Psychosomatic Issues Research Articles

A COMPARATIVE CLINICAL STUDY OF KWATHA DHARA AND TAIL DHARA IN STRESS MANAGEMENT

In ancient India, it was said that worry (chinta) had more detrimental effects than a funeral pyre (Chita). Today, stress is recognised as a major factor impacting human health, affecting physical, mental, and emotional well-being. In Ayurveda, stress is viewed as a condition resulting from pragyaparadha (intellectual errors). Alt-hough this procedure is not classically detailed under Panchakarma, Ayurvedic scholars have included it under snehana karma. This treatment can serve as a preparatory step or a primary therapy in Panchakarma, depend-ing on the patient's condition. Shirodhara is recommended for various conditions including insomnia, ADHD, anxiety disorders, phobias, depression, hypertension, and other psychosomatic issues. This paper presents evi-dence supporting the classical Ayurvedic procedure of “shirodhara” and reviews recent research to explore its potential mechanisms of action.

Effect of Deficiency of Vitamin D on Depression and Premenstrual Syndrome.

Vitamin D, otherwise called the daylight vitamin, is critical for the control of calcium and phosphorus assimilation. Defienceny of it is also associated with many medical problems like multiple sclerosis, cancer,cardiovascular disease and can also lead to psycho somatic issues. The study was conducted on 80 subjects who were further divided into 2 groups of 40 each. Group A with normal Vitamin D levels and group B was formed of people suffering from hypovitaminosis D, 20 females were tested on Premenstrual Syndrome as well. Hamilton Depression Rating Scale was used to measure level of depression. It was hypothesized that hypovitaminosis D would be positively related to depression, and premenstruation syndrome

Dose-Dependent Association Between Body Mass Index and Mental Health and Changes Over Time

Overweight and obesity affect 340 million adolescents worldwide and constitute a risk factor for poor mental health. Understanding the association between body mass index (BMI) and mental health in adolescents may help to address rising mental health issues; however, existing studies lack comprehensive evaluations spanning diverse countries and periods. To estimate the association between BMI and mental health and examine changes over time from 2002 to 2018. This was a repeated multicountry cross-sectional study conducted between 2002 and 2018 and utilizing data from the Health Behaviour in School-aged Children (HBSC) survey in Europe and North America. The study population consisted of more than 1 million adolescents aged 11 to 15 years, with all surveyed children included in the analysis. Data were analyzed from October 2022 to March 2023. Mental health difficulties were measured by an 8-item scale for psychological concerns, scoring from 0 to 32, where a higher score reflects greater psychosomatic issues. BMI was calculated using weight divided by height squared and adjusted for age and sex. Data were fitted by multilevel generalized additive model. Confounders included sex, living with parents, sibling presence, academic pressure, the experience of being bullied, family affluence, screen time, and physical activity. Our analysis of 1 036 869 adolescents surveyed from 2002 to 2018, with a mean (SD) age of 13.55 (1.64) years and comprising 527 585 girls (50.9%), revealed a consistent U-shaped association between BMI and mental health. After accounting for confounders, adolescents with low body mass and overweight or obesity had increased psychosomatic symptoms compared to those with healthy weight (unstandardized β, 0.14; 95% CI, 0.08 to 0.19; unstandardized β, 0.27; 95% CI, 0.24 to 0.30; and unstandardized β, 0.62; 95% CI, 0.56 to 0.67, respectively), while adolescents with underweight had fewer symptoms (unstandardized β, -0.18; 95% CI, -0.22 to -0.15). This association was observed across different years, sex, and grade, indicating a broad relevance to adolescent mental health. Compared to 2002, psychosomatic concerns increased significantly in 2006 (unstandardized β, 0.19; 95% CI, 0.11 to 0.26), 2010 (unstandardized β, 0.14; 95% CI, 0.07 to 0.22), 2014 (unstandardized β, 0.48; 95% CI, 0.40 to 0.56), and 2018 (unstandardized β, 0.82; 95% CI, 0.74 to 0.89). Girls reported significantly higher psychosomatic concerns than boys (unstandardized β, 2.27; 95% CI, 2.25 to 2.30). Compared to primary school, psychosomatic concerns rose significantly in middle school (unstandardized β, 1.15; 95% CI, 1.12 to 1.18) and in high school (unstandardized β, 2.12; 95% CI, 2.09 to 2.15). Our study revealed a U-shaped association between adolescent BMI and mental health, which was consistent across sex and grades and became stronger over time. These insights emphasize the need for targeted interventions addressing body image and mental health, and call for further research into underlying mechanisms.

