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Rometsch C. The Role of Female Physicians in Psychosomatic Medicine: Opportunities and Challenges. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:8-12. [PMID: 38249938 PMCID: PMC10797173 DOI: 10.1089/whr.2023.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 01/23/2024]
Abstract
Background Female physicians are in some cases preferred by patients due to their sex-related characteristics such as softness and empathy. Psychosomatic medicine presents a compelling working environment due to its holistic approach. Methods This brief review synthesizes the challenges encountered by female physicians in psychosomatic medicine and outlines potential strategies for overcoming these barriers. Results The presence of female role models may constitute a crucial advancement in this process. There exists a pressing demand for specialized clinical and scientific programs in psychosomatic medicine at both national and international levels. Such programs, offered by universities and ministries, as well as comprehensive training initiatives, are indispensable in fostering the next generation of females in psychosomatics. Leading journals can lend their support by publishing special issues dedicated to female physicians. Conclusion Strengthening female physicians throughout all positions in psychosomatic medicine can contribute ultimately to the improvement of patient care.
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Affiliation(s)
- Caroline Rometsch
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
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Kajikawa N, Yoshimoto H, Yokoya S. Descriptive Study of Patients Treated in a Psychosomatic Internal Medicine Declared by Japanese Family Medicine Clinic. J Clin Med Res 2023; 15:360-367. [PMID: 37575353 PMCID: PMC10416189 DOI: 10.14740/jocmr4939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Background Psychosomatic internal medicine (PSIM) assesses psychosocial factors and provides holistic consideration. In Japan, PSIM physicians seem to be recognized as providers of mental health services, but family medicine did not so. When family physicians confront with psychological problems, high dropout rate is reported so it is needed to reveal factors related to dropouts, The purpose of this study is to describe characteristics of patients, treatment dropouts and its related factors in PSIM practice by family physician. Methods This cross-sectional study used data from the medical records of the Kitaibaraki Center of Family Medicine located in Kitaibaraki City, Ibaraki, Japan. The study included all new patients who made an appointment and visited the PSIM in this clinic from January 2020 to December 2022.Chief complaints and diagnoses were coded based on the International Classification of Primary Care, version 2 (ICPC-2). Results In total, 377 new patients were included in this study. The mean age was 39.9 ± 20.2 years. We found that 69.2% of patients who visited the clinic had a psychological chief complaint and 84.1% of primary diagnoses consisted of a psychological problem. One hundred sixty-five patients (43.8%) were still receiving treatment 6 months after the initial visit. Of the patients who ended treatment within 6 months after the initial visit, 84 patients (39.2%) dropped out. In multivariate analysis, the dropouts were less likely to occur patients with primary diagnosis of psychological problem (odds ratio (OR): 0.35, 95% confidence interval (CI): 0.19 - 0.67). Conclusions Patients who visited a PSIM wanted consultation about psychological problems. Patients with a diagnosis of a psychological problem at the initial visit were less likely to drop out.
