MAKALE ÖZETLERİ" Her Hafta Başında Yeni Özetler Eklenir ! (04.08.2002)"

1: Langenfeld M.C., Cipani E., Borckardt J.J.

Hypnosis for the control of HIV/AIDS-related pain.
Int J Clin Exp Hypn 2002 Apr;50(2):170-88.
This intensive case study used an A-B time-series analysis design to examine whether 5 adult patients with various AIDS-related pain symptoms benefited from a hypnosis-based pain management approach. The 3 dependent variables in this study were: (a) self-ratings of the severity of pain, (b) self-ratings of the percentage of time spent in pain, and (c) amount of p.r.n. pain medication taken. Data were collected over a period of 12 weeks, including a 1-week baseline period and an 11-week treatment period. Autoregressive integrated moving-average (ARIMA) models were used to determine the effects of the hypnotic intervention over and above autoregressive components in the data. All 5 patients showed significant improvement on at least 1 of the 3 dependent variables as a result of the hypnotic intervention. Four of the 5 patients reported using significantly less pain medication during the treatment phase.


2: Gay M.C., Philippot P., Luminet O.

Differential effectiveness of psychological interventions for reducing osteoarthritis pain: a comparison of Erikson [correction of Erickson] hypnosis and Jacobson relaxation.
Eur J Pain 2002;6(1):1-16.
The present study investigates the effectiveness of Erikson hypnosis and Jacobson relaxation for the reduction of osteoarthritis pain. Participants reporting pain from hip or knee osteoarthritis were randomly assigned to one of the following conditions: (a) hypnosis (i.e. standardized eight-session hypnosis treatment); (b) relaxation (i.e. standardized eight sessions of Jacobson's relaxation treatment); (c) control (i.e. waiting list). Overall, results show that the two experimental groups had a lower level of subjective pain than the control group and that the level of subjective pain decreased with time. An interaction effect between group treatment and time measurement was also observed in which beneficial effects of treatment appeared more rapidly for the hypnosis group. Results also show that hypnosis and relaxation are effective in reducing the amount of analgesic medication taken by participants. Finally, the present results suggest that individual differences in imagery moderate the effect of the psychological treatment at the 6 month follow-up but not at previous times of measurement (i.e. after 4 weeks of treatment, after 8 weeks of treatment and at the 3 month follow-up). The results are interpreted in terms of psychological processes underlying hypnosis, and their implications for the psychological treatment of pain are discussed.


3: Borckardt J.J.

Case study examining the efficacy of a multi-modal psychotherapeutic intervention for hypertension.
Int J Clin Exp Hypn 2002 Apr;50(2):189-201.
This study examines the effectiveness of a multimodal psychotherapeutic approach using hypnosis in the treatment of a single case of hypertension. A systematic eclectic conceptualization and treatment approach was implemented using psychodynamic, behavioral, and cognitive-behavioral elements. Hypnosis was used to support each of the treatment modalities. Time-series analysis procedures indicate that the psychological interventions were associated with significantly reduced diastolic blood pressure. Additionally, the effect of the psychological interventions was significant over and above traditional pharmacological interventions. However, psychotherapeutic interventions had no substantial impact on systolic pressure. The flexibility of hypnosis as a therapeutic tool is discussed in terms of potential advantages in treatment.


4: Nash M.R.

Salient findings in the hypnosis literature: April 2002.
Int J Clin Exp Hypn 2002 Apr;50(2):202-7.
Four important investigations were reported during the latter part of 2001. All address the biological impact of hypnotic interventions. Three of these studies focus specifically on if and how hypnotic interventions affect immune functions. A range of immune assays is employed, from allergic response to blood-based assays of immune functioning during nonlaboratory periods of stress. In all 3 cases, measurable shifts in immune functioning are associated with hypnotic interventions. A 4th compares the pattern of event-related brain potentials (ERPs) associated with hypnotic analgesia interventions and standard distraction protocols during exposure to pain.


5: Farhadi A., Bruninga K., Fields J., Keshavarzian A.

Irritable bowel syndrome: an update on therapeutic modalities.
Expert Opin Investig Drugs 2001 Jul;10(7):1211-22.
Irritable bowel syndrome (IBS) is the most common condition that a physician faces in the GI clinic. Of the general population, 10 - 25% suffer from symptoms judged to be IBS. The negative impact of this disease includes not only pain, suffering and direct medical expenses but also significant social and job-related consequences. IBS can be the result of dysfunction in any part of the brain-gut axis: alterations in the CNS caused by psychological or other factors, abnormal gastrointestinal motility, or heightened visceral sensations. Diagnosis is based on either the Manning or Rome-II criteria. Education, reassurance and emotional support are the cornerstones of successful treatment. The mainstays of the current therapeutic approach continue to be: stress management strategies, dietary modification entailing addition of dietary fibre and pharmacotherapy. Pharmacotherapy is still limited to treating symptoms. Newer drugs that modulate motility or drugs that modulate visceral sensation may be useful in selected cases. Psychopharmacological agents are useful in the treatment of IBS, especially in those with psychological co-morbidity. Alternative therapies such as homeopathy, acupuncture, special diets, herbal medication and several forms of psychological treatments and hypnotherapy are sought by many patients and are now being offered by physicians as treatment options, either alone or in conjunction with conventional forms of therapy in patients with refractory symptoms.


6: Mellon M.W., McGrath M.L.

