Alexithymia appears to be directly related to the process of somatization of psychological distress that has not found verbal expression. The lack of a meaningful dialogue between mother and child in early infancy may predispose the development of an alexithymic strategy in expressing psychic and psychosocial stress. This can occur in the form of unpleasant bodily sensations or pain. The human skin is, in addition to the oral and gastrointestinal organs, the earliest contact sphere between the young infant and the environment. In a group of 312 randomly chosen patients at an outpatient primary health care clinic a significant relationship was found between palpational hypersensitivity to touch on the one hand and somatization proneness and the degree of alexithymia on the other hand.
diagnosis of low-back pain patients. A simple quantification of the pain drawing. Nord J Psychiatry 1992;46:55-62. Oslo. ISSN 0029-1455.This study presents and evaluates a simple quantification method for the Patient Pain Drawing (PPD). It is hypothesized that the resulting score can serve as an estimation of psychologic vulnerability and somatization proneness among patients with back pain. The subject sample consisted of 146 consecutive back-pain patients who had been referred to an outpatient physiotherapeutic rehabilitation clinic by general practitioners. They were tested once on three variables from the MMPI (Minnesota Multiphasic Personality Inventory): hypochondriasis (Hs), depression (D), and hysteria (Hy), and four times by means of a test battery including a pain questionnaire, the PPD, and a visual analog scale (VAS). Between the first and second test occasions the patients participated in a physiotherapeutic treatment program. Two follow-up testing sessions were conducted 6 and 18 months after the treatment. Positive relationships were found between Hs, D, Hy and four PPD scores, with the highest correlation coefficients (rho=0.64-0.79, Spearman rank correlation) for Hs and the four different testings with PPD. Forty-eight per cent of the patients with very low PPD scores were without pain after 18 months, compared with only 2% of the patients with high PPD scores. The PPD appears to be a good test for early screening of psychologic vulnerability in back pain patients. The test could easily be used in different primary health care settings and serve as a help in referring patients to more extensive psychologic investigation and adequate treatment. Back pain, MMPI, Patient Pain Drawing, Psychologic vulnerability, Screening.Tatjana Sivik, MD, MA, Mhtensgatan 7, S-421 63 V:a Frolunda, Sweden; Accepted: 1 .11.1991. It is not common that the staff has training in the Nord J Psychiatry Downloaded from informahealthcare.com by University of Auckland on 12/22/14 For personal use only. Nord J Psychiatry Downloaded from informahealthcare.com by University of Auckland on 12/22/14 For personal use only. 416 65 Goteborg. Kerstin Klingberg-Olsson, authorized physiotherapist. Department of Physiotherapy, Olskroken, Redbergsv. 6 . 416 65 Goteborg. Nord J Psychiatry Downloaded from informahealthcare.com by University of Auckland on 12/22/14 For personal use only.
Ten female patients with asthma-like symptoms but negative asthma tests (study group) were compared with 10 female asthmatics in an exercise test with and without pretreatment with beta 2-stimulants. The aim was to determine whether the asthma-like symptoms in the patients of the study group could be explained by bronchoconstriction, circulatory abnormalities, or physical unfitness when provoked physically, and whether the exercise test could be used to distinguish these patients from asthmatics. Without pretreatment, the asthma group reacted with bronchoconstriction, as indicated by postexercise systematic changes in PEFR, FEV1, FVC, and SaO2, which were not seen in the study group. The groups differed in the ratings of "difficulty in getting air", as only the asthma group had significantly lower ratings when pretreated. The study group's mean test performance was 94 W; the asthma group's was 106 W. The low performance was not explained by disturbances in heart rate, electrocardiogram, or blood pressure or physical unfitness. The exercise test was found to distinguish between the groups, especially for bronchoconstriction, oxygen saturation, and ratings of dyspnea. It could be used complementary to lung function tests to eliminate bronchoconstriction, circulatory abnormalities, and physical unfitness as a cause of the asthma-like symptoms.
This investigation was conducted during the war in Croatia from 1991 to 1993. General characteristics, traumas, and frequency of post-traumatic stress disorder (PTSD) were compared in three groups of soldiers: (1) soldiers who sustained non-disabling injuries; (2) soldiers who sustained permanently disabling injuries; (3) active soldiers (controls). Significant differences were found in general characteristics and in PTSD in the groups observed. Both groups of wounded soldiers were significantly younger (mean of 8 years), fewer of them were married, and they had fewer children than active soldiers (controls). The differences in marital status and the number of children were obviously due to the age difference. Soldiers who sustained non-disabling injuries developed PTSD significantly more often than soldiers who sustained permanently disabling injuries and active soldiers (controls). Possible reasons for the differences of PTSD in compared groups of soldiers are discussed.
Fifteen patients with asthma were compared with thirteen patients with asthma-like symptoms but without physiological signs of asthma. This condition is termed Functional Breathing Disorder, FBD. All patients were examined with regard to relevant physiological variables, and to specific personality traits and psychosocial status by means of psychological tests and questionnaires. The results indicated that the patients suffering from FBD were more psychologically distressed and had lower quality of life than the asthma patients. Further, they suffered from a significantly greater variety of symptoms and more intense symptoms than the asthmatics. Such symptoms included sleeping disturbances and somatic symptoms such as chest pain, cold hands or feet, blurred vision. The FBD patients had significantly more problems in their social and family lives, at work and in their leisure time than the asthmatics. They were significantly more depressed, less hedonic and more hypochondriac than the asthmatics. Moreover, they trusted other people to a significantly lesser degree. The patients with FBD had been hospitalized less often than the asthmatics, but they had sought medical care more often. The present study indicates that it is important to identify patients suffering from FBD at as early a stage as possible in order to offer them proper treatment.
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