Body, Mind & Spirit Articles and Latest News

A randomized, double-blind, placebo-controlled clinical study of the histamine H(2)-receptor antagonist famotidine in Japanese patients with nonerosive reflux disease.

J Gastroenterol. 2008 Jun;43(6):448-456

Authors: Hongo M, Kinoshita Y, Haruma K

BACKGROUND: To investigate whether histamine H(2)-receptor antagonists are sufficient to treat heartburn in nonerosive reflux disease in Japanese, who produce less gastric acid than Westerners, the efficacy of famotidine in Japanese nonerosive reflux disease patients was studied in a double-blind, placebo-controlled, parallel group-comparative, multicenter study. METHODS: The Los Angeles classification system with Japanese modifications was used to assess the severity of nonerosive reflux disease. Famotidine (10-or 20-mg doses) or placebo was administered to patients twice daily for 8 weeks. Heartburn symptoms were recorded daily by patients. RESULTS: A total of 528 patients participated in the study. The percentage of days without heartburn, the primary end point of the efficacy evaluation, was 62% for 40 mg and 59% for 20 mg of famotidine, and 55% for placebo, with a statistically significant difference between the 40-mg dose and placebo (P = 0.001; significance level, 0.025 one-sided). Famotidine at both doses provided immediate relief from heartburn, and relief persisted throughout the 8-week study with the 40-mg dose. CONCLUSIONS: The results indicate that famotidine relieves heartburn symptoms in Japanese nonerosive reflux disease patients.

PMID: 18600389 [PubMed - as supplied by publisher]

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Frequent Attenders in Primary Care: Impact of Medical, Psychiatric and Psychosomatic Diagnoses.

Psychother Psychosom. 2008 Jul 4;77(5):306-314

Authors: Ferrari S, Galeazzi GM, Mackinnon A, Rigatelli M

Background: Anxiety, mild depression and somatization are common in primary care (PC). Several studies have suggested that they may play a role in causing an excessive use of health care services, especially when combined with medical morbidity. The present case-control study explored how psychiatric and psychosomatic diagnoses and perceived quality of life are associated with the phenomenon of frequent attendance. Method: Fifty most frequent attenders (FAs) in a 1-year period at a PC clinic in Italy were compared with 50 randomly selected average frequency attenders at the same clinic. Sociodemographic and medical data were collected from PC files. The SCID-brief version for research and the Structured Interview for Diagnostic Criteria for Use in Psychosomatic Research (DCPR) were administered to both patient groups. Quality of life was also assessed. Results: FA status was associated with being female, older, less well educated, and living with their spouses and/or children. Medical-psychiatric comorbidity was more frequent in the FA group than in the control group. The median number of psychosomatic-DCPR syndromes per patient was 4 among FAs compared to only 1 in controls. Functional somatic symptoms secondary to a psychiatric disorder, type A behavior, irritable mood, and demoralization were significantly associated with being an FA. Perceived quality of life was significantly lower among FAs, although this was no longer significant after adjusting for sociodemographic variables. Conclusions: The present study confirms the association between medical-psychiatric comorbidity and frequent utilization of PC resources. It suggests a role for DCPR criteria in revealing subthreshold psychiatric comorbidity predicting a pattern of frequent attendance.

PMID: 18600036 [PubMed - as supplied by publisher]

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Invited Commentary: Stress and Mortality.

Am J Epidemiol. 2008 Jul 2;

Authors: Hotopf M, Henderson M, Kuh D

In this issue of the Journal, Nielsen et al. (Am J Epidemiol 2008;168:000-00) use data from a large Danish study to provide evidence that self-reported stress is associated with increased all-cause mortality over the next 20 years. The finding is remarkable. In this commentary, the authors explore what is really meant by stress; they argue that it would be naïve to view stress as reported in this way, with some external exposure. It has to be seen through the lens of the participant’s personal experience, and this lens is likely to be clouded by personality, coping styles, and the common mental disorders-depression and anxiety. The authors discuss a wider literature concerning similar findings associating depression with mortality, suggesting three broad reasons for the association. First, the findings might be explained by the impact of stress or distress on well-established risk factors for cardiovascular disease and cancer. Second, there might be direct, underlying psychosomatic pathways by which stress or distress can affect immune or autonomic function. Third, there might be common causal pathways-shared genes or early adversities that predict both stress and mortality from other causes independently. The authors suggest that life course epidemiologic research is required to test these competing hypotheses.

PMID: 18599491 [PubMed - as supplied by publisher]

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[Neither Descartes nor Freud? current pain models in psychosomatic medicine]

Praxis (Bern 1994). 2008 May 14;97(10):549-57

Authors: Egloff N, Egle UT, von Klänel R

Models explaining chronic pain based on the mere presence or absence of peripheral somatic findings or which view pain of psychological origin when there is no somatic explanation, have their shortcomings. Current scientific knowledge calls for distinct pain concepts, which integrate neurobiological and neuropsychological aspects of pain processing.

PMID: 18595370 [PubMed - in process]

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Related Articles

Mind-body interventions: applications in neurology.

