Psychosomatic Disorder: The Current Implications and Challenges.

In recent years, there has been increasing global concern about the rising prevalence and rapid progression of psychosomatic disorders (PD). This surge can be attributed to irregular biological conditions and the increasingly stressful lifestyles that individuals lead, ultimately resulting in functional impairments of vital organs. PD arises from intricate interactions involving the central nervous, endocrine, and immune systems. Notably, the hypothalamic-pituitaryadrenal (HPA) axis plays an essential role, as its dysregulation is influenced by prolonged stress and psychological distress. Consequently, stress hormones, including cortisol, exert detrimental effects on immunological function, inflammation, and homeostatic equilibrium. It emerges as physical symptoms influenced by psychological factors, such as persistent pain, gastrointestinal disturbances, or respiratory complications, and is pertinent to highlight that excessive and chronic stress, anxiety, or emotional distress may engender the onset or exacerbation of cardiovascular disorders, namely hypertension and heart disease. Although several therapeutic strategies have been proposed so far, the precise etiology of PD remains elusive due to the intricate nature of disease progression and the underlying modalities of action. This comprehensive review seeks to elucidate the diverse classifications of psychosomatic disorders, explicate their intricate mechanisms, and shed light on their impact on the human body, which may act as catalysts for the development of various other diseases. Additionally, it explores the inherent medico-clinical challenges posed by PD and also explores the cutting-edge technologies, tools, and data analytics pipelines that are being applied in the contemporary era to effectively analyze psychosomatic data.

Advantage of neuroeducation in managing mass psychogenic illness among rural school children in Nepal.

Introduction: Mass psychogenic illness (MPI), also known as mass hysteria (MH), is a mental health disorder that frequently occurs in Nepal. It primarily affects female students in government high schools and occurs during the course of the school day over a few days without corresponding organic causes. Purpose of the study: This study set out to evaluate and give neuroeducation with the goal of preventing and/or managing MPI after documenting the existing state of knowledge regarding MPI. Materials and methods: A total of 234 female students in grades 6 through 10 who attended MH-affected schools (SMH, n = 119) and schools without a mass hysteria history (SNOMH, n = 114) participated in this mass hysteria awareness study. Participants received written pre- and posttests formatted as questionnaires before and after receiving neuroeducation by watching a drama, viewing a human brain-spinal cord model demonstration, and attending an instructive lecture on the human neurological system, stress, and mass hysteria. Results: Our neuroeducation awareness study on mass hysteria was found to be effective among all of the participants from both SMH and SNOMH. The results indicated that the aforementioned neuroeducation tools are more effective in improving knowledge about mental stress differently in different grades of SMH and SNOMH students. The basic understanding of the human neurological system was not improved by the neuroeducation tool, according to our findings. Conclusion: Our study suggests that using day-structured neuroeducational tools might be an efficient way to treat mass psychogenic illness in Nepal.

Evaluating the Coping Behavior of Children with Psychosomatic Disorders under Frustrating Situations Simulated Using the Rosenzweig Picture-Frustration Study.

Psychosomatic disorders are influenced by psychosocial factors such as interpersonal relationships. Coping behaviors, especially in frustrating situations, reflect a patient's ability to cope with stress, and it is important to assess these behaviors for the treatment of psychosomatic diseases. This study aimed to clarify the interpersonal relationships and coping behaviors of pediatric patients with psychosomatic diseases during frustrating situations simulated using the Rosenzweig Picture-Frustration study. This retrospective study included 126 patients (41 male, 85 female) with an average age of 12.9 (6-16) years who were consulted at the Department of Pediatric Psychosomatic Medicine at Okayama University Hospital from 2013 to 2018 and underwent the P-F study. Each score was compared with a standardization sample. The mean group conformity rating did not differ significantly between the participants and healthy children. Compared with healthy children, those with psychosomatic diseases were less likely to explain their perspective. The children with psychosomatic disorders responded to frustrating situations in a sensible and age-appropriate manner. However, they were less likely to respond by explaining their perspective to protect themselves.

[Professor ZHUANG Li-xing's experience of mind-regulation acupuncture for psychosomatic disorders].

