[Complex therapy of psychosomatic disorders associated with the female reproductive cycle]. / Kompleksnaya terapiya psikhosomaticheskikh rasstroistv, assotsiirovannykh s reproduktivnym tsiklom zhenshchiny.

Psychosomatic disorders make a great contribution to the structure of reproductive health disorders in women. The purpose of this review was to analyze the available data on effective methods of therapy for psychosomatic disorders associated with the reproductive cycle of women - psychopharmacological, psychotherapeutic, non-drug biological, hormonal. The review summarizes the evidence in relation to the treatment of disorders such as: stress-related menstrual irregularities; premenstrual dysphoric disorder; perinatal affective disorders (especially depression); psychosomatic disorders of the involutionary period. General recommendations on the complex therapy of psychosomatic disorders associated with the menstrual cycle within the framework of an interdisciplinary team have been formed.

[The Interdisciplinary Family Consultation in Pediatrics - An Integrative Approach to Complex Burdened Families of Chronically ill Children]. / Die Interdisziplinäre Familienmedizinische Sprechstunde in der Kinderheilkunde ­ Ein integrativer Ansatz für komplex belastete Familien mit einem chronisch kranken Kind.

For families of chronically ill children with a high level of psychosocial stress, it is necessary to involve child and adolescent psychiatric or psychosomatic specialists directly in the pediatric treatment process. For this purpose, a family consultation was set up in the Heidelberg University Pediatrics as part of a model project, which deals with these families in an interdisciplinary and systemic way. It shows that the implementation of the consultation works despite a high organizational effort and is regularly used. The first evaluation results confirm the already described high levels of psychosocial stress in the affected families. They indicate a positive assessment of the consultation and a desire for a permanent offer. First follow-up results indicate a significant decrease in treatment-related concerns, uncertainty and a reduction in treatment-related problems. The lack of a viable funding model poses a challenge for long-term implementation.

[Psychosomatic aspects in otorhinolaryngology-historical milestones]. / Psychosomatische Aspekte in der HNO-Heilkunde ­ historische Meilensteine.

BACKGROUND: This investigation examined the development of psychosomatics in the field of otolaryngology in Germany using the examples of psychogenic deafness and chronic tinnitus by means of literature research. The focus of the study was on the period 1948-2022. METHODS: A literature search was carried out in the PubMed database from 1948 and antiquarian ENT textbooks were evaluated. The search terms used were "ENT and psychosomatics," "tinnitus," "retraining therapy," "analytical psychology," "behavioral therapy," and "sensory systems." RESULTS: Psychosomatic phenomena were mentioned in the treatment of nasal diseases and ear ailments in writings of Byzantine and medieval medicine. Even older are references to tinnitus in ancient Egyptian and Indian scripts. From the nineteenth to the mid-twentieth century, psychological abnormalities in ENT symptoms were assigned to the term hysteria. From the middle of the twentieth century, a paradigm shift in the assessment of psychosomatic disorders in otolaryngology became apparent. In the 1950s, a broad psychosomatic discussion was opened in individual lectures and book contributions on mental abnormalities in ENT diseases. With the implementation of the Psychosomatics Working Group of the German Society of Otorhinolaryngology, Head and Neck Surgery, psychosomatics in the field of ENT received the framework for scientific and clinical activity at the turn of the millennium. Psychosomatics is scientifically represented and part of the continuing education regulations for otolaryngology in Germany and at European level. It shows high standards in research, qualification of otolaryngologists, and patient care. CONCLUSION: As of 2022, psychosomatics in otolaryngology has been steadily developing for over 70 years. The standards achieved are to be further expanded and research on cognition, affectivity, and sensory analogies intensified.

Is psyche-soma dichotomy still clinically appropriate?

This article proposes a historical recontextualisation of the mind-body relationship and offers some evidence-based reflections on the current clinical appropriateness of psyche-soma dichotomy and psychosomatics. The debate concerning the mind-body relationship has a long medical, philosophical, and religious history, with psyche-soma dichotomy and psychosomatics alternating as the dominant clinical approach, depending on the prevalence of cultural orientations at different times. However, both models simultaneously benefit and limit the clinical practice.The neurosciences have reduced the gap between psyche and soma diseases, which can now be seen as overlapping and sharing a common pathogenesis. Diseases should also be considered as illnesses by considering all of their biopsychosocial aspects to avoid therapeutic failures due to only partially effective or ineffective interventions. Patient-centred care integrated with guideline recommendations may be the best means of uniting the psyche and the soma.

[Psychosomatic medicine: old resources and new technologies]. / Psikhosomaticheskaya meditsina: starye resursy i novye tekhnologii.

