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1.
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
2.
Soins Pediatr Pueric ; 40(310): 34-38, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31543233

RESUMO

Most children adopted in a foreign country present somatic disorders, which can have an impact on the construction of the bond with the adoptive parents. This potential complication must be taken into account in the adoption procedure and during the post-adoption follow-up, taking on board the trauma of everyone involved.


Assuntos
Adoção , Internacionalidade , Pais/psicologia , Transtornos Somatoformes/psicologia , Criança , Humanos , Relações Pais-Filho
3.
Continuum (Minneap Minn) ; 25(4): 1121-1140, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31356296

RESUMO

PURPOSE OF REVIEW: This article reviews a practical approach to psychogenic movement disorders to help neurologists identify and manage this complex group of disorders. RECENT FINDINGS: Psychogenic movement disorders, also referred to as functional movement disorders, describe a group of disorders that includes tremor, dystonia, myoclonus, parkinsonism, speech and gait disturbances, and other movement disorders that are incongruent with patterns of pathophysiologic (organic) disease. The diagnosis is based on positive clinical features that include variability, inconsistency, suggestibility, distractibility, suppressibility, and other supporting information. While psychogenic movement disorders are often associated with psychological and physical stressors, the underlying pathophysiology is not fully understood. Although insight-oriented behavioral and pharmacologic therapies are helpful, a multidisciplinary approach led by a neurologist, but also including psychiatrists and physical, occupational, and speech therapists, is needed for optimal outcomes. SUMMARY: The diagnosis of psychogenic movement disorders is based on clinical features identified on neurologic examination, and neurophysiologic and imaging studies can provide supporting information.


Assuntos
Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/psicologia , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/psicologia , Adolescente , Adulto , Terapia Cognitivo-Comportamental/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Exame Neurológico/métodos , Modalidades de Fisioterapia
4.
Eur J Pediatr ; 178(8): 1297-1300, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31254072

RESUMO

We report a case series of seven children admitted to a tertiary level pediatric ward for long-lasting physical symptoms with a previous diagnosis of chronic Lyme disease. In these children, medical history and clinical features were strongly suggestive of a psychopathological disorder, mainly a somatic symptom disorder. What is Known: • There is an increasing number of diagnoses of chronic Lyme disease both in North America and in Europe. Adults receive this diagnosis to explain chronic physical complaints often with negative history and serology. What is New: • Somatic symptom disorder should be suspected in children and adolescents with non-specific symptoms diagnosed with chronic Lyme disease.


Assuntos
Erros de Diagnóstico , Síndrome Pós-Lyme/diagnóstico , Transtornos Psicofisiológicos/diagnóstico , Transtornos Somatoformes/diagnóstico , Adolescente , Criança , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Síndrome Pós-Lyme/psicologia , Transtornos Psicofisiológicos/psicologia , Estudos Retrospectivos , Transtornos Somatoformes/psicologia
5.
Artigo em Russo | MEDLINE | ID: mdl-31156219

RESUMO

AIM: To study impairments of cognitive control in patients with somatoform disorders (SD) and to evaluate the efficacy of recognan in the treatment of this pathology. MATERIAL AND METHODS: Forty-six patients with SD, aged from 18 to 45 years, were studied. A clinical history, neurological examination, and assessment of autonomic disorders were collected from all patients. For the objectification of the severity of asthenic and emotional disorders, the Subjective Scale of Asthenia (MFI-20), the Hamilton Anxiety Scale (HARS), the Cognitive Emotion Regulation Questionnaire (CERQ were used. A quantitative assessment of impaired attention and impulsivity was performed using the psychophysiological test TOVA. Patients were treated with recognan (citicoline). The control group consisted of 30 healthy people aged from 18 to 45 years. RESULTS AND CONCLUSION: Patients with SD had specific characteristics of the cognitive sphere, most pronounced in the form of attention disorders. The psychological study showed the higher level of anxiety. In addition, patients with SD were characterized by the low levels of emotional intelligence and cognitive control of emotions compared with the control group. The results of the follow-up study after treatment suggest the high efficacy of recognan in the treatment of SD (improvement was noted in 67.4% of patients). A significant decrease in the severity of autonomic disorders and in indicators characterizing asthenia was established after the treatment.