Professor ZHUANG Li-xing's diagnosis and treatment method and manipulation key points of mind-regulation acupuncture for psychosomatic disorders are summarized. Professor ZHUANG proposes that psychosomatic disorders can be subdivided into "mind-body disorder" and "body-mind disorder". The former requires treatment aimed at regulating the mind. The main acupoints are Sishenzhen, Shenting (GV 24), Yintang (GV 24+), Shenmen (HT 7) and Sanyinjiao (SP 6). The additional acupoints are Suliao (GV 25), Shuigou (GV 26), Shenmai (BL 62), Zhaohai (KI 6), Hegu (LI 4) and Taichong (LR 3), etc. The latter requires treatment aimed at improving the original diseases, supplemented by regulating the mind (row acupuncture on the governor vessel). Acupoint selection is based on the theories of brain-mind, and the emphasis is placed on the governor vessel; in the meanwhile, regulating zangfu and qi-blood should be valued. After the arrival of qi, the Daoqi Tongjing method (the specific technique for directing qi and preserving essence) is applied, combined with auricular point sticking and fire needling at affected part to enhance the curative effect.

The Relationship between Mental and Physical Minor Health Complaints and the Intake of Dietary Nutrients.

Presenteeism is a problem that needs to be solved urgently, both for individual workers and for society overall. In this report, we propose the concept of MHC, which refers to mild mental and physical complaints subjectively perceived by individuals that are not caused by illness. We also planned to examine what kind of physical and mental disorder MHC is and whether food is effective as a method of self-care for MHC. First, we conducted "the comprehensive survey to establish an integrated database of food, gut microbiome, and health information" (the "Sukoyaka Health Survey") and obtained data on psychosomatic disorders and intakes of dietary nutrients. As a result, through factor analysis and item response theory analysis, we found the following specific examples of MHC: lack of vigor, irritability, fatigue, and somatic complaints. In addition, analysis of the relationship between these four MHC levels and the intake dietary nutrients indicated that they are closely related and that MHC levels can be improved by consuming sufficient amounts of multiple nutrients.

Somatic symptoms associated with mental distress during the COVID-19 pandemic: a systematic review.

OBJECTIVE: The primary objective of this article was to systematically review the prevalence of somatic symptoms in patients, healthcare workers and general population during the COVID-19 pandemic. The secondary objectives were to record the association between somatic symptoms and indices of mental distress and to record the qualitative characteristics of such somatic complaints. METHODS: Following the PRISMA methodology we systematically searched PubMed, Scopus and Google Scholar for primary research reporting on somatic symptoms in association with mental distress. We specifically sought papers reporting on bodily distress disorder, somatic symptoms disorder or medically unexplained symptoms. RESULTS: 1569 papers were retrieved, which yielded 36 relevant studies after screening. 15 studies referred to healthcare workers, 13 to general population, 5 to COVID-19 patients, 2 compared medical with non-medical professionals and 1 was studying COVID-19 patients some of which were also healthcare workers. The reported prevalence of somatic symptoms ranged from 7.4% to 67.8%. Commonly seen symptoms were shortness of breath, dyspnea, palpitations and pain in arms, legs and joints. CONCLUSIONS: Our systematic review suggests that somatic symptoms are very frequent during the pandemic and are often linked to mental distress. All three population groups are affected.

Effectiveness of Internet-Based Group Supportive Psychotherapy on Psychic and Somatic Symptoms, Neutrophil-Lymphocyte Ratio, and Heart Rate Variability in Post COVID-19 Syndrome Patients.