Two primary research directions closely coexist in psychosomatic medicine. One is the most traditional, associated with an assessment of the psychological aspects of the connection, interconnection and mutual impact of mental and somatic pathology. The second, based on the rapid development of biological medicine in the last decade, studies causal associations and looks for shared mechanisms. In our review, we consider the previous main stages in the psychosomatic medicine and the prospective approaches to its further study. Evaluation of the etiopathogenesis of the entire set of mental and somatic symptoms in their interaction and dynamics can help identify individual subpopulations of patients with shared pathobiochemical and neurophysiological disorders. The recent interpretation of the biopsychosocial model is mainly related to the etiology and pathogenesis of mental disorders and also provides a good perspective for research on these issues. Today, there are sufficient opportunities to study all three domains of the model. Productive study of the biological, personal and social domains is also possible on the base of evidence-based design using modern research technologies.

[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.

[Psychosomatic health inventory: Basic psychosomatic documentation for quality assurance inpatient care]. / Gesundheitsinventar Psychosomatik: Psychosomatische Basisdokumentation zur Qualitätssicherung im stationären Alltag.

Objectives: As part of the quality assurance of inpatient treatment, the severity of the disease and the course of therapy must be mapped. However, there is a high degree of heterogeneity in the implementation of basic diagnostics in psychosomatic facilities.There is a lack of scientifically based standardisation in determining the quality of outcomes. Methods: With the help of scientifically established test instruments, a resource-saving basic documentation instrument was developed. Many existing psychometric instruments were checked for test quality, costs and computer-supported application. Results: The Psychosomatic Health Inventory (gi-ps) consists of three basic modules with a total of 63 items: sociodemography, screening and psychosomatic health status.The latter is represented bymeans of construct-based recording on eight scales. Its collection at admission and discharge allows the presentation of the quality of outcomes.The development of a proprietary software solution with LimeSurvey enables the computer-based collection, evaluation, and storage of data. A list of test inventories for confirming diagnoses and predictors has been compiled, which are recommended for use in clinical routine. Discussion: With the gi-ps, a modular basic documentation instrument including the software solution is available to all interested institutions free of charge.

A framework for the implementation of consultation-liaison psychiatry from the characteristics of psychosomatic consultations at a general hospital in China.

OBJECTIVE: To describe the characteristics of a consultation-liaison psychiatry (CLP) service at a general hospital in China, compare the literature on CLP in other hospitals in China and abroad, and identify reasons for the differences. METHODS: The medical records of all inpatients who received liaison consultations in the first year of the establishment of Xi'an International Medical Center Hospital were reviewed. Demographic data, specific department, number of consultations, reasons for consultation, outcome of consultation, and follow-up information on patients was collected. RESULTS: A total of 630 patients were enrolled during the first year of the hospital's opening, of which 45.2% were male and 54.8% were female. A total of 89.2% of non-psychiatric departments requested a psychosomatic consultation. The percentage of middle-aged and elderly patients was 75.6%, of whom 61.6% were aged 45 to 74 years. The internal medicine department requested the highest number of consultations (48.2%), including those from respiratory medicine (12.1%), neurology (12.1%), gastroenterology (12.1%), and cardiology (12.1%). Among surgical patients, orthopedic patients (6.5%) comprised the majority of consults. The main reasons for requesting a psychosomatic consultation were depressive symptoms (139 cases, 22.8%), anxiety symptoms (137 cases, 22.5%), sleep problems (111 cases, 18.2%), and hallucinations, delusions, or behavioral problems (68 cases, 11.2%), accounting for a total of 74.6% of consultations (455/630). CONCLUSION: A significant gap exists between the level of CLP services in China and developed regions in Europe and the United States, mainly due to low psychiatric consultation rates and poor quality CLP services.

[From psychosomatic medicine to medical psychology: the theoretical and institutional trajectory of Julio de Mello Filho]. / Da medicina psicossomática à psicologia médica: a trajetória teórica e institucional de Julio de Mello Filho.

Studies on the causality of pathologies and the doctor/patient relationship based on psychoanalytic formulations received two denominations in Brazil: psychosomatic medicine and medical psychology. The physician and psychoanalyst Julio de Mello Filho took a leading role in this movement after the psychiatrist and psychoanalyst Danillo Perestrello was incapacitated by illness. This study investigates how the theoretical concepts of the psychosomatic movement were structured and the institutional strategies used to establish this discipline in Brazil. From an epistemological and historical point of view, the initial notion of transforming the hegemonic medical model was seen to lose force, followed by a shift in medical psychology as a field of health psychology.