Empirically supported treatments in pediatric psychology: nocturnal enuresis.
J Pediatr Psychol 2000 Jun;25(4):193-214; discussion 215-8, 219-24.
OBJECTIVE: To review the medical and psychological literature concerning enuresis treatments in light of the Chambless criteria for empirically supported treatment. METHOD: A systematic search of the medical and psychological literature was performed using Medline and Psychlit. RESULTS: Several review studies and numerous well-controlled experiments have clearly documented the importance of the basic urine alarm alone as a necessary component in the treatment of enuresis or combined with the "Dry-Bed Training" intervention, establishing them as "effective treatments." Other multicomponent behavioral interventions that also include the urine alarm such as "Full Spectrum Home Training" have further improved the outcome for bed-wetters, but are classified as "probably efficacious" at this time because independent researchers have not replicated them. Less rigorously examined approaches that focus on improving compliance with treatment or include a "cognitive" focus (i.e., hypnosis) warrant further study. CONCLUSIONS: We recommend a "biobehavioral" perspective in the assessment and treatment of bed-wetting and suggest that combining the urine alarm with desmopressin offers the most promise and could well push the already high success rates of conditioning approaches closer to 100%. Much important work is yet to be completed that elucidates the mechanism of action for the success of the urine alarm and in educating society about its effectiveness so that its availability is improved.


7: Montgomery G.H., David D., Winkel G., Silverstein J.H., Bovbjerg D.H.

The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis.
Anesth Analg 2002 Jun;94(6):1639-45, table of contents.
Hypnosis is a nonpharmacologic means for managing adverse surgical side effects. Typically, reviews of the hypnosis literature have been narrative in nature, focused on specific outcome domains (e.g., patients' self-reported pain), and rarely address the impact of different modes of the hypnosis administration. Therefore, it is important to take a quantitative approach to assessing the beneficial impact of adjunctive hypnosis for surgical patients, as well as to examine whether the beneficial impact of hypnosis goes beyond patients' pain and method of the administration. We conducted meta-analyses of published controlled studies (n = 20) that used hypnosis with surgical patients to determine: 1) overall, whether hypnosis has a significant beneficial impact, 2) whether there are outcomes for which hypnosis is relatively more effective, and 3) whether the method of hypnotic induction (live versus audiotape) affects hypnosis efficacy. Our results revealed a significant effect size (D = 1.20), indicating that surgical patients in hypnosis treatment groups had better outcomes than 89% of patients in control groups. No significant differences were found between clinical outcome categories or between methods of the induction of hypnosis. These results support the position that hypnosis is an effective adjunctive procedure for a wide variety of surgical patients. IMPLICATIONS: A meta-analytical review of studies using hypnosis with surgical patients was performed to determine the effectiveness of the procedure. The results indicated that patients in hypnosis treatment groups had better clinical outcomes than 89% of patients in control groups. These data strongly support the use of hypnosis with surgical patients.


8: Roelofs K., Hoogduin K.A., Keijsers G.P., Naring G.W., Moene F.C., Sandijck P.

Hypnotic susceptibility in patients with conversion disorder.
J Abnorm Psychol 2002 May;111(2):390-5.
Conversion disorder has been associated with hypnotic susceptibility for over a century and is currently still believed to be a form of autohypnosis. There is, however, little empirical evidence for the relation between hypnotic susceptibility and conversion symptoms. The authors compared 50 patients with conversion disorder with 50 matched control patients with an affective disorder on measures of hypnotic susceptibility, cognitive dissociation, and somatoform dissociation. Conversion patients were significantly more responsive to hypnotic suggestions than control patients. In addition, conversion patients showed a significant correlation between hypnotic susceptibility and the number of conversion complaints. These results provide the first evidence of a relationship between hypnotic susceptibility and the presence and number of conversion symptoms.


9: Gray C.M., Tan A.W., Pronk N.P., O'Connor P.J.

Complementary and alternative medicine use among health plan members. A cross-sectional survey.
Eff Clin Pract 2002 Jan-Feb;5(1):17-22.
CONTEXT. Many health plans have started to cover the cost of complementary and alternative medicine (CAM). National survey data indicate that CAM use is highly prevalent among adults. However, little is known about CAM use among health plan members. OBJECTIVE: To describe CAM users, the prevalence of CAM use, and how CAM use relates to utilization of conventional preventive services and health care satisfaction among health plan members. DESIGN: Cross-sectional mail survey in 1997. SETTING: Managed care organization in Minnesota. SAMPLE: Random sample of health plan members aged 40 and older stratified by number of chronic diseases; 4404 (86%) of the 5107 returned completed questionnaires. MEASURES: Use of CAM, patient characteristics (e.g., chronic diseases, health status), health behaviors (e.g., smoking, diet, exercise), and interaction with conventional health care (e.g., use of preventive services, having a primary care doctor, health care satisfaction). RESULTS: Overall, 42% reported the use of at least one CAM therapy; the most common were relaxation techniques (18%), massage (12%), herbal medicine (10%), and megavitamin therapy (9%). Perceived efficacy of CAM ranged from 76% (hypnosis) to 98% (energy healing). CAM users tended to be female, younger, better educated, and employed. Users of CAM reported more physical and emotional limitations, more pain, and more dysthymia but were not more likely to have a chronic condition. CAM users were slightly more likely to have a primary care provider (86% vs. 82% had chosen a primary care provider; P =0.014) and had more favorable health-related behaviors. CAM users and nonusers were equally likely to use conventional preventive services and were equally satisfied with their health plan. CONCLUSION: CAM use is highly prevalent among health plan members. CAM users report more physical and emotional limitations than do nonusers. CAM does not seem to be a substitute for conventional preventive health care.


10: Rainville P., Bushnell M.C., Duncan G.H.

