Field Of Psychosomatic Medicine Research Articles

Characteristics and Trends in Peer-Reviewed Publications in the Field of Psychosomatic Medicine

The field of psychosomatic medicine/consultation-liaison psychiatry, now a subspecialty in psychiatry, has focused its efforts on clinical care, education, and research at the interface of psychiatry, medicine, and neurology. We sought to categorize characteristics and trends (over the past decade) in several journals intended primarily for practitioners of psychosomatic medicine. We reviewed all articles published in 3 peer-reviewed journals (i.e., Psychosomatics, General Hospital Psychiatry, and the Journal of Psychosomatic Research) in 2002 and 2012. Each of the 3 journals has a different approach to publication of original research, clinical reviews, and case reports. The 3 journals demonstrate differing levels of international involvement, publish a different number of articles of different types (e.g., case reports, reviews, and original research), and focus on different types of medical-psychiatric problems.

Introducing a Psychosomatic Medicine Interest Group for Psychiatry Residents

Having gained subspecialty certification in 2003, the field of psychosomatic medicine (PM) addresses the mental health needs of individuals who suffer from general medical conditions. The rising prevalence of chronic illness, along with trends in medical delivery toward more collaborative models of care, underscores the value of recruitment to PM specialty programs. To foster interest and education in PM, we have developed and implemented a Psychosomatic Medicine Interest Group for trainees within a psychiatry residency program. Participants have found the Psychosomatic Medicine Interest Group to be an enjoyable experience that has improved their clinical practice and interest in PM. The Psychosomatic Medicine Interest Group has also been a successful vehicle to enhance clinical knowledge and mentoring opportunities during training, while bolstering residents' desire to pursue a career in PM.

Reprint of: Psychosomatic medicine and consultation-liaison psychiatry: Scope of practice, processes, and competencies for psychiatrists working in the field of CL psychiatry or psychosomatics. A consensus statement of the European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) and the Academy of Psychosomatic Medicine (APM)

Objective In 2008, the Board of the European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) and the Academy of Psychosomatic Medicine (APM) Council commissioned the creation of a task force to study consensus-based summaries of core roles, scope of clinical practice, and basic competencies for psychiatrists working in the field of Psychosomatic Medicine (PM) and/or Consultation-Liaison Psychiatry (CLP). Method The task force used existing statements of competencies and feedback from EACLPP and APM symposia and workshops to develop a draft document. After review by the EACLPP and APM committees, and the EACLPP Board and APM Council, a period of comment from the field preceded a final draft resubmitted for consideration of the EACLPP Board and APM Council in February 2010. Results The two organizations completed approval of final publication of the consensus statement on June 11, 2010. This consensus statement is a summary of clinical competencies, scope of clinical effort, and roles considered by the sponsoring organizations to be fundamental to the practice of this subspecialty or special area of expertise, anywhere, of PM or CLP. Conclusion This consensus statement delineates a set of basic competencies and roles of a PM/CLP psychiatrist to serve as an internationally recognized base that may be used by national societies and institutions to formulate their own competencies, scope of practice, and roles or help with guideline formulation.

Clearance of fear memory from the hippocampus through neurogenesis by omega-3 fatty acids: A novel preventive strategy for posttraumatic stress disorder?

Not only has accidental injury been shown to account for a significant health burden on all populations, regardless of age, sex and geographic region, but patients with accidental injury frequently present with the psychiatric condition of posttraumatic stress disorder (PTSD). Prevention of accident-related PTSD thus represents a potentially important goal. Physicians in the field of psychosomatic medicine and critical care medicine have the opportunity to see injured patients in the immediate aftermath of an accident. This article first briefly reviews the prevalence and associated factors of accident-related PTSD, then focuses on a conceptual model of fear memory and proposes a new, rationally hypothesized translational preventive intervention for PTSD through promoting hippocampal neurogenesis by omega-3 fatty acid supplementation. The results of an open-label pilot trial of injured patients admitted to the intensive care unit suggest that omega-3 fatty acid supplementation immediately after accidental injury can reduce subsequent PTSD symptoms.