Os estudos sobre as causalidades das patologias e da relação médico/paciente a partir de formulações psicanalíticas receberam duas denominações no Brasil: medicina psicossomática e psicologia médica. O médico e psicanalista Julio de Mello Filho assumiu o protagonismo dessa proposta a partir da doença incapacitante do psiquiatra e psicanalista Danillo Perestrello. A estruturação da concepção teórica do movimento psicossomático e as estratégias institucionais utilizadas para a consolidação desse campo disciplinar no cenário brasileiro são o objeto deste estudo. Por meio de um referencial epistemológico e histórico, conclui-se que a proposta inicial de transformação do modelo médico hegemônico perde força e observa-se um deslocamento da psicologia médica como um campo da psicologia da saúde.

Longitudinal Follow-Up of Death Anxiety and Psychophysical-Symptom Experience of Participants in the Silent Mentor Program.

This study assessed death anxiety (Death Anxiety Questionnaire, DAQ) and psychophysical- (psychological and physical) symptom experience following cadaveric dissection among the Silent Mentor Program (SMP) participants before thawing (T1), after the suturing, dressing and coffining session (T2), and one month post-program (T3). There was a significant decline in the total DAQ score comparing T1 and T2 (t = 7.69, p < 0.001) and T2 and T3 (t = 5.00, p < 0.001) and T1 and T3 (t = 10.80, p < 0.001). There was a significant reduction in total psychological-symptom score comparing T1 and T2 (t = 4.92, p < 0.001) and between T1 and T3 (t = 4.85, p < 0.001). However, for the physical-symptom experience, a significant increase in the physical-symptom score between T1 and T2 (t = -3.25, p = 0.001) was reported but the scores reduced significantly one month after the program (T2-T3; t = 4.12, p < 0.001). The mentoring concept of the SMP program has beneficial effects on improving attitude towards death and psychophysical-symptom experience associated with cadaver dissection.

What Kind of Patients Receive Inpatient and Day-Hospital Treatment in Departments of Psychosomatic Medicine and Psychotherapy in Germany?

INTRODUCTION: Germany is one of the few countries with a medical specialty of psychosomatic medicine and psychotherapy and many treatment resources of this kind. OBJECTIVE: This observational study describes the psychosomatic treatment programs as well as a large sample of day-hospital and inpatients in great detail using structured diagnostic interviews. METHODS: Mental disorders were diagnosed according to ICD-10 and DSM-IV by means of Mini-DIPS and SCID-II. In addition to the case records, a modified version of the CSSRI was employed to collect demographic data and service use. The PHQ-D was used to assess depression, anxiety, and somatization. RESULTS: 2,094 patients from 19 departments participated in the study after giving informed consent. The sample consisted of a high proportion of "complex patients" with high comorbidity of mental and somatic diseases, severe psychopathology, and considerable social and occupational dysfunction including more than 50 days of sick leave per year in half of the sample. The most frequent diagnoses were depression, somatoform and anxiety disorders, eating disorders, personality disorders, and somato-psychic conditions. CONCLUSIONS: Inpatient and day-hospital treatment in German university departments of psychosomatic medicine and psychotherapy is an intensive multimodal treatment for complex patients with high comorbidity and social as well as occupational dysfunction.

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.

[Office-based psychosomatic medicine with a focus on acute care]. / Das Praxismodell der Psychosomatischen Medizin und Psychotherapie mit Akut- beziehungsweise Versorgungsschwerpunkt neben der Richtlinienpsychotherapie.

Objectives: In Germany, the office-based psychosomatic medicine with focus on acute care offers psychosomatic treatment besides primary care by general practitioners and regular psychotherapy. The aim of this study is to determine specific characteristics of these innovative office-based practices. Methods: In a qualitative cross-sectional study, twelve board-certified specialists in psychosomatic medicine, practicing office-based psychosomatic medicine were surveyed by means of semi-structured telephone-interviews. After transcription and coding in MAXQDA 2020, a content analysis was conducted. Results: The innovative practice model was characterized by high numbers of initial contacts in walk-in or pre-planned consultation hours. Besides regular psychotherapy long-term and low-threshold treatment was offered. Physician assistants organised the workflow and administrative tasks. For settlement the EBM-number psychosomatic interview or short-term treatment was used. Focusses were set on somatopsychic and socio-medical treatment and consultant support. Psychotherapy often was realised in form of group sessions by integrating behavioural and psychodynamic psychotherapy. Discussion: The innovative psychosomatic practice model with focus on acute care shows an independent profile. A treatment based on medical understanding of complex somatic disease processes can be provided to somatopsychic patients. Future studies should compare this practice model to psychosomatic practices receiving a treatment by guideline psychotherapy. Conclusions: In Germany, the practices of psychosomatic medicine with a focus on acute care closes an increasing gap in psychosomatic care and augments treatment possibilities, especially for elderly and multimorbid patients.

