Body, Mind & Spirit Articles and Latest News

The anorectic and obese adolescent.

Best Pract Res Clin Obstet Gynaecol. 2009 Nov 23;

Authors: Bruni V, Dei M, Peruzzi E, Seravalli V

In view of the menstrual disturbances involved, gynaecologists frequently come into contact with girls suffering from eating disorders that can rapidly evolve into anorexia nervosa. The ability to make a precocious diagnosis of the severity of both physical and psychopathological involvement, to offer clear explanations of the links between reproductive function and energy availability and to motivate psychotherapy can be of paramount importance for the prognosis. Similarly, obese adolescents might require counselling for menstrual disorders or alleged endocrine dysfunction. Knowledge of the markers of metabolic impairment and of the possible therapeutic approaches to essential obesity is a necessary complement to the management of the more usual conditions related to overweight, such as polycystic ovary syndrome. Presented here is an overview of recent evidence on the pathogenesis, endocrine profile, short- and long-term health repercussions, therapeutic strategies and clinical trials regarding these two opposing pathologies, both related to unhealthy eating behaviour and also to psycho-relational problems.

PMID: 19939738 [PubMed - as supplied by publisher]

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Meta-analyses: a method to maximise the evidence from clinical studies?

Eur Arch Psychiatry Clin Neurosci. 2009 Nov 26;

Authors: Maier W, Möller HJ

Evidence-based medicine (EBM) is becoming the guiding principle for clinical treatment decisions. But evidence remains a loosely defined term. Multiple criteria for evidence criteria have been proposed. Most influential evidence criteria give priority to meta-analyses because they promise an objective procedure to combine the outcomes of all informative, putatively conflicting studies on the same issue in an overall score. However, we claim that meta-analyses are of limited informative value for the following six reasons: (1) meta-analyses are often “overpowered” with clinically irrelevant results that might emerge as highly significant; (2) there is serious concern of publication biases with “negative” studies not being published; (3) meta-analyses consider the variation in the results of the empirical studies included to be random noise, however, the variability of results across studies can be informative; (4) the result of a meta-analysis depends on the strategy used to identify the included empirical studies; (5) the quality of conclusions from meta-analyses depends on the statistical tests used to combine the results of the separate studies; (6) the qualitative conclusions drawn from the meta-analytical combination of individual studies may depend on specific design aspects of the individual studies. Thus, meta-analyses are primarily a method to generate hypotheses through an a posteriori analysis of treatment effects.

PMID: 19941000 [PubMed - as supplied by publisher]

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Telephone-administered psychotherapy for depression in MS patients: moderating role of social support.

J Behav Med. 2009 Nov 26;

Authors: Beckner V, Howard I, Vella L, Mohr DC

Depression is common in individuals with multiple sclerosis (MS). While psychotherapy is an effective treatment for depression, not all individuals benefit. We examined whether baseline social support might differentially affect treatment outcome in 127 participants with MS and depression randomized to either Telephone-administered Cognitive-Behavioral Therapy (T-CBT) or Telephone-administered Emotion-Focused Therapy (T-EFT). We predicted that those with low social support would improve more in T-EFT, since this approach emphasizes the therapeutic relationship, while participants with strong social networks and presumably more emotional resources might fare better in the more structured and demanding T-CBT. We found that both level of received support and satisfaction with that support at baseline did moderate treatment outcome. Individuals with high social support showed a greater reduction in depressive symptoms in the T-CBT as predicted, but participants with low social support showed a similar reduction in both treatments. This suggests that for participants with high social support, CBT may be a more beneficial treatment for depression compared with EFT.

PMID: 19941048 [PubMed - as supplied by publisher]

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What is a “good outcome” in psychotherapy? A qualitative exploration of former patients’ point of view.

Psychother Res. 2009 Nov 25;:1-10

Authors: Binder PE, Holgersen H, Nielsen GH

The aim of this study was to explore how former psychotherapy patients characterize “good outcome” after having completed treatment that they described as successful, in the sense that therapy had changed their lives in ways that made a difference. Semistructured qualitative depth interviews were conducted with 10 former psychotherapy patients. A hermeneutical-phenomenological approach was used to analyse interview transcripts. The former patients’ descriptions of good outcome clustered around four themes: establishing new ways of relating to others; less symptomatic distress, or changes in behavioural patterns contributing to suffering; better self-understanding and insight; and accepting and valuing oneself. Interrelationships between the four components of good outcome, along with limitations and implications of the study, are discussed.

PMID: 19941195 [PubMed - as supplied by publisher]

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Related Articles

‘Being a Chameleon’: labour processes of male nurses performing bodywork.

