Reduction of pain thresholds in fibromyalgia after very low-intensity magnetic stimulation: a double-blinded, randomized placebo-controlled clinical trial.

BACKGROUND: Exposure to electromagnetic fields has been reported to have analgesic and antinociceptive effects in several organisms. OBJECTIVE: To test the effect of very low-intensity transcranial magnetic stimulation on symptoms associated with fibromyalgia syndrome. METHODS: A double-blinded, placebo-controlled clinical trial was performed in the Sagrado Corazón Hospital, Seville, Spain. Female fibromyalgia patients (22 to 50 years of age) were randomly assigned to either a stimulation group or a sham group. The stimulation group (n=28) was stimulated using 8 Hz pulsed magnetic fields of very low intensity, while the sham group (n=26) underwent the same protocol without stimulation. Pressure pain thresholds before and after stimulation were determined using an algometer during the eight consecutive weekly sessions of the trial. In addition, blood serotonin levels were measured and patients completed questionnaires to monitor symptom evolution. RESULTS: A repeated-measures ANOVA indicated statistically significant improvement in the stimulation group compared with the control group with respect to somatosensory pain thresholds, ability to perform daily activities, perceived chronic pain and sleep quality. While improvement in pain thresholds was apparent after the first stimulation session, improvement in the other three measures occurred after the sixth week. No significant between-group differences were observed in scores of depression, fatigue, severity of headaches or serotonin levels. No adverse side effects were reported in any of the patients. CONCLUSIONS: Very low-intensity magnetic stimulation may represent a safe and effective treatment for chronic pain and other symptoms associated with fibromyalgia.

Estudio psicológico del trastorno distímico en la mujer / Psychological study of the dysthymic disorder in the woman

En este artículo estudiamos a dos mujeres distímicas a quiénes tratamos mediante psicoterapia y, a partir de ahí, se pusieron de manifiesto aquellos componentes “internos” que sustentan los síntomas depresivos. Estos mismos hallazgos se confirmaron en otras pacientes con idéntico diagnóstico. El resultado consistió en descubrir una desinserción sentimental respecto a sus parejas, permaneciendo con ellos sin separarse, al tiempo que van apareciendo insidiosamente las manifestaciones depresivas. Este desarrollo las lleva a la caída del “ideal de amor” al que aspiraban, que sostenía sus vidas y funcionaba como una “agarradera de la personalidad”. Tales apreciaciones ponen en cuestión las nociones clásicas acerca del “duelo” (AU)

In this article, we study two dysthymic women who we are treating with psychotherapy in order to reveal the inner components that maintain depressive symptoms. The same findings have been confirmed in other dysthymic patients. The result of the study consisted in discovering a sentimental separation from their love object, while the woman still lives with her partner and while the depressive symptoms are appearing insidiously. This development leads them to the deterioration in the “ideal of love” they sought, that supported their lives and served as an “anchor of their personality”. This point of view places classic notion about mourning into doubt (AU)

[Psychological study of the dysthymic disorder in the woman]. / Estudio psicológico del trastornodistímico en la mujer.

In this article, we study two dysthymic women who we are treating with psychotherapy in order to reveal the inner components that maintain depressive symptoms. The same findings have been confirmed in other dysthymic patients. The result of the study consisted in discovering a sentimental separation from their love object, while the woman still lives with her partner and while the depressive symptoms are appearing insidiously. This development leads them to the deterioration in the "ideal of love" they sought, that supported their lives and served as an "anchor of their personality. This point of view places classic notion about mourning into doubt.

Clinical variables and implications of the personality on the outcome of bipolar illness: a pilot study.

Outcome in bipolar patients is affected by comorbidity. Comorbid personality disorders are frequent and may complicate the course of bipolar illness. This pilot study examined a series of 40 euthymic bipolar patients (DSM-IV criteria) (bipolar I disorder 31, bipolar II disorder 9) to assess the effect of clinical variables and the influence of comorbid personality on the clinical course of bipolar illness. Bipolar patients with a diagnosis of comorbid personality disorder (n = 30) were compared with "pure" bipolar patients (n = 10) with regard to demographic, clinical, and course of illness variables. Comorbid personality disorder was diagnosed in 75% of patients according to ICD-10 criteria, with obsessive-compulsive personality disorder being the most frequent type. Sixty-three per cent of subjects had more than one comorbid personality disorder. Bipolar patients with and without comorbid personality disorder showed no significant differences regarding features of the bipolar illness, although the group with comorbid personality disorder showed a younger age at onset, more depressive episodes, and longer duration of bipolar illness. In subjects with comorbid personality disorders, the number of hospitalizations correlated significantly with depressive episodes and there was an inverse correlation between age at the first episode and duration of bipolar illness. These findings, however, should be interpreted taking into account the preliminary nature of a pilot study and the contamination of the sample with too many bipolar II patients.