Pathoreactive Experiences of Epileptic Females: An Interpretative Phenomenological Analysis

Background: Epilepsy is a prevalent neurological condition that affects individuals worldwide, with significant social and psychological impacts. Adolescent females with epilepsy in Pakistani society face unique challenges due to cultural perceptions, social stigma, and traditional beliefs regarding treatment. Understanding these challenges is crucial for developing effective support systems and interventions. Objective: This study aims to explore the pathoreactive experiences of adolescent females with epilepsy in Pakistan, focusing on the psychosomatic, social, and cultural barriers they encounter. The objective is to identify the specific needs of this group to inform targeted support strategies and public awareness campaigns. Methods: Employing a qualitative research design, this study utilized interpretative phenomenological analysis to delve into the experiences of adolescent females with epilepsy. Participants were selected through purposeful sampling from a government hospital in Lahore. Data were collected via in-depth interviews, transcribed verbatim, and analyzed using NVIVO-11 to identify themes and categories reflecting the participants' experiences. Results: The analysis revealed five key categories of challenges faced by the participants: psychosomatic difficulties, social withdrawal, family problems, superstitious beliefs, and the impact of social stigma. These findings highlight the complex interplay between epilepsy, cultural beliefs, and societal attitudes, underscoring the need for comprehensive support and public education. Conclusion: Adolescent females with epilepsy in Pakistan encounter a myriad of challenges that necessitate a multifaceted support approach. Addressing the psychosomatic issues, combating social stigma, and challenging traditional beliefs are essential steps towards improving their quality of life. Public awareness campaigns and culturally sensitive healthcare interventions are critical for de-stigmatizing epilepsy and promoting a more inclusive society.

Examining the Experiences of Affected Family Members in Morocco: A Descriptive Study of 64 Cases

The research described in this paper resulted from the study of the relatives of problem drug users called “affected family members” (AFM) involving two practitioners in our Psychiatric University Hospital Ar-Razi within the timeframe of January 2022 to April 2022. The objective of this research was simply to interview 64 close AFM, with the identification occurring through external consultations. Quantitative and qualitative results show that large numbers of these relatives reported many negative experiences, reporting both psychiatric and psychosomatic issues. Relatives reported many negative effects in terms of how they endure stigma and how the experiences had affected their health. They also described various coping mechanisms, and the extent of the support which they had received. The results are discussed in terms of coping, perceived stigma, health consequences, quality of life and it focuses on the difficulties, feelings, and interactions they face due to their loved one's substance use. The AFMs represent a vulnerable population susceptible to adverse health-related consequences. Therefore, they must be systematically included as pivotal targets for treatment protocols.

Network analysis of psychosomatic symptoms in pharmacists during the pandemic.

We explored the networks and discriminant abilities of the current Psychosomatic Symptoms Scale (PSSS) in pharmacists for future abbreviation. Ten thousand seven hundred twenty-one pharmacists participated in this study through an online investigation. We used network analysis to reveal the central and bridge symptoms between the subscales (psychological and somatic symptoms) of the PSSS. Then, we utilized item response theory (IRT) to identify discriminant abilities of the current 26-item of PSSS. Over twenty percent of the pharmacists were troubled with significant psychosomatic issues during the pandemic. Risk factors included age, lack of support, and impaired general health conditions. The network analysis revealed that "Irritability" was central to the psychological subscale and "Fatigue" was central to the somatic subscale. "Irritability-Fatigue," "Fatigue-Obsession," and "Self-injury idea-Perineum discomfort" was bridging between the somatic and psychological subscales. IRT found that "Anhedonia," "Depression," "Tightness," "Palpitations," and "Difficulty breathing" were highly discriminated. A future version of PSSS could be abbreviated according to the highlighted items, and they should also be emphasized in future psychosomatic research and targets for intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Addressing psychosomatic issues after lifting the COVID-19 policy in China: A wake-up call.

