Needs and Demands for e-Health Interventions in Patients Attending a Psychosomatic Outpatient Clinic: A Baseline Assessment for a User-Centered Design Approach.

Objective: Increased utilization of e-health services can help to meet shortages of psychotherapeutic treatment. e-Health interventions can be effective if tailored according to the individual needs and demands of the target group. To gather comprehensive data for the development of a user-centered e-health intervention, a cross-sectional study was conducted among a heterogeneous cohort of 309 patients seeking treatment or consultation at psychosomatic university hospital in a densely populated region of Germany. Methods: Sociodemographic data, psychometric dimensions of mental burden, as well as needs and demands regarding an e-health intervention were assessed. A descriptive statistical analysis and a cluster analysis were performed to examine distribution of preferences and differences based on level of burden regarding needs and demands for e-health interventions. Results: Two hundred thirty-nine (N = 239) participants were included in the final data analysis. Among this primarily urban target group smartphone availability was favored by 77.8% of the participants. The cluster analysis revealed significant differences dependent on mental burden. 75.2% of participants with a high mental burden preferred longer interventions of 1-4 months compared with 49% in the low burden group, which also considered short interventions of up to 1 month (46%). Differences were also identified for content preferences and daily-life integration and were consistent irrespective of the initial reason for consultation. Conclusion: The findings of this study can provide a foundational framework for developing user-centered psychosomatic interventions. The potential relationship between individual burden and individual needs and demands highlights the crucial role of preliminary research to tailor interventions to effectively address diverse needs and preferences.

A Single Case Multimethod Assessment to Detect Significant Changes in the Psychoanalytic Treatment of Psychosomatic Disorders.

Mental disorders with body-centered symptoms, such as somatic, eating, and body dysmorphic disorders, present difficulties in psychotherapy because psychological suffering is manifested in the body rather than expressed verbally. The present study illustrates a single case multi-method investigation sensitive to detecting characteristic change manifestations in the treatment of these disorders. We investigated a treatment of a patient with body dysmorphic disorder. Computerized linguistic measures were applied to 86 sessions to assess changes in symbolic processing; out of the 86 sessions, 40 were analyzed to calculate the proportion of speech focused on bodily symptoms versus on relationships. Changes in personality were assessed using the SWAP-200 on nine sessions from different treatment stages. Measures of linguistic style, speech content, and personality showed marked changes over the treatment. The patient manifested schizoid and schizotypal personality traits that decreased over time, along with an increase in personality high-functioning dimension. The patient's ability to translate his emotional experience into words steadily increased, switching the primary focus of narratives from bodily symptoms to relationships. A multimethod assessment of the treatment of body dysmorphic disorder shows that improvement in personality functioning is accompanied by a shift from a focus on bodily experiences to a focus on relationships.

Psychokardiologie ­ aus praktischer und klinischer Sicht.

In order to treat and research the development, progression, therapy and prevention of cardiological and psychosomatic disorders and their interactions, the field of psychocardiology has been established in recent years and now offers several treatment options.The well-known somatic risk factors for cardiovascular diseases such as smoking, diabetes mellitus, arterial hypertension and acquired or congenital lipid metabolism disorders, lack of exercise, malnutrition and sleep-related disorders are often related to psychosocial risk factors. Conversely, mental illnesses such as depression and post-traumatic stress disorder can also be viewed as independent risk factors for cardiovascular diseases.Somatic illnesses can, in turn, result in significant psychological reactions that have a severely negative impact on the course of the disease, participation and quality of life.In addition to the scientific research into these connections, psychocardiology offers a clinical specialty that questions, diagnoses and provides treatment for psychosocial connections in cardiovascular patients.The aim of this article is primarily to convey clinical and practical aspects of psychocardiology and the most important psychological comorbidities in connection with heart disease. In addition, it should be shown which therapeutic offers are available in the medical care structures and how therapy can be carried out. Psychotherapy and exercise therapy are preferred for the treatment of these comorbid disorders. The possibility of psychopharmacological therapy for cardiovascular patients is also presented, especially because of possible problematic medication interactions.

[Psychotherapeutic consultation at work: associations between company size and psychosomatic health]. / Psychotherapeutische Sprechstunde am Arbeitsplatz: Zusammenhänge zwischen Unternehmensgröße und psychosomatischer Gesundheit.

