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Background Hemodialysis (HD) patients are at a high risk of falls and fractures. The amount of physical activity (PA) they perform may be limited by psychosomatic factors associated with fear of falling, leading to frailty progression. This study aimed to clarify the relationship between fear of falling and PA in patients undergoing HD. Methods This cross-sectional study included 46 HD patients. Fear of falling was evaluated using the Modified Falls Efficacy Scale (MFES). A 3-axis accelerometer was used to measure PA, including number of steps; 1 to 1.9 METs = static PA, 2 to 2.9 = light PA, and 3 or more = moderate to vigorous PA (MVPA). We examined correlation of MFES with each type of PA. Factors affecting fear of falling were determined using multiple regression analysis. Results The median MFES was 9.2 (7.4, 10.0). MFES was associated with the number of steps (r = 0.608, p 0.001), light PA (r = 0.421, p = 0.004), and MVPA (r = 0.546, p 0.001). Eighteen participants (39.1%) experienced at least one fall in a year and had lower MFES than the non-fall group (fall group: 7.4 [5.1, 9.0] vs. non-fall group: 9.7 [8.5, 10.0], p 0.001). Multiple regression analysis showed that MFES was independently associated with the number of steps (B = 279.7, 95% confidence interval [CI] = 90.5–469.0, p = 0.005) and MVPA (B = 3.52, 95% CI = 1.14–5.90, p = 0.005), respectively. Conclusions Fear of falling was associated with amount of PA among patients undergoing HD. Interventions that target the fear of falling may be effective in reducing HD patients’ fall risk by enhancing PA.

There will be a great shortage of 4.3 million Doctors in 2030 in world level stated by WHO, their shortage in remote areas is an immense challenge. This review examines the evidence base of factors and preferences influencing medical students towards rural placements as they are the future workforce. The study adopted the PRISMA protocol. The factors reasoned for their aversion were formed into the framework of Alderfer’s ERG needs and classified based on positively and negatively perceived. Poor living conditions and social isolation is the major cause for the aversion of rural placements. But the proximity of the village and less competition were positively perceived in terms of existential needs. Family relationship, administrative hurdles and communication with rural people were perceived negatively perceived relationship needs, except availability of more support staff. The growth needs such as serving for poor, social status, Knowledge on rural diseases in an altruistic way, but only by rural background/rural upbringing students, Yet the urban origin students have a strong dislike for the reasons of professional stagnation, fewer career advancements, insufficient learning, and research opportunities in rural placements.

Atopic diseases have increased in prevalence over the last few decades and the rapid increases suggest that the predominant driving forces behind these increases are environmental factors rather than genetic alterations. A number of environmental factors have been implicated in the increased prevalence of allergic diseases. Predominant among them are increased exposure to pollutants and decreased exposure to microbes and parasitic infections. The hygiene hypothesis suggests that increased hygiene and lack of exposure to microbes and parasitic infections at an early age prevents the necessary stimulus to train the developing immune system to develop tolerogenic responses. Lifestyle factors, such as increased time spent indoors, use of antibiotics, and consumption of processed foods and decreased exposure to farm animals and pets, limit exposure to environmental allergens, infectious parasitic worms, and microbes. The lack of exposure to these factors is thought to prevent proper education and training of the immune system. Other factors that are also associated with increased risk of allergic diseases are Caesarian birth, birth order, tobacco smoke exposure and psychosomatic factors. Here, we review current knowledge on the environmental factors that have been shown to affect the development of allergic diseases and the recent developments in the field.

Psychosomatic disorders are frequent in gastroenterological practice. Visceral pain and motor-evacuation disorders of the gastrointestinal tract is a common symptom of functional gastrointestinal disorders which have a multifactorial etiology. Many patients with these diseases have comorbid behavioral disorders, such as anxiety or depression, and functional gastrointestinal disorders are described as disorders of the “gastrointestinal tract-brain” axis. Chronic stress can change the central pattern of pain, as well as motor activity and permeability of the gastrointestinal tract. The multidirectional treatment for these diseases should include psychotropic drugs and groups of somatic antipsychotics and antidepressants.