Representation of acute and persistent pain in the human CNS: potential implications for chemical intolerance.
Ann N Y Acad Sci 2001 Mar;933:130-41.
The study of pain may be relevant to the study of chemical intolerance (CI) in many ways. Pain is often reported as a symptom of CI and it is defined as a subjective experience similar to many other symptoms of CI, making its objectification difficult. Furthermore, the CNS plastic changes that underlie the development of persistent pain states and abnormal pain responses may share some similarities with those involved in the sensitization to environmental chemicals. Functional brain imaging studies in humans demonstrate that acute pain evoked by nociceptive stimulation is accompanied by the activation of a widely distributed network of cerebral structures, including the thalamus and the somatosensory, insular, and anterior cingulate cortices. Abnormal activity within these regions has been associated with the experience of pain following damage to the peripheral or central nervous system (neuropathic pain) in a number of clinical populations. In normal individuals, activity within this network is correlated with subjective pain perception, is highly modifiable by cognitive interventions such as hypnosis and attention, and has been associated with emotions. Other cognitive mediators such as expectations can also produce robust changes in pain perception (e.g., in placebo analgesia). These effects likely depend on both higher-order cerebral structures and descending mechanisms modulating spinal nociceptive activity. These psychological processes can be solicited to reduce clinical pain and we speculate that they may further attenuate or promote central mechanisms involved in the transition from acute to persistent pain states. The investigation of central determinants of subjective experience is essential to assess the possibility that higher-order brain/psychological processes modulate and/or mediate the development of persistent pain states. These factors may contribute to the development of symptoms in CI.


11: Elliott A.J., Fuqua W.R.

Acceptability of treatments for trichotillomania. Effects of age and severity.
Behav Modif 2002 Jul;26(3):378-99.
Based on the literature, trichotillomania (TTM, chronic hair pulling) in children and adults appears to be responsive to behavioral interventions such as habit reversal. However, some have questioned the generality and acceptability of such procedures. This study compared the acceptability ratings of four interventions targeting TTM (habit reversal, hypnosis, medication, and punishment). In the study, 233 college students read case vignettes in which the age of the analogue client and the severity of the hair pulling were manipulated. Results showed significant differences between the four treatment conditions, with hypnosis and habit reversal being rated most acceptable. Age of the analogue client and severity of TTM did not significantly influence acceptability ratings.


12: de Z., Sellman J.D.

Public knowledge and attitudes regarding smoking and smoking cessation treatments.
N Z Med J 2002 May 10;115(1153):219-22.
AIMS: To investigate current public knowledge and attitudes to tobacco smoking and smoking cessation treatments. METHOD: A telephone survey of 250 individuals randomly selected from the Christchurch Electoral Roll and assigned into one of three groups: current, ex and life-time never smokers. RESULTS: Significantly more current than ex-smokers cited habit as a major reason for continuing to smoke and a greater number reported using nicotine transdermal patches during a cessation attempt. Fewer ever smokers than never smokers stated health as a likely major motivation for cessation by smokers and believed doctors' advice and illness of a significant other highly influenced quit attempts. 55.7% of respondents believed nicotine patches to be the most effective smoking cessation method followed by 'cold turkey' (49.4%) and hypnotherapy (33.9%). While the majority of participants supported banning tobacco advertising (69.6%), banning tobacco sponsorship (59.6%), lower insurance rates for non-smokers (89.1%) and fully subsidised smoking cessation programmes (71.9%), significant differences were detected between groups regarding attitudes to tobacco control initiatives. CONCLUSIONS: This sample were relatively ill informed regarding smoking practices in New Zealand and unaware of useful information to aid cessation. While evidence emerged to support current smokers being slightly better informed regarding proven strategies for cessation than ex-smokers, few current smokers were aware of efficacious interventions for smoking cessation.


13: Szabo J.

Seeing is believing? The form and substance of French medical debates over Lourdes.
Bull Hist Med 2002 Summer;76(2):199-230.
Recent works on Lourdes have tended to emphasize the positive personal, social, and spiritual aspects of a pilgrimage, while downplaying the role of religious politics in (over)determining discussions around the events taking place there over the course of the Third Republic. This paper seeks to reassert the extent to which the medical community remained divided, along religious lines, over the existence and nature of the cures taking place at Lourdes well into the twentieth century, while analyzing how Catholic physicians were able to create an aura of therapeutic credibility around the cures.


14: Moene F.C., Spinhoven P., Hoogduin K.A., van D.

A randomised controlled clinical trial on the additional effect of hypnosis in a comprehensive treatment programme for in-patients with conversion disorder of the motor type.
Psychother Psychosom 2002 Mar-Apr;71(2):66-76.
BACKGROUND: The primary aim of this study was threefold: (1) to examine the additional effects of hypnosis aimed at symptom reduction, using symptom-oriented and expression- and insight-oriented techniques in a comprehensive clinical treatment programme for in-patients with a persistent conversion disorder of the motor type; (2) to assess whether the level of hypnotisability was predictive of treatment outcome, and (3) to explore the efficacy of the total clinical treatment programme. METHODS: The study population consisted of 45 in-patients between 18 and 65 years of age meeting the DSM-III-R criteria for conversion disorder of the motor type or somatisation disorder with motor conversion symptoms. A randomised controlled clinical trial was undertaken. The primary outcome measures were the Video Rating Scale for Motor Conversion Symptoms, the D(isabilities) code items from the International Classification of Impairments, Disabilities and Handicaps and the Symptom Checklist-90. Measures of the credibility of treatment and patient expectations of treatment outcome were used as manipulation checks. Hypnotisability was measured using the Stanford Hypnotic Clinical Scale. RESULTS: Significant treatment results for all outcome measures were found for the total sample. These effects proved to be clinically significant. The use of hypnosis had no additional effect on treatment outcome. Hypnotisability was not predictive of treatment outcome. CONCLUSION: A comprehensive treatment programme, either with or without hypnosis, can be worthwhile for patients with long-standing conversion symptoms.


