An Evidence-Based Review on Shirodhara: A Unique Panchakarma Therapy

Shirodhara is a procedure consisting of continuous pouring of a stream of medicated oil, milk, buttermilk, etc. on the forehead of the patient from a specific height for a specified period. Acharya Vagbhatta has described four types of Murdha Tail i.e., Abhyanga, Parishek, Pichu, and Shirobasti, which is successively more beneficial than the previous one. Shirodhara or Shiroparishechan is one of them. Indication of Shirodhara was found in our ancient textbooks in various diseases like Ardhavabhedaka, Suryavarta, Ardita, Pakshaghata, Hanugraha, Akshishula, Nidranasha, Shirogata Vata and Shirahkampa. In the modern era, it is a very widely used Panchakarma therapy and in this review article, an evidence-based approach is used to define the type, procedure, indication contraindication, mode of action, complications and management and evidence of efficacy etc. of Shirodhara. Based on evidence Shirodhara has been found effective in various disorders like Insomnia, Psoriasis, ADHD in children, Shirah Shoola, essential hypertension, cerebral ischemic stroke and premature ejaculation when accompanied with other treatment modalities. Shirodhara was found effective on subjective as well as scientific parameters or modern biochemical markers parameters in various studies.

Quality of life and psychometric evaluation of patients diagnosed with irritable bowel syndrome: an observational cohort study

ABSTRACT BACKGROUND: Very few data are available for evaluating health-related quality of life among people with irritable bowel syndrome (IBS) and even fewer data are available in relation to anxiety and depression status among these patients. OBJECTIVES: To evaluate the quality of life, anxiety and depression status of patients with IBS. DESIGN AND SETTING: Observational cohort study conducted in a tertiary-care university hospital. METHODS: Patients who had recently been diagnosed with IBS and who had been followed up for IBS-specific treatment for at least three months were included. A quality of life (QoL) survey, the Beck Anxiety Index (BAI) and the Hamilton Depression Index (HAM-D) were applied to the patients. RESULTS: In total, 274 patients with IBS were included in the study cohort. These patients presented very high baseline scores for anxiety and depression, and very poor QoL results. CONCLUSION: Our study showed that IBS had a very high impact on these patients, regarding their anxiety and depression levels, alongside very poor results relating to quality of life.

Somatic Complaints Are Significantly Associated with Chronic Uninvestigated Dyspepsia and Its Symptoms: A Large Cross-sectional Population Based Study

BACKGROUND/AIMS: Somatization may influence persistence and severity of symptoms in gastrointestinal diseases. Some studies suggest that somatization is associated with chronic uninvestigated dyspepsia (CUD); however, the association is unclear. We aimed to determine the association between the profiles of somatic complaints with CUD and its symptoms. METHODS: In a cross-sectional study conducted on 4763 Iranian adults, somatic complaints were assessed using a comprehensive 31-items questionnaire. Patients with CUD were identified by the Rome III diagnostic criteria. Profiles of somatic complaints were derived from factor analysis. Logistic regression analysis was used to assess the relationship between extracted profiles with CUD and its symptoms. RESULTS: CUD, bothersome postprandial fullness, early satiation, and epigastric pain or burning was identified in 723 (15.2%), 384 (8.1%), 302 (6.3%), and 371 (7.8%) of the study population. The frequency of all 31 somatic complaints was significantly higher in patients with CUD compared with controls (P < 0.001), and the most frequent was severe fatigue (45.1%). The profiles of somatic complaints were extracted in 4 domains, including “psychological”, “gastrointestinal”, “neuro-skeletal”, and “pharyngeal-respiratory”. The psychological (OR, 1.49; 95% CI, 1.44–1.54), gastrointestinal (OR, 2.22; 95% CI, 2.09–2.37), neuro-skeletal (OR, 1.52; 95% CI, 1.44–1.59), and pharyngeal-respiratory (OR, 2.09; 95% CI, 1.94–2.25) profiles were significantly associated with greater odds of CUD. CONCLUSIONS: CUD and its symptoms are strongly associated with higher levels of somatic complaints and their related extracted profiles. This perhaps explains that why it can be difficult to treat, however further prospective investigations are required to confirm these associations.