Introduction The impact of social isolation and touch deprivation on sleep symptoms (insomnia, nightmares) during the SARS-CoV-2 (COVID19) pandemic has been recognized. These results however may have been confounded by various other disease-related factors that can directly impact sleep eg., medical complications associated with COVID19; trauma response and the economic impact of the pandemic. We examined previously unpublished data, from an earlier Canadian community-based survey (1997–1998) of psychosomatic factors (including sleep symptoms), associated with perceived touch deprivation (PTD). Methods 360 consecutive consenting participants (316 community volunteers,44 psychiatric outpatients; 270 women; 94% white; mean±SD age: 38.3±14.5 years) completed a large battery of questions related to psychosomatic factors and the skin. The methods are described in previous publications [Gupta MA 2004; Gupta MA 2006] from this study. PTD was measured with the following item (rated on a 10-point Likert-type scale where “0” denoted “not at all” and rating of “9” denoted “very markedly”): “At the present time I wish I could get more hugs from others”’. Some of the sleep ratings in the survey read as follows: Insomnia1: “How long do you generally take to fall asleep at night?”(rating of “1” denoted “immediately”, “2” denoted ”1hour”). Secondly, participants rated how frequently they experienced the following sleep symptoms using a 4-point scale: “Awakenings from sleep”(Insomnia 2); “Dreams”; “Nightmares: “Snoring”; and “Jerking of arms or legs” (rating of “1” denoted “Never”, “2” denoted “Sometimes”, “3” denoted “Often”, 4 denoted “Always”). Results PTD scale scores (mean±SD: 3.81±2.85; range 0–9) correlated significantly with the following: Insomnia1 (r=0.219, p Conclusion In a pre-COVID19 community study, PTD was more problematic among the younger age group, and correlated with sleep onset and maintenance difficulties, nightmares and limb jerking, highlighting the importance of social touch in sleep. Support (if any) None

Zusammenfassung Fragestellung: In unserer alternden Gesellschaft gehort der Gelenkersatz bei gonarthrotischen Veranderungen zu den haufigen Operationen. Trotz hochentwickelter Prothetik und chirurgischer Technik fuhren diese Behandlungen nicht immer zum gewunschten Erfolg im Sinne einer weitgehenden Schmerzreduktion und funktionellen Beanspruchbarkeit des Gelenkes beziehungsweise zu einer befriedigenden Algofunktion (AF). Partiell machen Kliniker hierfur auch psychische Einflusse verantwortlich, zumal wenn objektive medizinische Komplikationen nicht bestehen. Methodik: Die vorliegende Ubersicht fasst bisherige Untersuchungen zur Rolle psychosomatischer Wechselwirkungen bei Kniegelenksersatztherapie (TKA) zusammen. Ergebnisse: Perioperativ zeigen sich ausgepragte psychische Belastungen, die eine Verbindung zur postoperativen Algofunktion aufweisen. Diskussion: Theoretische und praktische Implikationen der geschilderten Zusammenhange werden diskutiert.

Although genetic factors play a role in the etiology of atopic disease, the rapid increases in the prevalence of these diseases over the last few decades suggest that environmental, rather than genetic factors are the driving force behind the increasing prevalence. In modern societies, there is increased time spent indoors, use of antibiotics, and consumption of processed foods and decreased contact with farm animals and pets, which limit exposure to environmental allergens, infectious parasitic worms, and microbes. The lack of exposure to these factors is thought to prevent proper education and training of the immune system. Increased industrialization and urbanization have brought about increases in organic and inorganic pollutants. In addition, Caesarian birth, birth order, increased use of soaps and detergents, tobacco smoke exposure and psychosomatic factors are other factors that have been associated with increased rate of allergic diseases. Here, we review current knowledge on the environmental factors that have been shown to affect the development of allergic diseases and the recent developments in the field.

The article discusses the psychological and somatic factors associated with hypertension (HTN) and the characteristics of psychovegetative relationships in HTN from the perspective of a systemic concept of mental adaptation and maladaptation. Emotional and personality traits of individuals with HTN (behavior, anxiety, alexithymia, neurotic traits and cognitive emotion regulation) were identified and their change under the disease effect was noted. Some aspects of adaptation to the disease, adherence to treatment and changes of life quality in people with HTN are noted. Research data were critically analyzed and new lines of searching for psychosomatic factors associated with HTN were suggested. It was proposed to shift the focus from an isolated study of personality traits, and focus on the study of psychovegetative relationships in HTN, in particular, the relationship of emotion regulation (ER) with the cardiovascular response to stress. Due to the association of ER with blood pressure changes and the opportunity to improve ER through psychological aid, and therefore, treat HTN, this approach deserves further consideration as a part of cooperation between medical workers and psychologists.