15: Zahourek R.P.

Utilizing Ericksonian hypnosis in psychiatric-mental health nursing practice.
Perspect Psychiatr Care 2002 Jan-Mar;38(1):15-22.
TOPIC: Ericksonian hypnosis conceptual framework. PURPOSE: To acquaint psychiatric-mental health nurses with hypnotic principles and how these can be integrated into their practice. SOURCES: Published literature and author's clinical experience. CONCLUSIONS: Ericksonian hypnosis offers an array of potential interventions for psychiatric-mental health nurses to integrate into their practices in a framework familiar to nurses: holism, honoring and respecting individuality, and capitalizing on an individual's strengths.


16: Rashed H., Cutts T., Abell T., Cowings P., Toscano W., El-Gammal A., Adl D.

Predictors of response to a behavioral treatment in patients with chronic gastric motility disorders.
Dig Dis Sci 2002 May;47(5):1020-6.
Chronic gastric motility disorders have proven intractable to most traditional therapies. Twenty-six patients with chronic nausea and vomiting were treated with a behavioral technique, autonomic training (AT) with directed imagery (verbal instructions), to help facilitate physiological control. After treatment, gastrointestinal symptoms decreased by >30% in 58% of the treated patients. We compared those improved patients to the 43% who did not improve significantly. No significant differences existed in baseline symptoms and autonomic measures between both groups. However, baseline measures of gastric emptying and autonomic function predicted treatment outcome. Patients who improved manifested mild to moderate delay in baseline gastric emptying measures. The percent of liquid gastric emptying at 60 mins and the sympathetic adrenergic measure of percent of change in the foot cutaneous blood flow in response to cold stress test predicted improvement in AT outcome, with clinical diagnostic values of 77% and 71%, respectively. We conclude that AT treatment can be efficacious in some patients with impaired gastric emptying and adrenergic dysfunction. More work is warranted to compare biofeedback therapy with gastric motility patients and controls in population-based studies.


17: Nielson W.R., Weir R.

Biopsychosocial approaches to the treatment of chronic pain.
Clin J Pain 2001 Dec;17(4 Suppl):S114-27.
BACKGROUND: Biopsychosocial treatments address the range of physical, psychological, and social components of chronic pain. OBJECTIVE: This review sought to determine how effective unimodal and multimodal biopsychosocial approaches are in the treatment of chronic pain. METHODOLOGY: The literature search identified three systematic reviews of the literature and 21 randomized controlled trials to provide the evidence for this review. RESULTS: The systematic reviews and 12 randomized controlled trials reported on chronic low back pain. Other randomized controlled trials studied fibromyalgia (three trials) and back or other musculoskeletal disorders (five trials). Biopsychosocial components reviewed were electromyogram feedback and hypnosis as unimodal approaches, and behavioral and cognitive-behavioral treatments and back school, or group education, as multimodal approaches for chronic low back pain. For other chronic pain disorders, cognitive-behavioral treatments were reviewed. Comparisons were hindered by studies with heterogeneous subjects, varied comparison groups, different cointerventions and follow-up times, variable outcomes, and a range of analytic methods. CONCLUSIONS: Multimodal biopsychosocial treatments that include cognitive-behavioral and/or behavioral components are effective for chronic low back pain and other musculoskeletal pain for up to 12 months (level 2). There is limited evidence (level 3) that electromyogram feedback is effective for chronic low back pain for up to 3 months. The remaining evidence of longer-term effectiveness and of effectiveness of other interventions was inadequate (level 4a) or contradictory (level 4b). Future studies of cognitive-behavioral treatments should be condition specific, rather than include patients with different pain conditions.


18: O'Donnell J.J., Maurice S.C., Beattie T.F.

Emergency analgesia in the paediatric population. Part III non-pharmacological measures of pain relief and anxiolysis.
Emerg Med J 2002 May;19(3):195-7.



19: Buckwalter J.G., Simpson S.W.

Psychological factors in the etiology and treatment of severe nausea and vomiting in pregnancy.
Am J Obstet Gynecol 2002 May;185(5 Suppl Understanding):S210-4.
The assumption is frequently made that women with severe nausea and vomiting during pregnancy are transforming psychological distress into physical symptoms. Psychoanalytic theory supporting this assumption is reviewed, along with the few methodologically flawed empirical studies that have been conducted. Little support can be found for the hypothesis that nausea and vomiting during pregnancy is such a conversion disorder, but there are suggestions that psychological responses to the physiologic condition(s) underlying this problem may become entrenched, or conditioned. This possibility is supported by findings that psychological treatments, such as hypnosis, can be effective. This implies that psychological responses can interact with the physiology of nausea and vomiting during pregnancy to exacerbate the condition. As such, psychological treatments for the symptoms of this disorder need to be further explored.


20: Scoboria A., Mazzoni G., Kirsch I., Milling L.S.

Immediate and persisting effects of misleading questions and hypnosis on memory reports.
J Exp Psychol Appl 2002 Mar;8(1):26-32.
Immediate and persisting effects of misleading questions and hypnosis on memory reports were assessed. After listening to a story, 52 highly suggestible students and 59 low and medium suggestible students were asked misleading or neutral questions in or out of hypnosis. All participants were then asked neutral questions without hypnosis. Both hypnosis and misleading questions significantly increased memory errors, and misleading questions produced significantly more errors than did hypnosis. The 2 effects were additive, so that misleading questions in hypnosis produced the greatest number of errors. There were no significant interactions with level of hypnotic suggestibility. Implications of these findings for the per se exclusion of posthypnotic testimony are discussed.


