Psychosomatic Disorders

I. Psychosomatic Medicine: A Critical Appraisal:

The modern medical practitioner attempts to account for the various aspects of illness by considering them all together and, in doing so, adopts a biopsychosocial approach. As a general medical orientation, psychosomatic medicine finds its main purpose in pursuing such an approach.

The psychosomatic physician postulates "that mind and body are two inseparably linked aspects of man" ([9], p. 12). Such an approach is 'holistic', "in that it implies a view of the human organism as a whole, a mind-body complex" ([9], p. 12). Lipowski distinguishes several themes in current psychosomatics: the search for physiological mediating pathways between psyche and soma in fields such as neuro-endocrinology and neuroimmunology; the search for correlations of psychological "stress" and physiological effect; and the investigation of the psychosocial response to physical illness ([9],' pp. 8-9). In addition, psychosomatics is concerned with the interaction of psychological, social and physiological factors in health and illness and with the therapeutic consequences issuing from this holistic, i.e., biopsychosocial view ([9], p. 12). According to Lipowski, in psychosomatics, the "old" notion of causality is abandoned and replaced by the notion of "reciprocal interaction" so that it is impossible to say that physical events are caused by psychological events, or vice versa ([9], p. 14). Since every illness is invariably physiological' as well as psychological, all disorders are psychosomatic and there is no privileged list of psychosomatic disorders. Ironically, if this were to be generally acknowledged, the very term "psychosomatic" would be quite superfluous [22,.23]. .

But given the holistic starting point of the psychosomatic approach, how can medical research effectively proceed? Out of his concern that holism cannot conceivably allow for research, Lipowski sees a need to split and reduce this holism through "methodological reductionism":

"Furthermore, one needs to draw a distinction between methodological and theoretical reductionism. The former implies a research strategy involving a deliberate decision to abstract from, and hence disregard one or two classes of variables so as to be able to study the effects on behavior of variables belonging to only one class, say biological or psychological. This is a heuristically .valuable investigative strategy, one that appears indispensable for progress in our field ([10], p. 61)."

Hence, psychosomatics can be characterized by a holistic (i.e., biopsychosocial) starting point, the abandonment of classical "causality", psychophysiological correlations and methodological reductionism.

We may ask if this psychosomatic approach is able to offer a genuinely complete account of patients and their environment in health and in illness. And if not, are we able to suggest an alternative?

Mindfulness is a burgeoning field of study and practice within mental health care and medicine. Yet ethical codes, and the philosophy of the therapist-client relationship, differ greatly between disciplines, and even more between those disciplines and mindfulness-based approaches. The potential for ethical dilemmas is therefore significant.

The book breaks new ground by taking a focused look at an ethics derived from contemporary clinical mindfulness practice itself. What does a secular ethics of mindfulness look like? Who is competent to work therapeutically with mindfulness, and how does one delimit areas and levels of competence? How do clinicians ethically understand the therapist-client relationship from the therapeutic position of mindfulness? And how do clinicians respond when the necessary restraints of their professional role and ethics code come into conflict with the mindfulness-based relationship and therapeutic position?

This book makes a vital contribution to the understanding of ethics as the cornerstone of mindfulness-based practice, and will be of interest to all those involved in delivering mindfulness-based interventions, including psychologists, counselors, spiritual directors, occupational therapists, physicians, nurses, and educators.

Alexithymia is a personality trait characterised by difficulty identifying and describing subjective emotional feelings, a restricted imagination, and an externally oriented style of thinking. Individuals with high levels of this trait are at risk of developing several common psychiatric disorders. The concept of alexithymia has evolved considerably over the past twenty years, and this important new work responds to the need for a definitive book on the subject. The research, theory and clinical issues surrounding alexithymia are discussed in depth, examining the psychological, biological and social aspects of the construct and their related outcomes. Featuring contributions from researchers and clinicians in the field of emotion processing and regulation, chapters include methods for assessing and reducing alexithymia, and research findings from diverse fields of scientific enquiry including genetics, neuroimaging studies, emotion regulation, attachment and trauma research, and comorbidities with a number of psychiatric and medical disorders. • Discusses the state of the art alexithymia research-there has not been a comprehensive book on the topic for more than twenty years • Demonstrates the relationship between alexithymia and various medical and psychiatric disorders, and offers therapeutic interventions for reducing this personality trait • The book will help to develop more integrative research and interventions in the future

