On narcissism: an introduction (1914). Part II. Narcissism in organic disease, hypochondria, and erotic life

1971 ◽  
Author(s):  
Sigmund Freud
Keyword(s):  
2021 ◽  
Vol 60 (6-7) ◽  
pp. 304-313
Author(s):  
Shailender Madani ◽  
Rohit Madani ◽  
Suchi Parikh ◽  
Ahila Manivannan ◽  
Wilma R. Orellana ◽  
...  

Our study aims to assess improvement with symptomatic treatment of pain-related functional gastrointestinal disorders (FGIDs) in a biopsychosocial construct and evaluate validity of Rome III criteria. Children with chronic abdominal pain diagnosed with an FGID or organic disease were followed for 1 year: 256/334 were diagnosed with an FGID and 78/334 were diagnosed with a possible organic disease due to alarm signs or not meeting Rome III criteria. After 1 year, 251 had true FGID and 46 had organic diseases. Ninety percent of FGID patients improved with symptomatic treatment over an average of 5.4 months. With a 95% confidence interval, Rome criteria predicted FGIDs with sensitivity 0.89, specificity 0.90, positive predictive value 0.98, and negative predictive value 0.59. We conclude that symptomatic treatment of pain-related FGIDs results in clinical improvement and could reduce invasive/expensive testing. Rome III criteria’s high specificity and positive predictive value suggest they can rule in a diagnosis of FGID.


2021 ◽  
pp. 1753495X2110125
Author(s):  
Jonathan S Zipursky ◽  
Deva Thiruchelvam ◽  
Donald A Redelmeier

Background Cardiovascular symptoms in pregnancy may be a clue to psychological distress. We examined whether electrocardiogram testing in pregnant women is associated with an increased risk of subsequent postpartum depression. Methods We conducted a population-based cohort study of pregnant women who delivered in Ontario, Canada comparing women who received a prenatal ECG to women who did not. Results In total, 3,238,218 women gave birth during the 25-year study period of whom 157,352 (5%) received an electrocardiogram during prenatal care. Receiving an electrocardiogram test was associated with a one-third relative increase in the odds of postpartum depression (odds ratio 1.34; 95% confidence interval 1.29–1.39, p < 0.001). Conclusion The association between prenatal electrocardiogram testing and postpartum depression suggests a possible link of organic disease with mental illness, and emphasizes that cardiovascular symptoms may be a clinical clue to the presence of an underlying mood disorder.


2008 ◽  
Vol 10 (2) ◽  
pp. 96-108 ◽  
Author(s):  
Fred A. Baughman

All physicians attend medical school and learn of (a) all things physically normal; anatomy, physiology, and chemistry, (b) all things physically abnormal; pathology, disease, and (c) how to tell the difference. Diagnosis is the first obligation of every physician to every patient, and must precede treatment. Diagnosis first asks, “Is there a physical abnormality (physical abnormality = disorder = disease), yes or no?” Patients with no abnormality (no physical abnormality = no disorder = no disease = normal) are referred to as having “no evidence or disease” (NED) or “no organic disease” (NOD). Their problems may be psychological or psychiatric, but they are not medical or surgical. In patients found to have an abnormality, diagnosis now asks, “Which disease?” Psychiatrists are the only physicians who do not perform physical diagnosis. The absence of disease is determined for them by other physicians, usually referring physicians. In 1948 the previously conjoint specialty of neuropsychiatry was divided into neurology—responsible for the diagnosis and treatment or physical/organic disease of the nervous system—and psychiatry—responsible for the treatment of emotional and psychological problems, none of them due to organic diseases. Nor did psychiatry object to this scientific division of labor at the time. However, in the 1950s, with the advent of psychotropic drugs, psychiatry, increasingly in league with the pharmaceutical industry, began referring to psychological diagnoses as disorders/diseases/chemical imbalances of the brain, albeit with no proof or science. In a congressional hearing in 1970, psychiatrists and federal officials, including the Food and Drug Administration and the Department of Health, Education, and Welfare, represented hyperkinetic disorder (HKD) to be a disorder/disease of the brain leading to the appropriation of millions of dollars for research, diagnosis and treatment into the drug treatment of school children said to have the new disease HKD. HKD became ADD, then ADHD, a disorder/disease/chemical imbalance always in need of a “chemical balancer”—a pill. Without proof of an abnormality/disorder/disease, the ADHD epidemic grew from 150,000 in 1970 to 6 million to 7 million today, the most common childhood diagnosis in the United States, a multi-billion dollar industry, and a model for all 374 DSM–IV psychological/psychiatric diagnoses—none of them actual diseases. As such, psychiatry is not a legitimate branch of medicine deserving scientific-fiscal parity; rather, collectively, it is the greatest health care fraud in history. Every time a so-called chemical imbalance is diagnosed, a patient’s right to informed consent has been abrogated. Every time a medically normal person is treated with a psychotropic chemical balancer—a pill—their first and only abnormality is the iatrogenic intoxication: poisoning.


1990 ◽  
Vol 4 (1) ◽  
pp. 33-38
Author(s):  
Stephen M Collins

The traditional perspective of irritable bowel syndrome (IBS) as a behavioural problem has tended to downplay the role of gastrointestinal dysfunction. Contrary to predictions based on the traditional philosophy, a recent study has shown that IBS patients have increased pain tolerance compared to healthy subjects. This profile of pain tolerance is similar to that seen in chronic organic disease of the gut (eg, Crohn's disease), raising the possibility that IBS patients may experience pain resulting from gastrointestinal dysfunction. The recent finding of increased airway responsiveness to inhaled methacholine in certain IBS patients provides an objective and quantifiable measurement of tissue dysfunction in that syndrome, and focuses attention on possible mechanisms underlying the altered responsiveness of hollow organs in patients with IBS; these mechanisms are discussed.


The Lancet ◽  
1955 ◽  
Vol 265 (6854) ◽  
pp. 105
Author(s):  
RaymondW. Waggoner
Keyword(s):  

PEDIATRICS ◽  
1967 ◽  
Vol 40 (6) ◽  
pp. 1024-1026
Author(s):  
Donald G. Marshall

MUCH has been written in recent years about the importance of psychogenic disturbances as causes of abdominal pain in childhood. Yet, by no means all recurrent abdominal pain is so caused. A recent article in Pediatrics on nonorganic abdominal pain therefore promised this subsequent paper on pain of organic origin. I would like to caution the reader that his "surgeon's viewpoint" tends to exclude consideration of organic abdominal pain not surgically treated. Perhaps a third paper is indicated. Abdominal pain of whatever origin requires a planned approach to diagnosis. While it is only too easy for the clinician to submit a patient to innumerable investigations of varying degrees of unlikelihood of revealing disorders of differing degrees of rarity, a detailed history and searching interview with the parents, together with a complete physical examination, will go very far to reduce the number of cases submitted to any but quite simple tests. The diagnosis of psychogenic pain, no less than that of organic pain, must rest on positive findings. To make a diagnosis of psychogenic pain, there must be something more than the absence of demonstrable organic disease. There must be significant psychopathology. If there is evidence of neither this nor organic disease, one must resolve to be irresolute and decide to be undecided. One must not make a diagnosis of psychic disease simply because one can find no organic cause. One must also remember that psychic disturbance does not confer immunity from organic disease. A neurotic, psychotic, or brain-damaged child can have appendicitis.


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