Los idiomas del cuerpo: un estudio de caso sobre una paciente con epilepsia bifocal fármacorresistente

El autor del presente trabajo realiza un estudio de caso teórico-clínico acerca de un paciente que presenta un cuadro epiléptico bifocal fármacorresistente, detectable en el encefalograma, alternado con pseudocrisis epilépticas (histeroepilepsia), lo que lo lleva a cuestionarse, por un lado, sobre el alto porcentaje (30%) de pacientes epilépticos fármacorresistentes y su relación con los trastornos psicosomáticos; así como sobre la combinación en un mismo paciente de dos niveles de funcionamiento psíquico: uno narcisista no neurótico (las epilepsias como un trastorno psicosomático) y un funcionamiento neurótico histérico conversivo (las pseudocrisis). La importancia de dicho trabajo reside en el aumento en la consulta de pacientes con trastornos narcisistas no neuróticos, en los que se encuentran los trastornos psicosomáticos, así como en el difícil manejo (y alto porcentaje) de los pacientes epilépticos refractarios, que desde la neurología y la psiquiatría han representado un reto no resuelto y donde la clínica psicoanalítica tiene un saber por aportar.

The author of this paper builds a theoretical and clinical case study, based on a patient presenting with drug resistant bifocal epilepsy, detectable by EEG, that alternates with epileptic pseudoseizures (hystero-epilepsy) that rises the question on one side, about the high percentage (30%) of drug-resistant epileptic patients and its relationship with psychosomatic disorders; and, on the other, the combination of two levels of psychic functioning with the same patient: a non-neurotic narcissist (epilepsy as a psychosomatic disorder) and a functioning neurotic hysterical conversive operation (the pseudoseizures). The importance of this work lies in the increased consultation of patients with non-neurotic narcissistic disorders, among which are psychosomatic disorders, as well as the hard-to-handle (and high percentage of) refractory epilepsy patients, that have presented an unresolved challenge to Neurology and Psychiatry and where the psychoanalytic clinic has the knowledge to contribute.

Percepção e Enfrentamento do Psicossomático na Relação Médico-Paciente / Perceiving and Facing the Psychosomatic in the Physician-Patient Relationship

RESUMO Com o objetivo de compreender a vivência de médicos no atendimento a pacientes psicossomáticos, foi realizada uma pesquisa qualitativa e fenomenológica com quatro profissionais da medicina. A compreensão das entrevistas mostra que as condutas perfazem um percurso iniciado por um diagnóstico, seguido de uma mobilização pessoal que os conduz a tentativas de reorganizar a relação médico-paciente e a utilizar algumas terapêuticas, bem como demonstram seu despreparo na abordagem do tema. Esse percurso é compreendido de acordo com o modelo biomédico que rege as concepções e práticas apreendidas desde a graduação. No entanto, essa formação gera dificuldades no manejo de aspectos psicológicos, e não apenas dos referidos como elementos psicogênicos do adoecimento, típicos das compreensões psicossomáticas. Evidencia-se uma aprendizagem médica em que se dá mais atenção à doença do que ao ser que adoece.

ABSTRACT With the objective to understand the medical experience in attending psychosomatic patients, a qualitative and phenomenological research was carried on with four doctors. The comprehension of their reports shows that their conduct makes a course beginning at the diagnostic, followed by a personal mobilization which leads them to reorganize their relations with the patients and the offered therapeutics, as also how they reveal their lack of qualification to approach this subject. This course is understood in accordance with the biomedical model referred as the regent of their conceptions and practices, since medical undergraduate education. However, this formation brings them difficulties to manage the psychological aspects, not only the psychogenic ones related to the sickness, typical from psychosomatics comprehensions. It is evidenced a medical learning in which it is given more attention to illness than to human experience.

Pacientes difíciles en dermatología / Difficult patients in dermatology

La prevalencia de los trastornos psicosomáticos, dentro de los pacientes dermatológicos es muy alta, pero con frecuencia no se logra una terapéutica adecuada, debido a las severas dificultades en el abordaje, diagnóstico y tratamiento que los mismos representan. Patologías psiquiátricas y psicológicas, pueden desempeñar diferentes funciones en el mecanismo patogénico de varias enfermedades, que se manifiestan en la piel. La base del diagnóstico y del tratamiento, reside en poder diferenciar entre los trastornos de la piel asociados con enfermedades psiquiátricas y las de carácter puramente psiquiátrico pero que se expresan en la piel. Los dermatólogos y psiquiatras deben ser conscientes de estas patologías y trabajar juntos en equipo, para resolver estos difíciles casos.