Objective: Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic and psychiatric disorders. The program, nonreligious and nonesoteric, is based upon a systematic procedure to develop enhanced awareness of moment-to-moment experience of perceptible mental processes. The approach assumes that greater awareness will provide more veridical perception, reduce negative affect and improve vitality and coping. In the last two decades, a number of research reports appeared that seem to support many of these claims. We performed a comprehensive review and meta-analysis of published and unpublished studies of health-related studies related to MBSR. Methods: Sixty-four empirical studies were found, but only 20 reports met criteria of acceptable quality or relevance to be included in the meta-analysis. Reports were excluded due to (1) insufficient information about interventions,

Bevezetés: A kiégés gyakran előforduló jelenség az egészségügyi dolgozók, így az orvosok körében is. Célkitűzés: A kiégés esetleges összefüggésének feltárása az egészséggel, pszichoszomatikus tünetekkel, életérzéssel, alváskörülményekkel. Módszer: Kvantitatív keresztmetszeti vizsgálat online kérdőívvel 186 orvos részvételével. A kiégés mérésére Pines és Aronson 21 tételből álló kérdéssorozatát alkalmazta a szerző. Az adatok típusainak megfelelően χ 2-próbát, független kétmintás T-és Mann–Whitney-tesztet, korreláció analízist végzett a szerző. A kiégés stresszorainak vizsgálata lineárisregresszió-analízissel történt. Eredmények: A kiégés mértéke negatívan korrelált az életkorral (p = 0,040; r = –0,151), az egészségügyben eltöltött évek számával (p = 0,027; r = –0,162), a pozitív jólléttel (p<0,001, r = –0,670), és pozitívan korrelált a negatív jólléttel (p<0,001; r = 0,585), az élettel való elégedettséggel (p<0,001; r = –0,532). A burnout által érintettek rosszabbnak ítélték meg egészségi állapotukat (p<0,001), gyakrabban jelentkeztek pszichoszomatikus tünetek (p<0,001), daganatos (p = 0,007), allergiás (p = 0,030), pszichiátriai (p = 0,025) megbetegedések és alvászavar. Következtetések: A kiégés a válaszadó orvosok egyharmadát érinti; a magasabb életkor és a több gyermek protektív tényezőnek bizonyult.

Burnout among doctors and its correlations with health, life satisfaction and sleep Introduction: Burnout is common among health care providers and doctors. Aim: The correlations between burnout and health, psychosomatic symptoms, life satisfaction and sleep were investigated. Method: An online quantitative cross-sectional questionnaire was administered to 186 doctors. Burnout was assessed by the means of the 21-item questionnaire of Pines and Aronson (1981). Data were analysed with chi-square probe, Mann-Whitney test, correla-tional analysis and linear regression. Results: Level of burnout correlated negatively with age (p = 0.040; r = –0.151), years spent in the health care system (p = 0.027; r = –0.162) and positive well-being (p<0.001, r = –0.670), while there was a negative correlation with negative well-being (p<0.001; r = 0.585) and life satisfaction (p<0.001; r = –0.532). Doctors with burnout reported worse health (p<0.001), more frequent psychosomatic symptoms (p<0.001), tumours (p = 0.007), allergies (p = 0.030), psychiatric disorders (p = 0.025) and sleep disturbances. Conclusions: One-third of the doctors were affected by burnout in the present study. Higher age and having more children served as a protective factor.

Προτίθεμαι να παρουσιάσω εδώ ένα γενικό μοντέλο αναφορικά με τη σημειωτική διάσταση των ψυχοσωματικών διαταραχών.

Θα εικονογραφήσω τη λογική αυτού του μοντέλου προσφεύγοντας στο παράδειγμα της γαστρεντερικής ψυχοσωματικής σημειωτικής, με έμφαση σε μια οριακή όσο και δύσβατη περίπτωση, που μου δόθηκε η ευκαιρία να συναντήσω στο πλαίσιο ψυχοθεραπευτικών συνεργασιών: τις νεοπλασίες.

