Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) ar... more Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on question...
A. Steptoe, Editor, Depression and physical illness, Cambridge University Press, Cambridge (UK) (2007) £45.00, 420 pages
J Psychosom Res, 2007
Updates in Psychosomatic Medicine: 2014
Psychosomatics, 2015
The amount of literature published annually related to psychosomatic medicine is vast; this poses... more The amount of literature published annually related to psychosomatic medicine is vast; this poses a challenge for practitioners to keep up-to-date in all but a small area of expertise. To introduce how a group process using volunteer experts can be harnessed to provide clinicians with a manageable selection of important publications in psychosomatic medicine, organized by specialty area, for 2014. We used quarterly annotated abstracts selected by experts from the Academy of Psychosomatic Medicine and the European Association of Psychosomatic Medicine in 15 subspecialties to create a list of important articles. In 2014, subspecialty experts selected 88 articles of interest for practitioners of psychosomatic medicine. For this review, 14 articles were chosen. A group process can be used to whittle down the vast literature in psychosomatic medicine and compile a list of important articles for individual practitioners. Such an approach is consistent with the idea of physicians as lifelong learners and educators.
“Psychosomatic”: A Systematic Review of Its Meaning in Newspaper Articles
Psychosomatics, 2004
In this study, the authors describe the meaning of the word &... more In this study, the authors describe the meaning of the word "psychosomatic" in U.S. and U.K. newspaper articles using a systematic text word search and a consensus rating of the contextual meaning of all articles published in 14 U.S. and U.K. newspapers between 1996 and 2002. The survey was limited to broadsheet newspapers. "Psychosomatic" had a pejorative meaning, such as "imaginary" or "made up," in 74 of 215 (34%) of the articles in which the meaning could be judged. Most commonly, "psychosomatic" was used to describe a problem that was psychological or in which the mind affects the body (56%) rather than as a reciprocal interaction (5%). "Psychosomatic medicine" is the new name for the seventh subspecialty of psychiatry. More needs to be done to educate the media about its actual meaning to make it attractive to patients.
Functional Somatic Symptoms and Psychological States: An Electronic Diary Study
Psychosomatic Medicine, 2009
To investigate the links between functional physical symptoms and psychological states in a sampl... more To investigate the links between functional physical symptoms and psychological states in a sample of patients with persistent medically unexplained symptoms. Despite the epidemiological evidence for links between physical symptoms and mental processes, prior diary studies have shown inconsistent associations and generally been limited to single symptom and psychological variable pairs. Twenty-six patients with at least three functional physical symptoms completed twice daily self-report measures of symptoms, fatigue, anxiety, stress, mood, and symptom concern using electronic diaries over 12 weeks. Associations between physical symptoms and psychological variables were measured by linear mixed effects models at the levels of diary entry and individual. Despite high baseline questionnaire scores for depression and anxiety, diary ratings of anxiety and stress were relatively low. Fixed effects regression coefficients varied between symptoms and psychological variables; for instance, the fixed effects regression coefficient (95% Confidence Intervals) for fatigue as the outcome variable was 0.39 (0.31-0.47) with low mood and 0.05 (-0.01-0.10) with stress as the predictor. Random effects coefficients showed less variation between individuals for fatigue and musculoskeletal pain than for other symptoms. Self-reported mood and symptom concern were more strongly associated with functional physical symptoms than anxiety or stress. We suggest that one reason patients with functional somatic symptoms reject psychosomatic explanations is because they do not experience sufficient correlation between symptoms and psychological states.
Psychosomatic medicine and evidence-based treatment
Journal of Psychosomatic Research, 1996
1. J Psychosom Res. 1996 Aug;41(2):101-7. Psychosomatic medicine and evidence-based treatment. Sh... more 1. J Psychosom Res. 1996 Aug;41(2):101-7. Psychosomatic medicine and evidence-based treatment. Sharpe M, Gill D, Strain J, Mayou R. PMID: 8887823 [PubMed - indexed for MEDLINE]. Publication Types: Editorial; Review. MeSH Terms. ...
