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Early postoperative rehabilitation of the patients presenting with cholelithiasis and experiencing psychoemotional stress is designed to restore the function of bile secretion, enhance their adaptive capabilities, and normalize the psychovegetative status for the purpose of preventing further progress of the disease and reducing the risk of the development of post-cholecystectomy syndrome. The inclusion of drinking mineral water, magnetic laser therapy, and UHF therapy in the combined rehabilitative treatment of such patients results in the appreciable enhancement of all functional abilities of the body manifest as the significant improvement and normalization of clinical and laboratory characteristics (elimination of clinical symptoms of the disease, improvement of general and biochemycal parameters of peripheral blood). Simultaneously, the adaptive capabilities and the psychovegetative status of the patients improved as apparent from the increased lymphocyte count, normalization of the Kerdo and Hildebrandt indices and indices of stress level, decreased psychoemotional stress, enhancement of physical functioning characteristics. Taken together, these changes account for the high effectiveness of the above procedures of early postoperative rehabilitation of the patients presenting with cholelithiasisand experiencing psychoemotional stress (94.7%).

The impact of major life events and daily hassles on atypical chest pain is unknown. The aim of the present study was to investigate the relationship of the occurrence and perception of major life events and daily hassles in atypical chest pain patients. Five groups of subjects were studied. They were healthy controls, atypical chest pain patients without motility/reflux changes, atypical chest pain patients with motility/reflux changes, dyspeptic patients, and patients with chronic obstructive airway disease/peptic ulcer/gallstone. A questionnaire concerning the occurrence and perception of major life events and daily hassles was administered to all five groups of subjects. Using analysis of variance, we found that atypical chest pain patients without underlying motility/reflux changes had significantly higher scores of negative life events and total life events than healthy controls, atypical chest pain patients with underlying motility/reflux changes, and patients with chronic obstructive airway disease/peptic ulcer/gallstone. There were no significant differences between atypical chest pain patients without underlying motility/reflux changes and patients with dyspepsia in terms of the number of negative life events, negative scores, number of positive life events, positive scores, and total life events. Discriminate analysis identified five of the 47 major life events (major changes in sleeping habits, change in work situation, major changes in financial status, retirement, and suffering from severe illness or injury) to be useful for discriminating atypical chest pain patients without underlying motility/reflux changes from the healthy controls and from atypical chest pain patients with underlying motility/reflux changes. The overall correct classification rate was 81.8%. In conclusion, psychological factors, such as perception of negative life events and occurrence and perception of daily hassles, may play a role in the pathogenesis of atypical chest pain.

Objective: To assess psychological differences between patients with functional abdominal pain (FUNC) and three separate control groups comprising patients with duodenal ulcer (DU), patients with gallstone or urinary tract stone (STONE), and healthy non-patient controls (HEALTH)., Methods: All participants completed a self-administered questionnaire including questions about the relationship between symptoms and certain life events and psychometric tests for psychological distress (SCL-90) and vulnerability., Participants: The FUNC group consisted of 27 hospital outpatients with long-lasting abdominal pain without demonstrable abnormalities (ten men and 17 women; mean age 38 years). The DU group consisted of 13 untreated outpatients with endoscopically proven duodenal ulcer (nine men and four women; mean age 42 years) while the STONE group comprised 13 untreated patients with gallstone (n = 7) or urinary calculi (n = 6) (six men and seven women; mean age 43 years). The HEALTH group consisted of five men and nine women (mean age 36 years)., Results: Significantly more FUNC and DU patients compared with STONE patients experienced an association with at least one of 14 life events (74%, 77%, and 31%, respectively; p = 0.02). The FUNC and DU groups showed significantly higher scores on the depression subscale of the SCL-90 than the HEALTH group (p < 0.05), and on the anxiety subscale compared with the STONE and HEALTH groups (p < 0.05). The FUNC group scored significantly higher on the somatization subscale compared with all the other groups (p < 0.05). As an overall measure of psychological distress the Global Severity Index (GSI) was calculated. GSI was significantly higher in the FUNC group compared with the HEALTH group (p < 0.01) and tended to be higher in the DU group (p = 0.06). The FUNC and DU groups had significantly higher scores for vulnerability than the STONE and HEALTH groups (p < 0.05)., Conclusion: FUNC as well as DU outpatients seem to be more psychologically distressed and vulnerable than healthy controls or outpatients suffering from pain caused by stones in the gallbladder or urinary tract. As opposed to the STONE group, a high proportion of the FUNC and DU patients experienced that the onset or aggravation of abdominal pain was associated with certain life events. The similarities between the FUNC and DU group demonstrate that it is important to separate DU patients from other "organic" patients in such investigations.