The prevalence of psychosomatic disorders in dermatology patients is very high, but often adequate treatment is not achieved due to the severe difficulties in addressing diagnosis and treatment thereof. Psychiatric and psychological factors may play different roles in the pathogenic mechanism of some skin diseases. The basis of diagnosis and treatment is the differentiation between skins disorders associated with mental illness and psychiatric purely character. Dermatologists and psychiatrists should be aware of this condition and work together as a team to solve these difficult cases.

Psychosomatic Disorders Pertaining To Dental Practice

Psychosomatic symptoms are by definition clinical symptoms with no underlying organic pathology. Psychosomatic disorders represent impaired adaptation or deficiencies that limit the capacity to adapt successfully to the demands of everyday life. The symptoms are thought to be a response to stress. Appropriate health consultation should be considered for further evaluation and treatment.

Efficacy of the Santhiflex™ method of psychomotor postural re-education in the treatment of chronic low back pain / Eficácia do método Santhiflex® de reeducação postural psicomotora (RPP) no tratamento da lombalgia crônica

Introduction Chronic low back pain is conceived of as a multifactorial syndrome that results in the loss of functional capacity. It affects the quality of life of an individual and its treatment requires a comprehensive therapeutic approach. Objective The aim of this study is to assess the efficacy of the Santhiflex™ Method in the treatment of chronic low back pain, as well as its effects on functional capacity, health-related quality of life and body posture. Materials and methods 20 patients with chronic low back pain were randomly distributed into two groups of 10: an experimental group, which was treated with the Santhiflex™ Method of psychomotor postural re-education; and a control group, which was given a lecture on postural orientation after the first evaluation. Results The obtained data were analyzed using standard statistical software, SPSS-17 for Windows (SPSS, Chicago, IL, USA) and the results were expressed as absolute and relative frequencies, and median with first and third quartiles. The nonparametric Wilcoxon test was used for within-group samples. Intergroup comparison was performed using the Mann-Whitney test. A value of p < 0.05 was considered statistically significant. There were significant differences in the main factors assessed. Discussion The findings demonstrated a significant total improvement in low back pain scores in the EG, whereas there was no significant change in the CG. Conclusion The Santhiflex™ Method is effective in the treatment of low back pain and has positive effects on functional capacity and health-related quality of life. .

Introdução A dor lombar crônica como síndrome multifatorial resulta na perda da capacidade funcional com repercussão na qualidade de vida, sendo necessária uma abordagem terapêutica integral. Objetivo Verificar a eficácia do método Santhiflex® no tratamento da dor lombar crônica e de sua repercussão na capacidade funcional, na qualidade de vida e na postura corporal. Materiais e métodos 20 pacientes portadores de lombalgia crônica foram distribuídos aleatoriamente em dois grupos de 10 indivíduos cada: o grupo experimental, que foi submetido ao tratamento com o Método Santhiflex® de reeducação postural psicomotora, e o grupo controle, que recebeu uma aula de orientação postural após a primeira avaliação. Resultados Os dados obtidos foram trabalhados no programa estatístico SPSS 17, sendo verificados a frequência absoluta e relativa, o valor mediana, o primeiro e o terceiro quartis. Foi utilizado o teste não paramétrico de Wilcoxon para amostras intragrupo e realizada a comparação intergrupo por meio do teste de Mann-Whitney, estabelecido o valor de p ≤ 0,05. Foram encontradas diferenças significativas entre os principais fatores avaliados. Discussão Os dados demonstram que houve melhora de significância total do nível de dor lombar no GE; já no GC, o nível de dor não sofreu alteração significativa. Conclusão O método Santhiflex® é eficaz no tratamento da dor lombar e em suas repercussões na capacidade funcional e na qualidade de vida, avaliadas neste estudo. .

