Advances in Psychosomatic Medicine最新文献

{"title":"The psychological behaviorism theory of pain and the placebo: its principles and results of research application.","authors":"P. Staats, H. Hekmat, A. Staats","doi":"10.1159/000095364","DOIUrl":"https://doi.org/10.1159/000095364","url":null,"abstract":"The psychological behaviorism theory of pain unifies biological, behavioral, and cognitive-behavioral theories of pain and facilitates development of a common vocabulary for pain research across disciplines. Pain investigation proceeds in seven interacting realms: basic biology, conditioned learning, language cognition, personality differences, pain behavior, the social environment, and emotions. Because pain is an emotional response, examining the bidirectional impact of emotion is pivotal to understanding pain. Emotion influences each of the other areas of interest and causes the impact of each factor to amplify or diminish in an additive fashion. Research based on this theory of pain has revealed the ameliorating impact on pain of (1) improving mood by engaging in pleasant sexual fantasies, (2) reducing anxiety, and (3) reducing anger through various techniques. Application of the theory to therapy improved the results of treatment of osteoarthritic pain. The psychological behaviorism theory of the placebo considers the placebo a stimulus conditioned to elicit a positive emotional response. This response is most powerful if it is elicited by conditioned language. Research based on this theory of the placebo that pain is ameliorated by a placebo suggestion and augmented by a nocebo suggestion and that pain sensitivity and pain anxiety increase susceptibility to a placebo.","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"25 1","pages":"28-40"},"PeriodicalIF":0.0,"publicationDate":"2006-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000095364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64350681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid effectiveness, addiction, and depression in chronic pain.","authors":"P. Christo, T. S. Grabow, S. Raja","doi":"10.1159/000095370","DOIUrl":"https://doi.org/10.1159/000095370","url":null,"abstract":"Opioids are a viable treatment for chronic pain, but their use requires individualization, specified treatment goals, and patient education. Opioid responsiveness is influenced by patient-centered characteristics, including a predisposition to opioid side effects, psychological distress, and opioid use history; pain-centered characteristics, which involve the temporal pattern, rapidity of onset, severity, and type of pain; and drug-centered characteristics relating to the impact of specific types of opioids on specific patients. Thus, opioid doses should be titrated to achieve a favorable balance between analgesia and adverse effects. Opioid therapy can be enhanced through the adjunct administration of agents such as NMDA antagonists, calcium channel blockers, clonidine, and even low-dose opioid antagonists. Controversy exists over 1) the long-term use of opioids for non-cancer pain, and patients receiving opioids for long periods must be monitored carefully for signs of addictive and aberrant behavior, 2) the impact of opioid therapy on emotional depression in patients with chronic pain, and 3) whether opioid therapy causes cognitive impairment in the elderly. Our ability to determine the validity of such assertions and the exact role of opioids in the treatment of chronic pain will benefit from further study.","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"25 1","pages":"123-37"},"PeriodicalIF":0.0,"publicationDate":"2006-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000095370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64351636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can we prevent a second 'Gulf War syndrome'? Population-based healthcare for chronic idiopathic pain and fatigue after war.","authors":"C. Engel, A. Jaffer, Joyce A. Adkins, J. Riddle, R. Gibson","doi":"10.1159/000095369","DOIUrl":"https://doi.org/10.1159/000095369","url":null,"abstract":"In the 1991 Gulf War less than 150 of nearly 700,000 deployed US troops were killed in action. Today, however, over 1 in 7 US veterans of the war has sought federal healthcare for related-health concerns, and fully 17% of UK Gulf War veterans describe themselves as suffering from the 'Gulf War syndrome', a set of poorly defined and heterogeneous ailments consisting mainly of chronic pain, fatigue, depression and other symptoms. Even though over 250 million dollars of federally funded medical research has failed to identify a unique syndrome, the debate regarding potential causes continues and has included oil well smoke, contagious infections, exposure to chemical and biological warfare agents, and posttraumatic stress disorder. Historical analyses completed since the Gulf War have found that postwar syndromes consisting of chronic pain, fatigue, depression and other symptoms have occurred after every war in the 20th century. These syndromes have gone by a variety of names such as Da Costa's syndrome, irritable heart, shell shock, neurocirculatory asthenia, and battle fatigue. Though the direct causes of these syndromes are typically elusive, it is clear that war sets in motion an undeniable cycle of physical, emotional, and fiscal consequences for war veterans and for society. These findings lead to important healthcare questions. Is there a way to prevent or mitigate subsequent postwar symptoms and associated depression and disability? We argue that while idiopathic symptoms are certain to occur following any war, a population-based approach to postwar healthcare can mitigate the impact of postwar syndromes and foster societal, military, and veteran trust. This article delineates the model, describes its epidemiological foundations, and details examples of how it is being adopted and improved as part of the system of care for US military personnel, war veterans and families. A scientific test of the model's overall effectiveness is difficult, yet healthcare systems for combatants and their families are already being put to pragmatic tests as troops return from war in Iraq and Afghanistan and from other military