Acne is a chronic inflammatory disorder of the pilosebaceal unit. Dermatological disorders are often associated with a variety of psychological problems which the patient have. Psichodermatologic disorders (acne) are associated with skin problems that are not directly connected to the mind, but that react to emotional states, such as stress. The aim of this article is to show if there is any psychological characteristic which are common for the whole group of ill-patients from acne, as well as whether there is correlation between any type of acne and psychological parameters. Own exploration consist at thirty patients with three clinical type of acne. Personality test-Kornel index were used for identification and diagnostic psychosomatic disorders. The results are: neurastenic parameters, parameters of conversion and parameters of psychopathy in different percent at both sex, and different clinical features. We show correlation united 2-6 psichosomatic disorders in male sex with softly type of acne. In female sex with any type of acne are responsible 7-12 united findings. The association of several psychosomatic factors could possibly be responsible for the onset of acne at any type.

This study evaluates trepanations from five well-contextualized prehistoric sites in the south- central highlands of Andahuaylas, Peru. The emergence of trepanation in this region coincides with the collapse of the Wari Empire, ca. AD 1000. Thirty-two individuals from Andahuaylas, AMS radiocarbon dated to the early Late Intermediate Period (ca. AD 1000-1250), were found to have 45 total trepanations. Various surgical techni- ques were being employed concurrently throughout the region. Scraping trepanations evinced the highest sur- vival rate; circular grooving, drilling and boring, and lin- ear cutting were far less successful. Evidence of perioperative procedures like hair shaving, poultice application, and possible cranioplasty use aimed to ensure the survival of a trepanation recipient. Postmor- tem trepanations, also present in Andahuaylas, were likely executed on corpses as a means of better under- standing cranial anatomy and improving techniques. Similarities in trepanation patterns throughout the region attest to common motivations to engage in sur- gery. Although moderate physical head trauma seems to be the impetus for intervention in many cases of trepa- nation, other motivations included physiological and pos- sibly psychosomatic factors. Nevertheless, treatment was not for everyone. In Andahuaylas, trepanations were withheld from subadults, females, and those individuals who practiced cranial modification. Am J Phys Anthro- pol 152:484-494, 2013. V C 2013 Wiley Periodicals, Inc.

Subjects of the study were 100 chronic abdominal pain syndrome inpatients assigned to subgroups of different level of significance of psychological factors for the development of pain syndrome, different self-assessed pain level (utilizing visual analog scale), and different type of attitude towards disease (by the Bekhterev Institute Personality Inventory). Character and psychodynamic specialties were assessed in the aforementioned subgroups following to assignment. Proved by clinical and psychometric methods diagnosis of somatoform pain disorder was used as an indicator of high importance of psychological determinants. Differences between subgroups were assessed by the kit of questionnaires (Beck Depression Inventory, Spielberger Anxiety Scales, Wasserman Social Frustration Inventory, TAS, MCMI-III) and projective tests (Luscher and Szondi tests). Interference between psychosomatic and demographic characteristics within the sample, and accuracy of assigning subjects to subgroups were discussed. Interpretation of the acquired data with implications for psychotherapists was offered.

Background Clinical observations and epidemiological studies suggest that some negative life events and psychological factors may contribute to an increased susceptibility to periodontal diseases. Management of periodontal diseases is a fundamental part of general practice. This study explored general dental practitioner's awareness about psychosomatic factors and their role in periodontal disease progression. Aim To evaluate the awareness of general dental practioners of Mangalore city and their professional behavior towards patients with stress and depression and periodontal infection. Method Data were collected from 55 general dental practitioners of Mangalore city. 27 respondents were purely general practitioners and other were academicians who were practicing general dentistry. Results the respondents had awareness about the effect of stress and depression on periodontal tissues and their management. They were able to identify the periodontal conditions which occur primarily because of stress. Conclusion The general dental practitioners play a key role in the success of the treatment of periodontal disease since they are the primary care providers. The respondents were significantly aware about the psychological factors such as stress and depression and its significance on periodontium. This may be due to the involvement of more number of young practitioners who were well educated about psychosomatic factors and their effects on periodontium in their dental education.