Psychosomatic Medicine and Consultation-Liaison Psychiatry: Scope of Practice, Processes, and Competencies for Psychiatrists or Psychosomatic Medicine Specialists: A Consensus Statement of the European Association of Consultation-Liaison Psychiatry and the Academy of Psychosomatic Medicine

In 2008, the Board of the European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) [corrected] and the Academy of Psychosomatic Medicine (APM) Council commissioned the creation of a task force to study consensus-based summaries of core roles, scope of clinical practice, and basic competencies for psychiatrists working in the field of Psychosomatic Medicine (PM) and/or Consultation-Liaison Psychiatry (CLP).The task force used existing statements of competencies and feedback from EACLPP and APM symposia and workshops to develop a draft document. After review by the EACLPP and APM committees, and the EACLPP Board and APM Council, a period of comment from the field preceded a final draft resubmitted for consideration of the EACLPP Board and APM Council in February 2010.The two organizations completed approval of final publication of the consensus statement on June 11, 2010. This consensus statement is a summary of clinical competencies, scope of clinical effort, and roles considered by the sponsoring organizations to be fundamental to the practice of this subspecialty or special area of expertise, anywhere, of PM or CLP.This consensus statement delineates a set of basic competencies and roles of a PM/CLP psychiatrist to serve as an internationally recognized base that may be used by national societies and institutions to formulate their own competencies, scope of practice, and roles or help with guideline formulation.

The Role of Psychosomatic Medicine in Global Health Care

This article reviews the principles and skills involved with psychosomatic medicine and their potential ability to improve global health care. New awareness of the escalating global public health impact of noncommunicable diseases, including chronic medical conditions and mental disorders, has stimulated interest in determining how best to organize health services. Home to the biopsychosocial model, the field of psychosomatic medicine is well-suited to inform such efforts by virtue of its emphasis on cross-disciplinary collaboration and specialized knowledge at the interface of medicine and psychiatry that takes into account individual and contextual influences on health. Consistent with the principles of psychosomatic medicine, promising strategies to improve global health care include integrating mental health care into primary care, applying the chronic care model in programs aimed at enhancing disease self-management, and using innovative models such as Internet-based therapy and telemedicine to increase access to quality care.

Psychosomatic Medicine: A Psychoanalyst's Journey Through a Somatic World

Clinical discussions within the broad field of psychosomatic medicine tend to be concerned with either psychological influences on somatic functioning or somatic influences on the mental functioning of individual patients and tend to be conceptualized through either a psychological or a somatic lens. Gottlieb (2003) described this dichotomization by following the different paths taken by Freud and Janet. Efforts to bring these lenses together to form a psychosomatic whole, by bringing together the traditions of psychoanalysis and psychiatry, have generally resulted in a clash of cultures. This article represents an attempt to bridge the cultures of psyche and soma, by providing a case example of the daily practice of a psychoanalyst consulting in a medical–surgical healthcare setting, by highlighting important contributions to the consultation literature, and by describing ways of shifting focus from the individual patient to the system within which the patient exists.

Psychosomatic medicine

Psychosomatic medicine may be defined as a comprehensive, interdisciplinary framework for: assessment of psychological factors affecting individual vulnerability as well as course and outcome of illness; biopsychosocial consideration of patient care in clinical practice; specialist interventions to integrate psychological therapies in the prevention, treatment and rehabilitation of medical disease. The aim of this review was to provide an updated definition of psychosomatic medicine, to outline its boundaries with related disciplines and to illustrate its main contributions to clinical and preventive medicine. A review of the psychosomatic literature, using both Medline and manual searches, with particular reference to articles, which could be relevant to clinical practice, was performed. Current advances in the field have practical implications for medical research and practice, with particular reference to the role of lifestyle, the challenge of medically unexplained symptoms, the psychosocial needs entailed by chronic illness, the appraisal of therapy beyond pharmaceutical reductionism, the function of the patient actively contributing to his/her health. Today, the field of psychosomatic medicine is scientifically rigorous, more diversified and therapeutically relevant than ever before.