BACKGROUND: The utilization of psychotherapeutic consultation at work (PT-A) has so far been investigated in large enterprises (LEs). These differ structurally from small(est) and medium-sized enterprises (SMEs). Differences in the user profiles of a PT­A with regard to psychosomatic health, work-related self-efficacy, and work ability depending on company size have hardly been investigated. This study also examined differences in the employees' perception of the psychosocial safety climate (PSC) in the company, which represents management's efforts to promote mental health. METHODS: As part of the Early Intervention in the Workplace intervention study called "friaa", employees from LEs and SMEs interested in a PT­A were surveyed throughout Germany from September 2021 to January 2023. Using t­ and χ2-tests, differences between employees in LEs (n = 439) and SMEs (n = 109) were examined with regard to the ICD-10 F diagnostic code ("International Statistical Classification of Diseases and Related Health Problems"; mental and behavioral disorders), depression (PHQ-9), anxiety (GAD-2), level of functioning (GAF), somatic symptom burden (SSS-8), health (VR-12), ability to work (WAI), self-efficacy (SOSES), and psychosocial safety climate (PSC-4). The association between these variables and especially the PSC­4 were investigated using correlation analysis. RESULTS: Both groups showed similar levels of stress. From the employees' perspective, psychosocial issues were addressed significantly more frequently in LEs than in SMEs with a medium effect size. The study provided initial indications that in LEs there were positive correlations of the PSC­4 with SOSES and WAI and negative ones with PHQ­9 and SSS­8. DISCUSSION: The comparable psychological strain on employees in LEs and SMEs points to the need for behavioral and structural preventive measures regardless of the company size. Mainly in SMEs, organizational communication of psychosocial health should be given greater priority.

[Migraine and psychosomatic comorbidity]. / Migräne und psychosomatische Komorbiditäten.

As a common neurological disorder (10-15% of the population), migraine is associated with numerous comorbidities, particularly other pain syndromes, mental illnesses and functional disorders. These 'psychosomatic' comorbidities increase with migraine severity. Severely affected, comorbid patients also often have a poorer response to specific migraine therapy. Interestingly, migraine and the comorbidities mentioned have a number of common aetiological or facilitating factors, e.g. genetic factors, and show a higher incidence in women and in people with previous traumatic experiences, as well as (in the case of pain syndromes) signs of central sensitization. Another common feature is the association with current or chronic stress. We propose an extended diathesis-stress model that takes into account interrelated but individually different vulnerabilities and, depending on the stress experience, can depict both the occurrence of individual disorders (e.g. an isolated migraine) and the joint occurrence of migraine with other pain syndromes and other psychosomatic comorbidities. In summary, psychosomatic comorbidities should always be kept in mind in migraine therapy and, if necessary, treated early and multimodally.

Strategies to improve implementation of collaborative care for functional disorders and persistent somatic symptoms: A qualitative study using a Research World Café design.

INTRODUCTION: Persistent somatic symptoms and functional disorders (PSS/FD) are often complex conditions requiring care from multiple disciplines. One way of bringing the different disciplines together is through collaborative care. Little is known about the implementation barriers faced and relevant strategies to tackle the barriers in this field. Therefore, using expert knowledge, we aim to develop realistic strategies for dealing with implementation barriers of collaborative care in PSS/FD. METHODS: The Research World Café method is a single-session, expert-based method with multiple focus-groups forming and reforming to answer a set of inter-related questions, under the guidance of moderators. Using this method, participants involved in PSS/FD care across different areas of healthcare in the Netherlands developed several realistic strategies for dealing with ten implementation barriers for collaborative care in PSS/FD that were previously identified in a Delphi study. Strategies were grouped into strategy clusters using a card-sorting task. RESULTS: Thirty-three participants took part, representing ten different disciplines, most commonly physiotherapists, psychologists, and physicians. In total, 54 strategies, identified in response to the ten barriers, were grouped into eight strategy clusters. The strategy clusters were professional education, communication, care coordination, care pathways, joint consults, funding, patient involvement, and prevention. CONCLUSION: We identified a number of useful strategies for dealing with implementation barriers for collaborative care in PSS/FD. Many strategies provided ways to deal with multiple barriers at once. The effects of applying these strategies in collaborative care in PSS/FD will need testing through implementation studies, as well as in other areas needing multidisciplinary care.

Case study of invalid to valid shift in cognitive performance following successful treatment of psychogenic nonepileptic seizure events.