21: Schultz B., Grouven U., Schultz A.

Automatic classification algorithms of the EEG monitor Narcotrend for routinely recorded EEG data from general anaesthesia: a validation study.
Biomed Tech (Berl) 2002 Jan-Feb;47(1-2):9-13.
Impacts of hypnotic drugs on brain function are reflected in the EEG. The EEG monitor Narcotrend performs an automatic classification of the EEG using a scale which was proposed by Kugler for visual evaluation of the EEG. In this article the results of a validation study of the automatic classification algorithms implemented in the EEG monitor Narcotrend are presented. Visual and automatic classification of EEG data recorded in routine clinical practice were compared. The correlation between visual and automatic assessment was high (Spearman rank correlation r = 0.90, prediction probability Pk = 0.90) and a sufficient agreement between visual and automatic assessment was achieved for 92% of the analysed EEG epochs. The results of the study suggest that the automatic classification algorithms implemented in the EEG monitor Narcotrend yield a reliable assessment of the depth of hypnosis.


22: Huntley A., White A.R., Ernst E.

Relaxation therapies for asthma: a systematic review.
Thorax 2002 Feb;57(2):127-31.
BACKGROUND: Emotional stress can either precipitate or exacerbate both acute and chronic asthma. There is a large body of literature available on the use of relaxation techniques for the treatment of asthma symptoms. The aim of this systematic review was to determine if there is any evidence for or against the clinical efficacy of such interventions. METHODS: Four independent literature searches were performed on Medline, Cochrane Library, CISCOM, and Embase. Only randomised clinical trials (RCTs) were included. There were no restrictions on the language of publication. The data from trials that statistically compared the treatment group with that of the control were extracted in a standardised predefined manner and assessed critically by two independent reviewers. RESULTS: Fifteen trials were identified, of which nine compared the treatment group with the control group appropriately. Five RCTs tested progressive muscle relaxation or mental and muscular relaxation, two of which showed significant effects of therapy. One RCT investigating hypnotherapy, one of autogenic training, and two of biofeedback techniques revealed no therapeutic effects. Overall, the methodological quality of the studies was poor. CONCLUSIONS: There is a lack of evidence for the efficacy of relaxation therapies in the management of asthma. This deficiency is due to the poor methodology of the studies as well as the inherent problems of conducting such trials. There is some evidence that muscular relaxation improves lung function of patients with asthma but no evidence for any other relaxation technique.


23: Rieber R.W.

The duality of the brain and the multiplicity of minds: can you have it both ways?
Hist Psychiatry 2002 Mar;13(49 Pt 1):3-17.
Multiple Personality Disorder (MPD), now known as Dissociative Identity Disorder (DID), has been of great interest to the public for over a century. Case histories of MPD can be found in the literature as far back as the eighteenth century; nevertheless, publications from the latter part of the nineteenth century best describe this disorder as we know it today. This paper traces the case history literature of DID (MPD) from the earliest period to the present. This is done in such a way as to illuminate the basic theoretical and epistemological issues that are necessary to understand the process of dissociation (both normal, and abnormal aspects) and the role of hypnosis and its relationship to organic and 'hysterical epilepsy.' The theories of Fanet, Prince and Sidis are the major authorities discussed. The paper concludes with a discussion of the danger inherent in fostering a deterministic or reductionistic theory of consciousness.


24: Gonsalkorale W.M., Houghton L.A., Whorwell P.J.

Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness.
Am J Gastroenterol 2002 Apr;97(4):954-61.
OBJECTIVES: Hypnotherapy has been shown to be effective in the treatment of irritable bowel syndrome in a number of previous research studies. This has led to the establishment of the first unit in the United Kingdom staffed by six therapists that provides this treatment as a clinical service. This study presents an audit on the first 250 unselected patients treated, and these large numbers have also allowed analysis of data in terms of a variety of other factors, such as gender and bowel habit type, that might affect outcome. METHODS: Patients underwent 12 sessions of hypnotherapy over a 3-month period and were required to practice techniques in between sessions. At the beginning and end of the course of treatment, patients completed questionnaires to score bowel and extracolonic symptoms, quality of life, and anxiety and depression, allowing comparisons to be made. RESULTS: Marked improvement was seen in all symptom measures, quality of life, and anxiety and depression (all ps < 0.001), in keeping with previous studies. All subgroups of patients appeared to do equally well, with the notable exception of males with diarrhea, who improved far less than other patients (p < 0.001). No factors, such as anxiety and depression or other prehypnotherapy variables, could explain this lack of improvement. CONCLUSIONS: This study clearly demonstrates that hypnotherapy remains an extremely effective treatment for irritable bowel syndrome and should prove more cost-effective as new, more expensive drugs come on to the market. It may be less useful in males with diarrhea-predominant bowel habit, a finding that may have pathophysiological implications.


25: Lang E.V., Rosen M.P.