The Coronavirus has infected up to 900 million people as of 11 Jan 2023 in China Mainland, which is more than 60% of the population. The sudden and unprecedented nature of pandemic has resulted in a range of psychosomatic issues among the population. These issues can manifest in a variety of ways and it is important to address these issues as they can have serious consequences for individuals' mental and physical health. The lifting of lockdown measures in China presents an opportunity to address these issues and provide support to those who have been affected.

The dynamic changes of psychosomatic symptoms in three waves of COVID-19 outbreak and fatigue caused by enduring pandemic in China

BackgroundTwo years have passed since the 2019 novel coronavirus disease (COVID-19) was first reported. The persistent pandemic might lead to severe psychosomatic problems and fatigue. In addition, the recent rapid rising COVID-19 cases in China have become a trending issue. Therefore, this study aimed to investigate the dynamic changes in psychosomatic problems at the initial and current stages of the pandemic. MethodsThree waves of cross-sectional online survey were conducted during the initial COVID outbreak in China. The psychosomatic symptom scale (PSSS), perceived stress scale (PSS), and pandemic fatigue scale (PFS) were used to assess the psychosomatic problems, stress, and fatigue. Results4317, 1096, and 2172 participants completed the first, second, and third surveys. The prevalence of psychosomatic disorder was 22 %, 28 %, and 39 %, respectively. The network structure of PSSS symptoms has not significantly changed as the pandemic progresses. However, the global strength of the PSSS networks, indicating the overall connectivity, in the third wave was significantly higher than in the first wave (s = 0.54, P = 0.007). The most central symptoms in the first and third wave networks were depressed mood and tiredness. The PFS score was higher in the people concerned with indirect impact than those concerned with health (P < 0.001). PFS has positive relationships with PSSS and PSS score (R = 0.41, P < 0.001 and R = 0.35, P < 0.001, respectively). ConclusionsThe persistence of the pandemic caused critical psychosomatic issues, stress, and indirect burden over time, leading to inevitable fatigue. People endured needing immediate attention to prevent or reduce psychosomatic disorders.

The Use of Complementary and Alternative Medicine in Health Care

It's kind of mysterious how complementary and alternative medicine (CAM) is being used more and more in developed, "established" Western countries. There hasn't been much study or good understanding about it. The National Center for Complementary and Alternative Medicine (NCCAM) defines "complementary and alternative medicine" (CAM) as a collection of various medical and health systems, procedures, and objects that are not currently regarded as corresponding to traditional medicine. Over the past 15 years or so, CAM use has grown significantly, and it is without a dispute significant from a medical, economic, and sociological perspective. Even though there are literally hundreds of therapies that fall under the broad definition of CAM, only about 15-20 have definitive proof of their efficacy and safety to be taken seriously (Tiran, 2001). The NCCAM divides complementary and alternative medicine (CAM) into five primary categories: whole medical systems, mind-body healthcare, physiologically based, manipulative and body-based therapies, and energy fields [1].&#x0D; CAM is frequently used to supplement conventional treatment. Back issues, melancholy, sleeplessness, intense headaches or migraines, stomach or intestinal diseases, and back problems were the most frequent symptoms linked with CAM, according to a review of the worldwide CAM literature by Frass et al. [2]. A few earlier studies looked into the use of CAM for particular diseases or health issues, like cancer and multiple sclerosis.&#x0D; &#x0D; According to Menniti-Ippolito et al., herbal medicine was more frequently used to enhance life expectancy while acupuncture and manipulative treatments were mainly used to treat pain in Italy. Homeopathy, in comparison, was not linked to any particular health issues [3]. Other common reasons people turn to complementary and alternative medicine (CAM) are dissatisfaction with biomedicine, frustration with the doctor-patient relationship, relaxation, enhancements in subjective wellbeing, preventative medicine, a preference for natural care over biomedical medicine, and an eagerness for more individualized and holistic care.&#x0D; People in Pakistan who believe in quacks, pastors, hakeems, homoeopaths, or other psychic healers have used alternative treatments. For issues like infertility, seizures, psychosomatic issues, melancholy, and many other illnesses, these are the first line of defense. The proximity, reasonable cost, accessibility, family obligation, and the positive perception of the community are the primary justifications for visiting a CAM healer. Pakistan has a long history of using medicinal herbs to cure a variety of illnesses. The people's health-seeking behavior, particularly in emerging nations, necessitates integrating all CAM healers into society by giving them access to appropriate training, tools, and referral support.

