- [Psychotherapeutic Video Consultations in Primary Care - Concept of the PROVIDE Intervention and Results on the Intent to Adopt in Psychotherapists]. [Journal Article]
- PPPsychother Psychosom Med Psychol 2019 Jul 17
- Mental health conditions represent a significant burden to the individual as well as the society. Within the health care system, the general practitioner is the first and, in most cases, the only pro…
Mental health conditions represent a significant burden to the individual as well as the society. Within the health care system, the general practitioner is the first and, in most cases, the only provider. Timely referral of patients to specialized care is often difficult due to several barriers, particularly in rural areas. These barriers comprise long waiting times, the rising prevalence of psychosomatic and somatopsychic comorbidity, immobility in the elderly and stigmatisation related to mental health conditions. Following the Integrated Health Care approach, diagnosis and therapy of mental health conditions by psychotherapists directly within the general practice constitute an effective care model. We present a care model that is based on a telemental treatment approach for depression and anxiety disorders. Central is the piloting of psychotherapeutic video consultations in the general practice. The following article provides an overview of the care model and provides results concerning the intent to adopt the model in office-based psychotherapists.
- Psoriasis: Psychosomatic, somatopsychic, or both? [Journal Article]
- CDClin Dermatol 2018 Nov - Dec; 36(6):698-703
- Psoriasis is a chronic inflammatory disorder characterized by substantial psychiatric comorbidity. Historically, anecdotal observations have suggested that psychosocial distress can trigger flares of…
Psoriasis is a chronic inflammatory disorder characterized by substantial psychiatric comorbidity. Historically, anecdotal observations have suggested that psychosocial distress can trigger flares of psoriasis, but over the past several decades, high-quality data from experimental studies support the assertion that stress plays a critical role in the pathogenesis of psoriasis. There may be a subset of patients unable to elicit an appropriate immunosuppressive response to stress through upregulation of cortisol, with resultant exacerbation of their psoriasis. Other notable studies revealed that key neuromodulators, including substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and nerve growth factor may be potent regulators of neurogenic inflammation that induce psoriasis flares through a stress-mediated mechanism. Preliminary trials in humans that examine psychosocial interventions to reduce stress, as well as animal studies targeting specific neuropeptides, provide support for the concept that alteration of pathways mediated by the stress response represents novel forms of therapy in the management of psoriasis.
- Hypocapnia and mental stress can trigger vicious circles in critically ill patients due to energy imbalance: a hypothesis presented through cardiogenic pulmonary oedema. [Journal Article]
- NHNeuropsychopharmacol Hung 2018; 20(2):65-74
- The pathophysiologic significance of hypocapnia is strongly underestimated both in functional and organic diseases. Alterations of carbon dioxide levels immediately appear in the cytoplasm, causing a…
The pathophysiologic significance of hypocapnia is strongly underestimated both in functional and organic diseases. Alterations of carbon dioxide levels immediately appear in the cytoplasm, causing abrupt pH changes. Compensatory mechanisms develop with latency, so intracellular alkalosis or acidosis can affect metabolism for hours/days. Hyperventilation alkalosis increases metabolic energy/O₂ demand, while ATP production is often reduced due to developing hypophosphatemia. A healthy organism serves the increased energy demand conveniently, as a consequence, the excitability of the corticospinal and neuromuscular systems grows. Functional diseases can occur due to increased membrane Ca2+ transients but tissues remain structurally unchanged. By contrast, a critically ill myocardium cannot satisfy the increased energy demand caused by acute hypocapnia. Vicious circles can occur, with cardiac forward and backward failure; pulmonary wedge pressure increases parallel with the lack of energy which can lead to pulmonary oedema and death. Hypocapnia can generate fatal vicious circles in several critical illnesses. Sympathicotonia and hypocapnia enhance arousal and make biological systems energetically unstable, thus vicious circles almost unavoidably occur. Somatic and psychic processes mutually influence each other, resulting in psychosomatic or somatopsychic disorders. The ability to provide energy supplies can be an important dividing line between organic and functional diseases.
