Professor ZHUANG Li-xing's diagnosis and treatment method and manipulation key points of mind-regulation acupuncture for psychosomatic disorders are summarized. Professor ZHUANG proposes that psychosomatic disorders can be subdivided into "mind-body disorder" and "body-mind disorder". The former requires treatment aimed at regulating the mind. The main acupoints are Sishenzhen, Shenting (GV 24), Yintang (GV 24⁺), Shenmen (HT 7) and Sanyinjiao (SP 6). The additional acupoints are Suliao (GV 25), Shuigou (GV 26), Shenmai (BL 62), Zhaohai (KI 6), Hegu (LI 4) and Taichong (LR 3), etc. The latter requires treatment aimed at improving the original diseases, supplemented by regulating the mind (row acupuncture on the governor vessel). Acupoint selection is based on the theories of brain-mind, and the emphasis is placed on the governor vessel; in the meanwhile, regulating zangfu and qi-blood should be valued. After the arrival of qi, the Daoqi Tongjing method (the specific technique for directing qi and preserving essence) is applied, combined with auricular point sticking and fire needling at affected part to enhance the curative effect.
Humans ; Psychophysiologic Disorders/therapy* ; Acupuncture Therapy ; Acupuncture Points ; Drugs, Chinese Herbal ; Ethnicity

Depressive disorders are psychiatric diseases that have a high recurrent rate. Therefore, several psychosocial treatments have been tried to prevent recurrence of depression. Mindfulness-based therapy is psychotherapy designed to selectively focus on improving attention and awareness. Typical mindfulness-based therapy programs include mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT). MBSR was designed to be an easy-to-use stress reduction program and was reported to be effective in psychiatric and psychosomatic disorders. MBCT combines mindfulness with cognitive therapy, and aims at cognitive change based on mindfulness. In DBT, the patient learns how to deal with their emotions, thereby reducing impulsive behaviors. ACT helps to understand oneself by learning key concepts of acceptance and commitment. MBCT has recently been described as a primary treatment for the prevention of the recurrence of depressive disorder and has been reported to have effects on acute phase treatment. Many studies have shown that mindfulness can induce brain changes in default mode network and emotional regulation regions. In conclusion, mindfulness-based therapies have the potential to become effective therapeutic tools for psychiatric disorders such as depressive disorder.
Acceptance and Commitment Therapy ; Behavior Therapy ; Brain ; Cognitive Therapy ; Depression ; Depressive Disorder* ; Humans ; Impulsive Behavior ; Learning ; Mindfulness ; Psychophysiologic Disorders ; Psychotherapy ; Recurrence

PURPOSE: Our purpose was to investigate psychological problems and clinical outcomes in children with psychogenic non-epileptic seizures (PNES). MATERIALS AND METHODS: We retrospectively reviewed the data of 25 patients who were diagnosed with PNES between 2006 and 2012. RESULTS: Twenty-five children with PNES, aged 8 to 19 years (mean 13.82), were referred to psychiatrists for psychiatric assessment. On their initial visit, 72% of patients had comorbid psychological problems, including depression, anxiety, conduct disorder, adjustment disorder, Attention Deficit Hyperactivity Disorder, schizophrenia, and bipolar disorder. Among these, depression was the most frequent (36%). Predisposing and triggering factors included familial distress (40%), social distress (24%), and specific events (20%). The following treatment was advised based on the results of the initial psychological assessment: 3 patients regularly visited psychiatric clinic to assess their clinical status without treatment, nine underwent psychotherapy, and 13 received a combination of psychotherapy and psychopharmacological therapy. At the mean follow-up of 31.5 months after diagnosis, 20 patients (80%) were event-free at follow-up, three (12%) showed reduced frequency, and two (8%) experienced persistent symptoms. CONCLUSION: The outcomes of PNES in children are much better than those in adults, despite a high rate of psychological comorbidities.
Adolescent ; Adult ; Anxiety/epidemiology ; Attention Deficit Disorder with Hyperactivity/epidemiology ; Child ; Child, Preschool ; Comorbidity ; Depression/epidemiology ; Depressive Disorder/epidemiology/psychology ; Electroencephalography ; Female ; Humans ; Male ; Mental Disorders/*diagnosis/epidemiology/*psychology ; Middle Aged ; Psychophysiologic Disorders/*diagnosis/*psychology ; Psychotherapy ; Retrospective Studies ; Seizures/diagnosis/*psychology/*therapy ; Treatment Outcome ; Young Adult

INTRODUCTIONRecognising and appropriately treating psychosomatic factors in dermatological conditions can have a significant positive impact on the outcomes of patients. Treatment of psychodermatological patients requires a multidisciplinary approach that involves dermatologists, psychiatrists and allied health professionals.

METHODSThis was a retrospective case series of patients seen in our psychodermatology liaison conferences from November 2009 to July 2011. We reviewed all the case notes and analysed data such as age, gender, dermatologic and psychiatric diagnoses, treatment and outcome.

RESULTSThe majority of patients in our cohort were diagnosed with either a psychophysiologic disorder or a primary psychiatric disorder. The most common diagnosis among patients with primary psychiatric disorder was delusions of parasitosis. Other common primary psychiatric disorders seen were trichotillomania and dermatitis artefacta. About a fifth of our patients had psychiatric disorders resulting from their underlying dermatological conditions. A third of our patients were lost to follow-up.