Clinical Evaluation and Treatment of Patients with Postconcussion Syndrome.

Postconcussion syndrome (PCS) is a complex set of symptoms occurring in a small percentage of patients following concussion. The condition is characterized by headaches, dizziness, cognitive difficulties, somatosensory issues, and a variety of other symptoms with varying durations. There is a lack of objective markers and standard treatment protocols. With the complexity created by premorbid conditions, psychosomatic issues, secondary gains, and litigations, providers often find themselves in a tough situation in the care of these patients. This article combines literature review and clinical insights with a focus on the underlying pathophysiology of PCS to provide a roadmap for evaluating and treating this condition.

Alexithymia and physical outcomes in psychosomatic subjects: a cross-sectional study

Backgrounds. Alexithymia is a relevant phenomenon, occurring transversally to healthy subjects and individuals affected by several conditions. Its role is considerable, according to current state of the art several conditions emerged as influenced, maintained and worsened by alexithymic structures and figures. The present study was aimed at highlighting the existing relations, the differences and the directions assumed by alexithymic factors and health status in patients affected by psychosomatic conditions. Methods. The sample consisted of 150 participants, 42 males (28.0%) and 108 females (72.0%), aged 26 to 78 years old with a mean of 42.24 years old (SD = 12.39). Subjects were previously assessed through DCPR-SI, in order to identify psychosomatic issues. The study evaluated measures related to alexithymia (Tas-20) and health status (SF-36), and considered demographic characteristics such as age, gender, and education. Results and Conclusions. The analyses demonstrated a number of significant relationships between alexithymia, psychological outcomes, and physical outcomes, including psychosomatic disorders. In addition, sex differences were found in gastrointestinal outcomes, as well as outcomes related to energy/fatigue and physical functioning. The study of alexithymia may provide a fruitful approach in understanding various issues related to pathology and general health. Further studies are needed to expand the understanding of alexithymia to other groups and health-related outcomes.

PERSPECTIVE APPROACH TO PSYCHO-SOMATIC DISORDERS IN ELDERLY PATIENTS WITH CERTAIN MEDICINAL PLANTS IN COVID PANDEMIC

Psychosomatic disorders have now become a common disease in present global scenario due to Covid pandemic. People are always in panic due to morbidity of the disease whereas the livelihood has become a secondary morbid condition due to economic slowdown. Under the above global scenario almost every person is undergoing certain psychosomatic problems either one or both of the factors. Apart from this, the present trend of competitive and conservative life-style has made young and old person to panic mental situations. The egoistic attitude of the human being and his inability to compromise his desire/demands tends to imbalance of temperament resulting into essential hypertension, insomnia, irritability etc. Ultimately such person becomes addicted to anxiolytic, anti-depressant and tranquilising drugs of modern medicine. Psychiatric disorders are commonly encountered by clinical medicine and the management includes psychotherapy, behavioural therapy, physical treatment with antipsychotic drugs, but the post management leads to addiction or drug dependence along with morbid withdrawal symptoms in patients. In view of problems of dependence specific approach of Ayurvedic concept like Satwavajaya and Daivavyapasraya have provided the light of protection but the practices are still limited due to orthodox beliefs. Some psychotropic drugs like Medhyarasayana etc. in single and compound form are described in classical texts for the management of different mental disorders. The use of herbs to offset these antecedents and outcome has greatly increased in recent years. Not only it is helpful for psychosomatic issues rather it would be helpful at least in such Covid pandemic as because the anti-psychotic drugs are scarce in market due to heavy personal demands. Ayurvedic approach can also create a trend of revitalising herbal preparations keeping behind the hazardous post drug complication. It is an attempt for mainstreaming the Ayurveda in present scenario.