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Affiliation(s)
- Natsuki Kajikawa
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Kitaibaraki Center for Family Medicine, Kitaibaraki, Ibaraki, Japan
| | - Hisashi Yoshimoto
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Kitaibaraki Center for Family Medicine, Kitaibaraki, Ibaraki, Japan
- Research and Development Center for Lifestyle Innovation in University of Tsukuba, Ibaraki, Japan
| | - Shoji Yokoya
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Kitaibaraki Center for Family Medicine, Kitaibaraki, Ibaraki, Japan
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Li L, Zhang Y, Feng S, Cao Y, Li H, Li X, Ji Y, Sun H, Mao X, Zhou B, Ni A, Zhang J, Zhao Z, Li X, Wei X, Wu A, Yuan Y. Reliability and validity of the brief psychosomatic symptom scale (BPSS) in patients from general hospitals. Gen Hosp Psychiatry 2023; 83:1-7. [PMID: 37028094 DOI: 10.1016/j.genhosppsych.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVES To verify the Brief Psychosomatic Symptom Scale (BPSS) among patients with psychosomatic-related disorders in general hospitals and determine the threshold of BPSS. METHODS The BPSS is a shortened 10-item version of the psychosomatic symptoms scale (PSSS). Data from 483 patients and 388 healthy controls were included for psychometric analyses. Internal consistency, construct validity, and factorial validity were verified. The threshold of BPSS in distinguishing psychosomatic patients from healthy controls were determined using receiver operating characteristic (ROC) curve analysis. The ROC curve of the BPSS was compared with that of the PSSS and patient health questionnaire-15 (PHQ-15) by using Venkatraman's method with 2000 times Monte-Carlo simulations. RESULTS The reliability of the BPSS was good with Cronbach's α of 0.831. BPSS was significantly correlated with PSSS (r = 0.886, P < 0.001), PHQ-15 (r = 0.752, P < 0.001), PHQ-9 (r = 0.757, P < 0.001) and GAD-7 (r = 0.715, P < 0.001), which indicated good construct validity. ROC analyses demonstrated that the AUC of the BPSS was comparable with that of PSSS. The gender-specific threshold of BPSS was determined as ≥8 in males and ≥ 9 in females. CONCLUSIONS The BPSS is a brief and validated instrument for screening common psychosomatic symptoms.
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Affiliation(s)
- Lei Li
- The Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China; Department of Depression and Sleep Disorders, The Fourth People's Hospital of Lianyungang, Lianyungang, China
| | - Yubo Zhang
- The Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Simiao Feng
- The Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yin Cao
- Department of Clinical Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Hengfen Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xiangping Li
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yunxin Ji
- Department of Psychosomatic, Ningbo First Hospital, Ningbo, China
| | - Hua Sun
- Department of Clinical Psychology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xueqin Mao
- Department of Psychology, Qilu Hospital of Shandong University, Jinan, China
| | - Bo Zhou
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Aihua Ni
- Department of Clinical Psychology, HeBei General Hospital, Shijiazhuang, China
| | - Jing Zhang
- Department of Cardiovascular Medicine, the First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Zhong Zhao
- Department of Neurology, Suzhou Municipal Hospital, Suzhou, China
| | - Xiuli Li
- Department of Clinical Psychology, YiDu central hospital of Weifang, Weifang, China
| | - Xianwen Wei
- Department of Neurology, Puer People's Hospital, Puer, China
| | - Aiqin Wu
- Department of Clinical Psychology, The First Affiliated Hospital of Soochow University, SuZhou, China
| | - Yonggui Yuan
- The Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Southeast university, Nanjing, China.
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Hüfner K, Sperner-Unterweger B. Persistent-postural perceptual dizziness (PPPD): Yes, it is a psychosomatic condition! J Vestib Res 2023; 33:279-281. [PMID: 31561401 DOI: 10.3233/ves-190679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Barany society published recently the consensus document for the diagnostic criteria of persistent postural perceptual dizziness (PPPD). In this commentary we highlight the benefits of this new diagnosis and possible problems that can arise during the use of the criteria in day to day clinical practice at a University Clinic for Psychosomatic Medicine. The diagnostic criteria of PPPD are compared to those of somatic symptom disorder and bodily distress disorder. We think that a discussion from a psychosomatic point of view is important to improve the understanding between different specialties and how PPPD fits into the broader framework of psychosomatic medicine.
