In his psychobiological model of personality, Cloninger developed a novel approach concerning the relationships between psychopathological syndromes and personality. We investigated 207 chronic pain patients (CPPs) and compared them to 105 pain-free control subjects. Participants were assessed using the Temperament and Character Inventory (TCI), the Structured-Clinical-Interview-II, the Beck Depression Inventory and the Spielberger Anxiety Inventory. The CPPs scored higher on the depression and state anxiety scales and 41% fulfilled the criteria of having at least one personality disorder (PD). We used a covariance analysis to control for depression and state anxiety and found that the CPPs scored higher on the Harm Avoidance Temperament Dimension and lower on the Self-Directedness and Cooperativeness Character Dimensions. In CPPs, the symptom counts of all PD subtypes were significantly related to low Self-Directedness and, to a lesser degree, low Cooperativeness. The PD symptoms in Cluster A were related to low Reward Dependence, those in Cluster B were related to high Novelty Seeking and the PD symptoms in Cluster C were related to high Harm Avoidance. In multiple hierarchical regression analyses, controlling for age, gender, depression and state anxiety, TCI scales predicted on average 23% in PD symptom counts. The Self-Directedness and Cooperativeness personality traits appeared to be significant predictors in determining the presence or absence of a PD by correctly classifying 75.8% of CPPs. The TCI provides further insight into the mechanisms underlying the development of chronic pain. This useful diagnostic instrument helps to economically and validly facilitate the identification of core PD features.

Fat depletion and excess of tissue water in the bone marrow in anorexia nervosa can be quantified by 1H magnetic resonance spectroscopy and relaxometry. The distribution of the pathological changes in the lumbar and femoral marrow follows the pattern of normal bone marrow conversion from hematopoietic to cellular during childhood.

The continuing confrontation with the thoughts and feelings surrounding an unfulfilled wish for a child makes coping very difficult. There is empirical evidence that, in medical illnesses associated with stress and loss of quality of life, patients react with alexithymia, which means a difficulty to communicate emotions. In this study we compared 84 infertile men with a group of 96 healthy men and 43 male psychosomatic outpatients concerning their ability to communicate feelings, measured by the Twenty-Item Toronto Alexithymia Scale and the amount of psychopathologically relevant symptoms, especially somatization, measured by the Symptom Checklist 90-R and a List of Complaints (Beschwerden-Liste). The results showed a significantly higher alexithymia in infertile men compared with healthy men (P < 0.05), but a significantly lower alexithymia compared with psychosomatic outpatients (P < 0.05). Furthermore the study group showed significantly more somatic complaints in the List of Complaints compared with healthy men (P < 0.05). The importance of alexithymia in male infertility is discussed on the basis of empirical results that it might play a defensive role as far as depression is concerned but on the other hand increases the possibility of somatic complaints. The need for prospective studies in further research is emphasized.

Infertility is proposed to be a continuing stressor for couples suffering from involuntary childlessness. A long duration of the desire for a child and, correspondingly, a longer period of diagnostic and treatment procedures could have a negative impact on sexual satisfaction, thus leading to an unfavorable psychological circuit. The present evaluation should clarify the state of sexual satisfaction and relationships, with relevant parameters in 68 men with fertility problems, of couples with involuntary childlessness. Subjects reported relatively high average levels of present sexual satisfaction with only nonsignificant lower scores (p = .08) compared to recalled sexual satisfaction prior to diagnosis of infertility. Multiple regression analyses revealed that a positive age difference between men and their spouses (p = .042) and a higher weekly coitus frequency (p = .002) were the only significant parameters associated independently with higher sexual satisfaction. Neither the age of partners, attitudes toward sexuality, treatment duration, duration of the partnership and the duration of the desire for a child, nor andrological findings had an influence on present sexual satisfaction. The results propose that treatment duration and duration of the desire for a child may not necessarily be connected to lowered sexual satisfaction in infertile males and that coitus frequency seems to be an indicator of sexual satisfaction in this patient group.

No abstract

680 unselected outpatients of our Psychosomatic Clinic were divided into six diagnostic groups and examined by the SCL-90-R. By ANOVA we found differences of means between the diagnostic groups for the global severity score (GSI) and for the subscale scores. We describe the model of Jacobson et al. [1,2] for the determination of cut-off-points and reliable change indices for the assessment of changes over time, e.g. after psychotherapy. Our results lead to the conclusion that, although an overall reliable change index for the GSI can be applied to all psychosomatic patients, cut-off-points should be different following the diagnostic groups. Furthermore, information from the SCL-90-R-subscales as well as other specific symptom scales should be used for the interpretation of significant changes of the GSI.

Within the framework of inpatient psychosomatic treatment involving a psychotherapeutic treatment setting, substitution facilitates weight gain.

In this study we investigated the relationship between personality attitudes, psychopathological symptoms and biological parameters in male infertility. Eighty-four infertile men underwent a psychological and medical examination at our clinic. The psychological tests comprised the Symptom Checklist 90-R, the Toronto Alexithymia Scale and the NEO-Five Factor Inventory. Seminal parameters, gonadotrophins, sex steroids, cortisol and prolactin were analyzed to obtain biological data. Compared with questionnaires completed by normal populations those in the study group scored higher on the scales for 'conscientiousness', 'agreeableness', 'alexithymia' and 'somatization' and lower on the scale for 'neuroticism'. Regarding psychobiological correlations we found a negative correlation between seminal parameters and 'extraversion', 'anxiety' and 'psychoticism'. 'Alexithymia' was negatively correlated with stress hormones and 'conscientiousness' was correlated with sex steroids. The findings suggest above average social competence in the study group. The psychobiological correlations indicate a link between social-competence-related personality traits such as 'extraversion' and 'conscientiousness' and biological fertility characteristics. Implications of a higher alexithymia in infertile men, which is negatively correlated with stress hormones, are discussed.