Manfred Pflanz (1923-1980), Health Services Researcher: his Early Contribution to the Medical Care Pattern of Appendectomy

This article is a reminder of an early example of health services research and quality assurance in Germany. The occasion for this was the 50th anniversary of the opening of the Institute of Social Medicine and Epidemiology at Hannover Medical School in 1968. The founding director of the institute, Prof. Dr. med. Manfred Pflanz, a board-certified internist, had gained reputation by publishing on psychosomatic and medico-social issues. In 1971, Sigrid Lichtner, a doctoral student, and Pflanz published a paper on the epidemiology and medical care pattern of appendectomy [1]. In the late 1960s certified appendicitis mortality in the Federal Republic of Germany used to be 3 times higher than in comparable countries. A regional analysis of all appendectomies in Hannover discovered further "odd" findings such as a weekly profile of operations not in line with an acute emergency condition and clear social as well as regional differences in the appendectomy rate. The most probable reason why the mortality from appendicitis was 3 times higher in the Federal Republic than in any other country, the authors conjectured, was that appendectomy was performed 3 times more frequently than elsewhere - questioning the doctrine of early surgical intervention in suspected appendicitis. Since then, management of appendicitis has changed, quality assurance has been implemented, evidence broadened, laparoscopic and non-operative treatment evaluated in RCTs. Appendicitis mortality has continued to decline with an acceleration of the falling trend in the early 1970s. Absolute numbers of deaths are now very low. Numbers of appendectomies are declining. In this respect, health services have become more effective and efficient.

МЕТОДИКА ДІАГНОСТИКИ ТІЛЕСНОГО ЛОКУСУ КОНТРОЛЮ

Метою дослідження було створення психодіагностичної методики для вивчення тілесного локусу контролю. Відповідно до мети дослідження завданнями роботи виступили: операціоналізація феномену тілесний локус контролю та його емпіричних індикаторів, розробка опитувальника як набору тверджень, що відображують зміст визначених індикаторів, психометрична оцінка, розробленого опитувальника. Методи дослідження. Психометрична обробка результатів дослідження включалаперевірку внутрішньої узгодженості методики за коефіцієнтом альфа Кронбаха, оцінку конструктивної валідності та ретестової надійності опитувальника. Конвергентна та дискримінативна валідність методики перевірялась шляхом визначення кореляційних зв’язків показників методики «Тілесний локус контролю» та методик діагностики ставлення до свого тіла О.Б.Станковської, діагностики локусу контроля Дж. Роттера, діагностики рівня суб’єктивного контролю Є. Ф. Бажина, С. А. Голикіної, А. М. Еткінда, опитувальника Body Awareness Questionnaire (конвергентна валідність); діагностики інтрацептивної чутливості, «Вербалізація тілесного Я» (дискримінантна валідність). Психометричну вибірку склали 286 «умовно здорових» респондентів віком від 15 до 55 років. Процедура ретестування проводилася через чотири тижні із залученням 96 респондентів, що входили до психометричної вибірки. Результати. Теоретичною основою створення опитувальника діагностики тілесного локусу контролю були концепція локусу контролю, концепції реципрокного детермінізму та каузальної атрибуції, уявлення про профіль суб’єктивного контролю, уявлення про роль інтернальності у клініці соматичних та психосоматичних розладів, а також зв’язку тілесного досвіду та смислового аспекту особистості, визначення локусу тілесного контролю, як зв’язку локалізації тілесних відчуттів із усвідомленням власного психоемоційного стану та ступенем самоконтролю, визначення основних сфер ставлення до тілесного, як ідентифікаторів тілесного локусу контролю. Шляхом деревовидної кластерізації було виділено статистично значущі класи тверджень, що відповідають 5 сферам ставлення до тілесного: сфера здоров’я і хвороби; сфера краси і зовнішності; сфера харчової поведінки; сфера сексуальної поведінки; сфера фізичної активності і спорту. Опитувальник характеризується інтраіндивідуальною стійкістю та розподілом близьким до нормального, що дає підстави для перенесення отриманих результатів вибіркової сукупності на генеральну, високою внутрішньою узгодженістю, . Визначені три інтервали граничні значення статистичної норми, що характеризують високий, середній та низький рівні показника інтернальності тілесного локусу контролю. Показники конвергентної та дискримінативної валідності свідчать, що запропонована методика вимірює саме усвідомлення детермінації особливостей функціонування власного тіла та характеризують приписування внутрішніх або зовнішніх причин того, що відбувається з тілом. Висновки. Запропонована психодіагностична методика «Тілесний локус контролю» відповідає сучасним вимогам до психометричного обґрунтування особистісних опитувальників. Психометричними ідентифікаторами тілесного локусу контролю визначено ставлення до основних сфер тілесного – сфери здоров’я і хвороби; краси і зовнішності, харчової та сексуальної поведінки, фізичної активності і спорту. Стандартизація опитувальника показала його високу тест-ретестову надійність та валідність. Опитувальник може бути використаний для психодіагностики у структурі досліджень з психосоматичної проблематики та реалізації оздоровчих психотехнологій.