Cost analysis of adjunct hypnosis with sedation during outpatient interventional radiologic procedures.
Radiology 2002 Feb;222(2):375-82.
PURPOSE: To compare the cost of standard intravenous conscious sedation with that of sedation with adjunct self-hypnotic relaxation during outpatient interventional radiologic procedures. MATERIALS AND METHODS: Data were reviewed from a prospective randomized study in which patients undergoing vascular and renal interventional procedures underwent either standard sedation (n = 79) or sedation with adjunct hypnosis (n = 82). These data were used to construct a decision analysis model to compare the cost of standard sedation with the cost of sedation with adjunct hypnosis. Multiple sensitivity analyses were performed to assess the applicability of these results to other institutions with different cost structures with respect to the following variables: cost of the hypnosis provider, cost of room time for interventional radiologic procedure, hours of observation after the procedure, and frequency and cost of complications associated with over- or undersedation. RESULTS: According to data from this experience, the cost associated with standard sedation during a procedure was $638, compared with $300 for sedation with adjunct hypnosis, which resulted in a savings of $338 per case with hypnosis. Although hypnosis was known to reduce room time, hypnosis remained more cost-effective even if it added an additional 58.2 minutes to the room time. CONCLUSION: Use of adjunct hypnosis with sedation reduces cost during interventional radiologic procedures.


26: Oster M.I.

Contemporary methods in hypnotic preparation for childbirth.
CRNA 2000 Nov;11(4):160-6.
Hypnosis is a viable adjunct to any medical procedure and is not intended to replace conventional medical techniques. In recent years, many of us who practice hypnosis have seen a re-emergence of interest in mind-body approaches to health care. Hypnotic methods for preparation for childbirth are a logical contribution to that mind-body perspective.


27: Long L., Huntley A., Ernst E.

Which complementary and alternative therapies benefit which conditions? A survey of the opinions of 223 professional organizations.
Complement Ther Med 2001 Sep;9(3):178-85.
With the increasing demand and usage of complementary/alternative medicine (CAM) by the general public, it is vital that healthcare professionals can make informed decisions when advising or referring their patients who wish to use CAM. Therefore they might benefit from advice by CAM-providers as to which treatment can be recommended for which condition. AIM: The primary aim of this survey was to determine which complementary therapies are believed by their respective representing professional organizations to be suited for which medical conditions. METHOD: 223 questionnaires were sent out to CAM organizations representing a single CAM therapy. The respondents were asked to list the 15 conditions they felt benefited most from their CAM therapy, the 15 most important contra-indications, the typical costs of initial and any subsequent treatments and the average length of training required to become a fully qualified practitioner. The conditions and contra-indications quoted by responding CAM organizations were recorded and the top five of each were determined. Treatment costs and hours of training were expressed as ranges. RESULTS: Of the 223 questionnaires sent out, 66 were completed and returned. Taking undelivered questionnaires into account, the response rate was 34%. Two or more responses were received from CAM organizations representing twelve therapies: aromatherapy, Bach flower remedies, Bowen technique, chiropractic, homoeopathy, hypnotherapy, magnet therapy, massage, nutrition, reflexology, Reiki and yoga. The top seven common conditions deemed to benefit by all twelve therapies, in order of frequency, were: stress/anxiety, headaches/migraine, back pain, respiratory problems (including asthma), insomnia, cardiovascular problems and musculoskeletal problems. Aromatherapy, Bach flower remedies, hypnotherapy, massage, nutrition, reflexology, Reiki and yoga were all recommended as suitable treatments for stress/anxiety. Aromatherapy, Bowen technique, chiropractic, hypnotherapy, massage, nutrition, reflexology, Reiki and yoga were all recommended for headache/migraine. Bowen technique, chiropractic, magnet therapy, massage, reflexology and yoga were recommended for back pain. None of the therapies cost more than l60 for an initial consultation and treatment. No obvious correlation between length of training and treatment cost was apparent. CONCLUSION: The recommendations by CAM organizations responding to this survey may provide guidance to health care professionals wishing to advise or refer patients interested in using CAM.


28: Hernandez A., Tatarunis A.M.

The use of pre-, intra-, and posthypnotic suggestion in anesthesia and surgery.
CRNA 2000 Nov;11(4):167-72.
While under hypnosis, patients can be taught to alter their psychophysiological functions. With this ability to alter these functions, patients can overcome the anxiety associated with surgery. Patients with high anxiety often experience more depression, can have increased complications, need more anesthesia and medication, have suppressed immune function, and often take longer to heal. The purpose of this article is to review the research literature related to the use of hypnosis in preparing the patient for surgery and to present 2 approaches used by the authors to prepare patients for surgery. The first approach is used when there is enough time to condition the patient, and the second approach is used when the anesthetist meets the patient shortly before the surgery is to begin and there is no time to induce formal trance.


29: Gallagher G., Rae C.P., Kinsella J.

Treatment of pain in severe burns.
Am J Clin Dermatol 2000 Nov-Dec;1(6):329-35.
Burn pain can cause psychologic and functional difficulties, and is difficult to predict from wound depth. The initial painful stimulation of nerve endings by the burn with continued painful stimuli result in peripheral and central mechanisms causing amplification of painful stimuli, and the development of chronic pain syndromes that can be difficult to treat. In order to assess the effect of analgesic interventions it is essential to measure the patient's pain in a simple and reproducible manner. A number of tools exist for this measurement, ranging from longer and more detailed techniques such as the McGill pain questionnaire most suited to relatively stable pain, to visual analogue scores and picture-based scores for children. Pain management begins with the acute injury, with initial measures such as cooling of the burn and use of inhalational agents such as oxygen/nitrous oxide mixtures. On arrival in hospital, for any but trivial burns, intravenous opioids are appropriate and should be administered as small intravenous boluses titrated against effect. Following the initial resuscitation, pain may be divided into background pain and that associated with procedures. These often require different analgesic interventions. Background pain may be treated with potent intravenous opioids by infusion or patient controlled analgesia and then on to oral, less potent opioids, followed by other oral analgesics. Often drug combinations work best. More severe procedural pain may be treated with a variety of interventions from a slight increase in therapy for the background pain to more potent drugs, local blocks, or general anaesthesia. In addition to drug-based methods of managing burn pain, a number of nonpharmacologic approaches have been successfully employed including hypnosis, auricular electrical stimulation, massage, and a number of cognitive and behavioural techniques.