Assuntos
Transtornos Cognitivos , Nootrópicos , Transtornos Somatoformes , Adolescente , Adulto , Cognição , Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/etiologia , Citidina Difosfato Colina/uso terapêutico , Seguimentos , Humanos , Pessoa de Meia-Idade , Nootrópicos/uso terapêutico , Transtornos Somatoformes/tratamento farmacológico , Transtornos Somatoformes/psicologia , Adulto Jovem
6.
Ideggyogy Sz ; 72(5-6): 165-170, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31241260

RESUMO

Background and purpose: Two trait-like characteristics, somatosensory amplification and absorption, have been associated with symptom reports and idiopathic environmental intolerances in past research. Purpose - As the two constructs are not connected with each other, their independent contribution to symptom reports and electromagnetic hypersensitivity, as well as their interaction can be expected. Methods: On-line questionnaire. Patients - 506 college students completed an on-line questionnaire assessing absorption, somatosensory amplification, negative affect, somatic symptoms, and electromagnetic hypersensitivity. Results: Somatosensory amplification (ß = 0.170, p < 0.001) and absorption (ß = 0.128, p < 0.001) independently contributed to somatic symptoms after controlling for gender and negative affect (R2 = 0.347, p < 0.001). Similarly, somatosensory amplification (OR = 1.082, p < 0.05) and absorption (OR = 1.079, p < 0.01) independently contributed to electromagnetic hypersensitivity after controlling for somatic symptoms, gender, and negative affect (Nagelkerke R2 = 0.134, p < 0.001). However, no interaction effects were found. Conclusion: Somatosensory amplification and absorption independently contribute to symptom reports and electromagnetic hypersensitivity. Conclusion - The findings suggest that psychological mechanisms underlying symptom reports and electromagnetic hypersensitivity might be heterogeneous.


Assuntos
Ansiedade/psicologia , Campos Eletromagnéticos/efeitos adversos , Sensibilidade Química Múltipla/diagnóstico , Distúrbios Somatossensoriais/psicologia , Estudantes/psicologia , Ansiedade/complicações , Ansiedade/fisiopatologia , Humanos , Sensibilidade Química Múltipla/etiologia , Sensibilidade Química Múltipla/psicologia , Transtornos Somatoformes/psicologia , Distúrbios Somatossensoriais/complicações , Distúrbios Somatossensoriais/fisiopatologia , Inquéritos e Questionários
7.
Int J Soc Psychiatry ; 65(4): 265-270, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30969143

RESUMO

BACKGROUND: The positive association between adverse life events and somatoform disorders is a consistent observation. But no systematic studies have evaluated the relationship between health-related life events (HLEs) in patients with somatic symptom disorder (SSD)/somatoform disorders. AIM: To examine the nature and relationship of HLE in patients with SSD and to assess the correlates of HLE. METHODS: A total of 50 adult patients with SSD and 50 matched healthy controls from a Neuropsychiatric hospital were recruited. Sociodemographic interview, scale for assessment of somatic symptoms (SASS), Patient Health Questionnaire-15 (PHQ-15) and a semi-structured interview schedule to gather information on HLE were used. RESULTS: Patients in the SSD group had a significantly higher number of total HLE in general (4.72 ± 2.63, 3.36 ± 1.92; p = .004), major HLE (1.48 ± 1.45, 0.68 ± 0.94; p = .006), during their lifetime in comparison to controls. Infections, trauma, non-communicable diseases and reproductive system-related diseases were the more common types of HLE in SSD group. CONCLUSION: Our findings may implicate a role of major HLE of patients and HLE of their family members in the pathophysiology of SSD.