- "The Less I Think About It, the Better I Feel": A Thematic Analysis of the Subjective Experience of Malignant Mesothelioma Patients and Their Caregivers. [Journal Article]
- FPFront Psychol 2018; 9:205
- Aim: A cancer diagnosis-and in particular a Malignant Mesothelioma (MM) one-breaks the somatopsychic balance of the individual, compromising the quality of residual life and giving rise to many nega…
Aim: A cancer diagnosis-and in particular a Malignant Mesothelioma (MM) one-breaks the somatopsychic balance of the individual, compromising the quality of residual life and giving rise to many negative emotions difficult to integrate and to elaborate (such as depression, fears, anxieties, hopelessness, guilt, shame, and rage). Several national and international guidelines acknowledged the importance of evaluating psychological and socio-relational features in MM patients and their caregiver. However, only few studies have investigated the subjective experience of MM patients and even less research has focused on the caregivers' experience. Thus, the aim of the present study is to investigate the lived experience of both MM patients and their caregivers, providing an in-depth comprehension of the psychological sequelae of the disease. Materials and Methods: Within a psychoanalytically-informed conceptual framework, open-ended interviews were conducted with 10 MM patients and 9 caregivers. Thematic analysis was employed: interviews were audio-recorded, transcribed verbatim, and coded in order to identify the main recurring themes across the narratives. Results: We detected four different themes: (1) bodily symptoms and embodied emotions; (2) living in or near a National Priority Contaminated Site (NCPS); (3) "nothing is like it was" (that is, the impact of the diagnosis on everyday life, the changes it causes in the family relationships, the things that are still possible to do, the mourning process); (4) "what will become of us?" (that is, worries about the impact of the diagnosis on the beloved ones, death and legacy). Discussion: MM patients and caregivers seem to be stuck in a concrete mental functioning focused on symptoms and they find it difficult to openly think and talk about the affective and emotional consequences of the diagnosis. Alongside this, they express the need to find new and less conflictual ways to stay together and talk to each other during the period of active treatments for the illness (i.e., chemotherapy, radiotherapy, etc) and the end-of-life. The results of this study have important implications for the clinical management of MM and can help develop multi-professional specialist interventions addressed to both patients and caregivers.
- [Effect of Electroacupuncture at "Yintang" (GV 29) and "Tianshu" (ST 25) on the Ethology and the Expression of TRPV 1 Receptor in Colon of Irritable Bowel Syndrome Rats]. [Journal Article]
- ZCZhen Ci Yan Jiu 2017 Apr 25; 42(2):136-40
- CONCLUSIONS: EA at GV 29 and ST 25 can alleviate the abdominal pain and improve the mental and emotional disorders in IBS rats. GV 29 has a better effect on relieving the depressive-like psychoemotional behavior of IBS rats, while ST 25 is more effective in treating abdominal pain. There is significantly different influence on TRPV 1 expression in colon between these two treatment groups, which may contribute to their different effect in pain relieving.
- On Sublimation. [Review]
- IJInt J Psychoanal 2016; 97(5):1369-1392
- Although it encapsulates the Freudian theory of art, the theory of sublimation has become outmoded. What is more, since its inception there has always been something ill-defined about it. Does it use…
Although it encapsulates the Freudian theory of art, the theory of sublimation has become outmoded. What is more, since its inception there has always been something ill-defined about it. Does it use sexualized or de-sexualized drive energy? Is it a defence or an alternative to defence? Does it serve Eros or Thanatos? Is it useful in clinical work or is it unusable? The only, albeit uncertain, aid to a definition relies on the extrinsic criterion of concrete artistic realization. My aim here to revisit and possibly 'reinvent' sublimation in the light of certain principles of the pre-Romantic aesthetics of the sublime. Both are theories of spiritual elevation, in other words, elevation that moves towards abstract thinking, and of man's 'moral' achievement; and both attempt to explain the mystery of aesthetic experience. On the one hand, the aesthetics of the sublime offers a modern myth that helps us articulate a series of factors occasionally referred to by various authors as constitutive of sublimation but which have not been incorporated into a single organic framework: loss and early mourning work; the earlier existence of a catastrophic factor - to be regarded, depending on the situation, as either traumatic or simply 'negative'; the correspondence with a process of somatopsychic categorization which coincides with subjectivity. On the other hand, it also helps us grasp the experience of negative pleasure empathically, living it 'from the inside'.
- [Contribution of the physical and rehabilitation medicine in pediatric plastic surgery]. [Journal Article]
- ACAnn Chir Plast Esthet 2016; 61(5):589-597
- Physical, non-painful processes guide the scar reshaping in children in order to prevent growth anomalies due to cutaneous shrinkage. The objective of the surgical treatment, coordinated with the ree…
Physical, non-painful processes guide the scar reshaping in children in order to prevent growth anomalies due to cutaneous shrinkage. The objective of the surgical treatment, coordinated with the reeducation care, is to improve the physical abilities of the skin, to restore the function and avoid the deformations. Reeducation uses various techniques (i.e. sensitive-motility, massage and mobilizations) with or without physical agent (water, aspiration and touch-drive technique). Posture and positioning rely on the small or major aids, from orthosis to prosthesis. Compression is obtained by the adjustment of aids on molding and compression garment. Indications of the reeducation treatment depend on the timing of cutaneous covering and the advance of the healing process. It also depends on the underlying condition including skin traumas (frictions, wounds, burns), skin surgeries (purpura fulminans consequences, skin graft reconstruction after giant nevus resection, malignant lesion or vascular malformations). The final goal is the rehabilitation and development of the child and the adolescent in its entire somatopsychic dimension.