BACKGROUND: COVID-19 can have serious long term health consequences, which is called Post-COVID-19 Syndrome (PCS). Currently, the available evidence and understanding of PCS management is limited. Because one of the symptoms of PCS is associated to psychological symptoms, psychotherapy is believed to have a role in the management of PCS. This study aimed to identify the effectiveness of supportive psychotherapy in PCS patients at Cipto Mangunkusumo National General Hospital. METHODS: This study was a single blind randomized clinical trial using a pre-and post-test with control group study design. Participants were randomly divided into two groups: a psychotherapy group with 40 participants and an education group with 37 participants. Each group was given internet-based psychotherapy or education three times a week in a form of group consisting of 6-8 participants. Symptom Checklist-90 questionnaire was used to evaluate somatic and psychological symptoms. Heart rate variability and neutrophil lymphocyte ratio were also investigated. Data analysis was performed using the independent T test. RESULTS: An improvement in the SCL-90 score was found to be 17.51 (SD 30.52) in the psychotherapy group and 19.79 (SD 35.10) in the education group, although there was no significant difference between the two groups (p = 0.771). There was no significant difference between the two groups in decreasing NLR (p = 0.178) and improving HRV (p = 0.560). CONCLUSION: Both internet-based group supportive psychotherapy and education improved psychological and somatic symptoms in PCS patients, although there was no significant difference between the two groups. There was no significant difference between the two groups in decreasing NLR and improving HRV. Suggestions for further research regarding adding frequency of internet-based group psychotherapy in PCS patients and held in the morning to achieve more optimal results.

Professor ZHUANG Li-xing's experience of mind-regulation acupuncture for psychosomatic disorders / 中国针灸

Professor ZHUANG Li-xing's diagnosis and treatment method and manipulation key points of mind-regulation acupuncture for psychosomatic disorders are summarized. Professor ZHUANG proposes that psychosomatic disorders can be subdivided into "mind-body disorder" and "body-mind disorder". The former requires treatment aimed at regulating the mind. The main acupoints are Sishenzhen, Shenting (GV 24), Yintang (GV 24+), Shenmen (HT 7) and Sanyinjiao (SP 6). The additional acupoints are Suliao (GV 25), Shuigou (GV 26), Shenmai (BL 62), Zhaohai (KI 6), Hegu (LI 4) and Taichong (LR 3), etc. The latter requires treatment aimed at improving the original diseases, supplemented by regulating the mind (row acupuncture on the governor vessel). Acupoint selection is based on the theories of brain-mind, and the emphasis is placed on the governor vessel; in the meanwhile, regulating zangfu and qi-blood should be valued. After the arrival of qi, the Daoqi Tongjing method (the specific technique for directing qi and preserving essence) is applied, combined with auricular point sticking and fire needling at affected part to enhance the curative effect.

Infra-low frequency neurofeedback in persistent postural-perceptual dizziness-Case report.

Persistent Postural-Perceptual Dizziness, also known as PPPD or 3PD, is a chronic functional vestibular disorder characterized by persistent sensation of rocking or swaying unsteadiness and/ or non-spinning dizziness without vertigo lasting at least 3 months. Symptoms typically worsen with upright posture (like standing or sitting upright), head or body motion and exposure to busy or visually rich environments. The article describes the application of Infra-Low Frequency Neurofeedback (ILF NF) over 32 sessions on an unmedicated individual with symptoms related to PPPD that were still present 3 years after the initial diagnosis. Along with significant reduction in those symptoms, other accompanying symptoms (like anxiety, intrusive violent thoughts, suicidal thoughts) were markedly improved with ILF NFB. Consistent symptom tracking from session to session, as well as before and after CPT data were used to document reported changes with ILF NF.

Early intervention for psychosomatic symptoms of adolescents in school checkup.

BACKGROUND: The purpose of this study was to evaluate the efficacy of early medical intervention for psychosocial problems detected in adolescents in a school health checkup, with the broader goal of prevention of these problems in adolescents. METHODS: The Questionnaire for Triage and Assessment with 30 items score and scores for five subscales (physical symptoms, depression symptoms, anxiety symptoms, self-efficacy, and family function), and an investigation of lifestyle were determined in a school health checkup for 5th grade elementary to 3rd grade junior high school students. Forty-three children were found to be at high risk for psychosomatic disorder, of whom 18 then received a medical intervention (early intervention group) and 25 did not (non-intervention group). Fifty-seven children (outpatient group) treated for psychosomatic disorder for ≤3 months were also included in the study. The Questionnaire for Triage and Assessment with 30 items (QTA30) was completed by all participants every 3 months for 1 year and scores were compared among the groups. RESULTS: In the early intervention group, total Questionnaire for Triage and Assessment with 30 items scores; physical, depression, and anxiety symptoms; and unstable relationships with friends and teachers at school all significantly improved after 1 year compared to the first survey. None of these items improved in the non-intervention group, while the outpatient group had gradual improvement in all scores. Family function scores in the early intervention group improved over time, whereas those in the non-intervention group worsened. CONCLUSIONS: Early detection of children at high risk for psychosomatic disorder at a school health checkup and early medical intervention were useful for prevention of psychosomatic disorder in adolescents.

