Therapeutic suggestion helps to cut back on drug intake for mechanically ventilated patients in intensive care unit

Research was conducted on ventilated patients treated in an intensive care unit (ICU) under identical circumstances; patients were divided into two groups (subsequently proved statistically identical as to age and Simplified Acute Physiology Score II [SAPS II]). One group was treated with positive suggestions for 15-20 min a day based on a predetermined scheme, but tailored to the individual patient, while the control group received no auxiliary psychological treatment. Our goal was to test the effects of positive communication in this special clinical situation. In this section of the research, the subsequent data collection was aimed to reveal whether any change in drug need could be demonstrated upon the influence of suggestions as compared to the control group. Owing to the strict recruitment criteria, a relatively small sample (suggestion group n = 15, control group n = 10) was available during the approximately nine-month period of research. As an outcome of suggestions, there was a significant drop in benzodiazepine (p < 0.005), opioid (p < 0.001), and the α2-agonist (p < 0.05) intake. All this justifies the presence of therapeutic suggestions among the therapies used in ICUs. However, repeating the trial on a larger sample of patients would be recommended. © 2013 Akadémiai Kiadó, Budapest

Functional Symptoms in Pediatric Dermatology: The Canary in the Coal Mine

The skin is a window into the state of health revealing genetic predispositions, hormonal balance, nutritional status, and internal wellness. It exposes stress burden, emotional well-being, and psychological health. In this way the skin can operate as the metaphorical canary in the coal mine announcing the body’s hidden alarm signals. Psychocutaneous disorders draw attention to the intimate connections between the mind and the skin. During development, the brain and skin are born from the same embryonic tissue and throughout life they continue to be connected through elegant interactions involving neuropeptides, hormones, and inflammatory mediators, the so-called molecules of emotion. Disfiguring skin disease such as vitiligo, acne vulgaris, and ichthyosis have large emotional and psychological interactions. Perhaps surprisingly, the extent of the psychological fallout that results from these conditions is not necessarily related to the objective nature of the disease. Instead it is highly correlated with its subjective severity, which is dependent on self-perception and is highly personal. Recurrent skin disease often results in anxiety, depression, social isolation, body dysmorphic disorder, and dramatic reductions in quality of life rivaling those associated with debilitating systemic illnesses. Crosstalk between the mind and skin also exists wherein physical or psychological stressors can both initiate and worsen skin disease that has clear organic underpinnings such as acne vulgaris, psoriasis, atopic dermatitis, alopecia areata, and cutaneous warts. Primary psychiatric disorders may result in skin and hair conditions such as trichotillomania, psychogenic excoriation, dermatitis artefacta, and delusions of parasitosis. Although mind–skin interactions can cause obstinate symptoms and skin disease, these same connections can also be harnessed for therapeutic benefit