[Mentalization ability and treatment success in psychosomatic rehabilitation]. / Mentalisierungsfähigkeit und Behandlungserfolg in der Psychosomatischen Rehabilitation.

Objectives: Psychosomatic rehabilitation clinics represent an important branch of care with good treatment results in Germany. So far, however, it is largely unclear which processes underlie the treatment successes. In the partial evaluations of the Hersfeld catamnesis study presented here, recourse is made to the construct of mentalizing ability, which has become very important in recent psychotherapy research. Methods: The mentalization ability of a large sample (N = 559) was assessed with the help of the Mentalization Questionnaire (MZQ), and psychological and somatic complaints were assessed with HEALTH-PSB scale from HEALTH-49 at three points in time, namely at admission, at discharge and in a 6-month catamnesis. Results: Both the total score of the MZQ and all subscores show significant reductions in mentalization deficits in the small effect size range, the HEALTH-PSB in the high effect size range and the catamnesis in the medium effect size range. A regression analysis shows that the reduction in mentalization deficits has a high predictive power for symptom improvement. Conclusions: The results indicate that the construct of mentalization ability is a central target variable in psychosomatic rehabilitation.

Evaluation and Treatment of Psychogenic Nonepileptic Seizures.

Patients with psychogenic nonepileptic seizures (PNES) represent a distinct, challenging group among those with functional neurologic symptom (conversion) disorders and involve a complex set of symptoms and comorbidities, best evaluated and treated by a multidisciplinary team of clinicians. Multidisciplinary, collaborative care is becoming more common, using evidence-based treatment. Outpatient neurology clinics at sites not currently treating these patients hold potential for providing such a model of care, with coordination of services. Best practice care should encourage the integration of neurology and mental health professionals to improve communication among clinicians and with patients, allowing for better patient care and symptomatic outcomes.

Treatment of Psychogenic Nonepileptic Seizures.

PURPOSE OF REVIEW: Psychogenic nonepileptic seizures (PNES) are the most common Functional Neurological Disorder/Conversion Disorder subtype. Significant advances have been made related to diagnosis, neurobiology, and treatment. In this review, we summarize updates in diagnosis and management over the past 3 years. RECENT FINDINGS: Although evidence is mixed for the treatment of PNES, psychotherapeutic modalities remain a powerful instrument to empower patients and reduce seizures. A multidisciplinary, holistic approach is beneficial. While seizure freedom in all patients may not be the achieved endpoint in this chronic, paroxysmal disorder, quality of life can be improved with treatment. Additional treatment modalities and further research are needed for patients who are refractory to current treatment. Evidence-based therapies exist for PNES, and recent findings represent an increased understanding of the clinical and neurophysiologic aspects of PNES.

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.

Efficacy of group biofeedback treatment on hyperemesis gravidarum with psychosomatic symptoms diagnosed with the revised version of Diagnostic Criteria for Psychosomatic Research (DCPR-R): study protocol for a randomised controlled trial.

INTRODUCTION: Hyperemesis gravidarum (HG) is a condition characterised by dehydration, electrolyte imbalance, lack of nutrition and at least 5% loss in body weight, occurring in the first half of pregnancy. The aim of this trial is to examine the efficacy of group biofeedback treatment on patients with HG with psychosomatic symptoms, which will be evaluated through the revised version of Diagnostic Criteria for Psychosomatic Research (DCPR-R). METHODS AND ANALYSIS: In this single-blinded randomised controlled clinical trial, 68 patients with HG diagnosed with at least one psychosomatic syndrome according to DCPR-R and aged 18-40 years, will be recruited in a Chinese Maternal and Child Health Hospital. The sample will be randomised (1:1) into two arms: experimental group, which will undergo group biofeedback treatment, psycho-education and treatment as usual (TAU); and control group, which will undergo psycho-education and TAU only. The primary outcomes will be reduction of the frequency of psychosomatic syndromes, severity of nausea/vomiting, quality of life and heart rate variability. The secondary outcomes will include days of hospitalisation, repeated hospitalisation and laboratory investigations. ETHICS AND DISSEMINATION: This study has received ethical approval from the Nanjing Medical University (No. 2019/491, granted 22 February 2019). All participants will be required to provide written informed consent. Study outcomes will be disseminated through peer-reviewed publications and academic conferences, and used to confirm a tailored biofeedback intervention for patients with HG with psychosomatic symptoms. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR2000028754).