Culture shock is a common phenomenon for tourists. Recognized by Dr Hiroaki Ōta in the 1980s, the Paris Syndrome is characterized as a specific type of culture clash. It has been defined as a mental illness affecting some Japanese tourists visiting Paris. While some argue the people of Paris' notion of hospitality is responsible for it, others assert that the Japanese's cultural habits and expectations are also involved. However, no real and efficient solution against it has been proposed yet.
The purpose of this study is to apprehend in detail the puzzling Paris Syndrome in order to understand why such phenomenon concerns specifically the Japanese and the French capital, what its consequences can be, and if it is avoidable. As the title of this research suggests it, the Paris Syndrome is a more intricate problem than it seems to be.

Τι είναι η ΙΨΔ Η Ιδεοψυχαναγκαστική διαταραχή είναι μια διαταραχή που ανήκει στις αγχώδεις διαταραχές. Το άτομο που πάσχει από ΙΨΔ παγιδεύεται από μια σειρά επαναληπτικών σκέψεων που ονομάζονται ιδεοληψίες και επαναλαμβανόμενων συμπεριφορών που ονομάζονται ψυχαναγκασμοί και του προκαλούν μεγάλη δυσφορία. Η ΙΨΔ εμφανίζεται σε μέτρια έως σοβαρή μορφή. Όταν η μορφή που εμφανίζεται είναι σοβαρή και παραμείνει χωρίς θεραπεία μπορεί να αποδυναμώσει την δυνατότητα του ατόμου να λειτουργήσει ικανοποιητικά στην εργασία του, στο σχολείο κ.λπ Πόσο συχνή είναι η ΙΨΔ

By affirming that mind and body exist in different domains of knowledge as discriminations acted by an
observer, Constructivism has overcome the old dualism typical of psychosomatic medicine, that
traditionally considers mind and body as two separated entities.
However, both in everyday life and in clinical work, we often stumble upon our own language
that, being intrinsically dualistic, does not seem to allow the epistemological "leap" and instead leads us
back into the old dichotomy. This is an important issue particularly during a psychotherapy with a person
who suffers from so called "psychosomatic symptoms". Indeed, according to Kelly, in this case the aim
of the therapy is to help the patient to subsume their rigid mind-body dualism. But how can it be done, if
language does not support us? Through a case study, this paper suggests that the use of metaphorical
language allows us to "construct a bridge" between mind and body, in order to give the suffering a new
meaning.

Haruki Murakami’s _Norwegian Wood_ (1987) is set in Tokyo of 1960, when like many other countries, students there were protesting at the established order of the society. On the backdrop of this, Murakami, through a first-person narrative, sketches a story of loses and adolescent sexuality, reviews Muhammad Kamruzzamann--'NEW AGE'

OBJECTIVES: To explain the association between socio-demographical factors and the flooding factors with the incidence of psychosomatic in the productive age during the January 2014 flood disaster in the village of West Cilandak. Jakarta, Indonesia.
METHODES: This observational-analytical research uses a cross sectional method. 100 patients were chosen using the purposive sampling technique and the simple random sampling technique. Variables were measured with a psychosomatic questioner from the Bradford Somatic Inventory 21 and from the flood disaster questioner issued by the local government joined with the national red-cross association. The factors associated with each outcomes were then analyzed using chi-square technique which processed with SPSS program.
RESULTS: Factors related to the psychiatric incidence in the productive age in the village of West Cilandak are age (p=0.642), sex (p=0.780), education level (p=0.00), job (p=0.003), marriage status (p=0.065), readiness to face flood disaster/catastrophe (p=0.009), flood water level (p=0.008), flood receding time (p=0.007) and numerous flood disaster over the past years (p=0.015).
CONCLUSIONS: The incidence of psychosomatic disorder in the village of West Cilandak, Jakarta, do have a strong association with some socio-demographical factors (education level, job, and readiness to face flood disaster/catastrophe), and some flooding factors (flood water level, flood receding time and numerous flood disaster over the past years).