Assuntos
Acontecimentos que Mudam a Vida , Transtornos Somatoformes/etiologia , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Somatoformes/fisiopatologia , Transtornos Somatoformes/psicologia , Inquéritos e Questionários
8.
Gen Hosp Psychiatry ; 58: 94-102, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31031213

RESUMO

OBJECTIVE: This study describes medication prescribing patterns in patients with motor functional neurological disorder (mFND) treated in South London and Maudsley NHS Foundation Trust (SLaM), comparing outcomes to a control group of psychiatric patients from the same hospital trust. METHOD: This is a retrospective case-control study using a psychiatric case register. Cross-sectional data were obtained from 322 mFND patients and 644 psychiatry controls who had had contact with SLaM between 1st January 2006 and 31st December 2016. RESULTS: A slightly lower proportion of mFND patients received medication compared to controls (76.6% v. 83.4%, OR: 0.59, CI: 0.39-0.89, p < 0.05). Of medication recipients, mFND patients were prescribed a higher number of agents (mean: 4.7 v 2.9, p = 0.001) and had higher prescription rates of antidepressants, anti-epileptics, analgesics, and certain non-psychotropic medications. Higher numbers of prescriptions were associated with co-morbid physical conditions, and previous psychiatric admissions. CONCLUSIONS: This is the first study to describe medication prescriptions in a large cohort of mFND patients. Patients were prescribed a wide range of psychiatric and physical health medications, with higher rates of polypharmacy than controls. Psychotropic medication prescription is not necessarily the first line treatment for mFND, where physiotherapy and psychotherapy may be offered initially. There is limited, early-phase evidence for pharmacological therapies for mFND, and as such, the benefit-to-risk ratio of prescribing in this complex and poorly understood disorder should be carefully assessed.


Assuntos
Serviços de Saúde Mental/estatística & dados numéricos , Transtornos Motores/tratamento farmacológico , Doenças do Sistema Nervoso/tratamento farmacológico , Prescrições/estatística & dados numéricos , Psicotrópicos/uso terapêutico , Transtornos Somatoformes/tratamento farmacológico , Medicina Estatal/estatística & dados numéricos , Adulto , Idoso , Analgésicos Opioides/uso terapêutico , Anticonvulsivantes/uso terapêutico , Antidepressivos/uso terapêutico , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Motores/epidemiologia , Transtornos Motores/psicologia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Estudos Retrospectivos , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/psicologia , Reino Unido
9.
BMC Psychiatry ; 19(1): 120, 2019 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-31014294

RESUMO

BACKGROUND: Clinical outcomes for patients with heterogeneous somatoform disorder (bodily distress disorder, including medically unexplained symptoms) are suboptimal, new treatments are required to improve acceptance. Body-oriented psychological therapy approaches have been identified as potentially beneficial additions to the portfolio of treatments. This study was aiming to assess the acceptability, the potential benefits, and associated change processes of manualised group body psychotherapy (BPT) for outpatients with Somatoform Disorder. METHODS: A randomized controlled feasibility trial was carried out with follow-up at 6 months after baseline assessments using the Primary Health Questionnaire (PHQ), Somatic Symptom Screening Scale (SOMS-7), quality of life ratings (Short-Form Health Survey-36; SF-36) and body image measures (Dresden Body Image Questionnaire). Acceptance was assessed with the Helping Alliance Scale (HAS). RESULTS: A total of 24 patients were recruited to participate. Sixteen patients were randomly assigned to receive either manualised BPT or TAU, eight patients were directly assigned to BPT. Drop-out rates were acceptable, patients reported to be highly satisfied with the group intervention. Somatic symptom levels reduced significantly in the BPT group. Additionally, a significant effect on self-acceptance and the mental component of quality of life was observed. CONCLUSION: Group body psychotherapy is a feasible and acceptable treatment for patients with somatoform disorder and a larger trial studying the effectiveness of BPT in these patients should be conducted. TRIAL REGISTRATION: Retrospectively registered SRCTN12277345 ; Trial Registraton Date: 27/03/2019.