Patients with psychogenic nonepileptic seizure (PNES) who fail performance validity testing (PVT) may appear to produce non-valid cognitive profiles. Consequently, they may not get referred to treatment and events persist, with worsening disability and high resource utilization. As a result, we report pre- and post-treatment neuropsychological evaluation findings in a 59-year-old woman with a confirmed diagnosis of PNES established using video-EEG monitoring. At pre-treatment baseline neuropsychological evaluation, PNES events occurred weekly to daily. Performance was impaired across PVTs and across multiple cognitive domains. After behavioral intervention specific to PNES, these events substantially reduced in frequency to rare stress-induced flares. Post-treatment neuropsychological evaluation revealed marked improvement of most cognitive and behavioral scores from baseline, and valid PVT scores. We review predisposing, precipitating, and perpetuating factors for PNES and cognitive impairment in this case and discuss the patient's outcome from treatment. Effectively managing PNES events and dissociative tendencies while reducing unnecessary pharmacological interventions appears to have allowed this patient to function closer to her optimal state. This case illustrates the complexity of Functional Neurologic Disorder (FND) clinical presentation and challenges the assumption that suboptimal neuropsychological performance predicts poor treatment engagement and outcome. We showcase the reversibility of PNES and cognitive manifestations of FND using targeted psychotherapeutic interventions, which resulted in reduced disability and associated healthcare costs, as well as re-engagement in life.

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.

Fibromyalgia - offering evidence based treatment / Fibromialgia: tratamiento basado en la evidencia

INTRODUCTION: Fibromyalgia (FM) is a clinical condition characterized by chronic widespread pain, fatigue, non refreshing sleep, mood disturbance and cognitive impairment with accompanying functional disability. It's etiology and even it's existence as a clinical entity have been discussed over the last decades. The lack of understanding of it's physiopathology and the fact that, to this date, there is no strong effective treatment for it makes this discussion even more relevant for clinicians. We here try to revise some of the clinical relevant data available to this day.METHODS: This paper is a narrative revision which gathers information based on a PubMed database search from the last 6 years (2012-2018), in Portuguese or English, for clinical trials or reviews, on the term "Fibromyalgia treatment".Results and discussion: Although there isn't a single strong intervention for FM patients, there is enough evidence suggesting that patient education on the symptoms, on the disease itself and on the realistic treatment goals can benefit these patients. Exercise is also evidence based and should be appropriately suggested. Classical and new Cognitive Behavioural Therapy (CBT) interventions should be seen as the corner stone of treatment in these patients, specially if having co-morbid affective disorders. Many drugs have been studied in the hopes of helping FM patients but few have evidence to support its recommendation

INTRODUCCIÓN: La fibromialgia (FM) es una condición clínica caracterizada por dolor crónico generalizado, fatiga, sueño no reparador, alteraciones del estado de ánimo y deterioro cognitivo con discapacidad asiciada, en casis extremis. Su etiología, e incluso su existencia como entidad clínica, se han debatido en las últimas décadas. La falta de comprensión de su fisiopatología y el hecho de que, hasta la fecha, no exista un tratamiento suficientmente efectivo, convierte el debate en muy relevante para los clínicos. METODOLOGÍA: Este documento revisa información basada en una búsqueda en la base de datos de PubMed de los últimos 6 años (2012-2018), en portugués o inglés, para ensayos clínicos o revisiones, en los términos " Fybromialgia Treatment". Resultados y DISCUSIÓN: Aunque no existe una sola intervención suficientemente sólida para pacientes con FM, gozamos de evidencias suficientes que sugieren que la educación del paciente sobre los síntomas, la enfermedad misma y los objetivos del tratamiento realistas pueden beneficiarlos El ejercicio también se basa en la evidencia debe sugerirse de manera apropiada. Las intervenciones clásicas y de segunda y tercera generación de la Terapia Cognitivo Conductual (TCC) , deben considerarse la piedra angular del tratamiento en estos pacientes, especialmente si se asocian trastornos afectivos comorbidos. Muchos fármacos se han estudiado con la esperanza de ayudar a los pacientes con FM, pero pocos tienen evidencia para sostener su recomendación

Stendhal syndrome: a clinical and historical overview / Síndrome de Stendhal: una revisión histórica y clínica

ABSTRACT It could be argued that one of the few unifying qualities all human beings share is the ability to appreciate beauty. While the object of beauty may change from one person to another, the awe and the thrill experienced by an enthralled beholder remains the same. Sometimes, this experience can be so overwhelming it can bring someone to the edge of existence. A very rare condition, known as aesthetic syndrome and, more commonly, Stendhal syndrome, entails a clinical phenomenon in which the presence of a beautiful piece of work or architecture causes dysautonomic symptoms such as tachycardia, diaphoresis, chest pains and loss of consciousness. We present an historical and clinical review of this condition.