- The Alice in Worderland Syndrome. [Case Reports]
- NRNeuropsychol Rehabil 2018; 28(2):189-198
- The Alice in Wonderland Syndrome (AWS) was first described more than 60 years ago by Lippman. It refers to episodes during which an individual may variously experience (as did Alice during her time i…
The Alice in Wonderland Syndrome (AWS) was first described more than 60 years ago by Lippman. It refers to episodes during which an individual may variously experience (as did Alice during her time in Wonderland) somatic, visuo-perceptual and/or visuo-spatial hallucinations, as well as feelings of depersonalisation, derealisation and distorted sense of time. Although the prevalence of AWS is unknown, indirect evidence from both retrospective and prospective studies suggests that it is a rare disorder. This paper describes the case of Zoe, a right-handed, native English speaker who was age 45 years when she experienced an episode of AWS. On neuropsychological assessment, Zoe demonstrated notable impairment of attention, learning and recall (particularly for visuo-spatial information) as well as executive dysfunction (viz., impairment of planning, cognitive flexibility and abstraction), consistent with fronto-temporal dysfunction. Detailed profiles of neuropsychological impairment in the context of AWS have not previously been reported, and it is unclear if such impairment is, indeed, a central and characteristic feature of AWS.
- A disembodied man: A case of somatopsychic depersonalization in schizotypal disorder. [Case Reports]
- PJPsych J 2015; 4(4):186-98
- In the general concept of self-disturbances in schizophrenia and schizophrenia spectrum disorders, somatopsychic depersonalization (SPD) occupies a special place as it constitutes a syndrome that com…
In the general concept of self-disturbances in schizophrenia and schizophrenia spectrum disorders, somatopsychic depersonalization (SPD) occupies a special place as it constitutes a syndrome that comprises feelings of detachment from one's own body and mental processes. However, apart from clinical descriptions, to date the pathophysiology of SPD is not fully understood due to the rareness of the syndrome and a lack of experimental studies. In a case study of one patient with schizotypal disorder, we applied a multimodal approach to understanding the SPD phenomena. The patient's clinical profile was identified as disruption of implicit bodily function, accompanied by depressive symptoms. On a neuropsychological level, the patient exhibited impairment in executive functioning, intact tactile perception and kinesthetic praxis. Behavioral tests revealed an altered sense of time but unimpaired self-agency. Furthermore, the patient exhibited a lack of empathy and he had autistic traits, although with a sufficient ability to verbalize his feelings. On the neurobiological level using an active and passive touch paradigm during functional magnetic resonance imaging (fMRI), we found a hyperconnectivity of the default-mode network and salience network and a hypoconnectivity of the central executive brain networks in the performance of the touch task as well as intact perceptual touch processing emerging from the direct comparisons of the touch conditions. Our data provide evidence for the important role of altered large-brain network functioning in SPD that corresponds to the specific behavioral and neurocognitive phenomena.
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- [Chronic intestinal pseudo-obstruction complicated by an eating disorder]. [Case Reports]
- APArch Pediatr 2015; 22(11):1163-6
- Chronic idiopathic intestinal pseudo-obstruction is a rare and serious chronic disease starting in childhood, which can affect the entire digestive tract. It is caused by a peristalsis intestinal dis…
Chronic idiopathic intestinal pseudo-obstruction is a rare and serious chronic disease starting in childhood, which can affect the entire digestive tract. It is caused by a peristalsis intestinal disorder that leads to occlusions without any obvious obstruction. Few studies have been carried out regarding the prognosis of this illness. This disease is often diagnosed by a process of elimination, but some histological anomalies have been present in the digestive wall of certain patients. This clinical case concerns a 17-year-old girl affected by CIPO and eating disorders. It seems difficult to discriminate between digestive disorders and eating disorders. What psychological effects can this severe pathology have? Are eating disorders induced by CIPO? These questions are raised in this article through the example of this patient's somatopsychic complexity and the ensuing difficulties in her overall care.