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Affiliation(s)
- Katharina Hüfner
- Department of Psychiatry and Psychotherapy, and Psychosomatics, University Clinic for Psychiatry II (Psychosomatic Medicine), Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry and Psychotherapy, and Psychosomatics, University Clinic for Psychiatry II (Psychosomatic Medicine), Medical University of Innsbruck, Innsbruck, Austria
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Rothermund E, Pößnecker T, Antes A, Kilian R, Kessemeier F, von Wietersheim J, Mayer D, Rieger MA, Gündel H, Hölzer M, Balint EM, Mörtl K. Conceptual Framework of a Psychotherapeutic Consultation in the Workplace: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14894. [PMID: 36429612 PMCID: PMC9690206 DOI: 10.3390/ijerph192214894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: A new health care offer called 'psychotherapeutic consultation in the workplace' is an early and effective intervention for employees with common mental disorders. Although cost-effective, it lacks a broader roll-out. This might be attributable to undefined context, mechanisms of change, and a lack of communication; therefore, this study explores how the new model works and where problems occur. (2) Methods: Semi-structured interviews on motivation, expectations and experiences with 20 involved experts. Experts were members of the company health promotion team, service users, and cooperating mental health specialists. Analysis was conducted with ATLAS.ti. (3) Results: The conceptual framework comprises three main topics: (a) structured implementation concept; (b) persons involved, shaping the concept's processes; (c) and meaning and function of the offer within the given context. Concerning (c) we found three potential areas of conflict: (1) intra-corporate conflicts, (2) conflicts between company and employee, (3) and conflicts between the company health promotion and the health care system. Category (c) comprises the offer's core characteristics which were described as low-threshold and preventive. Furthermore, the offer was perceived as convenient in handling, confidential, and having immediate impact on a person's well-being. (4) Conclusions: Here we define structures, address the needs of the involved persons, and communicate foreseeable areas of conflict influences whether the implementation of the intervention succeeds.
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Affiliation(s)
- Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Tim Pößnecker
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Andreas Antes
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Reinhold Kilian
- Department of Psychiatry II, Ulm University Medical Center at BKH Günzburg, Lindenallee 2, 89312 Günzburg, Germany
| | - Franziska Kessemeier
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Jörn von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Dorothea Mayer
- Health and Safety Sindelfingen, Daimler AG, Bela-Barenyi-Straße, 71059 Sindelfingen, Germany
| | - Monika A. Rieger
- Institute for Occupational and Social Medicine and Health Services Research, University Clinic Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Michael Hölzer
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
- Sonnenbergklinik, ZfP Südwürttemberg, Christian-Belser-Straße 79, 70597 Stuttgart, Germany
| | - Elisabeth M. Balint
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Kathrin Mörtl
- Faculty of Psychotherapy Science, Sigmund Freud University, Freudplatz 1, 1020 Vienna, Austria
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Zhang Q, Ding L, Cao J. Evolution and significance of the psychosomatic model in gastroenterology. Gen Psychiatr 2022; 35:e100856. [DOI: 10.1136/gpsych-2022-100856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
The biomedical model, which limits itself to finding the attributions of organic disease, is challenged by gastrointestinal (GI) symptoms. Simultaneously, physicians' attribution of GI symptoms to underlying psychological issues is not readily accepted by patients and can negatively affect the clinical rapport between doctor and patient. In reality, psychosocial aspects are involved in many functional disorders and organic diseases, not just in mental disorders. Time is overdue for gastroenterologists to recognise the inadequacy and limitations of conventional gastroenterology and consider the role of psychological, social and biological variables throughout the entire clinical course of the illness, as is shown in George Engel’s model. This review discusses the following: (1) the current challenges of using the conventional clinical model for both functional and organic GI illness, (2) the inadequacy and limitations of explaining GI symptoms simply as psychological disorders, (3) the exploration of the symptom-centred, stepped reattribution clinical model, (4) the clarification of psychosomatic medical concepts for use in gastroenterology, and (5) the significance of a systematic and interdisciplinary framework for a comprehensive psychosomatic model in gastroenterology.