RESUMO Podría decirse que una de las pocas cualidades comunes a todos los seres humanos es la capacidad de apreciar la belleza. Si bien, es cierto que el objeto considerado como bello cambia de una persona a otra, la admiración y profunda emoción que experimenta un espectador en trance, es la misma. En ocasiones, esta experiencia puede llevar una persona hasta el borde mismo de la existencia. Una condición muy rara, conocida como síndrome estético, y en algunos casos, síndrome de Stendhal, comprende un cuadro clínico en el que la presencia de una magnífica y bella pieza de arte o arquitectura, produce síntomas disautonómicos como taquicardia, diaforesis, dolor torácico y pérdida de la consciencia. Presentamos aquí una revisión clínica e histórica de esta condición.

Corpo, luto e representação no campo analítico: algumas reflexões sobre a psicossomática hoje / Body, grief and representation in the analytic field: some reflections upon psychosomatics today

O autor, contrário a existência de estruturas psicopatológicas fixas, posiciona-se em defesa da expressão psicossomática como uma via possível para a manifestação de inscrições ainda não representadas e contidas em zonas psíquicas específicas. A partir do conceito de regrediência dentro do campo analítico, mostra que o analista poderá auxiliar no caminho representacional das referidas inscrições arcaicas, balizado pela autoanálise constante e pela supervisão. A seguir, mostra que a evolução patológica de um processo de luto, estruturado pela desmentida da perda e cindindo o Ego, poderia produzir uma melancolia corporal: presença e retorno do objeto desmentido através do corpo. Por fim, o autor alerta que dentro da elaboração analítica do luto de um objeto arcaico perdido, o analista deverá contrabalançar o estímulo à neurose transferencial com momentos de posposição ou mesmo de anulação do investimento pulsional, ausentando-se suficientemente como objeto transferencial da pulsão, de forma a não contribuir para uma possível saída somática deste luto em decorrência do processo analítico(AU)

The author, who does not agree with the existence of fixed psychopathological structures, defends the psychosomatic expression as a possible way of manifesting inscriptions that are not yet represented and contained in specific psychic areas. Starting from the concept of regredience within the analytic field, he shows that the analyst may be of assistance as far as the representational path of archaic inscriptions is concerned, based on continuing self-analysis and supervision. Subsequently, the author points out that the pathological evolution of the grief process, based on the disavowal of the loss and the splitting of the Ego, could give rise to bodily melancholia: the presence and return of the disavowed object through the body. Finally, the author warns that within the analytic elaboration of grief regarding a lost archaic object, the analyst should counterbalance the stimulus to the transference neurosis with moments of postponement or even annihilation of the drive investment, withdrawing himself sufficiently as transference object of the drive, so as not to contribute to a possible somatic outlet of this grief arising from the analytic process(AU)

El autor, contrario a la hipótesis de la existencia de estructuras psicopatológicas fijas, se posiciona en defensa de la expresión psicosomática como una vía posible para la manifestación de inscripciones aún no representadas y contenidas en zonas psíquicas específicas. Partiendo del concepto de regrediencia dentro del campo analítico, muestra que el analista podrá ayudar en el camino representacional de dichas inscripciones arcaicas apoyándose en el autoanálisis constante y en la supervisión. A continuación, muestra que la evolución patológica de un proceso de duelo, estructurado por el desmentido de la pérdida y escindiendo el Ego, podría producir una melancolía corporal: presencia y retorno del objeto desmentido por medio del cuerpo. Por último, el autor advierte que dentro de la elaboración analítica del duelo de un objeto arcaico perdido, el analista deberá contrarrestar el estímulo a la neurosis transferencial con momentos de posposición o aun de anulación de la investidura pulsional, ausentándose suficientemente como objeto transferencial de la pulsión, evitando, así, contribuir a una posible salida somática de ese duelo en el transcurso del proceso analítico(AU)