Sources and reactions to stress in brazilian lawyers / Fontes e reações de estresse em advogados brasileiros / Fuentes y reacciones al estrés en aAbogados brasileños

Job stress can negatively affect the health of employees. As such, the investigation of its characteristics in different professional categories is relevant. The aim in this study was to analyze the predictive power of seven stressors (decision latitude, psychological demands at work, physical demands at work, social support from colleagues, ergonomic stressors, relationships with clients, job insecurity) for job dissatisfaction, depression and psychosomatic problems in a sample of 702 Brazilian lawyers. The data were collected using a Brazilian version of the Job Content Questionnaire (JCQ). The results showed that decision latitude and social support were the main negative predictors of stress, while psychological demands and job insecurity were its main positive predictors. These results are discussed in the light of the demand-support-control model, which was used as a framework for the research.

O estresse ocupacional pode afetar negativamente a saúde do trabalhador, o que torna relevante a investigação de suas características em diferentes categorias profissionais. O presente estudo teve por objetivo analisar o poder preditivo de sete fontes de estresse (latitude de decisão, demandas psicológicas do trabalho, demandas físicas do trabalho, suporte social de colegas, estressores ergonômicos, relacionamento com clientes e insegurança no trabalho) na insatisfação no trabalho, na depressão e em problemas psicossomáticos, em uma amostra de 702 advogados brasileiros. A coleta de dados efetivou-se por meio de uma versão adaptada do Job Content Questionnaire (JCQ). Os resultados obtidos revelaram que a latitude de decisão e o suporte social constituíram-se nos principais preditores negativos do estresse, enquanto as demandas psicológicas e a insegurança no trabalho foram os seus principais preditores positivos.Tais resultados são discutidos a partir do modelo teórico de demanda-suporte-controle, que fundamentou a pesquisa.

El estrés laboral puede afectar negativamente la salud del trabajador y, por esto, es relevante investigar sus principales propiedades en diferentes categorías laborales. El objetivo del estudio fue analizar el poder predictivo de siete fuentes de estrés (latitud de la decisión, demandas psicológicas del trabajo, demandas físicas del trabajo, soporte social de colegas, motivos ergonómicos de estrés, relacionamiento con clientes e inseguridad en el trabajo) en la insatisfacción en el trabajo, en la depresión y en problemas psicosomáticos en una muestra de 702 abogados brasileños. La recolecta de dados fue mediante el Job Content Questionnaire (JCQ). Los resultados indicaron que la latitud de la decisión y el soporte social fueran los principales predictores negativos del estrés, mientras que las demandas psicológicas y la inseguridad en el trabajo fueran sus principales predictores positivos. Tales resultados son discutidos a partir del modelo de teórico de demandas-soporte-control que fundamentó la investigación.

The Psychosomatic Disorders Pertaining to Dental Practice with Revised Working Type Classification

Psychosomatic disorders are defined as disorders characterized by physiological changes that originate partially from emotional factors. This article aims to discuss the psychosomatic disorders of the oral cavity with a revised working type classification. The author has added one more subset to the existing classification, i.e., disorders caused by altered perception of dentofacial form and function, which include body dysmorphic disorder. The author has also inserted delusional halitosis under the miscellaneous disorders classification of psychosomatic disorders and revised the already existing classification proposed for the psychosomatic disorders pertaining to dental practice. After the inclusion of the subset (disorders caused by altered perception of dentofacial form and function), the terminology "psychosomatic disorders of the oral cavity" is modified to "psychosomatic disorders pertaining to dental practice".

Percepções e práticas sobre psicossomática em profissionais de saúde de Cacoal e Nova Brasilândia/RO / Perceptions and practices of health professionals in psychosomatic of the Cacoal and Nova Brasilândia/RO

Objetiva-se estudar as percepções e práticas sobre psicossomática em profissionais de saúde de Cacoal e Nova Brasilândia/RO. A amostra foi composta de 08 profissionais de saúde, pesquisa qualitativa, coleta de dados em entrevistas semiestruturadas e tratadas por Análise de Conteúdo, a partir das categorias: Relação corpo-mente, Formação e Conhecimento em psicossomática; e Prática e Tratamento em Psicossomática. Os profissionais relataram reconhecer uma complexa interação entre mente/psíquico e corpo, com relativo conhecimento sobre a temática psicossomática, citando as principais afecções ocorrentes em sua prática, no entanto, nota-se pouca interação profissional na perspectiva da interdisciplinaridade, predominando os encaminhamentos. Houve nos profissionais de saúde um certo conhecimento sobre a interação mente-corpo, inclusive levantando as doenças decorrentes do mal funcionamento desse processo, mas não existe na prática profissional um diálogo e interação de forma interdisciplinar, prevalecendo o encaminhamento ao psicólogo, que pode contribuir de forma estratégica para essa possível articulação na abordagem do fenômeno psicossomático.