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Cao J, Ding L. Psychosomatic Practice in Gastroenterology: New Insights and Models from China. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 88:321-326. [PMID: 31533116 DOI: 10.1159/000502780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 08/13/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Jianxin Cao
- Department of Gastroenterology, The Third Affiliated Hospital, Soochow University, Changzhou, China,
| | - Lixin Ding
- Department of Gastroenterology, The Third Affiliated Hospital, Soochow University, Changzhou, China
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8
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Li L, Peng T, Liu R, Jiang R, Liang D, Li X, Ni A, Ma H, Wei X, Liu H, Zhang J, Li H, Pang J, Ji Y, Zhang L, Cao Y, Chen Y, Zhou B, Wang J, Mao X, Yang L, Fang J, Shi H, Wu A, Yuan Y. Development of the psychosomatic symptom scale (PSSS) and assessment of its reliability and validity in general hospital patients in China. Gen Hosp Psychiatry 2020; 64:1-8. [PMID: 32070913 DOI: 10.1016/j.genhosppsych.2020.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/07/2020] [Accepted: 01/28/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To develop and verify the Psychosomatic Symptom Scale (PSSS) among psychosomatic patients and the cut-off value of PSSS in distinguishing psychosomatic patients from health controls. METHODS The PSSS was drafted by an expert workgroup. 996 patients and 366 controls from 14 general hospitals in China were recruited to complete PSSS, Patient Health Questionnaire-15 (PHQ-15) and Symptom Checklist-90 (SCL-90). Student's t-test, Kruskal-Wallis test, Cronbach's α, Spearman's correlation, and confirmatory factor analysis (CFA) were used to verify the PSSS. Receiver operating characteristic (ROC) analyses were used to determine the cut-off value. RESULTS Cronbach α of PSSS was 0.907. The PSSS was significantly correlated with SCL-90 somatization subscale (r = 0.682, P < 0.001) and PHQ-15 (r = 0.724, P < 0.001). CFA supported the theoretical two-factor structure of the PSSS, with comparative fit index (CFI) = 0.979, Tucker-Lewis index (TLI) = 0.977, root mean square error of approximation (RMSEA) = 0.039 (90% CI: 0.035-0.042), and standardized root mean residual (SRMR) = 0.054. As the sum score of PSSS was significantly higher in female, cut-off values were determined as 11 in females and 10 in males respectively. CONCLUSIONS The PSSS is a reliable and valid instrument for measuring psychosomatic symptoms.
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Affiliation(s)
- Lei Li
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China; Department of Clinical Psychology, The Forth People's Hospital of Lianyungang, Lianyungang, China
| | - Tianci Peng
- School of Information Science and Engineering, Southeast University, Nanjing, China
| | - Rui Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China; School of Information Science and Engineering, Southeast University, Nanjing, China
| | - Ronghuan Jiang
- Department of Psychological Medicine, Chinese PLA General Hospital, Beijing, China
| | - Dongfeng Liang
- Department of Rheumatism, Chinese PLA General Hospital, Beijing, China
| | - Xiangping Li
- Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Aihua Ni
- Department of Clinical Psychology, Hebei Provincial People's Hospital, Shijiazhuang, China
| | - Huan Ma
- Department of Clinical Psychology, Hebei Provincial People's Hospital, Shijiazhuang, China
| | - Xianwen Wei
- Department of Neurology, Puer People's Hospital, Puer, China
| | - Hanxiang Liu
- Department of Neurology, Puer People's Hospital, Puer, China
| | - Jing Zhang
- Department of Cardiovascular Medicine, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Hengfen Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianyue Pang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yunxin Ji
- Department of Psychosomatics, Ningbo First Hospital, Ningbo, China
| | - Li Zhang
- Department of Psychosomatics, Ningbo First Hospital, Ningbo, China
| | - Yin Cao
- Department of Neurology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Yun Chen
- Department of Neurology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Bo Zhou
- The Center of Psychosomatic Medicine, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China
| | - Jinny Wang
- The Center of Psychosomatic Medicine, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China
| | - Xueqin Mao
- Department of Psychology, Qilu Hospital, Shandong University, Jinan, China
| | - Lejin Yang
- Department of Psychology, Qilu Hospital, Shandong University, Jinan, China
| | - Jianqun Fang
- Mental Health Center, The General Hospital of Ningxia Medical University, Yinchuan, China
| | - Honglan Shi
- Mental Health Center, The General Hospital of Ningxia Medical University, Yinchuan, China
| | - Aiqin Wu
- Department of Clinical Psychology, The First Affiliated Hospital of Soochow University, SuZhou, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China.