Caminhos da dor: do corpo à dor de existir / Paths of pain: from the body to the pain of existing

Este trabalho se refere a uma reflexão sobre lutos e traumas precoces em uma paciente com queixa de dor física, em um centro clínico de pesquisa em psicoterapia. A dificuldade para lidar com dor psíquica, com as emoções ao lado do risco da desorganização pode levar a uma saída somática do luto. Procuramos ilustrar nosso trabalho por meio de vinhetas clínicas de um caso clínico articuladas com as teorias psicanalíticas(AU)

This paper refers to a reflection about mourning and early traumas in a patient with chronic pain in a clinical and research center of psychotherapy. The struggle to handle psychic pain and emotions, associated to the risk of mental disorganization, may lead to a somatic way out of grief. We try to illustrate our work through clinical vignettes of a case report articulated with psychoanalytic theories(AU)

Ese trabajo se refiere a una reflexión sobre duelos y traumas precoces en una paciente con queja de dolor físico, en un centro clínico de investigación en psicoterapia. La dificultad para hacer frente al dolor psíquico, con las emociones junto al risco de desorganización, pueden llevar a una salida somática del duelo. Lo que procuramos es ilustrar nuestro trabajo por las viñetas clínicas, articuladas con las teorías psicoanalíticas(AU)

The need of dermatologists, psychiatrists and psychologists joint care in psychodermatology

Abstract: The mind-skin connection has been studied since the nineteenth century. The last 40 years have set the development of new research areas which allowed the clarifying of how these two dimensions interact. The diseases that involve skin and mind constitute the field of psychodermatology and require that specialists in dermatology, psychiatry and psychology together and integrated take part in it, since skin, nervous system and mind are simultaneously affected. This paper aims to expose how psychodermatoses are currently conceptualized and the need of integration of these three specialties for conveniently treating the patients.

O corpo / The body

O autor oferece reflexões sobre a importante mudança que tem realizado o pensamento atual no que diz respeito à consideração da relação do corpo com o psiquismo desde a clássica dissociação cartesiana entre res cogitans e res extensa como entidades diferentes até a compreensão atual de dois aspectos funcionais de um mesmo organismo. Enfatiza a importância da obra freudiana nesta evolução, assim como nas contribuições da filosofia fenomenológica do século XX e das considerações atuais da neurociência. Da mesma maneira, reflete sobre as origens da citada dissociação ainda prevalente em certos modos de pensamento. Descreve, brevemente, as formas com que aparecem na clínica as alterações da organização psicossomática(AU)

The author reflects upon the important shift that has taken place within current thinking regarding the relationship between the body and the psyche, from the traditional Cartesian dissociation between res cogitans and res extensa as different entities, to the current understanding of two functional aspects of the same organism. He stresses the importance of Freud's work in this evolution, as well as in the contributions of phenomenological philosophy in the 20th century and of current neuroscience. Likewise, the author reflects upon the origins of the mentioned dissociation, which is still prevalent in certain ways of thinking. He also briefly describes the alterations in the presentation of psychosomatic organization that appear in the clinical practice(AU)

El autor ofrece algunas reflexiones sobre el importante cambio que ha efectuado el pensamiento actual respecto a la consideración de las relaciones del cuerpo con el psiquismo desde la clásica disociación cartesiana entre res cogitans y res extensa como entidades distintas hasta la comprensión actual de dos aspectos funcionales de un mismo organismo. Hace hincapié en la importancia de la obra freudiana en esta evolución, así como en las aportaciones de la filosofía fenomenológica del siglo XX y de las consideraciones actuales de las neurociencias. Asimismo reflete sobre los orígenes de la citada disociación aún prevalente en ciertos modos de pensamiento. Describe someramente las formas(AU)

Síndrome dispéptica: relato de caso, conceitos básicos e visão antroposófica / Dyspeptic syndrome: case report, basic concepts and anthroposophic approach

A autora relata o caso de um paciente de 69 anos que apresentava quadro crônico de dispepsia por aproximadamente 40 anos. Foram realizados exames laboratoriais e de imagem ao longo desse período. Tratado com medicina convencional alopática sem adesão adequada, com sintomas relacionados ao estresse e ansiedade associados à doença. A visão ampliada pela medicina antroposófica e seus tratamentos, juntamente com práticas meditativas, levaram o paciente à melhora significativa tanto de seus sintomas clínicos quanto emocionais.(AU)