This study focuses on Perceptions and Practices in Psychosomatic Health Professionals Cacoal and Nova Brasilândia/RO. A sample of 08 health professionals, qualitative research, collecting data in semi-structured interviews and handled by Content Analysis from the categories: mind-body relationship, Training and Knowledge psychosomatic, and Practice and Treatment Psychosomatics. Professionals reported recognizing a complex interaction between mind / mental and the body, with the theme of knowledge concerning psychosomatic, citing the major diseases occurring in their practice, however, there is little professional interaction in an interdisciplinary perspective, predominantly referrals. There were health professionals in a certain knowledge about the mind-body interaction, including raising the diseases arising from malfunction of this process, but there is in practice a dialogue and interaction across disciplines, prevailing referral to a psychologist, who can contribute strategic way to approach this possible connection in the psychosomatic phenomenon.

Psicossomática, gestação e diabetes: um estudo de caso / Psychosomatic disorders, pregnancy and diabetes mellitus: a case study / Psicosomática, gestación y diabetes: un estudio de caso

Este trabalho apresenta o estudo de caso de uma paciente gestante portadora de diabetes melito, cujo acompanhamento psicológico foi realizado em um hospital universitário público do interior do Estado de São Paulo, referência em atendimento de alta complexidade no que se refere à saúde maternoinfantil. Os atendimentos ocorreram na instituição nas situações de consulta de pré-natal da paciente, e totalizaram cinco sessões. A técnica de atendimento psicológico consistiu na psicoterapia breve de orientação psicanalítica. São apresentados as repercussões do diabetes na gestante, os aspectos psicológicos associados à gravidez, o trabalho do psicólogo dentro de uma instituição hospitalar e uma reflexão acerca do conteúdo psicossomático do diabetes. Com base nesses elementos, este estudo de caso buscou analisar os aspectos psicológicos da gestação associados aos traços de personalidade típicos do paciente diabético bem como fornecer uma visão acerca das possibilidades e das limitações vivenciadas na relação paciente-psicólogo dentro do contexto hospitalar...

This research presents the case study of a pregnant patient with diabetes mellitus. The psychological attendance took place in a public university hospital in the countryside of São Paulo, which is reference in high-complexity attendance regarding mother-child health care. The psychological interventions took place in the institution during the pre-birth attendance received by the patient, summing up five sessions. The chosen technique was brief psychotherapy - psychoanalysis oriented. The diabetes repercussions on the pregnant patient, the psychological aspects regarding pregnancy, the psychological care given inside a hospital institution, and a reflection on the psychosomatic content of diabetes are presented here. Based on these elements, this research aimed at analyzing the psychological aspects of pregnancy in association with the typical personality traits of patients with diabetes, as well as it provided a point of view of the possibilities and limitations experienced in the patient/psychologist relationship inside a hospital context...

Este trabajo presenta el estudio de caso de una paciente gestante portadora de diabetes melito, cuyo acompañamiento psicológico ha sido llevado a cabo en un hospital universitario público del interior del Estado de San Pablo, referencia en atendimiento de alta complejidad en lo que se refiere a la salud materno-infantil. Los atendimientos han ocurrido en la institución en las situaciones de consulta pre-natal de la paciente, y han totalizado cinco sesiones. La técnica de atendimiento psicológico ha consistido en la psicoterapia breve de orientación psicoanalítica. Son presentadas las repercusiones de la diabetes en la gestante, los aspectos psicológicos asociados al embarazo, el trabajo del psicólogo dentro de una institución hospitalaria y una reflexión acerca del contenido psicosomático de la diabetes. Con base en estos elementos, este estudio de caso ha tratado de analizar los aspectos psicológicos de la gestación asociados a las características de personalidad típicos del paciente diabético, así como facilitar una visión acerca de las posibilidades y de las limitaciones vivenciadas en la relación paciente-psicólogo dentro del contexto hospitalario...