Patient perspectives on the pathway to psoriatic arthritis diagnosis: results from a web-based survey of patients in the United States

BackgroundThere are limited real-world data on the diagnostic experiences of patients with psoriatic arthritis (PsA), including medical care sought and potential barriers to diagnosis. We aim to describe patient experiences related to receiving a PsA diagnosis.MethodsOurs was a mixed-method, 2-phase study. Phase 1 comprised concept elicitation and cognitive interviews with clinical experts and adults diagnosed with PsA to develop a cross sectional, web-based survey. US adults with a self-reported PsA diagnosis were recruited through a patient support community (CreakyJoints), an online patient research registry (ArthritisPower), and social media outreach. In Phase 2, the online survey collected data on sociodemographics, clinical symptoms, disease burden, and diagnosis history of survey respondents with PsA.ResultsOf the 203 respondents included, 172 (84.7%) were female, and the mean (SD) age was 51.6 (10.8) years. The time between seeking medical attention and receiving a diagnosis was < 6 months for 69 respondents, 6 months to 4 years for 68 respondents, and ≥ 5 years for 66 respondents. Most respondents sought care from general practitioners (79.8%) and rheumatologists (66.5%). Common initial symptoms that led respondents to seek medical attention were joint pain (70.0%) and stiffness (53.7%). Among the initial symptoms that led respondents to seek care, joint pain, swollen joints, and sausage-like fingers or toes (indicating dactylitis) were more common among respondents with shorter time to diagnosis, whereas stiffness, fatigue, enthesitis (indicated by foot problems, tendon and ligament pain), and back pain were more common among respondents with longer time to diagnosis. Common misdiagnoses were psychosomatic issues (26.6%) and osteoarthritis (21.7%). Respondents with shorter times to diagnosis had lower frequencies of misdiagnosis.ConclusionsRespondents with PsA reported delays in diagnosis and misdiagnoses on their journey to a PsA diagnosis. Symptom differences, such as enthesitis and stiffness, were noted among respondents with shorter vs longer time to diagnosis. Increased understanding of diagnostic barriers may lead to earlier diagnosis and appropriate management to improve outcomes.

Psychosomatic Problems and their Relation with Types of Involvement in School Bullying in Iranian Students: A Cross-Sectional Study

Background: There are few studies on the association between bullying types and psychosomatic issues in pupils. The current study aimed to examine the association of verbal, relational, physical, and cyber bullying with psychosomatic problems among students. Methods: This was a cross-sectional study conducted in northern Iran on 834 participants, which were in 8th and 9th grades in 2014. Bullying and psychosomatic problems were measured by the Iranian-version of the Olweus Bullying and the Health and Illness Questionnaires. Descriptive statistics and multilevel logistic regression analysis were used for data analysis. Results: Findings revealed that bad temper was the most prevalent psychosomatic problem and the prevalence of headache (P=0.021), feeling low (P=0.009), bad temperedness (P=0.004), nervousness (p <0.001), sadness (P=0.001), and anxiety (p <0.001) was higher in girls than boys. Only-bullies and bully-victims in the verbal form, and only-victims and bully-victims in the physical form had more psychosomatic issues. Difficulties in getting to sleep, anxiety, feeling low, dizziness, sadness, and headache were the most common conditions related to the types of bullying. For instance, the risk of difficulties in getting to sleep increased 1.5 to 3 times among the victims of verbal bullying (OR=1.54 for only-victim, OR=2.22 for bully-victims, and OR=3.08 for onlybully), relational only-bully (OR=2.69), physical only-victim and bully-victim, cyber only-bully and only-victim. Conclusions: The results showed the different psychological and somatic burdens associated with various types of bullying. Therefore, it is necessary to implement preventive and interventional programs so as to reduce bullying behaviors in Iran. Implications of these findings for health care professionals, educational systems, and parents were further discussed.

