With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“th...With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“the lack of something physical explaining everything”,this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom.Modelling and simulation have a long history in science to gain insight also into complex phenomena.Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research.Calculation models have to fit to the complexity of this disorder category.In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer,fine grained calculation model is elaborated.Starting from a clinical case history,within iterative discussion,by acknowledging the demand for interdisciplinary synergy and cooperation in science,psychoanalytic theory served as the basis for computer-scientific information technique.A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research.How psychic transformations can be understood properly in order to provide meaningful treatments,the respective training,and to conduct appropriate process-and outcome-research is established in simulating the mind and applications.展开更多
This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome （IBS）, discusses the rational use of antidepressants as well as non-pharmacological ...This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome （IBS）, discusses the rational use of antidepressants as well as non-pharmacological approaches to the management of IBS, and suggests guidelines for the treatment of IBS based on an interdisciplinary perspective from the present state of knowledge. Relevant published literature on psychiatric disorders, especially somatization disorder, in the context of [BS, and literature providing direction for management is reviewed, and new directions are provided from findings in the literature. IBS is a heterogeneous syndrome with various potential mechanisms responsible for its clinical presentations. IBS is typically complicated with psychiatric issues, unexplained symptoms, and functional syndromes in other organ systems. Most IBS patients have multiple complaints without demonstrated cause, and that these symptoms can involve systems other than the intestine, e.g. bones and joints （fibromyalgia, temporomandibular joint syndrome）, heart （non-cardiac chest pain）, vascular （post-menopausal syndrome）, and brain （anxiety, depression）. Host IBS patients do not have psychiatric illness per se, but a range of psychoform （psychological complaints in the absence of psychiatric disorder） symptoms that accompany their somatoform （physical symptoms in the absence of medical disorder） complaints. It is not correct to label IBS patients as psychiatric patients （except those more difficult patients with true somatization disorder）. One mode of treatment is unlikely to be universally effective or to resolve most symptoms. The techniques of psychotherapy or cognitive-behavioral therapy can allow IBS patients to cope more readily with their illness. Specific episodes of depressive or anxiety disorders can be managed as appropriate for those conditions. Medications designed to improve anxiety or depression are not uniformly useful for psychiatric complaints in IBS, because the psychoform symptoms that sound similar to those seen in psychiatric disorders may not have the same significance in patients with IBS.展开更多
This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is consi...This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.展开更多
背景躯体症状障碍的发病原因非常复杂,目前尚无有效的治疗方法,患者生活质量受到很大影响。目的分析2011年-2021年国内外躯体症状障碍领域研究现状及发展趋势,了解躯体症状障碍研究领域的前沿和热点。方法于2022年8月31日,以中国知网、...背景躯体症状障碍的发病原因非常复杂,目前尚无有效的治疗方法,患者生活质量受到很大影响。目的分析2011年-2021年国内外躯体症状障碍领域研究现状及发展趋势,了解躯体症状障碍研究领域的前沿和热点。方法于2022年8月31日,以中国知网、万方、Web of Science、PubMed作为数据来源,检索国内外躯体症状障碍研究的相关文献,检索时限为2011年1月1日-2021年12月31日。利用Excel和CiteSpace软件对纳入的15035篇文献的数量和关键词进行可视化分析。结果2011年-2021年,国外躯体症状障碍研究领域的发文量总体呈上升趋势,国内躯体症状障碍研究领域发文量总体呈缓慢下降趋势。关键词共现中,国内排名前五的关键词分别为“心理健康”“抑郁症”“抑郁”“焦虑”“躯体症状”,国外排名前五的关键词分别为“symptom”“prevalence”“depression”“disorder”“quality of life”。关键词突现显示,国内躯体症状障碍研究领域近五年持续关注且目前较活跃的关键词分别为“躯体症状”“症状群”“生活质量”,国外为“major depressive disorder”“outcome”。关键词聚类分析显示,国内躯体症状障碍研究关键词共8个聚类,国外为4个聚类,具体体现在躯体症状障碍涉及的相关疾病、防治方法和流行病学特点。结论近年来,国外对躯体症状障碍的研究数量和关注度呈上升趋势,而国内研究稍显不足。国内外研究均关注躯体症状障碍发生的影响因素。展开更多
文摘With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“the lack of something physical explaining everything”,this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom.Modelling and simulation have a long history in science to gain insight also into complex phenomena.Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research.Calculation models have to fit to the complexity of this disorder category.In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer,fine grained calculation model is elaborated.Starting from a clinical case history,within iterative discussion,by acknowledging the demand for interdisciplinary synergy and cooperation in science,psychoanalytic theory served as the basis for computer-scientific information technique.A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research.How psychic transformations can be understood properly in order to provide meaningful treatments,the respective training,and to conduct appropriate process-and outcome-research is established in simulating the mind and applications.