Summary Background. While psychosomatic factors may be involved in eliciting as well as coping with chronic itch, psychiatric comorbidity often goes unrecognized in dermatological patients. Aim. To record psychiatric illness, psychiatric and psychotherapeutic pretreatment, and psychotherapy indication in dermatology inpatients with pruritus. Methods. A consecutive sample of 109 dermatology inpatients with the symptom of pruritus were examined by interviews with consecutive ratings by experts (using psychiatric ICD-10 diagnoses, the Global Assessment of Functioning Scale and the Impairment Score) and self-assessment using the the Eppendorf Itch Questionnaire. Results. In > 70% of the pruritus patients, 1–6 psychiatric diagnoses could be demonstrated. In > 60%, psychotherapeutic or psychiatric treatment was recommended. In contrast, almost 90% of the patients had had no previous psychotherapeutic experience. Conclusion. As psychiatric comorbidity in dermatology inpatients suffering from chronic itch is high, dermatology departments should aim for an improvement of their psychosomatic consultation and liaison services.

There is increasing evidence of psychosomatic factors in dermatological disorders. The article shows the present aspects of psychosomatic dermatology: the psychiatric, the psychosomatic and the somato-psychiatric skin diseases. To each of this points two examples of specific skin diseases are discribed. Finally, clinically important issues of psychosomatic care and dermatological therapy of patients with psychosomatic diseases are reviewed.

Introdução: A amnésia global transitória (AGT) consiste na ocorrência de sintomas como perda da memória e perda da orientação temporal e/ou espacial, de caráter temporário, e cuja causa não está associada às condições neurológicas mais comuns e clássicas, como epilepsia ou acidente vascular cerebral (AVC). Os maiores fatores de risco conhecidos para a AGT são a idade, geralmente ocorrendo em maiores de 50 anos, a ocorrência de episódios de estresse ou esforço físico antes do evento, sendo comum ocorrer em pessoas com antecedentes de enxaqueca. Casuística: Neste trabalho foi relatado o caso de um paciente de 61 anos, do sexo masculino, com história de amnésia com duração de um período de 5 horas. O mesmo foi submetido ao exame de ressonância magnética no dia seguinte que não evidenciou alterações; devido à suspeita de AGT, um novo exame de RM foi realizado três dias depois, demonstrando pequena área de alteração de sinal no hipocampo direito. Discussão: Os testes diagnósticos a serem realizados incluem exames para investigar um possível AVC ou episódio epiléptico. Além disso, é importante a investigação de fatores psicossomáticos e pesquisa de transtornos psiquiátricos associados, bastante relacionados à ocorrência de AGT. Conclusão: Atualmente, ainda há estudos sobre esta patologia, principalmente em relação a sua causa subjacente, levantando-se a hipótese de que seja um sintoma comum a diversas doenças e não uma patologia em si, tornando de suma importância os exames complementares de imagem no seu diagnóstico. Palavras chave: amnésia, amnésia transitória, memória. Introduction: Transient global amnesia (TGA) is the occurrence of symptoms such as loss of memory and orientation to time and/or space, with a temporary character, and whose cause is not linked to the most common classic and neurological conditions, such as epilepsy or stroke. The major known risk factors for TGA are age, usually occurring in greater than 50 year-old people the occurrence of episodes of stress or physical exertion before the event, and it is common in people with a history of migraine. Case Report: We report the case of a 61 year old male with a history of amnesia lasting for a period of 5 hours without other changes. This patient was submitted to MRI on the next day, which showed no alterations, due to suspicion of AGT the examwas repeated and showed morphological changes in the hippocampus. Discussion: Diagnostic tests include some tests to be performed to investigate a possible stroke (CVA) or epileptic episode. Furthermore it is important to investigate psychosomatic factors, and research psychiatric disorders, that are closely related to the occurrence of AGT. Conclusion: Currently, there are no studies on this pathology, especially in relation to its underlying cause, raising the hypothesis that it is a common symptom of many diseases and not a disease itself, making it extremely important to perform complementary imaging in diagnosis Keywords: amnesia, transiente amnesia, memory.