30: Bell F.

The complex 'whole': exploring homoeopathic and spiritual considerations.
Aust J Holist Nurs 2000 Apr;7(1):31-5.
Unlike the biomedical model, holistic health care takes a much broader view of what constitutes health and the responsibility for helping restore an individual's health. Homoeopathy addresses the physical, mental and emotional aspects of the whole individual, while alternative practices such as yoga, hypnotherapy and meditation can be described as 'functional' spiritual practices which demonstrate the taking of personal responsibility for health care to the individual.


31: Breuer W.C.

The use of hypnosis in a primary care setting.
CRNA 2000 Nov;11(4):186-9.
An aware clinician using the modality of hypnosis either themselves or induced by a trained practitioner will find many indications on a daily basis. The application can be used for control of symptoms such as nausea or pain or, in the case of some clinical conditions, as a primary or adjunctive therapy. An overview of the commonly occurring opportunities for the use of hypnosis is presented in this article.


32: Eslinger M.R.

Hypnosis principles and applications: an adjunct to health care.
CRNA 2000 Nov;11(4):190-6.
Hypnosis has existed since the beginning of humankind, and is a part of everyday life. It is a valuable addition to the methods and techniques available to all health care-providers, as well as a safe and uncomplicated method used to enhance patient health care. It is simply a state of complete physical and mental relaxation which produces an altered state of consciousness acceptable to suggestions. It is characterized by an increased ability to produce desirable changes in habit patterns, motivation, self-image, lifestyle, and personal health.


33: Lehrer P., Feldman J., Giardino N., Song H.S., Schmaling K.

Psychological aspects of asthma.
J Consult Clin Psychol 2002 Jun;70(3):691-711.
Asthma can be affected by stress, anxiety, sadness, and suggestion, as well as by environmental irritants or allergens, exercise, and infection. It also is associated with an elevated prevalence of anxiety and depressive disorders. Asthma and these psychological states and traits may mutually potentiate each other through direct psychophysiological mediation, nonadherence to medical regimen, exposure to asthma triggers, and inaccuracy of asthma symptom perception. Defensiveness is associated with inaccurate perception of airway resistance and stress-related bronchoconstriction. Asthma education programs that teach about the nature of the disease, medications, and trigger avoidance tend to reduce asthma morbidity. Other promising psychological interventions as adjuncts to medical treatment include training in symptom perception, stress management, hypnosis, yoga, and several biofeedback procedures.


34: Curtis C.

Hypnotherapy in a specialist palliative care unit: evaluation of a pilot service.
Int J Palliat Nurs 2001 Dec;7(12):604-9.
There is evidence that hypnotherapy may have an application in the palliative care setting by relieving stress and helping patients to cope with their illness and the prospect of dying. It may also be of benefit to health professionals working in this sometimes stressful field. This article reports on the audit of a pilot hypnotherapy service for patients, carers and staff at a specialist palliative care unit. The audit explored the demand for hypnotherapy, the practicalities of providing the service and identified benefits as perceived by the clients and the therapist. Evaluation methods included questionnaires for quantifiable and qualitative data. The study was conducted over 5 months and involved 11 clients (seven staff and four patients). The main findings depicted unanimous positive coping and relaxation benefits to the clients. At the end of the therapy, 82% felt it had assisted in improving the presenting problem and 91% felt it had been of benefit in general. Further issues are discussed such as the therapeutic relationship, non-attendance and the environment used during the sessions.


35: Vickers A.J., Cassileth B.R.

Unconventional therapies for cancer and cancer-related symptoms.
Lancet Oncol 2001 Apr;2(4):226-32.
A significant proportion of cancer patients try unconventional therapies and many use 'complementary' therapies, as adjuncts to mainstream care, for management of symptoms and to improve quality of life. A smaller proportion use 'alternative' therapies, which are typically invasive, biologically active, and commonly promoted as replacements for, rather than adjuncts to, mainstream therapy. Many alternative therapies, including high-dose vitamin C, the Di Bella regimen, and laetrile have been shown not to be effective. For others, such as metabolic therapy, evidence is extremely limited. Conversely, most complementary therapies are well studied and of proven benefit. There is evidence from randomised trials supporting the value of hypnosis for cancer pain and nausea; relaxation therapy, music therapy, and massage for anxiety; and acupuncture for nausea. Such complementary therapies are increasingly provided at mainstream cancer centres.


36: Blanchard E.B., Scharff L.

Psychosocial aspects of assessment and treatment of irritable bowel syndrome in adults and recurrent abdominal pain in children.
J Consult Clin Psychol 2002 Jun;70(3):725-38.
This article presents a selective review of psychosocial research on irritable bowel syndrome (IBS) in adults and on a possible developmental precursor, recurrent abdominal pain (RAP), in children. For IBS the authors provide a summary of epidemiology, of the psychological and psychiatric disturbances frequently found among IBS patients, and of the possible role of early abuse in IBS. A review of the psychosocial treatments for IBS finds strong evidence to support the efficacy of hypnotherapy, cognitive therapy, and brief psychodynamic psychotherapy. The research relating RAP to IBS is briefly reviewed, as is the research on its psychological treatment. Cognitive-behavioral therapy that combines operant elements and stress management has the strongest support as a treatment for RAP.


37: Haskins C.