Assuntos
Imagem Corporal/psicologia , Psicoterapia de Grupo/métodos , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/terapia , Adulto , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida/psicologia , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento
10.
Res Dev Disabil ; 90: 31-40, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31035091

RESUMO

BACKGROUND: Although children across the world experience Developmental Disabilities, most research on DD has been conducted using Western cultural perspectives and has primarily focused on mothers, leaving significant gaps in the literature. This study intends to fill some of these gaps by exploring and gaining an understanding of the experiences of fathers raising children with DD. Thus, the aim of this study was: to examine whether stigma, somatization, and parental self-efficacy were associated with stress among Bedouin fathers of adolescents with DD. Besides, the relationship between somatization and stress was examined in this study, as it is mediated by the sense of stigma, as well as the intensity of the mediation of the knowledge of shame, between paternal self-efficacy and stress. METHODOLOGY: Notably, ninety Bedouin fathers of adolescents with DD completed five questionnaires. These questionnaires included demographic, stigma, parental self-efficacy, and stress and somatization questionnaires. RESULTS: Significantly, the study findings indicate significant negative relationships between general stress and parental self-efficacy, parental and economic stress and parental self-efficacy, and sense of stigma and parental self-efficacy. Also, the findings indicate significant positive relationships between stigma and anxiety, fear and somatization, and stigma and somatization. CONCLUSIONS: Arguably, concerning the findings of the study, intervention programs that are culturally tailored and that concern cognitive-behavioral foundations are recommended to help fathers cope with their sense of stigma. Further, the intervention programs help to deal with stress and somatization and to increase their understanding of parental self-efficacy in raising their child. Therefore, these cultural intervention programs should take into account the individual and his extended family, and place of the family in his life, considering the cultural values and the honor of the family. Further, the programs should take into account the centrality of religion and an awareness of the impact of the social hierarchy and the status of the fathers in the community and on the child with disabilities. In essence, these areas are focal points of power that can assist in providing solutions for the intervention program. Also, it is essential to refer to the living and economic conditions of this community.


Assuntos
Deficiências do Desenvolvimento , Pai/psicologia , Poder Familiar , Estigma Social , Transtornos Somatoformes , Estresse Psicológico , Adaptação Psicológica , Adolescente , Adulto , Árabes/psicologia , Árabes/estatística & dados numéricos , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/etnologia , Feminino , Humanos , Israel/epidemiologia , Masculino , Poder Familiar/etnologia , Poder Familiar/psicologia , Autoeficácia , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/fisiopatologia
11.
Rev Prat ; 69(2): 209-213, 2019 02.
Artigo em Francês | MEDLINE | ID: mdl-30983229

RESUMO

The diagnosis of a somatic symptom disorder must be based on both a negative approach - eliminating another psychiatric or non-psychiatric disorder that would better explain the symptoms - and a positive one, which is, based on the search for characteristic thoughts, emotions or behaviours as well as biological or psychological factors that may promote, trigger or sustain the disorder. Additional tests and specialized medical consultations should not be prescribed solely to reassure the patient; they may actually worsen the condition. The management will move away from the outdated notion of "medically unexplained symptoms" to rely on: the acknowledgment of the painful, debilitating and involuntary nature of the symptoms; the proposal of a positive diagnosis acceptable by the patient and an explanatory model compatible with his or her representations, aimed at putting an end to dysfunctional health care utilization; the proposal of therapeutic objectives aimed at functional rather than symptomatic recovery; the negotiation of pharmacological (selective or mixed serotonin reuptake inhibitor if necessary) and non-pharmacological interventions, especially when it comes to limiting the factors that sustain the disorder; the coordination of the various healthcare professionals.


Assuntos
Transtornos Somatoformes , Feminino , Humanos , Transtornos Somatoformes/psicologia
12.
Soc Psychiatry Psychiatr Epidemiol ; 54(10): 1255-1263, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30982118

RESUMO

PURPOSE: Epidemiologic studies document a lower prevalence of major depression in Blacks than Whites in the United States. This is paradoxical from the perspective of social stress theory. A long-standing claim in the (clinical) literature is that Blacks express depression more somatically than Whites. If true, the diagnostic algorithm may undercount depression in Blacks, since the screening symptoms privilege the psychological rather than somatic dimensions of depression. We test hypotheses that (1) Blacks express depression more somatically than Whites which (2) reduces their likelihood of endorsing screening symptoms, thereby undercounting Blacks' depression and explaining the Black-White depression paradox. METHODS: We use cross-sectional data collected in 1991-92 from the National Longitudinal Alcohol Epidemiologic Survey (n = 42,862) among Blacks and Whites endorsing at least one past-12-month depression symptom. We compare groups on depression somatization and test whether greater somatization in Blacks leads to lower endorsement of psychological screening symptoms, and therefore under-diagnosis. RESULTS: Blacks have higher mean depression somatization scores than Whites (0.28, SE 0.04 vs. 0.15, SE 0.02), t(122) = - 2.15, p = 0.03. This difference is small and driven by Blacks' higher endorsement of 1 somatic symptom (weight/appetite change) and Whites' greater propensity to endorse psychological symptoms. However, Blacks have the same odds as Whites of endorsing screening symptoms, before and after adjusting for somatization. CONCLUSIONS: We find minimal evidence that Blacks express depression more somatically than Whites. Furthermore, this small difference does not appear to inhibit endorsement of diagnostic depression screening symptoms among Blacks, and therefore does not resolve the Black-White depression paradox.