Effect of central sensitization on dizziness-related symptoms of persistent postural-perceptual dizziness.

BACKGROUND: Persistent postural-perceptual dizziness (PPPD) is a chronic functional dizziness symptom triggered by psychological stress, but its pathophysiology is unknown. Central sensitization is considered the cause of functional diseases, such as medically unexplained symptoms, and is a psychosocially affected condition. However, the association between dizziness symptoms in PPPD and central sensitization remains unclear. Thus, we conducted a cross-sectional study on the relation between dizziness symptoms and central sensitization in PPPD. METHODS: We recruited 61 outpatients with dizziness who met the PPPD diagnostic criteria. In addition to the evaluation of dizziness symptoms using the Dizziness Handicap Inventory, the participants were evaluated using the Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Central Sensitization Inventory (CSI). A CSI score of 40 or higher was defined as central sensitization syndrome (CSS), and the severity of each condition in CSS and non-CSS participants was compared. We also evaluated the association between dizziness symptoms and central sensitization and coexisting symptoms using linear multiple regression analysis. RESULTS: We analyzed the data of 50 valid responses (valid response rate of 82.0 percent). Compared with the non-CSS group, the CSS group had a higher degree of disability owing to dizziness and a higher rate of complications of anxiety and depression. The regression analysis results showed that the severity of central sensitization was a related factor that could enhance the dizziness symptoms of PPPD. CONCLUSIONS: Central sensitization may affect the dizziness symptoms of PPPD as an exacerbating factor.

Trocas na selva: uma experiência com grupo de fotoexpressão em meio ao distúrbio psicossomático / Exchanges in the jungle: a photoexpression group experience amid psychosomatic disorder / Cambios en la selva: una experiencia con grupo de fotoexpresión en medio al disturbio psicosomático

Este trabalho é mobilizado pela experiência institucional em um serviço de saúde publica que acolhe pacientes cuja problemática da somatização forma essencialmente seu quadro clínico. No sofrimento que circula no distúrbio psicossomático a incerteza do alojamento da psique no soma é a questão central. Todavia, esta clínica apresenta especificidades que desafiam as constantes de um enquadre psicanalítico tradicional. A técnica da Fotoexpressão como objeto mediador, utilizada em grupos, é observada como uma estratégia bastante apropriada no manejo destes pacientes. A situação clínica que este recurso suscita busca restabelecer a área de jogo e mediante uma zona intermediária, tenta abrir caminhos para processos elementares da experiência. Por meio de um recorte clínico buscamos problematizar a dimensão corporal e o elemento da violência diante do recurso da Fotoexpressão, analisando seus efeitos e possibilidades de deslocamentos.

This work is mobilized by an institutional experience in a public health service that welcomes patients whose somatization problem essentially forms their clinical picture. In the suffering that circulates in the psychosomatic disturbance the uncertainty of the psyche's accommodation in the soma is the central issue. However, this clinic has specificities that defy the constants of a traditional psychoanalytic framework. The technique of Photoexpression as a mediator object, used in groups, is observed as a very appropriate strategy in the management of these patients. The clinical situation that this resource raises seeks to reestablish the playing area and through an intermediate zone, tries to open the way for elementary processes of experience. Through a clinical outline we seek to problematize the body dimension and the element of violence in the face of the Photoexpression resource, analyzing its effects and possibilities of displacement.