—Metaphor therapy has been extensively studied as an emerging research area in cognitive psychology. Metaphors can transfer social and cultural concepts and applications. The metaphor fitting the client's culture increases the effect of cognitive therapy. The present study aimed to determine the effect of Metaphorical-Cognitive therapy based on Masnavi on depression in students. The sample included 60 students with depression symptoms selected by non-probability sampling and randomly divided into two equal groups (experimental and control groups). Beck Depression Inventory was used to measure the variables. This was a quasi-experimental study with a pre-test/post-test design with control group. Eight metaphor therapy sessions were held for the experimental group. A post-test was administered to both groups. Data were analyzed using multivariate analysis of covariance (MANCOVA). Results showed that the Metaphorical-Cognitive therapy based on Masnavi decreased depression in the experimental group compared to the control group.

Es difícil definir la medicina psicosomática, en tanto no existe una medicina que no sea psicosomática, al mismo tiempo que no tenemos una respuesta a la pregunta por la relación cuerpo-mente. Este libro nos presenta la amplitud del campo de la psicosomática actual. Incluye no sólo las siete enfermedades clásicas que describió Alexander sino también el área de la psiquiatría de enlace que se realiza en los hospitales generales, además de las patologías actuales, recogiendo la experiencia en el trabajo cotidiano de los autores.

Objective: Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic and psychiatric disorders. The program, nonreligious and nonesoteric, is based upon a systematic procedure to develop enhanced awareness of moment-to-moment experience of perceptible mental processes. The approach assumes that greater awareness will provide more veridical perception, reduce negative affect and improve vitality and coping. In the last two decades, a number of research reports appeared that seem to support many of these claims. We performed a comprehensive review and meta-analysis of published and unpublished studies of health-related studies related to MBSR. Methods: Sixty-four empirical studies were found, but only 20 reports met criteria of acceptable quality or relevance to be included in the meta-analysis. Reports were excluded due to (1) insufficient information about interventions,

Introduction about a new philosophical and therapeutical perspective in psychosomatics, published on eminent platform "cairn.info". (the english and spanish version are also coming).
Introduction à propos d'une nouvelle perspective philosophique et thérapeutique en psychosomatique, publiée dans la pateforme éminente "cairn.info"

Purpose-The purpose of this paper is to identify the specific causes of individual dimensions of coercive management behaviour (CMB) and identify the relationship between individual causes of CMB and the deployment of individual dimension of CMB as well as propose the matching of anti-CMB solutions to occupational types. Design/methodology/approach-This study used a sample of 371 respondents randomly selected from

Le rêve, quels que soient son contenu et son sens caché, a pour fonction de protéger et de maintenir le sommeil. Cette découverte freudienne coexiste avec la vision interprétative qui fait du rêve, au début de la pensée freudienne, l’accomplissement hallucinatoire d’un désir inconscient. La contribution majeure de M. Fain concernant la place du rêve dans l’économie psychique nous a amené à supposer que le rêve a également comme mission d’essayer de représenter le corps, en transformant, tout au long du sommeil, la sensorialité corporelle en représentation psychique.

The function of the dream, whatever its content and hidden meaning, is to protect and maintain sleep. This Freudian discovery coexists alongside the interpretative vision that, at the beginning of the development of Freud’s thought, makes the dream the hallucinatory fulfillment of an unconscious desire. Michel Fain’s major contribution concerning the place of the dream in the psychic economy led us to suppose that the dream also has the mission of trying to represent the body, by transforming, throughout sleep, bodily sensoriality into psychic representation.

The article focuses on the category of disharmony defining the beliefs about the nether world which functioned in folk culture of the 19th century and the beginning of the 20th century. The notion of harmony used herein refers to deviations from the sanctioned norm concerning the body and psychosomatic expressions. The analysis will center on beliefs related to changelings. These beliefs in turn will serve as a basis for defining the fear of otherness perceived as expressions of non-reality/the nether world.

Δεν θα παρουσιάσω κάποια γενική θεώρηση των ψυχοσωματικών επιπτώσεων κάθε διαταραχής. Θα περιοριστώ στη (σπουδαία, ποσοτικά και κλινικά) περίπτωση της φυσικής ή λειτουργικής βλάβης με περισσότερο ή λιγότερο χρόνια πορεία, ενδεχομένως δε και με προβλεπόμενη μοιραία κατάληξη.

Psychiatric emergencies are conditions that mostly destabilize the already frenetic activity of the Emergency Department. Sometimes the emergency is clearly referable to primitive psychiatric illness. Other times, psychiatric and organic symptoms can independently coexist (comorbidity), or develop together in different conditions of substance abuse, including alcohol and prescription drugs. Differentiating between substance induced and pre-existing psychiatric disorder (dual diagnosis) may be difficult, other than controversial issue. Finally, an organic disease can hide behind a psychiatric disorder (pseudopsychiatric emergency).