CONCLUSIONManaging patients with psychocutaneous disorders can be challenging, with many patients defaulting treatments. Psychodermatology clinics will benefit both patients and their caregivers. A collaborative approach using a consultation-liaison relationship between two medical departments in a friendly environment would result in more effective, integrated and holistic treatment strategies for such patients. Further studies should be conducted to determine how beneficial such services are to patients. With more experience, we hope to improve this service.

Adolescent ; Adult ; Aged ; Disease Management ; Female ; Hospitals, Special ; Humans ; Male ; Middle Aged ; Psychophysiologic Disorders ; complications ; epidemiology ; therapy ; Retrospective Studies ; Singapore ; epidemiology ; Skin Diseases ; complications ; epidemiology ; therapy ; Young Adult

Humans ; Medicine, Chinese Traditional ; methods ; Psychophysiologic Disorders ; therapy ; Yin-Yang

Self-induced pneumoparotitis is a rare cause of swelling of the parotid gland. It has been reported to be a result of psychosomatic disorder, unintentional habit, and it is sometimes self-induced by patients to achieve secondary gain. We report a case of a 18-year-old man who had a self-induced pneumoparotitis complicated by recurrent parotitis, subcutaneous emphysema and pneumomediastinum. With repeated behavior of insufflation, parotid acini may rupture and air may extend into the retropharyngeal space, causing pneumomediastinum or pneumothorax. In self-induced cases, treatment should necessitate psychologic therapy for behavior modification.
Adolescent ; Behavior Therapy ; Humans ; Insufflation ; Mediastinal Emphysema ; Parotid Gland ; Parotitis ; Pneumothorax ; Psychophysiologic Disorders ; Rupture ; Subcutaneous Emphysema

OBJECTIVETo probe into the feasibility of acupuncture and moxibustion combined with rapid and repeated cupping at points on the back for treatment of senile psychophysiologic disorders.

METHODSSixty cases of clinically commonly-seen senile psychophysiologic disorders were randomly divided into the treatment group treated by acupuncture and moxibustion combined with rapid and repeated cupping at points on the back and the control group treated by oral administration of small dose of medicine for expectant treatment. Their therapeutic effects were compared.

RESULTSThe therapeutic effect of the treatment group was better than that of the control group (P < 0.01).

CONCLUSIONAcupuncture and moxibustion combined with rapid and repeated cupping at points on the back can more rapidly alleviate the psychotic symptoms of thinking more and misgivings, gloominess, desire to cry, restlessness due to deficiency, anger, impatient for senile psychophysiologic disorders.

Acupuncture Points ; Acupuncture Therapy ; Combined Modality Therapy ; Humans ; Moxibustion ; Psychophysiologic Disorders

BACKGROUNDMedically unexplained dyspnea occurs commonly in medical settings and remains poorly understood. This study was conducted to investigate the psychophysiological characteristics of medically unexplained dyspnea and the efficacy of breathing retraining for these patients.

METHODSA group of patients with medically unexplained dyspnea were compared to patients with a variety of organic lung diseases and healthy subjects. In another group of patients, the influence of breathing therapy on complaints, anxiety, and breath-holding was evaluated for an average of 1.5 years.

RESULTSPatients with medically unexplained dyspnea reported more intense dyspnea than patients with a variety of organic lung diseases. Additionally, they were anxious and presented a broad range of symptoms in daily life and under challenge, for instance voluntary hyperventilation. More than one third of them qualified for panic disorder. They had shorter breath-holding time at rest, less increase in breath-holding time and higher chances of showing a "paradoxical" decrease of breath-holding time after hyperventilation. A combination of PaO2, forced expiratory volume in one second (FEV1), and anxiety measures distinguished them from organic dyspnea. Breathing retraining profoundly improved their symptoms and decreased the level of state and trait anxiety. Moreover, they better tolerated the voluntary hyperventilation and the symptoms induced were also markedly decreased after therapy. Breath-holding time was prolonged and PetCO2 in a representative group of patients increased.

CONCLUSIONSPatients with medically unexplained dyspnea appear to have the feature of a "psychosomatic" patient: an anxious patient with a wide variety of symptoms of different organ systems that do not have an organic basis. They can be distinguished from organic dyspnea using a small set of physiological and psychological measures. Breathing retraining turns out to be an effective therapy for those "difficult to treat patients".

Adult ; Aged ; Anxiety ; complications ; Breathing Exercises ; Dyspnea ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Panic Disorder ; complications ; Psychophysiologic Disorders

Medically unexplained dyspnea refers to a group of patients presenting marked dyspnea without structural alterations of organs/systems after thorough examinations. This clinically neglected group of patients accounts for about 14% of patients with dyspnea in secondary health care. They appear very difficult to manage clinically. In this paper an organized approach used to diagnose medically unexplained dyspnea is presented. Breathing re-training is recommended as a therapy for those "difficult to treat patients".
Breathing Exercises ; Diagnosis, Differential ; Dyspnea ; diagnosis ; psychology ; therapy ; Humans ; Psychophysiologic Disorders ; diagnosis ; therapy