Este trabajo es movilizado por la experiencia institucional en un servicio de salud pública que acoge pacientes cuya problemática de la somatización forma esencialmente su cuadro clínico. En el sufrimiento que circula en el disturbio psicosomático la incertidumbre del alojamiento de la psique en suma es la cuestión central. Todavía, esta clínica presenta especificidades que desafian las constantes de un encuadre psicoanalítico tradicional. La técnica de la Fotoexpresión como objeto mediador, utilizada en grupos, es observada como una estrategia bastante apropiada en el manejo de estos pacientes. La situación clínica que este recurso suscita busca restablecer la área del juego y mediante una zona intermediaria, intenta abrir caminos para procesos elementares de experiencia. Por medio de un recorte clínico buscamos problematizar la dimensión corporal y el elemento de la violencia ante al recurso de la Fotoexpresión analizando sus efectos y posibilidades de desplazamientos.

Evaluating the mental health of children in a local hospital outpatient clinic.

BACKGROUND: The 30-item Questionnaire for Triage and Assessment (QTA30) is a standardized triage and assessment tool for assessing pediatric psychosomatic disorders. It is estimated that one in 10 children in Japan experience difficulties in their school life. Using the QTA30 we evaluated mental health in children at an outpatient clinic in a local hospital. METHODS: All elementary and junior high school students (≥9 years) who visited our institution between December 1 2019 and March 31 2020 were asked to complete the QTA30. RESULT: A total of 372 children responded. Half of the children with a psychosomatic disorder and 9% of children with other chronic disorders were suspected to have poor mental health. Suspected poor mental health was associated with higher odds of female gender (odds ratio [OR]: 1.89, 95% confidence interval [CI]: 1.07-3.39), junior high school students (OR: 3.73, 95% CI: 2.11-6.73), and not enjoying exercise (OR: 2.13, 95% CI: 1.16-3.9). The mean ± standard deviation total QTA30 score was significantly worse in children with psychosomatic disorders (38.0 ± 19.1) among children with other chronic diseases; however, only the score in children with central precocious puberty (27.4 ± 13.7) showed no difference. CONCLUSION: Based on our survey, the percentage of children suspected to have mental health problems manifesting as non-psychosomatic chronic disorders was similar to the proportion of children suspected to experience difficulties with their school life. Pediatricians should carefully consider the possibility of mental health problems when children are seen in regular visits to the outpatient clinic.

Clinical Characteristics of Myofascial Pain Syndrome with Psychological Stress in Patients with Cancer.

Background: Despite the suggestion of a relationship between development or progression of myofascial pain syndrome (MPS) and psychological stress, few studies have reported its proportion or association with treatment efficacy. Objective: We aimed to investigate the proportion of MPS with psychological stress among cancer patients and to compare the efficacy of trigger point injection (TPI) in the same patients with/without psychological stress. Design: This was a prospective observational study. Setting/Patients: Participants were 205 patients with cancer who received TPIs for MPS at a hospital in Japan. Results: The proportion of patients with MPS and psychological stress was 0.57 (95% confidence interval [CI] 0.50-0.64). The TPI efficacy rate at seven days after treatment was 0.55 (95% CI 0.46-0.64) for patients with MPS and psychological stress and 0.82 (95% CI 0.74-0.90) for their counterparts without psychological stress (p < 0.004). The odds ratio for TPI efficacy seven days after treatment with psychological stress versus without psychological stress was 0.25 (95% CI 0.13-0.49). Conclusions: MPS was a clinical symptom of psychosomatic disorder in approximately half of our patients. The TPI efficacy for patients with MPS who had psychological stress was lower than for their counterparts without psychological stress. Trial registration: UMIN000041210. Registered 27 July 2020 (retrospectively registered).

Late bedtime reflects QTA30 anxiety symptoms in adolescents in a school checkup.