The bio-psycho-social model relates to a person as one system, with biological, psychological and social components in constant interaction. The model so far tends to objectivize the human experience of life and ignores a central component, existing exclusively in humankind, that is, the subjective component of meanings, narratives, images, and dreams, which is the main focus of psychology. This article proposes a two-layer bio-psycho-social model: an objective-rational layer and a metaphorical-spiritual layer, which contributes to the understanding of the way psychotherapy, and in particular how narrative and metaphor psychotherapyis, is associated to a person's objective life. The model is based on the assumption that people process and understand their experiences in two complementary ways: an objective-rational way typically associated with Freud's "secondary" thoughts and with the left hemisphere of the brain, and a metaphorical-spiritual way, typically associated with Freud's "primary" thoughts and with the right hemisphere. Every medical, psychological, or social intervention, whether tending to use objective or metaphorical devices, will eventually activate both layers-the entire system.

Background: As physicians in a referral hospital, we observed the association between history of enteric fever and somatic disorders associated with low mood. At the Al-Hussein University Hospital, Cairo and the National Liver Institute Hospital, Menoufia, we receive patients from all over Egypt, including rural areas where enteric fever is endemic. Aim: Here in, 60 Egyptian patients referred to us for evaluation of different somatic disorders are reported. Methods: After extensive evaluations, the patients' symptoms were function-related. Also, their typhoid carrier states were documented, and the severity of depression using Hamilton-D (HAM-D) questionnaire was evaluated and recorded. All patients were treated with ceftriaxone, 2 gm, IV, daily for 15 days. The clinical evaluation and Hamilton score were reassessed at the end of the treatment and 6 weeks thereafter. The patients did not receive any anti-depressant nor anti-anxiety treatment during their course. Typhoid carrier was defined by documenting the history of typhoid fever that was diagnosed by culturing the Salmonella species, and not by serology, isolated from stool culture along with febrile condition, plus the absence of fever in the past 3 weeks. The Widal test was not accepted as a criterion for enrollment. Results: Patients showed clinically significant improvement in the somatic complaints, and their HAM-D score immediately post-treatment that was consolidated for 6 weeks posttreatment completion. Conclusion: In this study, the typhoid carrier was associated with the psychosomatic depression that improved by antibiotic therapy.

Objective: The main purpose of the current study is to examine the factorial structure of the Psychological Problems (PP) scale, which is an inventory used for assessing anxious and depressive symptoms. No previous studies were found in which the dimensionality of the measure has been examined. Method: In order to test the underlying factorial structure of the scale, we performed both exploratory principal axis factor analysis and maximum likelihood robust confirmatory factor-analytic analysis on a sample of 266 international students. Parallel
analysis was also computed to identify the number of factors to take into account. Multigroup confirmatory factor analyses were performed to evaluate the factorial invariance of the scale across gender.
Results: Our results yield a bifactorial structure. One item is removed due to its double-loading, resulting in a 14-item scale. Both of the subscales’ alpha coefficients are good, with satisfying levels of adjusted item-scale correlations. Findings from the measurement invariance indicate adequate configural, metric, scalar and strict invariance across gender.
Conclusion: We conceptualize the two scales emerged from our factor analysis studies in terms of affective and psychosomatic domains of psychological problems. Despite some limitations, our findings may add new theoretical and practical implications, which are discussed also providing directions for future research.

De-stressing is a hot topic!
Sick leave, due to stress has increased explosively in recent years. According to ArboNed (Dutch Service for Employers and employees) (1), it costs trade and industry close to 2 billion euros annually. Numerous illnesses are also stress-related. It is clear to everyone that psychological stress is also translated physically and can lead to sick leave. In this article I don't want to go into all kinds of causes and consequences of stress, but more into a means that is generally recommended to de-stress, namely breathing and relaxation exercises. The most common relaxation exercises that are practiced are: muscle relaxation exercises or progressive relaxation, suggestive relaxation exercises, autogenic training, mindfulness or 'Mindfulness Based Cognitive Therapy' (MBCT), breathing exercises and various yoga techniques. In addition, there is a multitude of different mix-forms. I will try to discuss the pros and cons of the most important relaxation exercises.

