Clinical Interviewing: An Essential but Neglected Method of Medicine.

Clinical interviewing is the basic method to understand how a person feels and what are the presenting complaints, obtain medical history, evaluate personal attitudes and behavior related to health and disease, give the patient information about diagnosis, prognosis, and treatment, and establish a bond between patient and physician that is crucial for shared decision making and self-management. However, the value of this basic skill is threatened by time pressures and emphasis on technology. Current health care trends privilege expensive tests and procedures and tag the time devoted to interaction with the patient as lacking cost-effectiveness.

Clinimetric Criteria for Patient-Reported Outcome Measures.

Patient-reported outcome measures (PROMs) are self-rated scales and indices developed to improve the detection of the patients' subjective experience. Given that a considerable number of PROMs are available, it is important to evaluate their validity and usefulness in a specific research or clinical setting. Published guidelines, based on psychometric criteria, do not fit in with the complexity of clinical challenges, because of their quest for homogeneity of components and inadequate attention to sensitivity.

Psychosomatic medicine in the 21st century: understanding mechanisms and barriers to utilization.

The psychosomatic approach arose in antiquity as mankind looked for explanations for illness and death. With the rise of modern medicine, the links between emotions and medical conditions, such as cardiac disease and diabetes, were described by astute clinical observers, but the mechanisms for these conditions were based on correlation from observations rather than on experimental design. Psychoanalytic theory was often utilized to explain many common diseases.

Alexithymia and emotional intelligence in patients with panic disorder, generalized anxiety disorder and major depressive disorder.

Emotional Intelligence (EI) is a broad personality construct signifying the ability to perceive and to regulate affects within oneself. Alexithymia is another personality construct denoting difficulty in identifying and expressing emotions, with an externally oriented thinking style. Although previously considered to be independent, some studies have shown that these constructs overlap.

The psychosomatic interview.

The psychosomatic interview is a patient-focused dialogue between physician and patient. It differs from the traditional disease-focused encounter in that the psychosomatic approach includes the biological, psychological, and sociocultural domains irrespective of the patients initial complaint, whether somatic or psychological. The process of dyadic interaction and the techniques of open questions are reviewed.

Principles of psychosomatic assessment.

There is increasing awareness of the limitations of disease as the primary focus of medical care. It is not that certain disorders lack an organic explanation, but that our assessment is inadequate in most clinical encounters. The primary goal of psychosomatic medicine is to correct this inadequacy by incorporation of its operational strategies into clinical practice.

Update on diagnoses of sexual dysfunctions: controversies surrounding the proposed revisions of existing diagnostic entities and proposed new diagnoses.

The diagnosis of sexual dysfunction(s) or disorder(s) is paramount to the development of the field of sexual medicine. Historically, the diagnoses of these disorders have been considered reliable. The validity of diagnoses of sexual disorders (and the rest of our classification systems) has recently been questioned, especially from the point of clinical utility and homogeneity.

Kellner's emotional inhibition scale: a clinimetric approach to alexithymia research.

Background: Emotional inhibition has been an enduring concept in the psychosomatic literature explaining the onset and course of medical disorders. Currently the personality style of alexithymia is a focus of this dimension in psychosomatic theory, while actual conscious emotional inhibition, which may overlap with alexithymia, has received less attention. In the early 80s Robert Kellner developed the Emotional Inhibition Scale (EIS), a self-rating scale for emotional inhibition based on clinimetric principles.

Physician staffing for the practice of psychosomatic medicine in general hospitals: a pilot study.

Background: The treatment of psychiatric illnesses, prevalent in the general hospital, requires broadly trained providers with expertise at the interface of psychiatry and medicine. Since each hospital operates under different economic constraints, it is difficult to establish an appropriate ratio of such providers to patients.

Objective: The authors sought to determine the current staffing patterns and ratios of Psychosomatic Medicine practitioners in general hospitals, to better align manpower with clinical service and educational requirements on consultation-liaison psychiatry services.

Teaching psychiatric residents about paraphilic disorders.

Objective: The author describes a program for psychiatric residents in evaluating patients with paraphilic disorders.

Methods: The program curriculum offers clinical education in paraphilic disorders and is organized by various perspectives within psychiatry, including the disease model, the life story, the dimensional perspective, and the behavioral perspective.

Results: Graduates of this program generally find this clinical and educational rotation very useful in their future work.

Cognitive performance enhancement: misuse or self-treatment?

Objective: This cross-sectional survey study examines the link between ADHD medication misuse and a positive screen for adult ADHD symptoms.

Method: Surveys from 184 college student volunteers in Northern Virginia are collected and analyzed.

Results: A total of 71% of ADHD stimulant misusers screen positive for ADHD symptoms.