Psychosomatics
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Syndromes characterized by chronic, medically unexplained fatigue, effort- and stress-intolerance, and widespread pain are highly prevalent in medicine. ⋯ Further research should clarify the aim and outcome of different treatment strategies in CFS/FM, as well as the underlying mechanisms of change, including those facilitating neurobiological recovery.
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Guilt as a key emotional phenomenon in the cancer-caregiving experience is an understudied issue. ⋯ Results suggest that caregiver guilt compromises the psychosocial and somatic adjustment of cancer caregivers. Guilt may be a cardinal feature of the caregiving experience, and to fully understand the implications of this complex phenomenon, more research is needed.
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Factitious disorder (FD) presumably manifests at an early age, but epidemiological and clinical data about pediatric FD are still lacking. ⋯ The prevalence of pediatric FD among referrals to a CLS is similar to those found in studies of adults, and patients share many clinical characteristics.
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Comparative Study
Motor symptoms in 100 patients with delirium versus control subjects: comparison of subtyping methods.
Different motor presentations of delirium may represent clinically meaningful subtypes. ⋯ Motor disturbances are common in delirium, although whether they represent clinical subtypes is confounded by methodological issues. New motor subtyping methods are needed that are validated in other medical populations, use matched control subjects, and have higher sensitivity and specificity for pure motor features.
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Somatic symptoms are common in conditions such as fibromyalgia (FM) and chronic fatigue syndrome (CFS). ⋯ Sensory amplification may be an underlying pathophysiologic mechanism in these disorders that is relatively independent of depression and depressive symptoms.