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Baessler F, Ciprianidis A, Wagner FL, Zafar A, Kanellopoulos T, Baumann TC, Sandmann CL, Schultz JH. Impact of an educational workshop on psychiatrists' attitude towards psychosomatic medicine. BMC Psychiatry 2020; 20:6. [PMID: 31906911 PMCID: PMC6945435 DOI: 10.1186/s12888-019-2424-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 12/26/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although psychosomatic medicine is not recognised as a medical specialisation globally, it has proven useful for treating many disorders in Germany. This paper reports on the impact of an educational workshop as a tool for raising awareness about psychosomatic medicine among international psychiatrists. METHODS Psychiatrists from eight different countries were educated on psychosomatic medicine and psychotherapy during a 90-min workshop using a video, a slide presentation and an innovative teaching format called 'speed coaching'. Learning outcomes were assessed by analysing questionnaires completed by the participants before and after the workshop. RESULTS Half of the participants who initially rejected the notion that psychosomatic medicine should be a specialisation on its own changed their minds in favour for it to be a separate discipline (p = 0.125). Awareness about which diseases and patients psychosomatic doctors deal with was increased. The intent for treatment of patients with eating disorders by a psychosomatic physician quadrupled among the participants (p = 0.004). CONCLUSIONS A brief educational intervention can influence psychiatrists' decisions to opt for approaches by doctors specialized in psychosomatics for certain disorders. Further studies may explore why psychiatrists agree or disagree that psychosomatic medicine should be a separate specialisation on its own.
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Affiliation(s)
- Franziska Baessler
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
| | - Anja Ciprianidis
- 0000 0001 0328 4908grid.5253.1Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Fabienne Louise Wagner
- 0000 0001 0328 4908grid.5253.1Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Ali Zafar
- 0000 0001 0328 4908grid.5253.1Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Thanos Kanellopoulos
- 0000 0001 2155 0800grid.5216.0Mental Health Care Unit, Evgenidion Therapeftirion, National and Kapodistrian University of Athens, Athens, Greece
| | - Tabea Chiara Baumann
- 0000 0001 0328 4908grid.5253.1Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Clara-Louisa Sandmann
- 0000 0001 0328 4908grid.5253.1Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- 0000 0001 0328 4908grid.5253.1Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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Nakao M, Takeuchi T. Alexithymia and Somatosensory Amplification Link Perceived Psychosocial Stress and Somatic Symptoms in Outpatients with Psychosomatic Illness. J Clin Med 2018; 7:E112. [PMID: 29748483 PMCID: PMC5977151 DOI: 10.3390/jcm7050112] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 05/06/2018] [Accepted: 05/08/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Psychosomatic patients often complain of a variety of somatic symptoms. We sought to clarify the role of clinical predictors of complaints of somatic symptoms. METHODS We enrolled 604 patients visiting a psychosomatic outpatient clinic. The outcome was the total number of somatic symptoms, and the candidate clinical predictors were perceived psychosocial stress, alexithymia, somatosensory amplification, adaptation, anxiety, and depression. All participants completed questionnaires assessing the outcome and the predictors. RESULTS The average number of reported somatic symptoms was 4.8; the most frequent was fatigue (75.3%), followed by insomnia (56.1%), low-back pain (49.5%), headache (44.7%), and palpitations (43.1%). Multiple regression analysis showed that the total number of somatic symptoms was significantly associated with the degree of perceived psychosocial stress, alexithymia, somatosensory amplification, and depression. Also, structural equation models indicated links between excessive adaptation (via perceived psychosocial stress, alexithymia, and somatosensory amplification) and the total number of somatic symptoms. CONCLUSION The results suggested that the association between psychosocial stress and reported somatic symptoms is mediated by alexithymia and somatosensory amplification in psychosomatic patients.