Assuntos
Afro-Americanos/psicologia , Transtorno Depressivo Maior/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Transtornos Somatoformes/etnologia , Adulto , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Prevalência , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Estados Unidos
13.
Neurol Sci ; 40(8): 1607-1610, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30982134

RESUMO

OBJECTIVE: We investigated the frequency of reported sexual abuse in patients with psychogenic nonepileptic seizures (PNES) in a Middle-Eastern culture (Iran) and tried to characterize the association between a history of sexual abuse and the clinical characteristics of PNES in these patients. METHODS: In this retrospective database study, patients with PNES, who were investigated at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 until 2018, were studied. Patients were categorized into two groups: (1) those with a history of sexual abuse and (2) those without such a history. RESULTS: A total of 314 patients were studied. Twenty-six patients (8.3%) had a history of sexual abuse, while 288 patients (91.7%) denied having such an experience. Sex ratio (OR: 3.53; 95% CI: 1.14-10.89; p = 0.02) and a history of child abuse (OR: 4.85; 95% CI: 1.82-12.96; p = 0.002) were significantly associated with a history of sexual abuse. CONCLUSION: Some people with a history of sexual abuse are at risk of developing PNES later in their lives. While social, cultural, and even genetic predisposition may be interacting for such an association to come to play, there is no concrete direct evidence to clarify this link yet. This should be investigated in future international cross-cultural studies and also highlights the need for planning genetic studies in patients with PNES.


Assuntos
Convulsões/psicologia , Delitos Sexuais/psicologia , Transtornos Somatoformes/psicologia , Adolescente , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Estudos Retrospectivos , Adulto Jovem
15.
Interv. psicosoc. (Internet) ; 28(1): 19-27, abr. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-182608

RESUMO

The global economic crisis of the previous decade has accelerated internal mobility in the European Union. The main objective was to analyse perceived stress and mental health among Spanish immigrants and non-immigrants, as well as gender differences, and to examine the mediation role of perceived stress in the relationship between migration protective factors and mental health. A convenience sample (N = 941) was obtained by snowball sampling, contacting with social networks during 2014 and 2015. Spanish immigrants (n = 719) living in Germany or United Kingdom and non-immigrants (n = 222) living in Spain answered an online survey with a questionnaire about socio-demographic and migration variables (immigrants) as well as PSS-14 and GQH-28. The low level of perceived stress and mental health symptoms found were similar in Spanish immigrants and non-immigrants. Women immigrants presented slightly higher rates of prevalence of somatisation and anxiety/insomnia and higher perceived stress. A parsimonious structural equation model with two protective migration factors was obtained (R2 = .58), which had direct and indirect effects on mental health through perceived stress. The migration process was not related to poorer mental health in the European context, and gender differences were small. These findings could be explained by the privileged migration conditions of Spanish immigrants