This investigation assessed psychiatric symptoms among children aged 8-9 years in Finland and in Russia and compared differences in psychiatric symptoms in the countries. We studied 1268 Finnish and 1567 Russian children, using 3 questionnaires. Parents filled out the Rutter Scale A2, teachers filled out the Rutter Scale B2, and the children themselves filled out the Children's Depression Inventory (CDI). Russian children were reported to have more psychiatric symptoms than Finnish children. In particular, hyperactive and psychosomatic symptoms were more prevalent in Russia. Similar numbers of children in the two countries scored above the 90th percentile on at least one of the scales. Russian boys scored higher than their Finnish counterparts on three factors constructed of Rutter Scale A2 items (externalizing, hyperactivity, and psychosomatic factors), and Russian girls scored higher than Finnish girls on two factors (hyperactivity and psychosomatic factors). When a child scored high on at least one of ...

It has been estimated that in at least one third of dermatology patients, effective management of the skin disorder involves consideration of associated emotional factors. This article provides an overview of psychodermatology with a focus on the more recent literature and an emphasis on the clinical aspects and psychologic therapies for (1) cutaneous associations of psychiatric disorders and (2) psychiatric associations of certain cutaneous disorders that are known to be influenced by psychosomatic factors. This article also provides an update on the use of psychotropic drugs (i.e., the antianxiety, antidepressant, and antipsychotic agents) for the treatment of mental disorders that occur in conjunction with cutaneous conditions. Some of their other pharmacologic properties, such as the antihistaminic and analgesic effects of some antidepressant agents are also reviewed.

Objective To review the literature regarding the use of animal models in research addressing psychosomatic aspects of diabetes. Method We examine the key findings in animal model vs. human research in the area of stress and diabetes. Previous research has suggested that stress is a potential contributor to chronic hyperglycemia in diabetes. Stress affects metabolic activity via the stimulation of a variety of hormones that can result in elevated blood glucose levels. In patients with diabetes, due to a relative or absolute lack of insulin, stress-induced increases in glucose cannot be properly metabolized. Additionally, regulation of these stress hormones may be abnormal in diabetes. Results Human studies on the role of stress in the onset and course of type II diabetes are few and are limited by the constraints and logistics of examining life stress in humans. However, animal research allows for tight experimental control and the manipulation of factors that may contribute to the development and/or course of diabetes, such as stress, eating behavior, the nutrient content of food, and physical activity. Disease processes can be examined at a mechanistic level in animals which is typically limited in human research. Conclusions There is a large body of animal work to support the notion that stress reliably produces hyperglycemia in type II diabetes. Furthermore, there is evidence that the autonomic nervous system plays a role in the pathophysiology of this condition in both animals and humans. Examination of eating behavior and nutrient content of food in animal models of diabetes has shed light on the role of these factors in the development of diabetes, as well as obesity. Finally, genetic research using animal models of diabetes will provide new directions for research in humans to delineate the genetic contribution to the development of diabetes.

This study investigated the dentists’ knowledge about psychosomatic medicine. Anxiolytic techniques, considerations about psychosomatic medicine, and referrals to psychotherapists were examined by a questionnaire. Overall, 65 percent felt negatively affected by patients with dental fear. Few dentists used relaxation techniques and hypnosis. The relationship between psychosomatic factors and pain perception was well known, but not their impact on wound healing. The frequency of continuing education courses correlated with a broader range of treatment techniques and less difficulties in treatment. Research evidence about the impact of psychological factors on dental treatment has not been translated into dental practice.

The 24-h dietary intake, nutritional status parameters and psychosomatic factors of two-shift, three-shift and day workers were compared. Estimations of the dietary intake (across a work cycle) were made by use of a nutrient database. No significant differences were found between the groups for a large number of nutritional variables: intake of energy; intake and percentage of energy from protein, fat, total carbohydrates and sucrose; intake of coffee; and intake and density of vitamins and minerals. Only minor differences were found between the groups with regard to the quantitative intake of alcohol and calcium, and with regard to the quality of the diet (percentage of energy from alcohol, density of calcium). The groups differed significantly with respect to attitude towards work hours (three-shift workers being most negative in their attitude) and sleep disturbances (shift workers being most negative). The three-shift workers were more evening-oriented and they had higher concentrations of gl...

Evidence indicates that a link between peptic ulcer disease (PUD) and selected psychosomatic factors may exist. A series of 70 consecutive male and female adult patients were categorized by peptic symptoms and divided into four groups: a) controls; b) gastric ulcer (GU); c) duodenal ulcer (DU); and d) chronic non-ulcer dyspepsia (CNUD). All patients were interviewed and asked to answer a questionnaire that included demographics, medical history and the incidence of negative life events. A decreased level of activity was a predominant finding in GU, DU and CNUD patients. Family history of PUD may be correlated with CNUD. Of interest was the finding that DU and CNUD patients presented a higher incidence of negative life events when compared to the other study groups. Negative life events that produce considerable stress may predispose to peptic symptoms in certain patients.