The author reports the case of a 69 year-old patient who had chronic dyspepsia for about 40 years. Laboratory and imaging tests were performed during this period. In the same period the patient was treated with allopathic conventional medicine without proper result, with symptoms related to the stress and anxiety associated with the disease. The change of approach by starting to use anthroposophic medicine and its treatments, along with meditative practices, led the patient to a significant improvement of his clinical and psychological symptoms.(AU)

Terapia psicodinámica familiar de la anorexia nerviosa / Psychodynamic family therapy for anorexia nervosa / Teràpiafamiliar psicodinàmicade l’anorèxianerviosa

La anorexia nerviosa es un grave trastorno psicosomático, aunque muchas veces está íntimamente enlazado con las relaciones familiares. En algunos casos, también se produce en un contexto multifactorial, diferenciando cuatro niveles de desarrollo de la patología: el nivel biológico (neurofisiológico), el social, el familiar y el individual (psíquico). La dinámica familiar de la patología suele tener un elevado impacto en la relación terapéutica y en la dinámica de transferencia y contratransferencia. A continuación, se presentan la experiencia clínica y algunos resultados de estudios efectuados en las dinámicas familiares de la anorexia, así como también los pasos de su tratamiento. También se hablará sobre la indicación de las sesiones de terapia familiar y su ajuste al caso concreto. A través de las barricadas: entre profesores y estudiantes adolescentes

Anorexia nervosa is a severe psychosomatic disorder, but one that is often deeply interwoven with family interactions. In some cases it also appears in a multigenerational context. Four levels of development of the illness must be differentiated: the biological (neurophysiological), social, family and the individual (psychic) levels. The family dynamics involved with this illness often have a high degree of impact on the therapeutic relationship and the dynamic of transference and countertransference. Clinical experiences and some research results on the family dynamics of anorexia are presented, as well as the steps for treatment. Questions of indications for family therapy sessions and their setting will also be discussed

L’anorèxia nerviosa és un greu trastorn psicosomàtic, tot i que moltes vegades està íntimament enllaçat amb les relacions familiars. En alguns casos també es produeix en un context multifactorial, i es diferencien quatre nivells de desenvolupament de la malaltia: el nivell biològic (neurofisiològic), el social, el familiar i l’individual (psíquic). La dinàmica familiar de la malaltia sovint té un elevat impacte en la relació terapèutica i en la dinàmica de transferència i contratransferència. Seguidament es presenten l’experiència clínica i alguns resultats d’estudis efectuats en les dinàmiques familiars de l’anorèxia, així com també els passos del tractament. També es parlarà sobre la indicació de les sessions de teràpia familiar i de l’ajustament al cas concret

Una aproximación a la sintomatología psicosomática en la primera infancia: el efecto de la sensibilidad materna / An approach to psychosomatic symptoms in early childhood: the effect of maternal sensitivity / Una aproximació alasimptomatologiapsicosomàticaen laprimerainfància: l’efecte de lasensibilitat materna

El presente estudio examina la relación entre la sensibilidad materna y la presencia de síntomas psicosomáticos en niños de 18 meses de edad (N = 102), de los cuales el 40,2 % eran prematuros sin signos de riesgo. Los resultados indican que los niños prematuros muestran mayor probabilidad de presentar síntomas psicosomáticos relacionados con la alimentación y el sueño. Se observa que, especialmente en los casos de prematuridad, la sensibilidad materna puede funcionar como un factor protector ante estas alteraciones. Estos hallazgos muestran la importancia de considerar el funcionamiento diádico en la intervención de la sintomatología psicosomática en la primera infancia. Hacia una comprensión integradora del autismo

The present study examines the relationship between maternal sensitivity and the presence of psychosomatic symptoms in children of 18 months of age (N = 102), including 40,2 % preterm infants with no risk signs. The results indicate that preterm children show a greater probability of psychosomatic symptoms related to feeding and sleep disorders. Especially, in cases of prematurity it is observed that maternal sensitivity can function as a protective factor against these alterations. These findings emphasize the importance of considering the dyadic functioning in the intervention of psychosomatic symptoms in early childhood