This study compares psychological symptoms and sexual tendencies in women with a history of mental disorders, women with physical and health problems. This research is a methodological, descriptive, and causal comparison, in terms of the fundamental purpose and in terms of collecting data in a field type. The statistical population of this study consisted of women with a history of mental disorders, having a physical and health condition in the year 95. In order to select a sample in this study, 30 samples from each of the women's communities were selected and 90 subjects were selected as research samples. The method of sampling in this research was targeted to healthy people, randomized and available for people with a history of mental disorders and physical illness. According to the research goals and types of variables, a tool was used to measure the variables. Based on library studies and web searches, the psychotic symptoms questionnaire (Takata & Washakata, the Holbert) Sexuality Scale and (OBQ-44) questionnaire were selected as the research tool. In order to distribute the questionnaires, the relevant clinics were coordinated, the questionnaires were distributed among the research samples, and the questionnaires were completed after the response. In order to test the statistical hypotheses after confirmation of the default, the normal distribution of data was done using one-way ANOVA tests and post-Tukey and T-test dance tests for comparing psychosomatic symptoms and sexual tendencies among the research samples. The results of the test of statistical hypotheses showed that psychological symptoms and sexual orientation in women with a history of mental disorders, women with physical illnesses and healthy women have a significant difference.

Objective: Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic and psychiatric disorders. The program, nonreligious and nonesoteric, is based upon a systematic procedure to develop enhanced awareness of moment-to-moment experience of perceptible mental processes. The approach assumes that greater awareness will provide more veridical perception, reduce negative affect and improve vitality and coping. In the last two decades, a number of research reports appeared that seem to support many of these claims. We performed a comprehensive review and meta-analysis of published and unpublished studies of health-related studies related to MBSR. Methods: Sixty-four empirical studies were found, but only 20 reports met criteria of acceptable quality or relevance to be included in the meta-analysis. Reports were excluded due to (1) insufficient information about interventions,

Background and Objec-tives: The present study aimed to evaluate the protective and curative effects of the 15 KD protein isolated from the seeds of Peganum harmala L. against carbon tetrachloride (CCl 4) induced oxidative stress in rats. Materials and Methods: In the protective study, animals were pretreated intraperitoneally with 15 KD isolated protein at doses of 4 and 8 mg/kg body weight as well as vitamin C (250 mg/kg body weight p.o) for 7 days and then chal-lenged with CCl 4 orally (1 ml/kg body weight) in olive oil (50%) for 2 days. In the curative study, rats were administered CCl 4 orally for 2 days, then treated intraperitoneally with 15 KD protein (4 and 8 mg/kg body weight) and orally with vitamin C. Results: Administration of CCl 4 induced in-duction in malondialdehyde (MDA) and de-crease in reduced glutathione (GSH) levels as well as glutathione-S-transferase (GST) activi-ty in brain, testes and erythrocytes. The activi-ty of acetylcholinesterase (AchE) in brain was al...

Background and Objec-tives: The present study aimed to evaluate the protective and curative effects of the 15 KD protein isolated from the seeds of Peganum harmala L. against carbon tetrachloride (CCl 4) induced oxidative stress in rats. Materials and Methods: In the protective study, animals were pretreated intraperitoneally with 15 KD isolated protein at doses of 4 and 8 mg/kg body weight as well as vitamin C (250 mg/kg body weight p.o) for 7 days and then chal-lenged with CCl 4 orally (1 ml/kg body weight) in olive oil (50%) for 2 days. In the curative study, rats were administered CCl 4 orally for 2 days, then treated intraperitoneally with 15 KD protein (4 and 8 mg/kg body weight) and orally with vitamin C. Results: Administration of CCl 4 induced in-duction in malondialdehyde (MDA) and de-crease in reduced glutathione (GSH) levels as well as glutathione-S-transferase (GST) activi-ty in brain, testes and erythrocytes. The activi-ty of acetylcholinesterase (AchE) in brain was al...