Itch is a suffering as well as pain. Its impact on the quality of life and psychism can be considerable. Vice versa, stress and psychological factors can influence it.

Objective: To study the prevalence of symptoms of temporomandibular disorders (TMD) in two cohorts of 70-year-old subjects examined 8 years apart and analyse the relationship between such symptoms and dental status, general health and various background factors. Materials and methods: Two cohorts of 70-year-old subjects, born in 1922 (n = 422) and 1930 (n = 491) respectively, were examined with an interval of 8 years. A TMD symptom index (0–5) was established on answers to five questions related to TMD symptoms. Results: There were no statistically significant differences between the two cohorts for prevalence of TMD symptoms and TMD index, neither for headache, neck ache, bruxism and chewing ability. TMJ sounds was the most prevalent symptom, 14%, whereas other TMD symptoms had low prevalence. The distribution of the TMD symptom index showed that 81% reported no symptoms, 15% one symptom, 3% two symptoms and 1% three to five symptoms. Single TMD symptoms and the TMD index exhibited significant associations (p

Psychosomatics describes any aspect of dermatology with psychologic or psychiatric elements. Dermatologists know that a significant proportion of their practice involves patients for whom psychologic elements either partially or sometimes entirely dominate their presenting chief complaints. This article explores the role of psychosomatic factors in dermatologic disorders. The authors discuss the clinical interface between psychiatry, psychology and dermatology and the interpretation of possible relationships between cutaneous diseases, the role of the mind, and psychotherapeutic interventions.

Atopic dermatitis can now be considered a typical psychosomatic disease in which there is interaction between genetic disposition, multifactorial eliciting circumstances, and psychosomatic factors in the exacerbation or in coping with the disease.

Urinary disturbance is one of the significant symptoms of cervical myelopathy. To make the diagnosis of urinary disturbance, preoperative urodynamic studies and evoked spinal cord potentials (ESCPs) recording were performed on 60 surgical patients with cervical myelopathy. Half (30) of this group complained of urinary disturbance, and 22 (37%) were diagnosed as having neurogenic bladder. The presence of neurogenic bladder was closely correlated with severe limb symptoms and relatively slow ESCP velocity. It was confirmed that neurogenic bladder was caused by severe spinal cord damage. However, for 47% of the patients with urinary complaints, findings of urodynamic examinations were negative; these patients probably had pathologic or psychosomatic factors other than neurogenic bladder due to cervical myelopathy. The prognosis of the neurogenic bladder appears to be influenced by irreversibility of the spinal cord lesions.

A random sample of 400 Dutch general practitioners was asked to complete a questionnaire dealing with the prevalence, conditions and therapies of cervical hypersensitivity of their patients. According to the 259 responding dentists an average of 10% of their patients suffered from moderate cervical pain. The estimated mode for severe pain was 1%. More than two thirds of the dentists reported inadequate brushing of the teeth to cause the hypersensitivity, about one half acknowledged periodontal causes, well over one quarter mentioned the involvement of dietary acids, and about one sixth implicated psychosomatic factors. Other causal factors were mentioned less often. Of the therapies available, the home-care methods appeared to be promoted most often, i.e. brushing with therapeutic toothpastes (77%), improvement of oral hygiene (51%) and local self-application (with finger) of a therapeutic toothpaste or fluoride preparations before the night (41%). Well over 50% reported to apply occasionally bondings/varnishes and 28% said to make sometimes cervical fillings. Other therapeutic possibilities were not, or very seldom, used.

The role of occupational environment in the occurrence of low-back pain was analyzed for 1719 commercial travelers (1376 men and 343 women). At the beginning of the study (T0) the group was interviewed to determine current lifestyle and occupational factors associated with low-back pain during the previous 12 months. Twelve months later (at T1), a subsample of 1118 persons (893 men, 225 women) was reinterviewed to study the association between the incidence of low-back pain during the year of follow-up and the risk factors at T0. At T0 low-back pain was significantly related with time spent driving a car at work, comfort of the car seat, carrying loads during work, standing for long periods at work, smoking, and psychosomatic factors. At T1 driving 10 h/week or more, seat comfort, and psychosomatic factors were associated with first occurrence of low-back pain.