challenges.","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"25 1","pages":"102-22"},"PeriodicalIF":0.0,"publicationDate":"2006-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000095369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64351351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex regional pain syndrome: diagnostic controversies, psychological dysfunction, and emerging concepts.","authors":"Theodore S Grabow, Paul J Christo, Srinivasa N Raja","doi":"10.1159/000079060","DOIUrl":"https://doi.org/10.1159/000079060","url":null,"abstract":"Complex regional pain syndromes (CRPS) types I and II are neuropathic pain disorders that involve dysfunction of the peripheral and central nervous system. CRPS type I and type II were known formerly as reflex sympathetic dystrophy and causalgia, respectively. Most experts believe that a multidisciplinary approach including pharmacotherapy, physiotherapy, and psychotherapy is warranted. Historically, there has been considerable controversy regarding this disease entity. In particular, the precise mechanism of the sympathetic dysfunction as well as the nature of the psychological dysfunction commonly observed in patients with CRPS has been the subject of considerable debate. Current strides in our understanding of the pathophysiology of this disease have improved treatment options.","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"25 ","pages":"89-101"},"PeriodicalIF":0.0,"publicationDate":"2006-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24609935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Function, disability, and psychological well-being.","authors":"P. Katz","doi":"10.1159/000095365","DOIUrl":"https://doi.org/10.1159/000095365","url":null,"abstract":"Disability research in arthritis, as in disability research in general, has focused on functional limitations and activities of daily living/instrumental activities of daily living (ADL/IADL) disability, and has thus ignored a great deal of daily life. Unfortunately, the areas of life that have been ignored may be those that are most important to individuals, and may also be the most sensitive to the first signs of developing disability. The ability to perform valued life activities, the wide range of activities that individuals find meaningful or pleasurable above and beyond activities that are necessary for survival or self-sufficiency, has strong links to psychological well-being--in some cases, stronger links than functional limitations and disability in basic activities of daily living. A broader assessment of disability has great potential for interrupting the disablement and distress process, thereby improving the quality of life of individuals with arthritis. Assessment of the effects of arthritis, pain, or other chronic health conditions should expand beyond assessment of functional limitations and disability in basic activities to include assessment of disability in advanced, valued activities.","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"1 1","pages":"41-62"},"PeriodicalIF":0.0,"publicationDate":"2006-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000095365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64350377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive behavior therapy of binge eating disorder.","authors":"Varsha Vaidya","doi":"10.1159/000090966","DOIUrl":"https://doi.org/10.1159/000090966","url":null,"abstract":"<p><p>Binge eating disorder (BED) is characterized by recurrent episodes of uncontrollable eating, even when not hungry, until uncomfortably full, occurring at least twice a week for a 6-month period. This is differentiated from bulimia nervosa (BN) by the lack of compensatory mechanisms such as purging/laxative abuse. There are significantly higher levels of psychiatric symptoms in patients with BED as compared to those without BED. Furthermore, depressive symptomatology may increase the patient's vulnerability to binge eating as well as to relapse after treatment. Grazing is defined as eating small amounts of food continuously. BED in the pre-bariatric patient can manifest as 'grazing' about 2 years post-bariatric surgery. Treatment should be directed at eating behavior, associated psychopathology, weight and psychiatric symptoms. Cognitive behavior therapy is based on changing the patient's erroneous ways of thinking about themselves, the world and how others perceive them. This includes a focus on normalizing food intake as well as challenging dysfunctional thinking, identifying feelings, and developing non-food coping skills. It increases a sense of control and therefore helps the patient adhere to behavior change strategy, as well as improving mood and reducing associated psychopathology. Interpersonal therapy is based on the relationship between negative mood low self-esteem traumatic life events, interpersonal functioning and the patient's eating behavior. The rationale being that eating represents maladaptive coping with underlying difficulties. While psychotherapy either CBT or IPT leads to decrease in disordered eating behaviors and improved psychiatric symptoms, it has little effect on weight hence; its benefit is optimal when used in conjunction with bariatric surgery.</p>","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"27 ","pages":"86-93"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090966","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25804442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bariatric surgery.","authors":"M. Schweitzer, A. Lidor, T. Magnuson","doi":"10.1201/b13198-52","DOIUrl":"https://doi.org/10.1201/b13198-52","url":null,"abstract":"Bariatric surgery is currently the only effective long-term treatment of morbid obesity and its related co-morbidities. Gastric bypass, adjustable gastric banding, and duodenal switch with biliopancreatic diversion are the three most common operations performed in the United States to induce sustained weight loss. Patient selection is important since compliance postoperatively leads to a successful outcome in over 80% of patients. Preoperative psychological and behavioral problems may lead to maladaptive eating habits postoperatively that defeat the purpose of the surgery. To date, we do not have