J Adv Nurs. 2009 Oct 12;

Authors: Fisher MJ

fisher m.j. (2009) ‘Being a Chameleon’: labour processes of male nurses performing bodywork. Journal of Advanced NursingAbstract Title. ‘Being a Chameleon’: labour processes of male nurses performing bodywork. Aim. This paper is a report of a study examining the labour processes of male nurses in the conduct of bodywork, and is part of a broader study of social practices that configure masculinity through the lives of male nurses. Background. Bodywork is defined as the direct work on others’ bodies, and involves interactions of bodies and the control of emotions. As the body is an arena in which social practice occurs then bodywork is a form of social engagement. Bodywork is inextricably intertwined with gender where bodywork is socially structured and culturally accepted as women’s work. Method. Life history method was used in this study. Twenty-one life stories from male registered nurses were gathered in 2003-2004 using semi-structured interviews. Each life story underwent structural analysis, using a four-dimension structural model of gender relations. Findings. The ability of male nurses to do bodywork and provide care is dependent on the way they ‘do’ gender, that is, they have to be perceived to be performing the masculine identity that best represents the individual patient’s ideology of what it is to be a man, which is set in a particular location and time. In addition, they have to counter the representations of the male nurse, whether it is homosexual, paedophile or heterosexual deviant. Respondents develop labour processes and workplace strategies to overcome the effects of gender stereotypes that may hinder their nursing work. Conclusion. Nursing procedures, policies and texts should reflect the complexity and multiplicity in the conduct of bodywork in nursing and refrain from representing essentialist ways (reinforcing nursing as feminine) of doing nursing.

PMID: 19824908 [PubMed - as supplied by publisher]

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[Psychosomatic diseases: etiology, diagnostic and clinic approach.]

Minerva Pediatr. 2009 Dec;61(6):869-871

Authors: Iester A, Giannattasio A

PMID: 19935578 [PubMed - as supplied by publisher]

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Nephroptosis in a young woman with joint laxity.

Nat Rev Nephrol. 2009 Dec;5(12):722-725

Authors: Clark BA, Sekhon A

Background. A 25-year-old woman was evaluated repeatedly from 10 months following her first pregnancy and delivery for recurrent episodes of lower right quadrant abdominal pain, hematuria and a sensation of mass. Despite investigations by several physicians over a 7 month period no clear diagnosis had been made, but a psychosomatic disorder or possible periodic blocked bowel had been suggested, after which the patient requested a consultation with a nephrologist. Her history indicated joint laxity syndrome and a mitral valve prolapse. She was undergoing continuing evaluation for a possible rheumatic condition.Investigations. Full history, physical examination, and intravenous pyelography.Diagnosis. Nephroptosis of the right kidney.Intervention. Exercises were prescribed to strengthen her abdominal musculature and she was advised to wear an elastic abdominal corset during the daytime. The patient is currently considering surgical intervention.

PMID: 19935816 [PubMed - as supplied by publisher]

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[Somatic and psychosomatic aspects. Integrated strategy for chronic constipation]

MMW Fortschr Med. 2009 Oct 22;151(43):28

Authors: Scheurlen M

PMID: 19938796 [PubMed - in process]

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[Psychosomatic aspects of obstipation]

MMW Fortschr Med. 2009 Oct 22;151(43):33-5

Authors: Csef H

PMID: 19938798 [PubMed - in process]

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Functional correlates of distractor suppression during spatial working memory encoding.

Neuroscience. 2009 Nov 16;

Authors: Toepper M, Gebhardt H, Beblo T, Thomas C, Driessen M, Bischoff M, Blecker CR, Vaitl D, Sammer G

Executive working memory operations are related to prefrontal regions in the healthy brain. Moreover, neuroimaging data provide evidence for a functional dissociation of ventrolateral and dorsolateral prefrontal cortex. Most authors either suggest a modality-specific or a function-specific prefrontal cortex organization. In the present study we particularly aimed at the identification of different prefrontal cerebral areas that are involved in executive inhibitory processes during spatial working memory encoding. METHODS:: In an fMRI study (functional magnetic resonance imaging) we examined the neural correlates of spatial working memory processing by varying the amount of executive demands of the task. Twenty healthy volunteers performed the Corsi Block-Tapping test (CBT) during fMRI. The CBT requires the storage and reproduction of spatial target sequences. In a second condition, we presented an adapted version of the Block-Suppression-Test (BST). The BST is based on the original CBT but additionally requires the active suppression of visual distraction within the target sequences. RESULTS:: In comparison to the CBT performance, particularly the left dorsolateral prefrontal cortex (BA 9) showed more activity during the BST condition. CONCLUSIONS:: Our results show that the left dorsolateral prefrontal cortex plays a crucial role for executive controlled inhibition of spatial distraction. Furthermore, our findings are in line with the processing model of a functional dorsolateral-ventrolateral prefrontal cortex organization.

PMID: 19925856 [PubMed - as supplied by publisher]

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