Causes of psychophysiologic disorder (PPD) symptoms are so diverse that even after assessing thousands of patients I still encounter new variations. Earlier this year a 65 year old retired nurse practitioner from Oregon whom I have worked with in the past contacted me because of months of abdominal pain. She suspected PPD because medical evaluation was unrevealing and her symptoms fluctuated for no obvious reason.
Archive for the ‘Stress Illness Causes’ Category
Among physicians with a humanistic soul, perhaps no quotation is more fondly remembered than one from Dr Francis Peabody. He was born in 1881 to a prominent New England family, trained at Harvard and Massachusetts General Hospital and was the first director of the Thorndike Laboratory at Boston City Hospital. Tragically, he died of sarcoma at age 46.
Recent on-line and in-person discussions with my colleagues who care for patients with Psychophysiologic Disorders (PPD) make it clear that there are many successful approaches to diagnosis and treatment. What these techniques have in common is clarifying for patients that psychosocial stress can cause real pain and/or other physical symptoms and that uncovering and treating these issues can relieve the illness (partially or completely). Our discussion led me to summarize my approach: (more…)
A study of the brain (published on-line Jan 2015) has uncovered an important difference in the processing of pain signals between people with fibromyalgia (FM) and those without FM.(1) Participants with FM had brain imaging with functional magnetic resonance (fMRI) while a blood pressure cuff on their leg created pain at a level (determined by each person) of 40 out of 100.
Psychophysiologic Disorders (PPD) consist of pain or other physical symptoms that are partly or completely relieved when underlying psychosocial issues are uncovered and treated. The process that produces this form of illness is an area of active investigation.
A colleague asked how I would screen for Adverse Childhood Experiences (ACEs) in primary care patients with unexplained illness, chronic pain or functional syndromes such as irritable bowel or fibromyalgia. (A blog of mine describing ACEs is here with an important web site here). Here is my answer:
There is a new compilation of the latest research on the long-term impact of childhood adversity. I have written about this key subject in earlier blogs (here and again here). Now there is a new DVD where the latest research and its implications for policy are presented by those who conducted the studies.
A therapist recently posed a key question about adverse childhood experiences (ACEs): what is the benefit to a patient of their family doctor knowing this information?
A match for the Women’s World Chess Championship recently finished in Tirana, the capital of Albania. The winner was incumbent champion Hou Yifan, a 17 year old from China who won the title last December, the youngest ever. The pressure on her was enormous for several reasons. The weight of national pride was heightened by the fact that Ms Koneru, her 24 year old challenger, is a native of India, China’s geopolitical rival. Ms Koneru had also surpassed Hou (slightly) in the world rankings. In addition, prize money for the match winner was more than $50,000 greater than for the loser.