International journal of psychosomatics : official publication of the International Psychosomatics Institute最新文献

This article discusses the psychological parameters that dentists must take into account when constructing full denture prostheses. The etiologies of fear in the edentulous patient are discussed; and the intake, interview, and treatment protocols developed and used at the Mount Sinai Dental Phobia Clinic for this special patient population are presented.

This study deals with four major characteristics that directly affect motivation and attitude of patients at risk for infective endocarditis (IE) toward oro-dental health. Dental anxiety, self image, recognized importance of oro-dental care, and active coping were self-assessed by 25 patients at risk for IE and by a matched control group. The study group demonstrated less dental anxiety, lower self image and higher levels of recognized importance of oro-dental care than the controls, while active coping did not differ between the two groups. A review of the relevant literature is also presented.

The general problem of stress assessment and the role of anxiety state is considered using a widely accepted theoretical model of stress. The need for clear conceptualizations of stress production and stress response factors is indicated, to avoid confusion between measurements taken from instruments assessing anxiety state and emotional stress response.

We studied 108 male and 110 female dreams that had been collected in response to a television announcement. We did not find a number of gender differences that had been previously reported. We found no difference between men's and women's dreams in the amount of aggression, friendliness, sexuality, male characters, weapons, or clothes. However, women's dreams still contained a higher number of family members, babies, children, and indoor settings than did men. We also looked at geographic differences, finding that while patterns of aggression did not distinguish men from women, they did distinguish residents of different areas. In dreams in which the dreamer was either the aggressor or victim, dreamers from the East coast were more likely to be the aggressor than those from the Midwest and West coast.

The effects of three commonly performed cardiac procedures on cognitive performance were evaluated in patients undergoing coronary artery bypass graft (CABG) surgery (N = 20), percutaneous transluminal coronary angioplasty (PTCA) procedure (N = 8), or cardiac valve repair (N = 11). Patients completed a neuropsychological test battery on the day prior to their surgery and at discharge. Results showed that valve and CABG patients exhibited declines in performance on the Digit Symbol subtest, while PTCA patients did not change. Reaction time performance improved for the PTCA patients but declined significantly for valve patients. These results suggest that common cardiac procedures may have measurable effects on cognitive performance, as assessed by a relatively brief test battery.

In this case study, hypnosis combined with progressive relaxation effectively eliminated the cause of panic attacks in a 34 year old female. After an initial period of progressive relaxation, this patient was trained in desensitization techniques and in hypnosis. The introduction of hypnosis provided this young woman with long term relief from her symptoms of agoraphobia and panic. This study provides further evidence for the efficacy of hypnosis in the elimination of panic attacks.

Three patients with documented peptic ulcer and four patients with depressive disorder were followed every month for 10 to 14 months. A life events inventory, clinical ratings of depressive mood and ulcer symptoms, and analysis of the urinary excretion of cortisol and melatonin were used on every occasion. Although the number of patients was small a few tentative findings were made. First of all, associations between life events and depressive mood seemed to be "delayed" more often in the ulcer patients than in the depression patients. Secondly, there were individual associations between cortisol excretion and life events or between cortisol excretion and ulcer symptoms, but these associations seemed to form individual patterns. Two of the ulcer patients who had correlations in the expected directions showed a personality profile close to the one expected from classical literature, whereas the third patient who showed no correlations showed alexithymic traits.

The prevalence of bestiality (both actual sexual contacts and sexual fantasy) was investigated in an experimental group (psychiatric in-patients) and two control populations (medical in-patients and psychiatric staff). Psychiatric patients were found to have a statistically significant higher prevalence rate (55%) of bestiality than the control groups (10% and 15% respectively). Implications of these findings are discussed. It is recommended that due to the obvious prevalence of this condition, questions exploring this previously ignored topic should be routinely included in the psychiatric interview.

The history and present state of psychosomatic medicine in Czechoslovakia are described in detail. At the present time, a concept of Z.J. Lipowski is spreading. Since the formation of the Section for Study of Psychosomatic Medicine, a part of the Czech Psychiatric Association in 1975, several teams of physicians and clinical psychologists have started work in various fields of psychosomatic medicine. Some inpatient and outpatient psychosomatic wards and units were opened. Pre- and postgraduate training in psychosomatics and behavioral medicine have started. Future developments of psychosomatic health care in Czechoslovakia will require the integration of the psychosomatic approach and the bio-psychosocial model of disease into primary health care and other bio-medical disciplines. Psychosocial theory must be incorporated into prevention, diagnosis, treatment and rehabilitation of all diseases using the method of liaison psychiatry, along with the further institutionalization of psychosomatic care.

This is a case report of a spontaneous remission of depression after an attempted suicide by hanging. The patient suffered from cardiopulmonary arrest and anoxic encephalopathy, but recovered without apparent neurologic sequelae. The authors review the literature and explore the possible effects of hypoxia and hypercapnea on the locus ceruleus and the limbic system which could contribute to the patient's remission of symptoms. Also discussed are the psychosocial factors affecting patients' moods after a suicide attempt.