Secretions of apocrine and eccrine glands can be stimulated by psychosomatic factors. Sweating is not an exclusively physiological phenomenon. It can be stimulated by a nervous condition stemming from concern over sweating.

The improvement of acne appears to be associated with decreased depression and anxiety and greater satisfaction with aspects of body image that are generally unrelated to the appearance of the skin, ie, body shape and weight. The latter emphasizes the profound effect of the appearance of the skin upon the patient's overall body image. Our preliminary findings underline the need for larger controlled studies of psychosomatic factors among patients with mild to moderate acne.

Although Crohn's disease has been recognized for more than 50 years, its etiology has not been clarified, and the mechanisms underlying the intestinal inflammation are poorly understood. There has been no lack of provocative hypotheses, and etiologic theories have invoked hereditary, allergic, dietary, infectious, autoimmune, vascular, neuromotor, and psychosomatic factors. So far, however, no exploration of any of these fields has yielded any conclusive answers, and it has not been clearly established into which, if any, of these categories the disease falls.

In a nation-wide investigation, covering all the hearing centres in Sweden, a study was made of adaptation processes, subjective discomfort from tinnitus, subjective loudness of tinnitus and psychological complaints in 3372 subjects by means of a questionnaire. The most important predictors of discomfort from and adaptation to tinnitus were found to be the controllability and the degree of maskability by external sounds, i.e. the subject's coping abilities or internal-external locus of control. Increased control and masking effects from the environment imply a decrease in discomfort and better adaptation. The most important predictor of worsened subjective loudness of tinnitus was the duration of the tinnitus. That is, subjects who had had tinnitus for a longer time perceived the loudness as more intense. The psychosomatic factors which most strongly predicted increased discomfort from and decreased tolerance to tinnitus were depression and insomnia. These findings have theoretical and practical implications for the management and treatment of tinnitus.

Background : The aim of this study was to confirm the risk factors for low back pain and injury to improve the prevention and treatment of lower back pain. Materials and Methods : An epidemiologic study of low back pain and injury was performed with questionnaires distributed to 471 women working at Yeungnam university hospital. The differences in low back pain and injuries among various hospital departments were analyzed by a one-way analysis of variance (ANOVA), and the relevant factors included in the questionnaire were determined by a factor analysis. Results : The frequency of low back pain in women in the department of diet and in the maintenance department was higher than among the other departments. The frequency of low back pain was mainly related to the frequency of psychosomatic symptoms. In addition, the low back pain was partially related to the frequency of psychosomatic symptoms and partially related to the frequency of pushing during the workday. The degree of disability from low back pain was increased by lifting and hard physical work and was related to the frequency of psychosomatic symptoms and the degree of work dissatisfaction. The frequency of low back injury was increased by increased standing time during work and hard physical work. The frequency of low back injury was related to advancing age and in part to psychosomatic symptoms. Conclusion : Lower back pain and its associated complications are related to psychosomatic factors and type of work. Lower back injury is related to physiological factors such as age. For the prevention and treatment of lower back pain, a multidisciplinary approach is required.

It has long been recognized that psychosomatic factors play a role in dermatologic disease.1The past four decades have seen a marked progress in the understanding of the biologic basis of psychopathology and in the development of pharmacologic treatments for mental disorders. However, at present, psychosomatic dermatology is, at best, on the fringes of mainstream clinical dermatology. Do dermatologists need to familiarize themselves with psychiatric principles along with the principles of general internal medicine? How clinically relevant is the relation between the psyche and the skin? The following perspectives on some interfaces between psychiatry and dermatology may shed light on these questions. PSYCHONEUROIMMUNOLOGIC INTERRELATIONSHIPS There is evidence that central nervous system (CNS) processes modulate immune function and that the immune system in turn provides feedback to the brain.2-5Some of the many findings2-5that support the preceding statement include the following: hypothalamic lesions affect immune function; the

