Archive for the ‘Stress Research’ Category

New Research on Back Pain and Stress

Saturday, May 26th, 2012

Keele University in Staffordshire, England is fifty years old and educates 10,000 undergraduates on a square mile of land once owned by the same family for four centuries and prior to that by the medieval Knights Templar.  Their arthritis research unit has published an interesting paper comparing usual care of low back pain with a new approach based on stratifying patients into three groups (1).


Stress and the Immune System: Dr Robert Ader

Tuesday, December 27th, 2011

Thirty five years ago, Robert Ader, PhD serendipitously discovered a key part of our physiology that was not thought to exist.  The story begins with rats drinking water sweetened with saccharine.  Half the rats were simultaneously given low doses of Cytoxan to cause stomach pain.  (Cytoxan is a chemotherapy drug for cancer.)  It was no surprise that soon the rats associated the sweetened water with the pain and refused to drink it.


Stress Illness and CBT

Monday, August 1st, 2011

Stress Illness (also known as Psychophysiologic Disorder or PPD) is one of the most common causes of Medically Unexplained Symptoms (MUS).  These are symptoms for which no link to a diseased organ or structure can be found after diagnostic testing.  Javier Escobar, MD and colleagues (1) at the Robert Wood Johnson medical school in New Jersey, USA, decided to try a treatment called Cognitive Behavioral Therapy for these patients.


Stress Illness and Placebos

Thursday, May 19th, 2011

In the next edition of The Economist magazine is an article about Edzard Ernst, professor of complementary medicine at Peninsula College of Medicine in Exeter, in southwestern UK.  He is retiring after 18 years of studying “alternative” medical remedies which includes acupuncture, chiropractic medicine, Reiki, herbal remedies, Ayurvedic medicine, homeopathy, reflexology and many others.  During this time he and his group published over 160 analyses of the research in these fields.


Psychosocial Context (2)

Monday, September 20th, 2010

Continuing from the last post,  recall that in my practice a large majority of over 7000 patients with medically unexplained symptoms were referred due to failure to grasp the their psychosocial issues.


Psychosocial Context (1)

Saturday, September 11th, 2010

The health care system has a strong bias toward viewing people as purely biological organisms.  This approach ignores two critical facts:


Stress and Seizures (3)

Monday, August 16th, 2010

Continuing the review from the last post of research from Melbourne, Australia on psychogenic nonepileptic seizures (PNES), we have seen that there was no assessment of childhood stress in  their subjects (1).  This glaring omission meant that the opportunity to therapeutically address these issues in their patients was lost.  Consequently it is not surprising that the outcome in their subjects was poor.  In the 28% of their patients who returned a follow-up questionnaire (averaging four years later): (more…)

Stress and Seizures (2)

Sunday, August 15th, 2010

Continuing the review of the research from Melbourne in the last post (1), the huge flaw is that the paper fails to report on childhood stress experience in patients with PNES (psychogenic non-epileptic seizures, which is a form of stress illness in many cases).  Just how big a flaw is made clear in a paragraph from Dr Anna Luise Kirkengen’s latest book The Lived Experience of Violation: How Abused Children Become Unhealthy Adults (Zeta Books, 2010):


Stress and Seizures (1)

Thursday, August 12th, 2010

One of the best recent research articles on a form of stress illness (1) has a huge flaw.  The study was done over ten years at the Comprehensive Epilepsy Program at Royal Melbourne Hospital in Australia.  They evaluate people who have seizures that are difficult for their regular doctors to manage.  Among many other tests, patients have simultaneous video monitoring and EEG (brain wave) for five full days around the clock.  This test identified 221 adult patients who outwardly appeared to be having seizures but the EEG showed they were not true epilepsy.  These are called psychogenic (meaning “caused by a psychological process”) non-epileptic seizures (PNES).  In the few patients I have seen who had these they were a form of stress illness.  The patients are not deliberately pretending or faking, they are reacting to overwhelming life stresses.


Stress Illness Screening (3)

Tuesday, May 18th, 2010

The search continues for a valid, ultra-short screening questionnaire for stresses capable of causing physical illness.  Once that is in place, the next step is for primary care clinicians to learn how to further evaluate a patient with a positive screen.  This should then lead to systems for follow-up care and monitoring, including the option of referral to mental health clinicians experienced with patients who have physical symptoms.