文摘This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome （IBS）, discusses the rational use of antidepressants as well as non-pharmacological approaches to the management of IBS, and suggests guidelines for the treatment of IBS based on an interdisciplinary perspective from the present state of knowledge. Relevant published literature on psychiatric disorders, especially somatization disorder, in the context of [BS, and literature providing direction for management is reviewed, and new directions are provided from findings in the literature. IBS is a heterogeneous syndrome with various potential mechanisms responsible for its clinical presentations. IBS is typically complicated with psychiatric issues, unexplained symptoms, and functional syndromes in other organ systems. Most IBS patients have multiple complaints without demonstrated cause, and that these symptoms can involve systems other than the intestine, e.g. bones and joints （fibromyalgia, temporomandibular joint syndrome）, heart （non-cardiac chest pain）, vascular （post-menopausal syndrome）, and brain （anxiety, depression）. Host IBS patients do not have psychiatric illness per se, but a range of psychoform （psychological complaints in the absence of psychiatric disorder） symptoms that accompany their somatoform （physical symptoms in the absence of medical disorder） complaints. It is not correct to label IBS patients as psychiatric patients （except those more difficult patients with true somatization disorder）. One mode of treatment is unlikely to be universally effective or to resolve most symptoms. The techniques of psychotherapy or cognitive-behavioral therapy can allow IBS patients to cope more readily with their illness. Specific episodes of depressive or anxiety disorders can be managed as appropriate for those conditions. Medications designed to improve anxiety or depression are not uniformly useful for psychiatric complaints in IBS, because the psychoform symptoms that sound similar to those seen in psychiatric disorders may not have the same significance in patients with IBS.
文摘This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.
文摘背景躯体症状障碍的发病原因非常复杂,目前尚无有效的治疗方法,患者生活质量受到很大影响。目的分析2011年-2021年国内外躯体症状障碍领域研究现状及发展趋势,了解躯体症状障碍研究领域的前沿和热点。方法于2022年8月31日,以中国知网、万方、Web of Science、PubMed作为数据来源,检索国内外躯体症状障碍研究的相关文献,检索时限为2011年1月1日-2021年12月31日。利用Excel和CiteSpace软件对纳入的15035篇文献的数量和关键词进行可视化分析。结果2011年-2021年,国外躯体症状障碍研究领域的发文量总体呈上升趋势,国内躯体症状障碍研究领域发文量总体呈缓慢下降趋势。关键词共现中,国内排名前五的关键词分别为“心理健康”“抑郁症”“抑郁”“焦虑”“躯体症状”,国外排名前五的关键词分别为“symptom”“prevalence”“depression”“disorder”“quality of life”。关键词突现显示,国内躯体症状障碍研究领域近五年持续关注且目前较活跃的关键词分别为“躯体症状”“症状群”“生活质量”,国外为“major depressive disorder”“outcome”。关键词聚类分析显示,国内躯体症状障碍研究关键词共8个聚类,国外为4个聚类,具体体现在躯体症状障碍涉及的相关疾病、防治方法和流行病学特点。结论近年来,国外对躯体症状障碍的研究数量和关注度呈上升趋势,而国内研究稍显不足。国内外研究均关注躯体症状障碍发生的影响因素。