食品嗜好, パーソナリティや心身の健康状態の分析から, 食に関する教育指導の有無, パーソナリティ要因および身体要因と食品嗜好の関係を明らかにするため, 栄養専門学校生232名 (男子40名, 女子192名), 大学生87名 (男子72名, 女子15名) を対象に調査研究を試みた。嗜好因子の分析は, 村松の食品嗜好因子テストを用い, これにより嗜好指数を算出した。性格検査はモーズレイ性格検査 (MPI), 健康状態検査はコーネル医学指数 (CMI) を用い, 性格特性と嗜好指数および嗜好因子指数, 心身の健康状態と嗜好指数および嗜好因子指数との関係を検討し, 次の結果を得た。1) 男子において, 栄養専門学校生は大学生に比べ, 嗜好指数, 嗜好因子指数が高く, 教育環境の違いが, 献立や調理の知識や技術の習得, 食生活に関する社会学的配慮や生理学的・心理学的な要因を通じての嗜好に大きく影響することが推察される。2) 栄養専門学校生については, 男女ともに外向性得点の高い者ほど嗜好指数が高い傾向がみられ, 食物に対しての順応性や弾力性があると考えられる。3) 神経症的傾向と嗜好指数の間には, 有意な相関関係はみられなかった。4) 身体的自覚症数および精神的自覚症数と嗜好指数の間には, 有意な相関関係はみられなかった。5) 大学生に関しては, 男女ともに多少神経質なほうが食生活についての社会学的配慮もあり, 自己の心身についての関心が高い。

Read as the address ofthe President·Elect at the 14th Annual Meeting, Academy ofPsychosomatic Medicine, November 14, 1977, Costa Mesa, Calif. Dr. Manhold is professor and chairman ofthe department ofgeneral andoralpathology, College of Medicine and Dentistry ofNew Jersey. Reprint requests to Dr. Manhold, 352 Shunpike Road, Chatham Township, NJ 07928. The SEM studies were done with P. Farnsworth, M.D.

In a Yugoslav village, psychosocial, anamnestic medical, and pathophysiological data were recorded for 1,353 persons in a longitudinal study. The role of psychosocial stress in carcinogenesis, as far as we have investigated it, may be described as follows: (1) Psychosocial stress in terms of high hopelessness, high antiemotionality, etc. has a strong relevance for cancer incidence which does not act via one of our physiological variables associated with cancer. This follows from the results of our multivariate analysis. (2) Psychosocial stress is substantially associated with a low lymphocyte percentage, which in turn is a relatively strong risk factor for cancer. (3) Psychosocial stress is relatively weakly associated with the cholesterol minimum; but apart from the fact that the cholesterol characteristics of cancer subjects are more marked descriptively under stress conditions, psychosocial stress significantly enhances the efficacy of the most important physiological risk variables for cancer.

Involuntary infertility is regarded as a cause of much distress and marital un-happiness. Couples arrive at the IVF Clinic after many years of investigations and operations and often a long waiting list. The IVF procedure itself is highly stressful and involves medicalisation of the most intimate aspects of the couple's relationship. Inability to achieve pregnancy after so much emotional, physical and financial expense may lead to feelings of failure in one or both members of the couple. Furthermore, since IVF is regarded as the last chance for treatment, when pregnancy does not occur the couple are often forced for the first time to confront their sterility as a pair. This may trigger a crisis, which if successfully resolved can lead to adaptation. Thus the clinician involved with IVF needs to be aware of psychological and social aspects of the aetiology, maintenance, sequelae and adaptation to infertility. Psychiatrists, psychologists and social workers have to be integral members of the IVF team. By ut...

An age-matched case control study was conducted on 50 patients with breast cancer and 105 controls in which 23 biopsychosocially oriented questions were asked by personal interview. Cases were more likely than controls to have had a depleting life event in the previous 5 years, especially in the younger age groups. Cases were more likely than controls to have a commitment to prevailing social norms and to the external appearances of being a ‘nice' or ‘good' person. Cases were more likely than controls to suppress and internalise their feelings, particularly feelings of anger. Suppression of feelings was particularly frequent in cases who were 45 years or older. Total scores developed to combine response to questions show that cases deny, internalise and repress feelings especially anger, and have a commitment to the social norms significantly more frequently than controls. Further research into the bio-psychosocial characterisation of the breast cancer patient will add another risk factor to the profile o...

The various physiological mechanisms described, which are triggered by meteorological stimuli, may help to explain the effect of psychosomatic factors on cancer29. Whereas in purely psychosomatic research it may be difficult to study the real mechanisms involved, biometeorological studies on the effects of meteorological stress may assist future psychosomatic cancer research.