A clínica psicanalítica dos transtornos psicossomáticos: de Freud a Winnicott / The psychoanalitical clinic for psychosomatic disorders: from Freud to Winnicott / La clínica psicoanalítica de los transtornos psicosomáticos: de Freud a Winnicott

O artigo reflete sobre as dificuldades da clínica dos Transtornos Psicossomáticos. Baseia-se em Freud e Winnicott para conceituá-los como uma defesa psíquica referente a um modo de organização subjetiva bastante arcaico do desenvolvimento afetivo no qual a função simbólica operada pela linguagem ainda não fora alcançada pelo infante. Destaca-se a necessidade de se incluir o holding como instrumento clínico além da interpretação. Como ilustração, apresenta-se um caso clínico no qual o movimento de integração das vivências pré-verbais requisitou o envolvimento de todos os membros de uma família.

The paper reflects on the difficulties when practicing clinical of Psychosomatic Disorders. It is based on Freud and Winnicott's theories to postulate that these illnesses can be understood as a psychic defense related to an archaic organization of the subjective emotional development in which the symbolical function operated by language was not reached by the newborn yet. It focuses on the necessity to include the holding as a beyond interpretation clinical instrument. As an illustration, it presents a clinical case in which the integration movement of the preverbal experiences required the participation of all family members.

El artículo reflexiona sobre las dificultades de la clínica de los trastornos psicosomáticos. Se basa en Freud y Winnicott para conceptualizar los trastornos como una defensa mental de la organización subjetiva arcaica del desarrollo afectivo en que la función simbólica operada por la lengua no se ha alcanzado por el niño. Atención a la necesidad de incluir la construcción (holding) como una adición a la interpretación clínica. A modo de ejemplo, es presentado un caso en que el movimiento para la integración de las experiencias non verbales pidió la participación de todos los miembros de una familia.

Relación entre la depresión, la ansiedad y los síntomas psicosomáticos en una muestra de estudiantes universitarios del norte de México / The relationship among depression, anxiety, and somatic symptoms in a sample of university students in northern Mexico

Objetivo. Determinar la relación existente entre la ansiedad, la depresión y los síntomas psicosomáticos en una muestra de estudiantes universitarios del norte de México. Métodos. Se realizó un estudio exploratorio a partir de cuestionarios de autoinforme aplicadosa una muestra de conveniencia de 506 estudiantes de psicología de dos universidades de Monterrey, estado de Nuevo León, México. Para evaluar los síntomas psicosomáticos se utilizó el cuestionario sobre la salud del paciente, para la depresión se empleó el inventario de Beck y la ansiedad se evaluó mediante la escala social para adolescentes. Se utilizó la correlación deSpearman para determinar el nivel de significación de la relación entre las variables y la prueba de Kruskal-Wallis para comparar los niveles de ansiedad y depresión en los grupos de estudiantesconformados según la intensidad de los síntomas psicosomáticos. Resultados. De los participantes, 129 (25,5%) presentaron síntomas psicosomáticos de intensidad media o alta, solo 4 (0,8%) manifestaron depresión intensa y únicamente 2 (0,4%) estudiantes presentaron niveles de ansiedad por encima del 75% de la puntuación máxima de la escala. La intensidad de los síntomas psicosomáticos aumentó a la par que aumentaban los niveles de ansiedad y depresión. Los síntomas psicosomáticos más frecuentes y que causaban mayor preocupación en la muestra fueron: dolores de cabeza, menstruales y de espalda, así como sentirse cansado y dificultades para dormir. Conclusiones. Se confirmó la relación directa entre la intensidad de los síntomas somáticos, la depresión y la ansiedad. Se recomienda incluir en los programas de prevención o tratamientode cualquiera de estos tres trastornos a los otros dos. Se deben implementar programas específicos para los jóvenes universitarios.