Cardiovascular Responses to Stress and Disease Outcomes

The idea that stress can contribute to disease has been a part of the lore of medicine since the ancient Greeks. In the field of psychosomatic medicine, Alexander1 argued that emotional dispositions could lead to persistent bodily response biases that could contribute to organic disease. In hypertension research, Hines and Brown2 proposed that an increased risk for hypertension could be revealed by an exaggerated blood pressure response to the stress of immersing a hand or foot in ice water (the cold pressor test). These proposals contributed to the more recent “stress reactivity hypothesis” that a highly reactive psychological disposition or physiological constitution could increase risk for disease.3 Despite the intuitive appeal of this idea, proof of a reactivity connection to cardiovascular disease has been very difficult to produce. Barriers to such proof include the gradual development of hypertension and heart disease, resulting in the need for long follow-up periods on large numbers of persons; the presence of confounding variables, such as higher rates of smoking in persons experiencing stress in life; and the lack of standardized psychological stress paradigms analogous to the exercise protocols used in cardiology. Additional difficulty arises from uncertainty over the stability of emotional and stress responses in a given individual. …

Psychosomatic Medicine: The Scientific Foundation of the Biopsychosocial Model

This article presents major concepts and research findings from the field of psychosomatic medicine that the authors believe should be taught to all medical students. The authors asked senior scholars involved in psychosomatic medicine to summarize key findings in their respective fields. The authors provide an overview of the field and summarize core research in basic psychophysiological mechanisms-central nervous system/autonomic nervous system, psychoneuroimmunology, and psychoendocrinology-in three major disease states-cardiovascular, gastrointestinal, and HIV virus infections. Understanding the core scientific concepts and research findings of psychosomatic medicine should provide medical trainees with a scientific foundation for practicing medicine within a biopsychosocial model of care.

Der Unterricht im Fach „Psychosomatische Medizin und Psychotherapie” an den Hochschulen der Bundesrepublik Deutschland nach Änderung der Approbationsordnung für Ärzte

The new licensing regulations for physicians introduced in 2002 place core competencies in the field of Psychosomatic Medicine and Psychotherapy at the centre of medical training and have been considered to constitute a favourable opportunity for psychosocial faculties. To date, no data have been published concerning the consequences of these new regulations. All 34 chairs of Psychosomatic Medicine and Psychotherapy currently held by professors were surveyed by means of a written questionnaire at the beginning of the year 2006, regarding the present teaching situation and changes occurring through the introduction of the new regulations, as well as particular problem areas and respective solutions and suggestions. The rate of return for the questionnaires was 100 %. The consequences of the new regulations were rated predominantly positively. From a content point of view, classes continue to be more heavily weighted in cognitive areas and less so in areas of clinical practice; demands for an emphasis on affective learning objectives hence appear to have not been adequately met thus far. The newly established course formats (cross-sectional areas, obligatory optional courses, tutorials) also appear to have been employed to a rather limited degree. In addition to a lack of resources, the co-ordination with other specialist areas as well as the adequate assessment of teaching content poses a particular problem. The field of Psychosomatic Medicine and Psychotherapy constitutes an important engine for the didactic and content-related advancement of the medical curriculum in Germany. Nevertheless, the opportunities which the new licensing regulations for physicians offer to psychosocial faculties have not yet been entirely made use of. Surveyed individuals consider nationwide agreement concerning learning objectives, an exchange of experiences regarding the efficient and creative use of available resources and the development of suitable assessment methodologies, to be tasks to be urgently undertaken.

Morita therapy in psychosomatic medicine

Morita therapy is a unique Japanese treatment devised to cure sufferers of Morita's neurosis. It is effective in the treatment of psychosomatic diseases as well as neurotic illnesses and can be regarded as important in the field of psychosomatic medicine. Morita's original suggestion of treating patients solely on an outpatient basis is impossible. I believe that Walking Training therapy (a modification of Morita therapy) represents an effective alternative adaptation of the treatment.

Evaluating complementary and alternative medicine by individual response

A new methodology for the evaluation of complementary and alternative medicine (CAM) using individual response to replace randomized controlled trial (RCT) is introduced. Two research projects on “Scientific criteria for the evaluation of CAM” are discussed. The new methodology would be especially useful in the field of psychosomatic medicine.

Somatoform disorders as disorders of affect regulation: A development perspective

This paper considers the role of disturbances in affect regulation in the development and course of somatoform disorders. We first give an overview of contemporary theories in the field of psychosomatic medicine that links deficits in emotion regulation to the process of somatization, and then review recent empirical research that focuses on the association between affect regulation and somatoform disorders, with an emphasis on studies investigating the alexithymia construct. Overall, the findings suggest that somatoform disorders are linked to a diminished capacity to consciously experience and differentiate affects and express them in an adequate or healthy way. It must be noted, however, that this result has not been obtained exclusively for somatoform disorders. A promising approach to further our understanding of the developmental roots of impaired affect regulation in somatoform disorders is attachment research. The attachment research reviewed in this paper indicates that a dismissing status of attachment is linked to defensive forms of processing and expressing emotions. We present some new data that not only provide empirical support of a high proportion of dismissing attachment in somatoform disorders but also suggest that the degree to which somatoform disorder patients employ dismissing attachment strategies is strongly related to affect dysregulation. Finally, some implications for psychotherapeutic interventions in patients with somatoform disorders are considered.