En la última década la crisis económica global ha acelerado la movilidad interna dentro de la Unión Europea. El objetivo principal de este estudio ha sido analizar el estrés percibido y la salud mental de los españoles inmigrantes en comparación con los no inmigrantes, atendiendo a las diferencias de género. Un objetivo complementario era examinar el papel mediacional del estrés percibido en la relación entre los factores protectores migratorios y la salud mental. Se obtuvo una muestra de conveniencia (N = 941) a través del muestreo de bola de nieve contactando con redes sociales en el periodo 2014-2015. Españoles inmigrantes (719 residentes en Alemania o Reino Unido) y no inmigrantes (n = 222) respondieron en internet a un cuestionario sobre variables sociodemográficas y migratorias (inmigrantes), así como a los instrumentos PSS-14 y GHQ-28. Los bajos niveles de estrés percibido y los síntomas de salud mental encontrados fueron similares en la población española inmigrante y no inmigrante. Las mujeres inmigrantes presentaban tasas de prevalencia ligeramente más elevadas en somatización, ansiedad e insomnio que los hombres inmigrantes. Se obtuvo un modelo de ecuaciones estructurales parsimonioso que incluía dos factores migratorios protectores (R2 = .58), con efecto directo e indirecto en la salud mental a través del estrés percibido. El proceso migratorio estudiado no se relaciona con peor salud mental en el contexto europeo y las diferencias en función del sexo son muy pequeñas. Estos resultados pueden explicarse por las condiciones privilegiadas migratorias de la población española en otros países de la Unión Europea


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Saúde Mental , Emigrantes e Imigrantes/psicologia , Fatores de Proteção , Estresse Psicológico/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Sociedade Receptora de Migrantes , Inquéritos e Questionários , Transtornos Somatoformes/psicologia , Transtornos de Ansiedade/psicologia , Distúrbios do Início e da Manutenção do Sono , Reino Unido , Alemanha , Espanha , Análise de Variância
16.
Neurol Sci ; 40(Suppl 1): 93-98, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30877615

RESUMO

Migraine is one of the most frequent complaints in children and adolescents and it can have a significant impact on quality of life. There are several factors underlying the onset and the maintenance of this disorder and there is still no a clear etiopathogenesis common to all subjects suffering from migraine. Psychological factors such as individual characteristics, psychiatric comorbidities, and temperament are strictly related to psychosomatic disorders and to migraine. Also, the environmental influence is very relevant and studied: socio-economic status, family dysfunctions, attachment style, or psychiatric disease in parents can influence the onset of migraine in children. Finally, many studies are trying to find out any alteration in genetics or in cerebral areas or networks that can explain migraine vulnerability. In this review, we analyze the most recent findings on neurological, psychological, and environmental factors that may potentially cause migraine.


Assuntos
Transtornos de Enxaqueca/psicologia , Transtornos Psicofisiológicos/psicologia , Qualidade de Vida , Transtornos Somatoformes/psicologia , Comorbidade , Humanos , Transtornos de Enxaqueca/fisiopatologia , Transtornos Psicofisiológicos/fisiopatologia , Transtornos Somatoformes/fisiopatologia , Estresse Psicológico/psicologia
17.
HNO ; 67(Suppl 2): 46-50, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30927015

RESUMO

BACKGROUND: Tinnitus frequently occurs alongside psychological comorbidities whose assessment is important for treatment planning and -success. The selection of suitable questionnaires is thus crucial. The present study aims to investigate the ICD-10 Symptom Rating (ISR) to this regard. METHODS: The current study investigated tinnitus burden and psychological comorbidities in a sample of N = 311 patients with chronic tinnitus. All participants completed an intensive 7­day multimodal tinnitus-specific therapy. Tinnitus burden was measured using the German version of the Tinnitus Questionnaire (TQ). Psychological comorbidities were measured using the ISR (total score, depressive disorder, anxiety disorder, obsessive-compulsive disorder, somatoform disorder, and eating disorder), the Perceived Stress Questionnaire (PSQ; total score, tension, worries, joy, and demands), and the General Depression Scale (Allgemeine Depressionsskala, ADS). RESULTS: Sixty-five percent of participants suffered from psychological comorbidities. Treatment response comprised improvements in the TQ, ISQ, PSQ and ADS. At baseline, tinnitus-burden correlated with the ISR-total, ISR-obsessive-compulsive disorder and PSQ-tension scores. Post treatment, the-now reduced-tinnitus burden was additionally predicted by ISR-depressive and eating disorder scores. CONCLUSION: The ISR is a useful tool for measuring psychological comorbidities in patients with chronic tinnitus as well as short-term treatment response. Therapeutic approaches for chronic tinnitus should address stress-related tension, depressive symptomatology and coping strategies such as maladaptive eating behaviours.