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Affiliation(s)
- Mutsuhiro Nakao
- Department of Psychosomatic Medicine, School of Medicine, International University of Health and Welfare, Narita, Chiba 286-8686, Japan.
- Department of Psychosomatic Medicine, Teikyo University Hospital, Tokyo 173-8605, Japan.
| | - Takeaki Takeuchi
- Department of Psychosomatic Medicine, Teikyo University Hospital, Tokyo 173-8605, Japan.
- Department of Psychosomatic Medicine, School of Medicine, Toho University Hospital, Tokyo 143-8541, Japan.
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11
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Deter HC, Kruse J, Zipfel S. History, aims and present structure of psychosomatic medicine in Germany. Biopsychosoc Med 2018; 12:1. [PMID: 29434655 PMCID: PMC5795290 DOI: 10.1186/s13030-017-0120-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/24/2017] [Indexed: 12/12/2022] Open
Abstract
Combining its two traditions of integrated psychosomatics in internal medicine and focusing on psychotherapeutic/psychiatric methods in many clinical fields, German psychosomatic medicine has developed well over the last decades. It benefits from its institutional independence and the progressive changes in health care. Clinically, disorder-oriented psychotherapy is a core method integrated with other modes of therapy. As a conceptual base for empirical research, non-reductionist accounts of the interactions of (sick) persons with their environment are most important. Germany has developed a model of Psychosomatic Medicine that has conceptualized and integrated psychotherapeutic methods into clinical practice and realized one way to practice bio-psycho-social medicine in the health care system of the country.
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Affiliation(s)
- Hans-Christian Deter
- Medical Clinic, Psychosomatics, Charité, Hindenburgdamm 30, 12200 Berlin, Germany
| | - Johannes Kruse
- Clinic for Psychosomatic Medicine and Psychotherapy, German Association of Psychosomatic Medicine and Psychotherapy (DGPM), University Gießen und Marburg GmbH, Giessen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tuebingen, German College of Psychosomatic Medicine (DKPM), Tuebingen, Germany
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[Bio-psycho-socio or psychotherapeutic medicine - actual development of psychosomatics in clinical practice]. Wien Med Wochenschr 2017; 168:52-61. [PMID: 28744775 DOI: 10.1007/s10354-017-0582-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/19/2017] [Indexed: 10/19/2022]
Abstract
In Germany a model of Psychosomatic Medicine has developed, which integrated several psychotherapeutic methods in clinical practice. The concept, which focused on disease mechanisms in the human body and the interaction between diseased individuals and their environment became a basic psychosomatic research strategy and was imlemented in medical care. In this paper the result of a psychosomatic development in clinical health care and research and possible deficiences are described. Perspectives of development and future tasks of Psychosomatic Medicine will be reviewed.
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Zipfel S, Herzog W, Kruse J, Henningsen P. Psychosomatic Medicine in Germany: More Timely than Ever. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:262-9. [PMID: 27509065 DOI: 10.1159/000447701] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/16/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
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Conti C, Di Francesco G, Fontanella L, Carrozzino D, Patierno C, Vitacolonna E, Fulcheri M. Negative Affectivity Predicts Lower Quality of Life and Metabolic Control in Type 2 Diabetes Patients: A Structural Equation Modeling Approach. Front Psychol 2017; 8:831. [PMID: 28596745 PMCID: PMC5443140 DOI: 10.3389/fpsyg.2017.00831] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 05/08/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction: It is essential to consider the clinical assessment of psychological aspects in patients with Diabetes Mellitus (DM), in order to prevent potentially adverse self-management care behaviors leading to diabetes-related complications, including declining levels of Quality of Life (QoL) and negative metabolic control. Purpose: In the framework of Structural Equation Modeling (SEM), the specific aim of this study is to evaluate the influence of distressed personality factors as Negative Affectivity (NA) and Social Inhibition (SI) on diabetes-related clinical variables (i.e., QoL and glycemic control). Methods: The total sample consists of a clinical sample, including 159 outpatients with Type 2 Diabetes Mellitus (T2DM), and a control group composed of 102 healthy respondents. All participants completed the following self- rating scales: The Type D Scale (DS14) and the World Health Organization QoL Scale (WHOQOLBREF). Furthermore, the participants of the clinical group were assessed for HbA1c, disease duration, and BMI. The observed covariates were BMI, gender, and disease duration, while HbA1c was considered an observed variable. Results: SEM analysis revealed significant differences between groups in regards to the latent construct of NA and the Environmental dimension of QoL. For the clinical sample, SEM showed that NA had a negative impact on both QoL dimensions and metabolic control. Conclusions: Clinical interventions aiming to improve medication adherence in patients with T2DM should include the psychological evaluation of Type D Personality traits, by focusing especially on its component of NA as a significant risk factor leading to negative health outcomes.
