The American Psychosomatic Society - integrating mind, brain, body and social context in medicine since 1942

Effect of Psychosomatic Symptom Intervention on Psychosomatic Symptoms During Initial Treatment in Patients With Differentiated Thyroid Cancer: A Single-blind Randomized Controlled Trial

BACKGROUND

There is increasing evidence suggesting that patients with thyroid cancer may experience prolonged anxiety and depression postsurgery, which could potentially impact their treatment outcomes adversely.

OBJECTIVES

To investigate the impact of a psychosomatic symptom intervention program on the psychological and physical health of patients with differentiated thyroid cancer (DTC).

METHODS

Eighty-four patients with DTC were recruited from one cancer hospital and were randomly assigned to either the experimental (n = 42) or control group (n = 42). The intervention group received a 12-week psychosomatic symptom intervention. Anxiety and depression, thyroid-stimulating hormone attainment rate, self-management efficacy, and shoulder joint function were evaluated before intervention, after intervention, and during follow-up.

RESULTS

The generalized estimating equation showed that the intervention group had significantly lower levels of anxiety and depression at T1 and T2 compared with the control group (P < .001). The time, group, and interaction effects were significant (P < .001). The thyroid-stimulating hormone target rate in the intervention group (59.5%) was higher than that in the control group (26.2%) (P = .008). There were significant differences in self-management efficacy and shoulder joint function between the 2 groups (P < .001).

CONCLUSIONS

These findings hold significant implications for the psychological and physical symptoms of DTC patients. It suggests that early interventions can expedite patient recovery during the initial treatment phase.

IMPLICATION FOR PRACTICE

During the initial treatment phase, nurses can implement interventions targeting psychological and physical symptoms in DTC patients, aimed at facilitating postoperative self-care and promoting expeditious recovery of overall health.

The Evolution of Fibromyalgia, Its Concepts, and Criteria

Fibromyalgia developed in the 1950s from a substrate of difficult to explain regional and widespread pain mixed with symptoms of psychosocial distress. Controversies regarding psychological issues were common. Multiple criteria arose to define the disorder, but each identified a different set of patients. The identification of widespread pain as a criterion changed the nature of the disorder by effectively eliminating regional pain as a component condition. The easy-to-measure and relatively reliable widespread pain criterion then came to define the disorder. In the primary care community, diagnostic criteria were largely ignored, and a substantial fraction of diagnosed patients with lower pain scores, particularly women and those with high non-pain symptom scores, were diagnosed. Non-pain symptoms were added back to the fibromyalgia definition and criteria in 2010. Recognition grew that fibromyalgia fit the description of a functional somatic disorder. The idea of fibromyalgia as a primary pain disorder with a neurobiological basis contended with fibromyalgia as a broader biopsychosocial disorder. It is increasingly recognized that fibromyalgia represents a dimensional, non-binary condition and that features of fibromyalgia extend to persons who do not satisfy the criteria. Severity assessments are now available but rarely used. The course of fibromyalgia is not well studied, and improvement and remission criteria have not been successfully defined. The future of fibromyalgia as a discrete disorder remains uncertain as features of fibromyalgia are increasingly observed in patients with multiple different medical conditions.

Impact of an educational workshop on psychiatrists' attitude towards psychosomatic medicine

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.

Past, Present, and Future of Psychosomatic Movements in an Ever-Changing World: Presidential Address

OBJECTIVE

The American Psychosomatic Society was founded in 1942 and is celebrating its 75th anniversary in 2017. In recognizing the society's anniversary, this article provides a historical perspective on its history, the field of psychosomatic medicine in general, and anticipated future directions.

METHODS

Essay and narrative review of the literature on the historic development of psychosomatic concepts and their impact on medicine over time.

RESULTS

Mind-body associations have been described in the medical literature for more than 3500 years. Early concepts of mind-body dualism and attempts to overcome them are found in classical Greek medicine. Psychosomatic thinking can be observed ever since, but only in the 20th century, a "psychosomatic movement" emerged in Europe and North America, aiming at humanizing medicine by introducing a holistic understanding of man into what was considered a widely reductionistic practice of medicine. This movement led to the inauguration of the American Psychosomatic Society during World War II and of national and international societies of psychosomatic medicine and its subspecializations thereafter.

CONCLUSIONS

Psychosomatic medicine has its roots in the beginnings of medicine. During the past 75 years, it has made substantial contributions to the science and practice of medicine. The field has also changed in response to developments in medicine, technology, and society and is facing new challenges and opportunities that may require further adaptation of its concepts and practice.