Whiplash associated disorder (WAD) is a common, yet poorly understood condition. It has both been considered a chronic pain disorder, due to injury in neck, and a functional somatic syndrome. Based on the hypothesis that chronic WAD lies closer to functional somatic syndromes than to organic pain disorders, we compared the reported level of symptoms associated to somatization (including among others, abdominal pain, nausea, chest pain, breathlessness, skin discoloring and headache) of persons reporting WAD and persons not reporting WAD.

Data from the population based Hordaland Health Study (HUSK) in Norway 1997-99 (n = 18.581) were used. In this study, 489 participants reporting whiplash also answered questions on symptoms linked to somatic syndromes. These questions were also answered by 13.490 participants without whiplash. Comparing these two groups, independent t-tests were employed for a range of somatic symptoms. Subsequently, a linear regression model was used, enabling adjustment for possible confounding factors, including gender, anxiety, depression, education, poor sleep, benefit recipiency, physical activity, alcohol consumption, smoking, somatic diagnoses and marital status.

The WAD group reported a significantly higher prevalence of all the reported somatic symptoms (all p< 0.01), compared to the control group (mean difference in somatization tendency 0.6 SD). Adjustment for covariates, only marginally reduced the association between whiplash and somatic symptoms.

Our results indicate an association between WAD and somatic symptoms, supporting the notion that WAD should be considered a functional somatic syndrome.

Somatization (Greek, soma = body) is a disorder in which the psychological and emotional problems are expressed in physical symptoms. People prone to somatization tend to complain about the pain within the multiple organic systems although it cannot be find any organic cause.

Somatization as a separate diagnostic entity exists in the Somatoform disorder, but it occurs in a number of other psychopathological entities, such as mood disorders, panic disorder (in the attack), generalized anxiety disorder, delusions in schizophrenia, dependence on psychoactive substances, etc. Also, some personality disorders are more related to the expression of somatization. There is usually referred Histrionic, borderline, antisocial personality disorder etc.

Because of possible multiple access to somatization as a symptom of psychopathological entity, the case of patient who expressed somatization was selected for presentation. Focus was on the course of hospitalization and differential diagnostic dilemmas with which we encountered in the diagnostic procedure according to DSM-IV.

Psychiatric interview, mental status, EEG, Psychological Testing, SCID I DSM-IV.

According to the used methods it was selected -Unspecific Somatoform disorder- as solution to the dilemma in our case.

The aim of this study was to find relationship between life events stress, mental disorders and irritable bowel syndrome.

This descriptive and cross sectional study was performed during six months on the 76 patients IBS. The life events stress or Paykel, GHQ-28 and Rome III criteriaand clinical interview was used assessment.

The differences were statistically significant between life events stress and mental disorders with IBS (P< 0/05).

Psychology distress and life events stressor is important component of the IBS symptom experience and shoud be considered when treatment strategies are designed.

The objective of this Project was to develop and evaluate the applicability of a psychoeducative manual adapted to the Brazilian population reality, as first intervention on the treatment of BED patients.

The manual is printed in a brochure format, using a non-medic language, where the information is presented with images and fictitious characters, allowing patients to make use of it without supervision of a specialized professional.

The first part gives information about the disease, characteristics and symptoms, allowing the patient to identify if he has or not the disorder, partial or complete.

The second part gives the mechanisms that predispose, start and perpetuate the eating disorder, helping the patient to recognize them and develop strategies to modify his behavior.

Several versions have been improved by the authors; when a definitive format was achieved, the manual was evaluated by eight eating disorders specialized professionals, who presented their comments and suggestions on the format and contents. After implemented the changes, the 12th version was settled as final, consisting of 10 items. Then, this manual was submitted to 10 patients, to be evaluated regarding information assimilation through a questionnaire specially developed for this purpose.

This is the first psychoeducative manual for BED patients in Brazil. Its final version was considered by the patients a quick and easy to understand reading. Due to the low range of specialized professional assistance, such manual can be very relevant. Studies to evaluate the efficaciousness of this manual are currently under process.

Study of the clinical features in the group of somatoform and psychosomatic disorders.

The results of clinical and epidemiological study of 2181 patients (average age-54 ± 0.8) are presented.

inventory for clinical-anamnestic behavior sign of adaptation form of disease of patients with comorbid phenomenon and standard scales for value of anxiety and depressions were used.

The homogeneous group of disorders in which somatic as well as psychical symptoms are equivalent 6,7 (P< 0,05).The phenomenon of comorbidity as the independent clinical adaptive mechanism was revealed 8,3 (P< 0,05). In the research group the positive response for the psychotropic therapy was registered 5,3 (P< 0,05).

The phenomenon of comorbidity in practice area reduces to new understanding of the coexistence of the psychic and somatic register, illustrates the possibility of the valuation of indicator of quality of manifestation of symptom and syndrome in context of social functioning. The social functioning is the indicator of quality and optimization of the diagnostic and therapeutic processes, which are demanding independent culturally dependent diagnostic directives from existing classifications (ICD-10, DSM-IV). The somatic symptom is the integral part of psychopathologic syndromes.