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Affiliation(s)
- Chiara Conti
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-PescaraChieti, Italy
| | - Giulia Di Francesco
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-PescaraChieti, Italy
| | - Lara Fontanella
- Department of Legal and Social Sciences, University "G. d'Annunzio" of Chieti-PescaraChieti, Italy
| | - Danilo Carrozzino
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-PescaraChieti, Italy.,Psychiatric Research Unit, Mental Health Centre North Zealand, University of CopenhagenHillerød, Denmark
| | - Chiara Patierno
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-PescaraChieti, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging, University "G. d'Annunzio" of Chieti-PescaraChieti, Italy
| | - Mario Fulcheri
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-PescaraChieti, Italy
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Nakao M, Takeuchi T. Clinical Characteristics and Referral Patterns of Outpatients Visiting a Japanese Psychosomatic Medicine Clinic. Int J Behav Med 2015; 23:580-8. [PMID: 26590140 DOI: 10.1007/s12529-015-9520-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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16
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De Giorgio G, Quartesan R, Sciarma T, Giulietti M, Piazzoli A, Scarponi L, Ferrari S, Ferranti L, Moretti P, Piselli M. Consultation-Liaison Psychiatry-from theory to clinical practice: an observational study in a general hospital. BMC Res Notes 2015; 8:475. [PMID: 26403798 PMCID: PMC4582719 DOI: 10.1186/s13104-015-1375-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 08/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate significant association between various clinical and extra-clinical factors brought out the activities of Consultation-Liaison Service. METHODS Data from all psychiatric consultations for patients admitted to the Perugia General Hospital and carried out over a 1-year period (from July the 1st 2009 to June the 30th 2010) were collected by a structured clinical report including: socio-demographic features, features of referrals, features of back-referrals. T-test, Mann-Whitney U-test, χ(2)-test and Fischer's were statistically used. RESULTS 1098 consultations were performed. The consultations carried out the Emergency Unit were excluded from the study. The type and the reasons for the referrals were discussed such as the ICD-10 diagnosis and the liaison interventions too. Significant associations emerged between gender and: social status and occupation (p < 0.05 and p < 0.01 respectively). Clinical sector related with reason for referral (p < 0.01), type of consultation (p < 0.01), liaison investigations (p < 0.01) and long-term treatment plan after hospital discharge (p < 0.01). The ICD-10 psychiatric diagnosis (Schizophrenia, Affective Syndrome and Neurotic-StressSomatoform Syndrome) was associated with social status (p < 0.01), social condition (p < 0.01), consultation type (p < 0.01), advice (p < 0.01) and reason for consultation (p < 0.01). CONCLUSIONS The need for better physical and psychological investigation is confirmed in order to promote not only disease remission but overall wellbeing.