Return to Work between the Conflicting Priorities of Work and Health Orientation

The basic aim of this study was to analyse health-related exit processes from working life and their conditional constellations. It focused on biographical coping in the context of professional reorientation and Return to Work (RTW). The aim was to describe, among other things, phases, characteristics and mechanisms of coping with a double-folded biographical disruption, i. e. coping with the chronic disease and the vulnerable occupational situation. The study focused on 6 women and 4 men between 25 and 57 years of age who were interviewed (episodically-narrative) at 2 different points in the survey period from 2011 to 2014: during their medical respectively vocational rehabilitation (t1) and again about one year later (t2). The overall characteristic of all cases was the initiated or already faced health-related occupational biographical disruption caused by a chronic musculoskeletal disease partly accompanied by psychosomatic issues or triggered by a mental illness. This study followed the methodological approach and research style of the Grounded Theory 1. A health-related exit from working life is usually gradual and is caused by complex risk constellations. Only in the interplay of personal and contextual factors does a framework for the double-folded biographical disruption develop. The resulting social, biographical and health challenges lie in the areas of private and working life. RTW is experienced as an experimental phase to return to everyday working life under limited health conditions. A key finding of this study is the recognition that the transformation of the importance of health is taking place in exit and reorientation processes. This paper focuses on its significance for the rehabilitation and RTW process. The applied perspective on biographical processes makes it possible to describe health-related breaks as a change in status from healthy to sick, from high performance to limited performance. Professional stakeholders in medical and rehabilitative settings should be made more aware of the identity-building processes, individual professional biographical crises and disease management processes of those affected. It is important not only to evaluate RTW as the one and only success, key outcome and end of the rehabilitation process, but to understand RTW as a continuing process of occupational reorientation under limited health conditions and to design it as a participatory process.

Increasing in level of education of physicians in questions of psychosomatic medicine as one of the ways of psychosomatic medical aid optimizing

The results of a survey of physicians of various specialties with the purpose of revealing a level of training of specialists in the field of psychosomatic medicine are presented. The importance of this study is determined by the wide spread of psychosomatic pathology among the population. Wide prevalence of psychosomatic pathology in the practice of doctors of various profiles was revealed. It was found that a significant proportion of patients (on average, 11,1±1%) had complaints at the time of examination, but no objective evidence was provided in favor of one or another pathology. At the same time, it was shown that insufficient awareness of physicians in psychosomatic issues, including an understanding of terminology of psychosomatics and nosologies capable of inducing psychosomatic disorders as well as the possibility of using different scales for a mental pathology detection. Almost a quarter of the doctors surveyed (23,1%) misinterpret the term «psychosomatic disorder», while the incorrect interpretation of this concept is significantly higher among general practitioners and therapists than among doctors of particular specialities. In addition, the need for doctors to expand their knowledge in the field of psychosomatic medicine has been established. Thus, 67,3% of doctors note a lack of knowledge in the field of psychiatry. At the same time, only 11,5% of respondents use questionnaires and surveys in their daily practice to identify various psychiatric disorders among their patients. Practically one third of the doctors surveyed (28,8%) cannot list any indications for sending patients to the psychosomatic department. The results of the study confirm the importance of developing and implementing a course of psychosomatic medicine for clinical residents of various specialties.

プライマリ-ケアにおける心理社会的アプローチ(超高齢社会におけるプライマリ-ケア医の心身医学的課題,2014年,第55回日本心身医学会総会ならびに学術講演会(千葉))

プライマリ-ケアにおける心理社会的アプローチ(超高齢社会におけるプライマリ-ケア医の心身医学的課題,2014年,第55回日本心身医学会総会ならびに学術講演会(千葉))

認知症や経済問題などが絡む複雑困難事例への対応と臨床教育/臨床研究(超高齢社会におけるプライマリ-ケア医の心身医学的課題,2014年,第55回日本心身医学会総会ならびに学術講演会(千葉))

認知症や経済問題などが絡む複雑困難事例への対応と臨床教育/臨床研究(超高齢社会におけるプライマリ-ケア医の心身医学的課題,2014年,第55回日本心身医学会総会ならびに学術講演会(千葉))