Introduction: Over the past two decades, the field of resiliency has attracted increasing attention in evolutionary psychology. Having mentally retarded children is one of life's stressors for parents, that can have a devastating impact on their mental health. Therefore, any strategy that can help the parents of these children relieve stress and deal effectively is important. This study aimed to determine the impact of Adler lifestyle education on resiliency, especially on parents of mentally retarded students and will measure the following two hypotheses. Method: This was a semi-experimental study with pre and post-test with control group. The statistical population of this study included parents of all the students of the Shahid Alavian Exceptional Education Center in Gonabad (N=120) whose children were studying in the 2012/2013 academic year; 60 people were randomly selected and assigned to two groups of 30 (case and control). It should be noted that each group consisted of 15 fathers and 15 mothers. The pre-test was administered to both groups separately. After that, the training in 11 sessions of 60 minutes was presented in the workshop of advisers for the case group. In this study, the Connor and Davidson's resiliency questionnaire was used. In this study, the reliability coefficient equal to 0.89 was obtained using Cronbach's alpha method. To determine the validity, the correlation of each item with the total score was calculated. In the present study, the reliability of this instrument using Cronbach's alpha coefficient was determined as 0.89. Data were analyzed using SPSS for Windows version 16. Results: The mean scores of the resiliency have increased in the case group than the control group which is statistically significant (P < 0.01). The mean scores of fathers' resiliency have increased than mothers, but the differences were not significant between the two groups (P > 0.05). Conclusion: The result of this study concluded that appropriate Adler lifestyle training helps parents of educable mentally retarded children to boost their resiliency. This is important due to the existence of mentally retarded children on parental stress.

Background: As physicians in a referral hospital, we observed the association between history of enteric fever and somatic disorders associated with low mood. At the Al-Hussein University Hospital, Cairo and the National Liver Institute Hospital, Menoufia, we receive patients from all over Egypt, including rural areas where enteric fever is endemic. Aim: Here in, 60 Egyptian patients referred to us for evaluation of different somatic disorders are reported. Methods: After extensive evaluations, the patients' symptoms were function-related. Also, their typhoid carrier states were documented, and the severity of depression using Hamilton-D (HAM-D) questionnaire was evaluated and recorded. All patients were treated with ceftriaxone, 2 gm, IV, daily for 15 days. The clinical evaluation and Hamilton score were reassessed at the end of the treatment and 6 weeks thereafter. The patients did not receive any anti-depressant nor anti-anxiety treatment during their course. Typhoid carrier was defined by documenting the history of typhoid fever that was diagnosed by culturing the Salmonella species, and not by serology, isolated from stool culture along with febrile condition, plus the absence of fever in the past 3 weeks. The Widal test was not accepted as a criterion for enrollment. Results: Patients showed clinically significant improvement in the somatic complaints, and their HAM-D score immediately post-treatment that was consolidated for 6 weeks post-treatment completion. Conclusion: In this study, the typhoid carrier was associated with the psychosomatic depression that improved by antibiotic therapy.

In this research, the emotions and the patterns of EEG signals of human brain are studied. The aim of this research is to study the analysis of the changes in the brain signals in the domain of different emotions. The observations can be analysed for its utility in the diagnosis of psychosomatic disorders like anxiety and depression in economical way with higher precision.

Somatic symptom disorder (SSD) is a debilitating disorder that significantly diminishes quality of life and causes psychological
distress such as anxiety and depression. The paper explored the efficiency of the eye movement desensitization and
reprocessing (EMDR) therapy in SSD. The current investigation is a clinical trial investigating the effectiveness of eye movement
desensitization (EMDR) therapy in the treatment of 31 first-diagnosed SSD patients in comparison to age, education and marital
status matched 31-first-diagnosed SSD patients who received duloxetine over a 6-week course of treatment. Somatization
subscale of the Symptom Checklist-Revised 90 (SCL-90), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and
Short Form Health Survey (SF-36) were administered to the participants. EMDR group showed enhanced improvement relative
to baseline after 6 weeks of treatment compared to duloxetine group. We concluded that EMDR appears to be a highly
promising therapy and should be considered among the first-line interventions in the treatment of SSD.
Keywords: Somatoform disorders, Treatment efficacy, Clinical trial, Selective serotonin and norepinephrine reuptake inhibitor
(SNRI), Quality of life, Emotion dysregulation

Introduction: Modern Heritage and the Puzzle about Persons in Medical Practice

Hans Jonas has broken new ground in the history of Gnosticism and modernity, medical ethics, and philosophical biology.  He has been embraced by people on the political left and others on the political right.  Our presentation draws on his interpretation of modernity and his attempt in his philosophical biology to provide a new path out of some of the dead-ends of modernity. As Jonas knew, these concerns have a direct bearing on how we think about medicine.