El present estudi examina la relació entre la sensibilitat materna i la presència de símptomes psicosomàtics en nens de 18 mesos d’edat (N = 102), el 40,2 % dels quals eren prematurs sense signes de risc. Els resultats indiquen que els nens prematurs mostren més probabi­litat de presentar símptomes psicosomàtics relacionats amb l’alimentació i la son. S’observa que, especialment en els casos de pre­maturitat, la sensibilitat materna pot funcionar com un factor protector davant d’aquestes alteracions. Aquestes troballes mostren la importància de considerar el funcionament diàdic en la intervenció de la simptomatologia psicosomàtica en la primera infància

Una nueva «vacuna»: la del autoconocimiento. Autoconocimiento a través de la neurociencia, la inteligencia emocional y el mindfulness / A new vaccine. The vaccine of self-knowledge. Self-knowledge through neuroscience self-knowledge, emotional intelligence and the mindfulness

Un alto porcentaje de pacientes acuden a la consulta del pediatra por un problema que tiene una raíz emocional o psicosocial. Para este tipo de pacientes, el pediatra, en muchas ocasiones, no tiene conocimiento suficiente y el sistema público de salud ofrece alternativas escasas. Los conocimientos que la neurociencia, la inteligencia emocional y el mindfulness aportan acerca del funcionamiento de la mente del ser humano permiten un empoderamiento de este, convirtiéndose en dueño de su vida y en responsable de su felicidad, lo que repercute en una mejora en su salud física, emocional y mental. El autoconocimiento, una nueva "vacuna" para la prevención de muchas enfermedades con base emocional (AU)

A high percentage of patients come to the pediatrician consultation by a problem that has an emotional root, psycho-social. For such patients, the pediatrician on many occasions, do not have enough knowledge and the public health system offers few alternatives. Knowledge provided by neuroscience, emotional intelligence and the mindfulness about the functioning of the human mind allows an empowerment of this, becoming owner of his life and in charge of your happiness, what has an impact on an improvement in their physical, emotional and mental health. Self-knowledge, a new vaccine for the prevention of many diseases with emotional core (AU)

Pediatría psicosomática y medicalización de la infancia en Buenos Aires, 1940-1970 / Pediatric psychosomatic medicine and the medicalization of childhood in Buenos Aires, 1940-1970

Resumen Analiza cómo el predominio de la pediatría psicosomática en el campo médico argentino supuso una transformación en los tratamientos. Estudia cómo, a partir de la década de 1950, los expertos psi y los abordajes interdisciplinarios encontraron espacios en el Hospital de Niños de Buenos Aires; y cómo la difusión de la teoría del apego facilitó la internación conjunta de las madres. Explica la configuración de ciertas dolencias como “enfermedades de familia” en un escenario en el que bajaron las tasas de natalidad. Se focaliza en los discursos de su principal referente, Florencio Escardó, no sólo porque fue hegemónico en el campo científico sino porque también ocupó un rol predominante como consejero en los medios de comunicación.

Abstract This article analyzes how the dominance of pediatric psychosomatic medicine in the Argentine medical field caused a transformation in treatments. It shows how, beginning in the 1950s, psy-experts and interdisciplinary approaches found a space at the Hospital de Niños (Children’s Hospital) in Buenos Aires; and how the growth of attachment theory made it possible for mothers to stay with their children in hospital. It explains the construction of certain conditions as “family diseases” in a context of declining birthrates. It focuses on the speeches of a key figure, Florencio Escardó, not only because he was hegemonic in the scientific field but because he also played an important role dispensing advice in the media.

A proposal of basic guidelines for training in psychosomatic and liaison psychiatry in Spanish psychiatry training programs

Background and Objectives: The Psychosomatic and Liaison Psychiatry is an emerging psychiatric subspecialty. This article is intended to summarize the philosophy supporting training programmes in Spain, and the recommended training guidelines. Methods: Review of the literature and teaching experience. Results: The increasing complexity of diagnosis and treatment, and the demand by patients and providers of resources for higher and more efficient quality of care, make skills training a key tool for achieving these goals. The human being is biology, feelings, thoughts, experiences and thus individuality when sick. Understanding all this is the core on which to base our competencies in this exciting crossroads between psychiatry and other medical specialties. We propose a set of competencies to achieve, and point learning spaces and evaluation mechanisms. Conclusions: Based on accumulated experiences in Spain, and the review of European and international literature, it is possible to summarize a realistic set of norms and directions for training in Psychosomatic and Liaison Psychiatry in residency programmes (AU)