a 100% reliable method of profiling patients who will fail to keep weight off for the long term. It is therefore important that patients who have preoperative psychological problems that may lead to failure to lose or keep weight off after surgery are offered postoperative counseling along with group support.","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"27 1","pages":"53-60"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65976566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current nutritional treatments of obesity.","authors":"Ashli Greenwald","doi":"10.1159/000090961","DOIUrl":"https://doi.org/10.1159/000090961","url":null,"abstract":"<p><p>Obesity in our country is a growing concern. There are several different options for weight loss; however, individuals must be self-motivated and amendable to change in order to achieve success with their weight loss goals. Several strategies used by professionals in the US today to treat overweight and obesity, include diet therapy, exercise, behavior modification, pharmacotherapy, and surgery. The focus of the American Dietetic Association (ADA) Weight Management Position Statement is no longer just on weight loss but now on weight management. Reaching one's ideal body weight is recommended but not often realistic. Frequently, the goal of treatment shifts to maintenance of ones current weight or attempts at moderate weight loss. Lifestyle modification or behavioral modification interventions rely on analyzing behavior to identify events that are associated with appropriate vs. inappropriate eating, exercise, or thinking habits. Certain primary strategies that have been found to be useful for helping people change their behaviors so that they can lose weight and maintain their weight loss, include self-monitoring, stimulus control, cognitive restructuring, stress management, social support, physical activity, and relapse prevention. Weight loss programs should strive to combine a nutritionally balanced dietary regimen with exercise and lifestyle modifications at the lowest possible cost. There are several different methods used for dietary modifications; low calorie diets, very low calorie diets, fasting, formula diets and meal replacement programs, and popular diets. Bariatric surgery is gaining popularity as it has been an effective way to treat obesity. Following gastric bypass surgery, the patients must be prepared to modify their eating behaviors and dietary selections to assist with weight loss and prevent potential complications. Patients should be educated on the dietary guidelines extensively prior to surgery and again post-operatively.</p>","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"27 ","pages":"24-41"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090961","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25804437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacologic treatment of obesity.","authors":"Aniket Sidhaye,&nbsp;Lawrence J Cheskin","doi":"10.1159/000090962","DOIUrl":"https://doi.org/10.1159/000090962","url":null,"abstract":"<p><p>Obesity is strongly associated with conditions such as hypertension, diabetes mellitus and osteoarthritis that have known adverse health outcomes. The rising prevalence of obesity threatens to overburden our health care system. As a result, the need for safe and effective treatment options is urgent. Unfortunately, pharmacologic treatment options have been disappointing either because of poor side effect profiles or limited long-term efficacy. Our goal is to review currently available pharmacologic treatments and the data supporting their use so that practicing physicians may better incorporate them into a comprehensive, long-term treatment strategy for their patients. We focus on orlistat and sibutramine as these are the two medicines approved by the FDA for long-term treatment of obesity. In addition, we review briefly agents approved for short-term use as well as agents such as zonisamide and topiramate which have shown some promise as weight loss agents in specific clinical circumstances. Finally, we highlight one medicine currently in phase III clinical trials, an endocannabinoid receptor antagonist. Given the overwhelming research focus on this disease, it is likely that the coming years will bring more treatment options, raising the chance that our patients will have meaningful and sustained weight loss.</p>","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"27 ","pages":"42-52"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090962","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25804438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in obesity: adiposity signaling and fat metabolism in energy homeostasis.","authors":"Susan Aja,&nbsp;Timothy H Moran","doi":"10.1159/000090959","DOIUrl":"https://doi.org/10.1159/000090959","url":null,"abstract":"<p><p>Interactions between our conserved 'thrifty genotype' and current trends toward reduced physical activity and increased food intake are posited as the root cause of the rising prevalence of obesity in the modern era. The past decade has seen tremendous advances in our understanding of the physiological regulation of energy balance and adiposity, and important insights into the pathogenesis of obesity. We have gained a more comprehensive view of the energy homeostasis system from the discovery of the adiposity hormone leptin, the subsequent identification of hypothalamic and other brain neuropeptide systems controlling energy balance, and the progress in understanding the molecular mechanisms by which cells can sense and respond to changes in metabolic state. Numerous targets have been identified for potential pharmacological and genetic approaches to obesity management. Some of the most recent developments are prototypic compounds that manipulate fat metabolism, both in peripheral tissues and in the brain, to reduce body fat synthesis and storage and to increase fat oxidation, to reduce food intake, and to increase energy expenditure.</p>","PeriodicalId":50851,"journal":{"name":"Advances in Psychosomatic Medicine","volume":"27 ","pages":"1-23"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25805584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}