Objective. To determine how anxiety, depression, and somatic symptoms are related in a sample of university students in northern Mexico. Methods. An exploratory study was conducted through self-administered questionnairesapplied to a convenience sample of 506 psychology students at two universitiesin Monterrey, in the state of Nuevo León, Mexico. To evaluate somatic symptoms,the Patient Health Questionnaire was used; for depression, the Beck Depression Inventory; and for anxiety, the Social Anxiety Scale for Adolescents. Spearman’s correlation was used to determine to what extent the associations among the variables were significant. The Kruskal-Wallis test was used to compare anxiety and depressionlevels between groups of students organized by severity of somatic symptoms. Results. Of the participants, 129 (25.5%) presented somatic symptoms that were of medium intensity or severe; just 4 (0.8%) had severe depression; and only 2 (0.4%) studentspresented anxiety levels over 75% of the scale maximum. The severity of somatic symptoms increased in step with anxiety and depression levels. The somatic symptoms occurring most frequently and of greatest concern among the study sample were: headache, menstrual pain, and backache, as well as feeling tired and having difficulty sleeping. Conclusions. The direct association between the severity of somatic symptoms anddepression and anxiety was confirmed. It is recommended that all treatment and/or prevention programs addressing one of these conditions, include the other two as well. Programs specifically aimed at university youth should be implemented.

Psychiatric Considerations on Pediatric Psychosomatic Disorders with Gastrointestinal Symptoms / 대한소아소화기영양학회지

Gastrointestinal (GI) symptoms in children and adolescents are influenced by diverse psychiatric components such as psychosocial stresses, familial environment, school-related situations, and comorbid psychiatric conditions. Absolutely psychiatric symptoms of pediatric patients are also affected by problems of GI system. Lots of symptoms including anorexia, dyspepsia, nausea and so on are commonly originated from either GI or psychiatric causes or both. Sometimes the negative interactions between GI and psychiatric problems aggravate the severity and eventually decline the functions of children and adolescents with GI symptoms. We summarized the common GI and psychiatric conditions which have GI and psychiatric associations. To a clinician who manages pediatric GI disorders, psychiatric considerations can be beneficial to understand the clinical manifestations of patients and to find the way to relieve them. This short and somewhat superficial review may help to have a bird's-eye view on this topic.

Trastornos psíquicos y psicosomáticos: problemática de salud actual de los docentes mexicanos / Psychological and psychosomatic disorders: a survey of teachers in Mexico

Objetivo: Identificar las exigencias asociadas a problemas psíquicos y psicosomáticos en profesores que laboran en instituciones educativas públicas y privadas del nivel medio superior. Planteamiento del problema: Las condiciones de trabajo que enfrentan actualmente los profesores, han dado lugar a un incremento de trastornos psíquicos y psicosomáticos, dado que el trabajo que realizan es más de tipo intelectual y/o de servicio, con una baja exposición a riesgos laborales y un alto nivel de exigencias que se desprenden de la redistribución de las tareas y competencias laborales, entre otras características inherentes al modo en que el trabajo está organizado. Material y Método: Se realizó un estudio de prevalencia. Participaron 203 profesores de una escuela pública y 105 docentes de seis escuelas particulares. Se aplicó una encuesta individual, con el fin de detectar la relación de exigencias laborales con la presencia de problemas psíquicos y psicosomáticos. Los datos fueron procesados y analizados por medio de un programa computarizado diseñado para este fin. Resultados y conclusiones: Se detectó mayor número de exigencias derivadas de la organización de trabajo en las instituciones privadas, en tanto en la escuela pública, predominaron las exigencias que se desprenden de la infraestructura en la institución. La ansiedad, la depresión, los trastornos del sueño y la cefalea tensional, estuvieron asociados a horarios extensos, supervisión estricta, tareas repetitivas, entre otros. Por lo que es necesario implementar medidas preventivas, para mejorar las condiciones laborales y de salud de los docentes.