Modern medicine has enjoyed much success by drawing on those sciences which study the most elementary components of living beings, namely, the sciences of physics, chemistry, genetics, and others.  There can be no doubt that these basic sciences do and will play large roles in helping to explain and treat diseases and injuries of various kinds.  However, such sciences fall far short in providing for medical practitioners, especially clinicians, a conception of the patient as a living human self that is needed for the practical purposes of healthcare.

Approaches to this Puzzle

In its approach this chapter is divided into two main sections: historical background and conditions for life. The two sections are continuous with one another by drawing on the philosophy of living beings developed by Hans Jonas. 

In historical background , we shall briefly sketch the history of modern conceptions of human life which lead to our present-day puzzlement. This sketch will lead to the recognition of the mind/body problem as the persistent intellectual framework from which we still have not succeeded in escaping.  As the new sciences of nature emerged in the 17th and 18th centuries, a philosophical framework for trying to unify the ever-expanding multiplicity of theories and concepts took shape.  This framework consisted in a hierarchy of the sciences, each higher level science being theoretically dependent upon the concepts and laws of sciences of the lower levels. This hierarchy of the sciences, however, gave rise to an attempt to simplify them all by proposing an all-encompassing naturalism, the philosophy that all the sciences would (and must) someday be reduced to physics. Reductionistic naturalism has never proven to fully satisfy the modern mind, however; and consequently the mind/body dualism persisted to thwart attempts to see living beings – human beings in particular – as unified wholes. Present-day efforts in medicine to make overall sense of the patient as a person thus encounters road blocks.

In this second part of the chapter, we seek to lay out conditions for being alive that are found in both the mental and the more physical dimensions of life. These conditions are the following: (1) the necessity for living individuals to constantly act in order to sustain their ongoing existence; (2) the separateness of the individual living being from its environment while at the same time maintaining an openness to the environment and engaging in transactions with it; (3) the necessity for the organism to undergo constant change while always making a sameness of self throughout this change; (4) the directedness of the organism’s activity toward its own future being, hence the teleological orientation of organic processes; (5) the origin of feelings in higher life forms. These five conditions of life can serve as a framework within a unified conception of the person which for the purposes of medicine includes both the more physical and the more mental dimensions of patients.

A structural explanation of psychosomatic personality structure is proposed, that of a functional or physical deconnection of the two cerebral hemispheres, If the affective and symbolic energies of the right hemisphere cannot be externalized through verbal expressions of the left hemisphere (alexlthymia), then they are apt to be directed inward, thereby contributing to psychosomatic personality structure. In an experiment, 8 cerebral commissurotomy patients and 8 precision-matched normal control subjects were shown a 3-minute videotaped film symbolically depicting the deaths of a baby and a boy. Gottschalk-Gleser content analysis of the subjects' verbal responses to the film was carried out for anxiety and hostility scales. A complex of shame and total anxiety in combination with hostility directed both inward and outward was interpreted as an indicator of 'psychosomatic personality structure'. Cerebral commissurotomy patients showed a significantly higher level of psychosomatic personal structure than did normal controls.

Eating disorders are of interest because they are serious mental illnesses that affect millions of individuals regardless of race, age, nationality or sex and have a serious impact on personal, family and social life. Differentiating or comorbid diagnoses of anorexia nervosa should include unintentional chronic malnutrition, oncological, immunological and infectious diseases. Among the rarest complications of this condition is pulmonary aspergilloma. To date there are only 4 cases published, one of them with fatal outcome, the other 3 with resolution of Aspergilloma by surgery. In this case it was not possible to perform the surgical surgery due to the severity of the low weight. These case have significant implications, because the diagnostic and therapeutic approach of this type of complicated patients must be interdisciplinary and should include the pulmonary surgeon, the internist, the nutrition service and the psychiatrist. It is recommended to particularize treatment with a medical, nutritional, psychopharmacological, behavioral and family approach.