BACKGROUND: In adolescence, physical symptoms may develop due to psychosocial problems but such problems are not fully evaluated in school medical checkups. The aim of this study was to compare lifestyle factors with psychosomatic symptoms in adolescents using the subscales of the Questionnaire for Triage and Assessment with 30 items (QTA30) in school health checkups. METHODS: The QTA30 was used in checkups for 3,414 students from the fifth grade of primary school to the third grade of junior high school in south Wakayama prefecture. The QTA is a self-completed questionnaire with five subscales of physical symptoms, depression symptoms, self-efficacy, anxiety symptoms, and family function. Each subscale is divided into three groups of clinical, borderline, and healthy, based on the subscale score. Subscale scores were compared with lifestyle items of gender, grade, habits, life events, and school attendance. RESULTS: The clinical rate for all subscales was significantly higher for a higher grade (P < 0.001). Anxiety symptoms were correlated with physical symptoms (r = 0.560). Anxiety and physical symptoms were significantly higher for students who went to bed at a later time with no absences in the last month and who had problems with friends and teachers (both P < 0.001). Family function correlated with self-efficacy (r = 0.418) but not with other subscales. Study time was most related to self-efficacy (P < 0.001). CONCLUSIONS: The QTA30 subscale scores facilitated detection of psychosomatic stress and latent risks of psychosomatic disease at an early stage. Thus, the use of the QTA30 in a school medical checkup may permit early intervention for psychosomatic stress in adolescents.

Psychological profile of pet owners in Isfahan, Iran / Perfil psicológico de tutores de animais em Isfahan, Irã

This study aimed to compare the psychological profile of pet owners with the ones who didn't own any pets. The research method was a casual-comparative study. Pet owners and people without pets were included in this research which was done in Iran in February 2017. One hundred and sixty people were selected in this sample in a nonrandom available sampling method and matched in terms of demographic characteristics. Eighty people, pet owners, were referred to the veterinary clinics and 80 didn't own any pets. They were assessed by a psychological signs inventory. The result of ANOVA indicated that pet owners and those without any pets were indifferent in the characteristics of anxiety, obsessive-compulsive disorder, hostility, paranoid, interpersonal sensitivity, and psychosis, while those without any pets, statistically had a higher average in somatization and depression than the pet owners and it could be justified by corrective emotional experience, displacement, and sublimation in the pet owner. This statistic can be based on the fact that pet owners use these animals as an object for thrilling topics which is a factor to decrease their psychological stress and increase their physical health.(AU)

O presente trabalho é um estudo comparativo casual que comparou o perfil psicológico de tutores e não tutores de animais de estimação. Os tutores e os não tutores foram incluídos na pesquisa realizada no mês de fevereiro de 2017 em Isfahan, Irã. Os 160 participantes da investigação foram selecionados de forma não casual e associados com base nas suas características demográficas. Os 80 tutores de animais haviam procurado clínicas veterinárias e o grupo controle nunca teve qualquer animal de estimação. Os dois grupos foram submetidos a um questionário psicológico. O tratamento estatístico dos resultados por análise de variância revelou a ausência de diferença entre os dois grupos para as características: ansiedade, desordens obsessivas-compulsivas, hostilidade, paranoia, sensibilidade interpessoal e psicoses. Contudo, foi constatado que os não tutores de animais de estimação apresentaram uma média estatisticamente mais elevada de somatização e depressão, o que pode ser justificado por uma experiência emocional corretiva, deslocamento e sublimação evidenciada nos tutores que pode ser atribuída ao fato dos animais constituírem um fator de valor emocional que contribui para a redução do estresse psicológico e melhoria da saúde física e emocional dos seus tutores.(AU)

Los trastornos psicosomáticos en el niño y el adolescente / The psychosomatic disorders in children and adolescents

Los trastornos psicosomáticos se caracterizan por manifestaciones somáticas de origen no patológico y poseen una significativa prevalencia en niños y adolescentes; sin embargo, resulta difícil identificarlos, pues no existe un consenso adecuado para su diagnóstico y las investigaciones acerca del tema son insuficientes. Lo anterior condujo a efectuar el presente artículo, en el que se abordan aspectos etiopatogénicos y clinicoepidemiológicos que proporcionan los principales elementos para identificar dichos trastornos y establecer un diagnóstico acertado; asimismo se destaca que estas afecciones son frecuentes en poblaciones infantojuveniles con rasgos de introversión y/o antecedentes personales y familiares de enfermedades físicas y mentales, y que su causa es multifactorial, aunque entre los muchos factores sobresalen la vulnerabilidad al estrés, la disfunción familiar, la sobreprotección parental, así como también las situaciones precipitantes (acoso escolar, separación de los padres, abuso sexual) y las perpetuadoras; estas últimas están condicionadas por los beneficios primario y secundario que los menores obtienen de estos padecimientos.