Illness beliefs and locus of control
Journal of Psychosomatic Research, 2004
The aim of this study was to examine the illness beliefs and locus of control of patients with re... more The aim of this study was to examine the illness beliefs and locus of control of patients with recent onset pseudoseizures and to compare these with patients with recent onset epilepsy. Twenty consecutive patients with pseudoseizures of recent onset (mean duration 5.4 months) were compared with 20 consecutive patients with recent onset epilepsy on their responses to (a) the Illness Behaviour Questionnaire (IBQ) and (b) a measure of locus of control, a dimension of the tendency to attribute events to internal or external factors. In comparison with patients with epilepsy, patients with recent onset pseudoseizures believed that psychological factors were less important than somatic ones were (P < .005) and had a greater tendency to deny nonhealth life stresses (P < .0001). No significant differences were detected in disease conviction or illness worry. Patients with pseudoseizures had a more external locus of control (P < .001), Patients with pseudoseizures are less likely than those with epilepsy to see psychological factors as relevant to their symptoms, more likely to deny that they have suffered from life stress and also to have a more external locus of control. The implications for treatment are discussed.
Is there a better term than “Medically unexplained symptoms”?
Journal of Psychosomatic Research, 2010
1. J Psychosom Res. 2010 Jan;68(1):5-8. Is there a better term than "medically unexplained s... more 1. J Psychosom Res. 2010 Jan;68(1):5-8. Is there a better term than "medically unexplained symptoms"? Creed F, Guthrie E, Fink P, Henningsen P, Rief W, Sharpe M, White P. PMID: 20004295 [PubMed - indexed for MEDLINE]. Publication Types: Editorial. MeSH Terms: ...
Modern medicine is based on pathological diagnosis. But many patients present with symptoms that ... more Modern medicine is based on pathological diagnosis. But many patients present with symptoms that lack any identifiable pathology. How should their 'medically unexplained' complaints be understood and categorized so as to provide an understanding of their condition and guide their care? Within psychiatry medically unexplained symptoms have been classified under the somatoform disorder label. Medical specialties have also played a part in naming symptoms-based syndromes, leading to a number of specialist-based diagnoses, for example, irritable bowel syndrome (gastroenterology), non-cardiac chest pain (cardiology), and chronic pelvic pain (gynaecology). Should we be interested in these syndromes and are these syndrome-based diagnoses the most accurate and useful way to conceptualize them?
Psychotherapy in liaison psychiatry
European Psychiatry, 1996
Liaison psychiatry and psychological sequelae of physical disorders
SummaryPsychological medicine (liaison psychiatry) aims to integrate psychiatry into other areas ... more SummaryPsychological medicine (liaison psychiatry) aims to integrate psychiatry into other areas of medicine. It is currently enjoying considerable expansion. The degree to which it can take advantage of this opportunity will be important not only for its own future, but also for the survival of psychiatry as a medical discipline.
A major and increasing task for health services is the management of chronic illness. Although th... more A major and increasing task for health services is the management of chronic illness. Although the details of chronic illness management will depend on the illness in question, many of the principles are common to all chronic conditions. Whatever health services may offer, most of the day to day responsibilities for the care of chronic illness fall on patients and their families. Planners and organisers of medical care must therefore recognise that health care will be most effective if it is delivered in collaboration with patients and their families. To enable patients to play an active role in their care, health services must not only provide good medical treatment but also improve patients' knowledge and self management skills. This can be done by supplementing medical care with educational and cognitive behavioural interventions. Chronic disease treatment programmes have tended to underestimate the need for this aspect of care, and, consequently, many treatment programmes have been psychologically naive and, as a result, less effective than they could have been. Services also need to be not merely reactive to patients' requests but proactive with planned follow up. Finally, to be most efficient, interventions are best organised in a stepped fashion-that is, the more complex and expensive interventions are given only when simpler and cheaper ones have been shown to be inadequate or inappropriate. * From; Department of Health. The expert patient: a new approach to chronic disease management for the 21st century (www.ohn.gov.uk/ohn/people/expert) Treating chronic conditions must involve the family
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