Investing in emotional and psychological wellbeing for patients with long-term conditions
by Matt Fossey
co-authored with Dr Alan Cohen, Dr Elizabeth Fellow-Smith, Tom Nixon, Prof Andre Tylee and Prof Rona Moss-Morris
A guide to service design and productivity improvement for commissioners, clinicians and managers in primary care,... more
A guide to service design and productivity improvement for commissioners, clinicians and managers in primary care, secondary care and mental health.
For many patients, several physical illnesses will coexist at any one time, and for some a mental health disorder will also be present. In the face of such multi-morbidity and need, focus on the patient journey across the lifespan and across the care system will maximise effective service design and delivery.
The collation of evidence and emerging economic analysis, together with examples of service design and delivery in this guide, will assist commissioners, clinicians and managers in primary care, secondary care and mental health in designing services, improving productivity and learning across disease-specific groups.
Somatization in Latin America: a review on the classification of somatoform disorders, functional syndromes, and medically unexplained symptoms
Version in Portuguese also available:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-444620110
ABSTRACT
OBJECTIVE: medically unexplained symptoms are common and associated with mental illness in various... more
ABSTRACT
OBJECTIVE: medically unexplained symptoms are common and associated with mental illness in various contexts. Previous studies show that Latin American populations are prone to somatization. Given the reformulation of the International Classification of Diseases towards its 11th edition the peculiarities of the population from this region of the world shall be taken into consideration. The objective of this study is to provide information on somatization in Latin American populations to help the decision making about medically unexplained symptoms diagnostic categories in the 11th edition of the International Classification of Diseases.
METHOD: Extensive review of the academic production from 1995 to 2011 on somatization in populations of Latin American origin.
RESULTS: The analysis of 106 studies included in this review was divided into 15 categories: systematic reviews, conceptual reviews, prevalence, primary care, depression and anxiety, risk factors, violence, organic conditions, relationship with health care, ethnicity, culture-bound syndromes, chronic fatigue syndrome, fibromyalgia, body dysmorphic disorder, and conversion and dissociation.
CONCLUSION: The Latin American studies confirm the difficulty in defining medically unexplained symptoms categories. The supposed "somatizing trace" of Latin cultures may be linked more to cultural and linguistic expression than to an ethnic nature, and these peculiarities must be on the agenda for the new classification of these phenomena in the Classification of Diseases-11th edition.
Descriptors: Somatoform disorders; Latin America; International Classification of Diseases; Psychopathology; Symptoms
Response to “Multiple chemical sensitivity is a response to chemicals acting as toxicants via excessive NMDA activity”.
by Ann Meulders
Van den Bergh, O., Meulders, A., De Peuter, S., Vansteenwegen, D., Van Diest, I. (2010). Journal of Psychosomatic Research, 69 (3), 328-330.
Download (.pdf) Resistance to extinction in an odor–20% CO2 inhalation paradigm: Further evidence for a symptom learning account of multiple chemical sensitivity.
by Ann Meulders
Meulders, A., Fannes, S., Van Diest, I., De Peuter, S., Vansteenwegen, D., Van den Bergh, O. (2010). Journal of Psychosomatic Research, 68 (1), 47-56.
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Medically unexplained symptom reports are associated with a decreased response to the rubber hand illusion
Miles, E., Poliakoff, E., & Brown, R.J. (2011). Medically unexplained symptom reports are associated with a decreased response to the rubber hand illusion. Journal of Psychosomatic Research, 71(4), 240-244.
Medically unexplained symptoms (MUS) have been hypothesized to result from a distortion in perception, whereby... more Medically unexplained symptoms (MUS) have been hypothesized to result from a distortion in perception, whereby top-down factors influence the process of body representation. Perceptual illusions provide a novel method of investigating this hypothesis. This study aimed to investigate whether self-reported unexplained symptoms are associated with altered experience of the rubber hand illusion (RHI). A non-clinical MUS group with high scores on the Somatoform Dissociation Questionnaire (SDQ), and a control group with low scores on this scale, were exposed to the RHI. Illusion experience was measured by self-reports and by proprioceptive alteration. After controlling for somatosensory amplification and trait anxiety, the low-SDQ group responded significantly more strongly to the RHI on both questionnaire and proprioceptive measures of the illusion. In contrast, the high-SDQ group scored significantly higher on the Perceptual Aberrations Scale, a measure of bodily distortions in daily life. These findings support the proposed link between MUS and disturbances in body representation, and suggest that a decreased reliance on current sensory inputs may contribute to symptom experience in susceptible individuals.
Attention to the body in nonclinical somatoform dissociation depends on emotional state.
Brown, R.J., Danquah, A.N., Miles, E., Holmes, E., & Poliakoff, E. (2010). Attention to the body in nonclinical somatoform dissociation depends on emotional state. Journal of Psychosomatic Research, 69(3), 249-257.
Unexplained neurological symptoms (“somatoform dissociation”) are common in health care settings and associated with... more Unexplained neurological symptoms (“somatoform dissociation”) are common in health care settings and associated with disproportionately high levels of distress, disability, and resource utilization. Theory suggests that somatoform dissociation is associated with disturbed attentional processing, but there is a paucity of research in this area and the available evidence is contradictory. We compared undergraduate participants (n=124) with high and low scores on the Somatoform Dissociation Questionnaire (SDQ-20) on a tactile cueing paradigm measuring the time course of attention to touch, following either a neutral film or a film designed to simulate the emotional effects of trauma exposure. Following the neutral film, high SDQ-20 participants exhibited delayed disengagement from tactile cue stimuli compared to the low SDQ-20 group. Following the “trauma” film, however, the high SDQ-20 group showed attentional effects suggesting avoidance of the tactile stimuli in this condition. Early attention to tactile cues following the trauma film predicted film-related intrusive thoughts after the experiment. These findings suggest that both body vigilance and body avoidance may be involved in the expression of somatoform dissociation.