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Affiliation(s)
| | - Roberto Quartesan
- Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
| | - Tiziana Sciarma
- Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
| | - Martina Giulietti
- Department of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy.
| | - Angela Piazzoli
- Department of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy.
| | - Laura Scarponi
- Department of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy.
| | - Silvia Ferrari
- Department of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy.
| | - Laura Ferranti
- Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
| | - Patrizia Moretti
- Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
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Abstract
Consultation-liaison psychiatry (CLP) is a psychiatric subspecialty addressing the psychological care of medically ill patients as well as the relationship between medical and psychiatric disorders. As a specialty, it has developed over the last 30 years. Yet several cultural and organizational problems in different countries have emerged, including differences regarding implementing CLP services and in the application of CLP guidelines. This paper examines the progress and challenges of CLP in three culturally diverse countries: the UK, Italy, and Japan. In all three countries, the provision of CLP service remains insufficient, and the application of officially acknowledged standards of care is necessary.
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Nakao M, Takeuchi T, Fricchione G. Definition of psychosomatic medicine and the applicability of DSM-IV-TR to outpatients visiting a Japanese psychosomatic clinic. PSYCHOTHERAPY AND PSYCHOSOMATICS 2014; 83:120-1. [PMID: 24457266 DOI: 10.1159/000354182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 07/01/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Mutsuhiro Nakao
- Department of Psychosomatic Medicine, Teikyo University Hospital, Tokyo, Japan
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19
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Pagnini F, Bosma CM, Phillips D, Langer E. Symptom changes in multiple sclerosis following psychological interventions: a systematic review. BMC Neurol 2014; 14:222. [PMID: 25433519 PMCID: PMC4253984 DOI: 10.1186/s12883-014-0222-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 11/11/2014] [Indexed: 02/08/2023] Open
Abstract
Background Multiple Sclerosis is a disease of the central nervous system involving a variety of debilitating physical, sensory, cognitive and emotional symptoms. This literature review evaluated the impact of psychological interventions on the physiological symptoms associated with the illness. Methods A systematic literature search was conducted using Medline, PsycINFO, Scopus, and the Cochrane Library databases, as well as reference lists. Relevant studies were selected and assessed according to a preset protocol. Results The search produced 220 articles, with 22 meeting inclusion criteria for the review. A total of 5,705 subjects with Multiple Sclerosis were analyzed. Results from the included studies indicate a general improvement in both psychological and physiological outcomes following psychological treatment. The most highly influenced physical symptoms include fatigue, sleep disturbances, pain, and physical vitality. Conclusions Findings from the review suggest a positive relationship between psychological interventions and physiological Multiple Sclerosis symptoms. Implications for future research are discussed.
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Affiliation(s)
- Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy. .,Niguarda Ca' Granda Hospital, Milan, Italy. .,Department of Psychology, Harvard University, Cambridge, MA, USA.
| | - Colin M Bosma
- Department of Psychology, Harvard University, Cambridge, MA, USA.
| | - Deborah Phillips
- Department of Psychology, Harvard University, Cambridge, MA, USA.
| | - Ellen Langer
- Department of Psychology, Harvard University, Cambridge, MA, USA.
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Pagnini F, Phillips D, Bosma CM, Reece A, Langer E. Mindfulness, physical impairment and psychological well-being in people with amyotrophic lateral sclerosis. Psychol Health 2014; 30:503-17. [PMID: 25361013 DOI: 10.1080/08870446.2014.982652] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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21
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Hassan I. Symptomiatry: interdisciplinary scope and implications. Aust N Z J Psychiatry 2013; 47:684-5. [PMID: 23322912 DOI: 10.1177/0004867412474075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Islam Hassan
- Neuropsychiatry Unit, Royal Melbourne Hospital, Australia
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22
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Lahmann C, Henningsen P, Dieterich M, Feuerecker R, Cyran CA, Schmid G. The Munich Diagnostic and Predictor Study of Dizziness: objectives, design, and methods. J Neurol 2011; 259:702-11. [DOI: 10.1007/s00415-011-6250-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 09/07/2011] [Accepted: 09/09/2011] [Indexed: 11/29/2022]
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