Versorgungsaspekte stationärer psychosomatischer Behandlung am Allgemeinkrankenhaus

The study objective is to outline basic aspects of medical care service structure in the fields of psychosomatic medicine in a clinical acute-care setting. A total of 216 inpatients in a psychosomatic ward of a general hospital were investigated during a 32 months period using a retrospective study design. Referring physicians and clinics along with referral procedures, the waiting period, teamwork with other clinics, as well as patient and therapy characteristics are described. According to provisions of outpatient psychosocial care, general practitioners refer the majority of the inpatients (55 %), followed by other clinics (25 %) and psychosomatic and psychiatric outpatient specialists (20 %). An outpatient department along with a psychosomatic C-L service are key elements for a psychosomatic department to ensure coordination of the referral procedure. The average waiting period lasts 21 days, the average length of stay is 48 days. 60 % of the inpatients show somatic and psychiatric co morbidity. A psychopharmacological treatment has to be taken into consideration along with multi-modal psychotherapy in a third of all patients.

Psychosoziale Medizin, Psychosomatik und Psychotherapie in der Schweiz

The development of psychosocial and psychosomatic medicine in Switzerland is as diverse as the country itself with its four official languages and 26 cantons. Psychosomatic medicine of the past and present can be seen in three phases: Psychogenesis of somatic diseases ( phase 1: from about 1930-1960), bio-psycho-social medicine (phase 2: from 1960-1990) and psychobiology in medicine (phase 3: since 1990). In Switzerland the first phase scarcely noticeable, whereas active development in all fields of psychosomatic medicine and psychotherapy has taken place since 1960. The main tendencies of this development are described. The current situation for patients with psychosomatic and somatopsychic disorders is quite good in the outpatient setting. For inpatient treatment there are only about 400 beds in 19 small departments for the whole country. The strengths of the psychosomatic service system are well-established cooperation of doctors and psychotherapists and only few reactions by health insurance companies. Weaknesses are too few inpatient treatment facilities with long waiting times for patients and a lack of specialized treatment for migrants with psychosomatic disorders. Future prospects are not rosy due to the financial situation in the healthcare system, but neither are they bleak, since patients are emphatically asking for more narrative-based medicine and a partnership-based doctor-patient relationship.

Realizing Engel's vision: psychosomatic medicine and the education of physician-healers.

Many of the exciting conceptual and scientific advances in the field of psychosomatic medicine are not taught in United States medical schools. This article, based on the Presidential Address given at the Annual Meeting of the American Psychosomatic Society in Phoenix, Arizona in March 2003, reviews the rationale for integrating psychosomatic medicine into medical curricula, identifies educational needs, proposes a core curriculum, and suggests how American Psychosomatic Society members can be instrumental in curriculum development and implementation.

Proposals for Starting Radical Reforms of the Systems of Medical Education and Medical Care in Cooporation with the Related Societies in the Field of Psychosomatic Medicine (<Special Program II> About the Relationship between the Japanese Society of Psychosomatic Medicine and the Related Societies)

Proposals for Starting Radical Reforms of the Systems of Medical Education and Medical Care in Cooporation with the Related Societies in the Field of Psychosomatic Medicine (<Special Program II> About the Relationship between the Japanese Society of Psychosomatic Medicine and the Related Societies)

History and Development of Music Therapy in the Field of Psychosomatic Medicine

History and Development of Music Therapy in the Field of Psychosomatic Medicine

Solution-Focused Approach Which Improves the Therapist-Client Relationship Is Useful in the Treatment of Eating Disorder(Development of Brief Psychotherapy in the Field of Psychosomatic Medicine)

Solution-Focused Approach Which Improves the Therapist-Client Relationship Is Useful in the Treatment of Eating Disorder(Development of Brief Psychotherapy in the Field of Psychosomatic Medicine)