Assuntos
Classificação Internacional de Doenças , Zumbido , Comorbidade , Depressão/psicologia , Humanos , Escalas de Graduação Psiquiátrica , Transtornos Somatoformes/psicologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Zumbido/diagnóstico , Zumbido/psicologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-30845721

RESUMO

This commentary presents commonalities in medically unexplained symptoms (MUS) across multiple organ systems, including symptoms, aetiological mechanisms, comorbidity with mental health disorders, symptom burden and impact on quality of life. Further, treatment outcomes and barriers in the clinician⁻patient relationship, and cross-cultural experiences are highlighted. This discussion is necessary in aiding an improved understanding and management of MUS due to the interconnectedness underlying MUS presentations across the spectrum of medical specialties.


Assuntos
Sintomas Inexplicáveis , Transtornos Mentais/epidemiologia , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/terapia , Comorbidade , Assistência à Saúde Culturalmente Competente , Humanos , Relações Médico-Paciente , Qualidade de Vida/psicologia , Transtornos Somatoformes/patologia , Transtornos Somatoformes/psicologia , Resultado do Tratamento
19.
Recenti Prog Med ; 110(2): 100-105, 2019 Feb.
Artigo em Italiano | MEDLINE | ID: mdl-30843537

RESUMO

Functional disorders that we observe neurologically primarily pose terminology problems: some of them such as migraine, narcolepsy, restless legs syndrome have a recognized nosographic status, although without demonstrable lesions; others are interpreted only as somatic manifestations of psychic conflicts. There is also the risk that the "functional" diagnosis masks - as prejudice - lesional pathologies not adequately investigated with the available technology, leading to serious clinical errors. Moreover, even in presence of a probable psychogenic disorder, patients tend to reject the "functional" diagnosis, for cultural reasons linked to the old philosophical separation between diseases of the body and mind (the latter with a "lower" status). The current evolution of neuroscience should lead us to the conclusion that all so-called "functional" disorders are manifestations of cerebral suffering; at the same time an existential approach to the disease must make us wary of reductionist conclusions, because the clinical expression of a lesion is in the great majority of cases modulated by the culture and the history of the patient.


Assuntos
Doenças do Sistema Nervoso/diagnóstico , Transtornos Somatoformes/diagnóstico , Humanos , Doenças do Sistema Nervoso/psicologia , Transtornos Somatoformes/psicologia , Terminologia como Assunto
20.
Br J Gen Pract ; 69(681): e254-e261, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30858336

RESUMO

BACKGROUND: GPs have a central position in the care of patients with medically unexplained symptoms (MUS), but GPs find their care challenging. Currently, little is known about symptom management by GPs in daily practice for patients with MUS. AIM: This study aimed to describe management strategies used by GPs when confronted with patients with MUS in daily practice. DESIGN AND SETTING: Qualitative study in which videos and transcripts of 39 general practice consultations involving patients with MUS in the region of Nijmegen in the Netherlands in 2015 were analysed. METHOD: A thematic analysis of management strategies for MUS used by GPs in real-life consultations was performed. RESULTS: The study revealed 105 management strategies in 39 consultations. Nearly half concerned symptom management; the remainder included medication, referrals, additional tests, follow-up consultations, and watchful waiting. Six themes of symptom management strategies emerged from the data: cognitions and emotions, interaction with health professionals, body focus, symptom knowledge, activity level, and external conditions. Advice on symptom management was often non-specific in terms of content, and ambiguous in terms of communication. CONCLUSION: Symptom management is a considerable part of the care of MUS in general practice. GPs might benefit from support in how to promote symptom management to patients with MUS in specific and unambiguous terms.


Assuntos
Ajustamento Emocional , Clínicos Gerais , Administração dos Cuidados ao Paciente/métodos , Atenção Primária à Saúde/métodos , Transtornos Somatoformes , Adulto , Remediação Cognitiva/métodos , Feminino , Clínicos Gerais/psicologia , Clínicos Gerais/normas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Relações Médico-Paciente , Pesquisa Qualitativa , Melhoria de Qualidade , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/terapia
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