The psychosomatic disorders are characterized by somatic signs of non-pathological origin which possess a significant prevalence in children and adolescents; however, it is difficult to identify them, because there is no appropriate consent for its diagnosis and the investigations about the topic are insufficient. That is the reason why we decided to carry out the present work, in which some etiopathogenic, clinical and epidemiological aspects are approached that provide the main elements to identify these disorders and to establish a good diagnosis; it is also relevant that these disorders are frequent in juvenile populations with introversion features and/or personal and family history of physical and mental diseases, with multifactorial cause, although among the many relevant factors we can mention vulnerability to stress, family dysfunction, parental overprotection, as well as the precipitant situations (school harassment, parents' separation, sexual abuse) and the permanent situations; the latter are conditioned by the primary and secondary benefits that minors obtain with these sufferings.

Multidisciplinary Management of Chronic Atypical Facial Pain of Psychogenic Origin: A Unique Case Report.

AIM: The following case report discusses the diagnostic dilemma presented by and the multidisciplinary management of a patient with chronic atypical facial pain of psychogenic origin. BACKGROUND: Though oral health care professionals are primarily concerned with the treatment of somatic disorders of the orofacial region, there remains a particularly challenging need to identify, diagnose and treat various psychological and psychosomatic symptoms. CASE DESCRIPTION: This case report describes the management of a 13-year-old male patient with the chief complaint of pain and discoloration of the skin over the right side of the face for the last 5 months, who also demonstrated symptoms of chronic anxiety and social withdrawal. As no associated soft or hard tissue abnormalities could be identified, a diagnosis of atypical/psychogenic facial pain was established. The skin discoloration was diagnosed as pityriasis versicolor and treatment for the same commenced. Following the complete resolution of the skin lesion the patient was asymptomatic, and no longer anxious. CONCLUSION: Our role as dentists is to mitigate the suffering of patients and to improve their quality of life in collaboration with specialists in psychosomatic medicine. CLINICAL SIGNIFICANCE: This case highlights that dentists must be trained to treat not only teeth, but also attend to patient's psychosomatic symptoms. HOW TO CITE THIS ARTICLE: Naidu J, Bhattacharya P, Mendonsa JP, et al. Multidisciplinary Management of Chronic Atypical Facial Pain of Psychogenic Origin: A Unique Case Report. Int J Clin Pediatr Dent 2020;13(2):196-198.

Mothers' and Fathers' Perspectives on the Causes of Their Child's Disorder.

BACKGROUND: Parental beliefs about the cause of their child's illness are thought to affect parents' help-seeking behaviors, treatment decisions, and the child's health outcomes. Yet, research on parental beliefs about disease causation is still scarce. While a small number of studies assesses parental cause attributions for singular disorders (e.g., neurodevelopmental disorders), no study has compared disorders with differing physical versus mental conditions or with mixed comorbidities in children and adolescents or their caregivers. Furthermore, most pediatric research suffers from a lack of data on fathers. OBJECTIVE: Hence, the objective of the current study was to test for possible differences in mothers' and fathers' perceptions about the etiology of their child's illness. METHODS: Forty-two parent couples (overall N = 84) whose child had been diagnosed either with Attention Deficit Hyperactivity-Disorder (ADHD) or Autism Spectrum Disorder (ASD) (category "neurodevelopmental disorder") or with a primary physical illness and a comorbid mental disorder, e.g. depression (category "psychosomatic disorder") were asked to rate possible causes of their child's illness using a modified version of the revised Illness Perception Questionnaire (IPQ) Cause scale. RESULTS: A two-way ANOVA showed that psychosomatic disorders were significantly more strongly attributed to be caused by medical and environmental stressors than neurodevelopmental disorders. A significant parent × illness category interaction revealed that this effect was more pronounced in fathers. CONCLUSIONS: By providing first insights into parental beliefs about the etiology of their children's neurodevelopmental versus psychosomatic disorders, this study paves ground for future research and tailored counseling of affected families.