multicausal biopsychosocial explanation for their symptoms.


Assuntos
Sintomas Inexplicáveis , Transtornos Somatoformes/psicologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Criança , Terapia Familiar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pais , Pesquisa Qualitativa , Transtornos Somatoformes/terapia , Estresse Psicológico/terapia
18.
Clin Child Psychol Psychiatry ; 25(1): 273-290, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31232094

RESUMO

BACKGROUND: Medically unexplained symptoms affect between 4% and 20% of children and adolescents; 30-60% of these children also experience mental health difficulties. Trials and reviews have focussed on physical gains in this population, often overlooking mental health outcomes. OBJECTIVES: To use a systematic review methodology guided by the PRISMA checklist to (1) investigate the effectiveness of psychological interventions for mental health difficulties in children and adolescents with medically unexplained symptoms and (2) identify aspects of interventions associated with their success. METHODS: Randomised controlled studies investigating the impact of psychological interventions on mental health in children and adolescents with medically unexplained symptoms were included. Systematic searches of PsycINFO, MEDLINE and CINAHL were undertaken from inception to January 2018. Studies were appraised using the quality appraisal checklist. A qualitative synthesis of studies was completed. RESULTS: In all, 18 studies were identified. Interventions targeting parental responses to illness and family communication appeared to have the best outcomes. CONCLUSIONS: Psychological interventions may be effective in improving mental health outcomes within this population; however, evidence for the efficacy of these interventions is limited due to a high risk of bias within the majority of reviewed studies. Future research using rigorous methodology and non-cognitive behavioural therapy interventions is recommended.


Assuntos
Sintomas Inexplicáveis , Saúde Mental , Psicoterapia , Transtornos Somatoformes/terapia , Adolescente , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos Somatoformes/psicologia
19.
Internist (Berl) ; 61(1): 44-50, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31853579

RESUMO

Somatoform disorders are encountered in primary medical care with above-average frequency but are too rarely named as such in the differential diagnostics. The prevalence is approximately 30 % with a predominance of female patients. This patient group puts the physician-patient relationship to the acid test from the very beginning due to the fixation on organ-related symptoms, the expectations of repeated instrumental diagnostics and the special way of acting. The consequences are frequent changes of physicians, chronification and disappointment on both sides; however, a workable physician-patient relationship can be developed through an empathic but critically distanced fundamental attitude of the general internist based on a biopsychosocial illness concept. In the further course corrections in the understanding and expression of the illness on the part of the patient can be achieved with a pacing and leading strategy and with psychoeducative measures. The primary psychologization of functional complaints will not satisfy the affected person but outpatient psychotherapy should be initiated only after the patient has been well-prepared. Measures with medications mostly remain unspecific and serve only for relief of symptoms. For comorbidities with anxiety and/or depressive disorders the use of selective serotonin reuptake inhibitors should be considered.


Assuntos
Transtorno Depressivo/diagnóstico , Medicina Interna , Medicina Psicossomática/métodos , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/terapia , Assistência Ambulatorial , Assistência à Saúde , Transtorno Depressivo/psicologia , Feminino , Humanos , Pacientes Ambulatoriais , Relações Médico-Paciente , Transtornos Somatoformes/psicologia
20.
Clin Exp Dermatol ; 45(1): 15-19, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31456245

RESUMO

Functional - or somatoform - symptoms are those that arise with no proven organic pathology. Also known as 'medically unexplained' symptoms, they can present in any medical speciality, including dermatology. Mucocutaneous pain syndromes and functional pruritus are two examples of functional disorders encountered by dermatologists. Patients presenting with somatoform symptoms have paradoxically complex and often subjectively severe symptomatology, yet minimal abnormalities on clinical examination or investigation. Such disparity can be frustrating and distressing for patients and clinicians alike, and there are many pitfalls regarding overinvestigation and misleading communication. However, with an honest and open approach - sometimes requiring collaboration with psychological services - management of functional symptoms can be effective, and patients can be successfully rehabilitated.


Assuntos
Dor Crônica , Doença Ambiental/psicologia , Transtornos Somatoformes , Anafilaxia , Dor Crônica/etiologia , Dor Crônica/psicologia , Humanos , Prurido/diagnóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA