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“My Patient is Hysterical”
Published in Paul Ian Steinberg, Psychoanalysis in Medicine, 2020
Excessive serum cortisol levels and adrenal carcinoma must be considered in the differential diagnosis of the catatonic syndrome. Appropriate clinical and laboratory evaluation must be undertaken to rule out medical illness in patients with psychiatric diagnoses, especially in patients with psychotic or affective symptoms (Harris & Menza, 1989; Steinberg, 1994). Special care must be taken with patients presenting with acute psychiatric symptoms, with a previous history of normal emotional functioning, and those in whom psychological symptoms may obscure signs of medical illness. A history of psychological stresses, no matter how severe and complex, does not warrant concluding that symptoms that might represent either psychiatric disturbance or medical disease are psychogenic and represent a psychiatric disorder; appropriate medical investigation to rule out medical disease must be undertaken.
The Reproductive System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Impotence (also called erectile dysfunction), which is the inability to achieve or maintain an erection, is most frequently psychogenic, although several physical disorders such as diabetes mellitus and hypothyroidism may be involved as well.
Characteristics Of Dependence On And Abuse Of Psychoactive Drugs
Published in S.J. Mulé, Henry Brill, Chemical and Biological Aspects of Drug Dependence, 2019
Clearly these symptoms and signs are in part psychogenic. They occur as an overlay to intensify the specific signs of physical origin in morphine and alcohol-barbiturate types of physical dependence. With the stimulants they derive largely from somatic changes relating to the intensity of the intoxication and the inability or the lack of desire of the user to follow the ordinary life routine required for maintenance of homeostasis, and even survival. For example, the “speed freak” who is under constant and unremitting stimulation for days, consumes little food and has absolute insomnia. The intense fatigue and weakness associated with withdrawal can be accounted for by the severe and rapid weight loss, acidosis, and disturbances in salt and water balance. The psychotic manifestations can be explained by the insomnia alone, since it is known to occur regularly with severe sleep deprivation.
Evaluation of the effects of chronic stress applied from the prepubertal to the adult stages or only during adulthood on penile morphology in rats
Published in Stress, 2019
Carina Teixeira Ribeiro, Waldemar Silva Costa, Francisco José Barcellos Sampaio, Marco Aurélio Pereira Sampaio, Diogo Benchimol de Souza
Stress is a condition that affects people worldwide. The potential deleterious effects of stress are related to the chronicity of the events. Studies showed that chronic stress affects the organs of the male reproductive system (Garcia-Diaz et al., 2015). Nevertheless, studies on the penis are scarce (de Souzaet al., 2012). Recently, penile erection failures were reported in men with stressful routines (Hehemann & Kashanian, 2016; Song, Kim, Shim, Lim, & Yang, 2016). Certain conditions that are commonly preceded by stressful events, such as anxiety disorders and depression, increase the risk of erectile dysfunction (Hedon 2003; Sahin, Urkmez, Verit, Yuksel, & Verit, 2017). Furthermore, chronic stress is known to influence brain function and play a role in the development of anxiety (and others stress-related disorders), which could, in turn, compromise penile erection and ejaculation (Sakamoto et al., 2009, Clark et al., 2015). Children and teenagers also suffer from stress that is mainly of psychogenic origin (Tal et al., 2009, Teicher & Samson, 2016). However, no studies have investigated the association between stress during childhood or youth with impairment of the corpus cavernosum of the penis.
Chasing as a model of psychogenic stress: characterization of physiological and behavioral responses
Published in Stress, 2018
Ji-Hye Lee, Sunwhi Kimm, Jung-Soo Han, June-Seek Choi
In the current study, we developed a novel stress paradigm in which the rats were repeatedly chased by a fast-approaching robot in an unpredictable, inescapable manner. The validity of chasing stress as a model of psychogenic stress was examined. First, we observed increased CORT levels in response to chasing stress, comparable to those induced by restraint stress, a commonly used stress treatment. It has been revealed that stress induces activation of the hypothalamic–pituitary–adrenal (HPA) axis resulting in an increase in CORT secretion, whereas there could be other factors causing elevation of CORT (Kim & Diamond, 2002). Physical activity would be the most reasonable factor in the current study. However, the increased CORT level may not be due to the animal’s movement as the chasing-stress group froze more than the no-chasing group during chasing. Therefore, it could be concluded that chasing stress, indeed, induced a physiological stress response.
Why Bioethics Should Be Concerned With Medically Unexplained Symptoms
Published in The American Journal of Bioethics, 2018
Most of us have had firsthand experience with psychogenic symptoms in the form of aches and pains that take our attention for a time, but that later reveal themselves to be driven mostly by emotional issues. Any minor ache can become the focus of anxiety and deliberation when we're facing personal discomforts in our lives, and when we do take note of the role those discomforts play in the symptom experience, that revelation can make the pain improve or even disappear. In cases of this kind it seems clear biological treatment is not in patients’ best interests, and that biological testing might sometimes pose unjustified threats. And it seems on the surface that the most direct route to relief in these cases would be one that leads patients to recognize the role their psychosocial distress plays in the symptom experience—but it turns out there are formidable obstacles along that path. Things are not nearly that simple.