In 1876, Josiah Macy, Jr, scion of a wealthy Nantucket mercantile family, died of yellow fever at age 38, when his daughter Kate was only 13. In 1930, at age 67, she established a charitable foundation in his name. During the next 15 years until her death, she donated the equivalent of $20 million annually (in today’s dollars), much of it during the Depression.
- History of Stress (6)
- Lectures (7)
- Stress Illness Causes (34)
- Stress Relief (16)
- Stress Research (27)
- Words of Wisdom (11)
Archive Categories
American Psychosomatic Society
March 9th, 2010Childhood Stress in Film: Festen (1998)
March 8th, 2010Dysfunctional families are a favorite subject of the movies but it is rare when a film can provide a new perspective to my readers with professional or personal experience in this area. Oscar night made me think of the Danish film (with subtitles) called Festen (Celebration) which begins as family, friends and business associates gather for a banquet to celebrate the 60th birthday of a wealthy family patriarch. A tragedy has occurred in the family recently. One family member believes this event was linked to past abuse and, to put it mildly, is interested in clarifying the connection.
Assessing Medical Research (3)
March 5th, 2010Published medical research can be designed in a variety of ways but the greatest credence is given to placebo-controlled randomized trials (PCRT). Ideally, and in simplest form, this design has the following characteristics: Read the rest of this entry »
Assessing Medical Research (2)
March 4th, 2010How can a person without formal medical training assess health-related information presented by the news media? We can start with wisdom from over 400 years ago:
Assessing Medical Research (1)
March 3rd, 2010In a perfect world, every claim for a new health care treatment that reached you via the news media would be accurate and clear. Unfortunately, the reality is that even experienced clinicians reading the evidence in medical journals need to consider carefully the meaning of the research before they use it to change how they manage their patients. There are many ways for errors in collection, analysis and interpretation of medical research data to creep into even the best published studies. The subject is so complex that one well-reviewed book on how to assess medical research (1) runs to over 300 pages.
Self-Care Skills
March 2nd, 2010Are you the kind of person who cares for everyone but yourself? In #4 of my series of posts about the DSM-5, I proposed a new definition for Complex Somatic Symptom Disorder. Part B of the definition included the concept that symptoms improve in response to treatment of ongoing social or psychological stresses including insufficient self-care skills. In this post I want to elaborate on the latter.
5. Medically Unexplained Symptoms in DSM-5
March 1st, 2010In the last post, I proposed a revision of the Somatoform Disorders section for the next edition of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association. The DSM-5 group has proposed changing the name from Somatoform Disorders to Somatic Symptom Disorders (SSD) but this term neglects the central role of psychological or cognitive factors. It will also cause confusion with the DSM-5 group’s other new proposal, the term Complex Somatic Symptom Disorder (CSSD). The term CSSD suggests that it is simply a complex form of SSD but that is not at all how the DSM-5 group has defined it. This is why I suggest replacing Somatoform Disorders with Psychosomatic Disorders, not as a diagnostic term (patients consider it stigmatizing) but as a name for this category that is well understood by mental health practitioners, medical clinicians and the public.
4. Medically Unexplained Symptoms in DSM-5
February 26th, 2010Changes to the Somatoform Disorders section of the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association potentially will have greater practical impact than revisions of any other section. This will be the case if the tens of millions of patients (in the U.S. alone) with physical symptoms connected to psychosocial stresses are given an appropriate diagnostic term. To that end, I offer the following ideas to revise the Somatoform Disorders section in the next edition, the DSM-5.
2. Medically Unexplained Symptoms in DSM-5
February 24th, 2010Can we repair the gaping hole in how we classify patients with medically unexplained symptoms (MUS)? Changes are proposed for the fifth revision of the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (the DSM-5, due out in May, 2013). Unfortunately, the proposals don’t solve the problems. To see for yourself, you can review and comment here until April 20, 2010. To comment, you first need to register so you can log in with a password. Then you need to go to the Somatoform Disorders and scroll down to find the comment window.
1. Medically Unexplained Symptoms in DSM-5
February 22nd, 2010The Bible of mental health diagnosis has a glaring omission (1). The Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, used globally as a reference for classifying and defining mental health disorders, was first published in 1952, listing 106 disorders in 130 pages. The last major revision was released in 1994 (297 disorders, 886 pages), followed by a “text revision” in 2000 (365 disorders, 943 pages). None of these volumes has a diagnostic term appropriate for more than a tiny fraction of Stress Illness patients. (Stress Illness is my term for physical symptoms not fully explained by diagnostic tests that improve when psychosocial stresses are treated.)