The aim of this study was to estimate the prevalence of disorders eating among patients with diabetes mellitus.

Studies have shown that The Eating Attitudes Test (EAT-26) can be an efficient screening instrument as part of a two-stage screening process in which those who score at or above a cut-off score of 20 are referred for a diagnostic interview. 44 patients with diabetes mellitus (28 women and 16 men) were recruited for this study. Height, current weight, body mass index (BMI) were determined. The EAT- 26 for Eating Disorders was completed. Results were compared with measurements in 32 nondiabetic subjects (22 women and 10 men).

The prevalence of disorders eating among patients with diabetes mellitus was 18.18%. Of the 44 patients with diabetes mellitus, 8 scored higher on EAT (average score 32.01, BMI 31.36 kg/m2) than the remaining 36 patients with diabetes mellitus, whose score averaged 14.22 (BMI 26.32 kg/m2). In this study we found significant differences for the recorded parameters between diabetic patients with and without disorders eating. Age were similar in both groups, but BMI were higher, and scored on EAT were higher in diabetic patients with disorders eating. The prevalence of disorders eating among nondiabetic subjects was 6.25%. Two patients with diabetes mellitus develop a clinical eating disorder and needs cognitive-behavioral, interpersonal psychotherapy and pharmacologic treatment. The EAT-26 score at or above of 20 needs expertise in eating disorders, and nutrition.

Nowadays several authors defend the existence of an obsessive-compulsive (OC) spectrum in which eating disorders (ED), especially anorexia nervosa, would be include. We investigated the presence of OC symptoms in bulimic and anorexic patients and its relationships with personality traits.

The Maudsley Obsessive Compulsive Questionnaire (MOCQ) and the revised version of the Temperament and Character Inventory (TCI-R) were administered to patients and healthy controls.

Patients show higher scores than controls in the global punctuation of de MOCQ, and in the checking and doubt subscales. Cases also score higher in harm avoidance (dimension associated with personality disorders of cluster C) and in its subscale anticipatory worry. No differences were found between patients subgroups.

Patients present more OC behaviours in comparison with healthy population but measures of obsessivity do not differ between the types of ED. Traits of personality characteristically associated to cluster C and to anxiety disorders seem to be also common features. These results do not support a separated classification of RAN into the OC spectrum.

Major depression and post-traumatic stress disorder (PTSD) are commonly associated with coronary heart disease (CHD) as well as hyperhomocysteinemia and hypercholesterolemia. Personality types A and D are claimed to be risk factors for CHD.

To evaluate relations between risky personality types, cholesterol and homocystein serum levels in patients with major depression compared to PTSD patients with and without depression.

Personality types A and D, cholesterol and homocysteine level were assessed in 40 patients with major depression and 40 male PTSD patients with and without depression.

Hypercholesterolemia and hyperhomocysteinemia were found more frequently in patients with major depression and PTSD patients with depression than in PTSD without depression. Personality type D (tendency to experience negative emotions and social inhibition) was more frequent among PTSD patients compared to patients with depression, while there was no difference in personality A type (competitiveness, time urgency, aggressiveness and hostility) distribution.

Hypercholesterolemia and hyperhomocysteinemia may be useful clinical markers related to specific treatment options in patients with major depression as well as in PTSD patients.

Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorder. The aim of our study was to assess the prevalence of irritable bowel syndrome (IBS)-like symptoms in Crohn's disease (CD) patients in remission. Furthermore, the possible relation of IBS-like symptoms with quality of life was studied.

Sixty-four patients with known Crohn's disease were invited to complete the SF-36 (to assess quality of life) while in clinical remission and were studied for the possibility of IBS-like symptoms. Diagnosis of IBS was made according to ROME III Criteria. Physical health summary score (PCS) and mental health summary scores (MCS) of CD patients with IBS-like symptoms were compared with PCS and MCS of CD patients without IBS-like symptoms.

IBS-like symptoms were found in 55% of Crohn's disease patients in remission. CD patients with IBS-like symptoms had lower well-being scores than those without IBS-like symptoms.

The presence of irritable bowel syndrome-like symtoms impaired the quality of life of patients with Crohn's disease.

Anorexia nervosa (AN) is a chronic and relapsing disorder, characterized by aberrant patterns of weight regulation and eating behaviour, body image distortion and resistance to treatment.

This study aims to investigate the reversibility of the most important structural and functional cerebral alteration found in the illness state after weight recovery, in order to distinguish between state-dependent abnormalities and neurological signs of traits vulnerability.

The most significant neuroimaging studies are reviewed from the scientific literature of the last ten years, using the following keywords: “neuroimaging”, “anorexia”, “reversibility”, “weight recovery”, “cerebral blood flow”, differently matched together.