Objective: To Identify job demands associated with psychological and psychosomatic disorders among teachers working in public and private high schools in Mexico. Background: The working conditions faced by teachers today place them at an increased risk of psychological and psychosomatic disorders. Their work is more of an intellectual and/or service type, with little exposure to traditional workplace hazards, but there are high demands due to redistribution of job skills and tasks, among other characteristics inherent to the way their jobs are organized. Methods and Materials: A prevalence study was conducted. Study participants consisted of 203 public school teachers and 105 teachers from six private schools. An individual questionnaire was administered in order to explore the relationship between job demands and the presence of psychological and psychosomatic problems. The data were processed and analyzed using a computer program designed for this purpose. Results and conclusions. A greater number of demands arising from the organization of the work was observed among private school teachers. In public schools, demands related to school infrastructure predominated. Anxiety, depression, sleep disorders and tension headaches were associated with long hours, strict supervision, and repetitive tasks, among other factors. This points to the need for greater preventive efforts to improve working conditions and the health of teachers.

The Autonomic Nervous Function and the Yin-Yang Constitutional Characteristics of the Patients with Functional Gastrointestinal Disorders / 신경정신의학

OBJECTIVES: It was revealed that autonomic dysfunction, especially decreased parasympathetic functions, seems to be one of the major etiological factors in functional gastrointestinal disorders(FGID) The physiological characteristics of sympathetic and parasympathetic functions are externally similar to the features of Yin and Yang based on oriental medicine theory. And it was also revealed that gastrointestinal symptoms are prevalent in Lesser Yin constitutional type riginated from four types of constitution shown in Sasang constitutional theory. If we obtain the findings on the similarities or compatibilities between autonomic nervous functions and physical constitutional features in functional gastrointestinal disorders, we could apply various oriental treatment modalities to the patients with functional disorders, especially according to Yin-Yang constitutional concept. METHODS: We investigated the correlations between characteristics of physical constitution(Yin and Yang)and imbalance of the autonomic functions in patients with FGID. Subjects consisted with three groups: 27 patients with FGID (including irritable bowel syndrome, functional dyspepsia, functional abdominal pain syndrome according to the Rome criteria) 28 patients with somatoform disorders who had symptoms other than abdominal symptoms (other somatoform disorders) and 26 normal healthy controls. Characteristics of constitutions were evaluated and divided into two major groups, i.e., Lesser Yin constitution and other constitutions (Greater Yin & Yang and Lesser Yang included)according to the Je-Ma Lee's Classification Questionnaire for Four Constitutional Types (Song et al. 1993) For evaluating the autonomic functions, three parasympathetic functions and two sympathetic functions were measured. Levels of anxiety and depression were also evaluated to be used as a covariant controlling the autonomic functions. RESULTS: 1)FGID group showed significantly lower parasympathetic functions compared to healthy controls, however, there was no differences between FGID and other somatoform disorder groups. 2)Lesser Yin constitutional type was not so prevalent in FGID group. 3)When FGID and other somatoform disorder groups were combined and compared with normal healthy controls, the former group showed significantly lower parasympathetic functions than the latter group. CONCLUSIONS: According to these results, Lesser Yin constitutional type do not seem to be closely related with FGID. However, it was suggested that decreased parasympathetic functions were partly associated with this group. We could not find any correlations or compatibilities between two constitutional characteristics and autonomic dysfunction in FGID. This means that functional symptoms of FGID when those were deducted as Yin and Yang characteristics based on oriental medicine could not be understood as two oppositional and co-operative functions such as autonomic functions. Further research with more restricted symptoms selected in the functional disorders and with other physiological cues applied would be needed.

ANALYSIS OF PSYCHOSOMATIC DISORDERS IN 500 SCHIZOPHRENIC PATIENTS / 西安交通大学学报(医学版)

Schizophrenia and psychosomatic disorders (PSD) are obviously affected by psycho-social factors. However, there is a hypothesis that schizophaenia and PSD are mutually exclusive. The analysis of PSD was carried out in 500 schizophrenic patients, of which 6 (1.2%) had essential hypertension, 4 (0.8%) peptic ulcer, 2 (0.4%)asthma, 3 (0.6%) rheumatoid arthritis, 2 (0.4%) hyperthroidism, 5 (1.0%) neurodermatitis and 1 (0.2%)chronic urticaria. These 23 patients were 4.6%. The incidence of these 7 diseases is lower in schizophrenic patients than in any other population in the same area and lower than that reported in the data from north America or Roland. In this paper, we try to analyze the psychological and physiological factors.