Neurology. 2008 Jun 10;70(24):2321-8

Authors: Wahbeh H, Elsas SM, Oken BS

OBJECTIVE: Half of the adults in the United States use complementary and alternative medicine with mind-body therapy being the most commonly used form. Neurology patients often turn to their physicians for insight into the effectiveness of the therapies and resources to integrate them into their care. The objective of this article is to give a clinical overview of mind-body interventions and their applications in neurology. METHODS: Medline and PsychInfo were searched on mind-body therapies and neurologic disease search terms for clinical trials and reviews and published evidence was graded. RESULTS: Meditation, relaxation, and breathing techniques, yoga, tai chi, and qigong, hypnosis, and biofeedback are described. Mind-body therapy application to general pain, back and neck pain, carpal tunnel syndrome, headaches, fibromyalgia, multiple sclerosis, epilepsy, muscular dysfunction, stroke, aging, Parkinson disease, stroke, and attention deficit-hyperactivity disorder are reviewed. CONCLUSIONS: There are several conditions where the evidence for mind-body therapies is quite strong such as migraine headache. Mind-body therapies for other neurology applications have limited evidence due mostly to small clinical trials and inadequate control groups.

PMID: 18541886 [PubMed - indexed for MEDLINE]

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Peer-assisted learning: a planning and implementation framework. Guide supplement 30.3–practical application.

Med Teach. 2008;30(4):442-3

Authors: Nikendei C, Köhl-Hackert N, Jünger J

PMID: 18589886 [PubMed - in process]

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Association between anger and first-onset primary spontaneous pneumothorax.

Gen Hosp Psychiatry. 2008 Jul-Aug;30(4):331-6

Authors: Lee SH, Choi H, Kim S, Choi TK, Lee S, Kim B, Suh SY, Yook KH, Kim YW

OBJECTIVE: Primary spontaneous pneumothorax (PSP) is a frequent and problematic disease, but its underlying causes and pathophysiology remain unclear. This study examined whether anger, which is related to many psychosomatic diseases, is a psychosocial factor associated with first-onset PSP. METHOD: We administered the State-Trait Anger Expression Inventory, Stress Response Inventory, Coping Scale, Beck Depression Inventory and Global Assessment of Recent Stress to 91 patients with first-onset PSP and to 77 patients with recent minor trauma as controls. RESULTS: The scores on anger-in, anger-out, state anger and trait anger were significantly higher in the PSP group than in the control group. Logistic regression analysis revealed that low body mass index and trait anger could be associated with PSP. CONCLUSION: We hypothesize that anger could play a role in the pathophysiology of PSP.

PMID: 18585536 [PubMed - in process]

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Understanding fatigue in major depressive disorder and other medical disorders.

Psychosomatics. 2008 May-Jun;49(3):185-90

Authors: Arnold LM

BACKGROUND: Although fatigue is a common symptom that occurs in many psychiatric and other medical disorders, the pathophysiological mechanisms of fatigue are still unclear. OBJECTIVE: The goal of this review is to assess the state of knowledge about fatigue in depression and other disorders and identify new avenues for research in the study of fatigue. METHOD: The author reviewed some 50 articles in the field. CONCLUSION: An approach that emphasizes the similarities between fatigue and depression may improve the understanding of these complex syndromes. As more is learned about the neuropathology of the heterogeneous syndrome of depression, the etiology of many of the symptoms domains associated with depression, including fatigue, may become clearer.

PMID: 18448771 [PubMed - indexed for MEDLINE]

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Normalizing attributions may contribute to non-help-seeking behavior in people with fibromyalgia syndrome.

Psychosomatics. 2008 May-Jun;49(3):212-7

Authors: Gulec H

BACKGROUND: Causal attributions of bodily perceptions indicate the possibility of some degree of control over events. Therefore, attributions are important to support the social significance of experience and confer meaning. OBJECTIVE: The aim of this study is to investigate whether non-patients with fibromyalgia (FMS) use more normalizing attributions than healthy control subjects and help-seeking patients. METHOD: Thirty-seven FMS patients attending tertiary care were compared with 38 non-patients and 34 healthy controls on mean anxiety, depression, attribution style, and alexithymia scores. RESULTS: Mean normalizing scores were greatest in the non-patient group, followed by the healthy-control group, and smallest in the tertiary-care attending group. Non-patients are using more normalizing explanations than the FMS patients and the healthy-control subjects. CONCLUSION: Thus, normalization may negatively influence help-seeking behavior and contribute to non-help-seeking behavior.

PMID: 18448775 [PubMed - indexed for MEDLINE]

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Related Articles

The safety of ECT in patients with chronic obstructive pulmonary disease.

Psychosomatics. 2008 May-Jun;49(3):208-11

Authors: Schak KM, Mueller PS, Barnes RD, Rasmussen KG

BACKGROUND: Electroconvulsive therapy (ECT) involves the administration of general anesthesia and assisted ventilation while the patient is apneic. OBJECTIVE: Care must be taken to screen for significant pulmonary dysfunction before treatment. Very little has been written about the safety and management strategy of ECT patients with chronic obstructive pulmonary disease (COPD). METHOD: In this retrospective chart review, authors describe their experience with patients in recent years who had this disorder and were treated with ECT. RESULTS: Authors list recommendations for the pre-ECT work up and anesthetic management during and after the treatments. CONCLUSION: Recent guidelines recommend administration of patients’ prescribed inhalers on the morning of ECT treatment. Also, caution is recommended when using ECT in patients taking theophylline because this drug has been associated with prolonged seizures and status epilepticus in these patients.

PMID: 18448774 [PubMed - indexed for MEDLINE]

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