Structural neuroimaging techniques show a widening of internal cerebrospinal fluid filled spaces and a brain gray and white matter volume loss. These alterations take place in the low-stages of AN, as body weight decreases, and generally reverse with weight restoration, as a function of re-feeding. Functional neuroimaging studies reveal a reduced global and regional cerebral glucose metabolism in the acute state, that reverses with recovery. On the other hands, techniques based on stimuli provocation reveal a greater activation in the medial prefrontal and anterior cingulate cortices in response to food stimuli, that persists after recovery, suggesting that these alterations could be primary abnormalities related to trait vulnerability.

Other studies needs to distinguish between primary neural disturbance and secondary phenomena due to starvation, in order to individuate patterns of vulnerability and to develop new strategies of treatment and prevention.

Hemodialysis as a treatment manner in chronic renal failure is a stressful process and has several various psycho-cognitive and social complications. This procedure can made mental disorder in these patients. Therefore it is better that moreover prescription of medication in hemodialysis centers, psychological interventions is done for patient's rehabilitation too.

This research is a quasi experimental and clinical trial study. Samples were young adults who were 18- 45 aged. The Beck depression & anxiety inventories were used as a measure of psychological symptoms at pretest and post test. Cognitive-behavioral group therapy as intervention was done at 12 week. Information were analyzed with SPSS-16 and Paired t-test and Analysis variance one way.

The result showed a significant difference between anxiety and depression before and after intervention in case group (p=0/0001) and there was not a significant difference among variables such as: age, sex, education and economic level, dialysis long time with anxiety and depression among in studied group.

This research shows that group therapy (cognitive- behavioral) has been decreased depression and anxiety remarkably in dialysis patients. Therefore it is suggested that moreover description of medication, psychological interventions are done for this patients.

We present a case study of Anorexia Nervosa and Obsessive Personality Disorder as an argument to describe the main therapeutic interventions used framed in so-called third-generation therapies.

The sessions were recorded on videotape by independent observers. Both the particularities of the therapeutic relationship (based on functional analytic psychotherapy) and contextual strategies used (based on acceptance and commitment therapy) were analyzed.

During the therapy, several changes where observed. Among them: Better social behavior, congruence between vital values and vital actions, resolution of the eating disorder, greater openness to experience and decrease of obsessive thoughts.

The changes that were observed during the therapeutic process will be associated with specific interventions resulting from the contextual-functional approach.

The paper gives an overview about classic psychoanalytic formulations of psychic trauma and compares them with recent contributions from trauma therapy, attachment research, and neurobiology.

Brain research and psychotherapeutic methodes.

Results of the brain research show that early traumatization affects brain areas in emotional states which verbalization cannot reach.

For early traumatized patients a treatment concept of non-verbal methods as well as verbal are necessary,

Several studies, carried out to assess the efficacy of psychological and pharmacological treatments for depression, have shown thar combined treatments are, in general, more efficacious than an unique approach. We will present the preliminary results of an on-going research, being carried out with the main purpose of analysing the efficacy of two psychological empirically supported treatments, Cogntiive-Behvioral therapy (CBT) and Interpersonal Therapy (IPT), combined with a pharmacological antidepressive (AD) intervention, for recurrent depression.

A sample of 20 adult females has been randomly assigned to one of three conditions: a) CBT plus AD, b) IPT plus AD, and c) AD only.

A multimodal assessment matrix was developed and is being used to evaluate depression features (including suicidal ideation, intention and attempts), and the main individual, social, and environmental factors commonly related to the onset and mantainance of the disorder, namely hopelessness and pessimism, cognitive processing, interpersonal relations, and life events.

Repeated measurements are being collected at 0, 2, 4, and 6 months, and follow-up.

We expect that both combined approches will be more efficacious for the reduction of depressive symptoms, including suicidal behaviors, compared to the pharmacological approach. we also expect to understand the sensitivity to change of the assessed psychological processes underlying each form of psychotherapy.

Mindfulness meditations (MM) are a group of meditation practices which are recently receiving growing attention. Following the increasing interest towards the neural correlates of meditation, particularly Mindfulness meditations (MM), the aim of the present work is to review current findings about the neural correlates of MM and compare such findings to those of further specific and non specific treatments.

A literature search was undertaken using MEDLINE, ISI web of knowledge, the Cochrane database and references of retrieved articles. Studies which focused on the functional neural correlates of MM, psychotherapy, pharmacotherapy and placebo published up to August 2009 were screened by the reviewers in order to be considered for the inclusion.

Main findings suggest that long term MM practice could allow a more flexible emotional regulation by engaging frontal cortical structures to dampen automatic amygdala activation when it is needed. A great overlap could exist between cerebral areas activated during MM, psychotherapy,pharmacotherapy and those activated by expectancy in placebo studies. However, while MM, psychotherapy and placebo could act through a top-down regulation, antidepressants could act through a bottom-up process.

MM could target specific brain areas related to emotions and emotional regulation. Consistent similarities could exist between MM and other interventions, particularly psychotherapy. Despite these promising findings, however, further research is needed in order to extend current findings, to more deeply compare MM to other treatments and to better investigate the neurochemical correlates of MM.