Blepharoplasty under hypnosis: a personal experience.
Plast Surg Nurs 2001 Fall;21(3):143-5, 160.
This paper is a first-hand account of my experience undergoing upper and lower blepharoplasty surgery in which hypnosis was used as the primary sedative agent. It describes the basics of hypnosis. It also includes a description of how I prepared myself for surgery as well as how I helped the surgical team prepare for this surgery. Recommendations are offered for nurses who would like to incorporate hypnotherapy into the operating room.


38: Noble S.

The management of blood phobia and a hypersensitive gag reflex by hypnotherapy: a case report.
Dent Update 2002 Mar;29(2):70-4.
Coping with a hypersensitive gag reflex can be a cause for concern for both the patient and the operator. This report describes a case of blood phobia directed solely towards the oral cavity, linked with the inability to tolerate dentures due to a hypersensitive gag reflex. Management by hypnotherapy using a systematic desensitization technique allowed for extraction of teeth and permanent elimination of the gagging problem.


39: Baird C.L.

First-line treatment for osteoarthritis. Part 2: Nonpharmacologic interventions and evaluation.
Orthop Nurs 2001 Nov-Dec;20(6):13-8; quiz 18-20.
Because of the chronic nature of osteoarthritis, nonpharmacologic interventions provide the client with self-care strategies that may lessen pain, improve physical functioning, and increase independence and sense of control. Nonpharmacologic interventions include exercise, rest and joint protection, heat and cold, hydrotherapy, therapeutic touch, acupuncture/acupressure, biofeedback, hypnotherapy, cognitive-behavioral techniques, activity and home maintenance modification, nutrition, and transportation interventions. Most of these therapies are very useful for nurses as independent interventions. Suggestions for evaluation of interventions are made.


40: Frischenschlager O., Pucher I.

Psychological management of pain.
Disabil Rehabil 2002 May 20;24(8):416-22.
PURPOSE: In this article an overview is given on the attempts of understanding and treating chronic pain from the psychodynamic view and the perspective of behavioural medicine. ISSUE: Pain cannot be reliably measured. Assessment of pain depends on verbal description, nonverbal expressions, specific tests and our empathy. From this perspective pain is a matter of subjective experience and communication. Several phenomena (e.g. phantom limb pain, stress analgesia, the pain-relieving effects of relaxation, hypnosis, placebo, etc., pain in spite of a non-existing injury) obviously show that psychological factors like distraction, relaxation, fear, depression, former pain experiences as well as family and cultural influences modulate the way pain is experienced. Different parts of the CNS are involved in the modulation of pain-experience. Referring to cognitive and emotional processes, the importance of the the neocortex and and the limbic system are to be underlined. CONCLUSION: Chronic pain (as a category of ICD-10) presupposes a continuous, torturing pain, which sometimes even cannot be explained sufficiently by an organic damage. Psychosocial problems such as emotional conflicts, misleading thoughts, etc. are recognizable and can be brought into connection with the pain the patient experiences.


41: Ikezuki M., Miyauchi Y., Yamaguchi H., Koshikawa F.

[Development of Autogenic Training Clinical Effectiveness Scale (ATCES)]
Shinrigaku Kenkyu 2002 Feb;72(6):475-81.
The purpose of the present study was to develop a scale measuring clinical effectiveness of autogenic training. In Study 1, 167 undergraduates completed a survey of items concerning physical and mental states, which were thought to vary in the course of autogenic training. With item and factor analyses, 20 items were selected, and the resulting scale (ATCES) had high discrimination and clear factor structure. In Study 2, reliability and concurrent and clinical validity of the scale were examined with three groups of respondents: 85 mentally healthy, 31 control, 13 clinical persons. The scale showed a high test-retest correlation (r = .83) and alpha coefficient (alpha = .86). ATCES had a Pearson correlation coefficient of r = .56 with General Health Questionnaire (GHQ-12), and r = .73 with trait anxiety (STAI-T). And ATCES successfully discriminated the mentally healthy and clinical groups in terms of clinical effectiveness. These results demonstrated high reliability and sufficient concurrent and clinical validity of the new scale.


42: Soo S., Moayyedi P., Deeks J., Delaney B., Lewis M., Forman D.

Psychological interventions for non-ulcer dyspepsia.
Cochrane Database Syst Rev 2001;(4):CD002301.
BACKGROUND: Studies have also shown that NUD patients have higher scores of anxiety, depression, neurotism, chronic tension, hostility, hypochondriasis, and tendency to be more pessimistic when compared with the community controls. OBJECTIVES: This review aims to determine the effectiveness of psychological interventions including psychotherapy, psychodrama, cognitive behavioral therapy, relaxation therapy, guided imagery or hypnosis in the improvement of either individual or global dyspepsia symptom scores and also quality of life scores patients with non-ulcer dyspepsia (NUD). SEARCH STRATEGY: Trials were located through electronic searches of the Cochrane Controlled Trials Register (CCTR), MEDLINE, EMBASE, CINAHL and PsycLIT, using appropriate subject headings and text words and searching bibliographies of retrieved articles. SELECTION CRITERIA: All randomised controlled trials (RCTs) or quasi-randomised studies assessing the effectiveness of psychological interventions (including psychotherapy, psychodrama, cognitive behavioural therapy, relaxation therapy, guided imagery or hypnosis) for non-ulcer dyspepsia (NUD). DATA COLLECTION AND ANALYSIS: Data were collected on individual, global dyspepsia symptom scores, as well as measures of quality of life (QoL) scores and adverse effects. MAIN RESULTS: The three trials identified showed that there was improvement in the dyspepsia symptom scores at the end of treatment and one trial showed improvement in the psychological parameters. However, meta-analysis was not possible as these trials used different psychological interventions and two of the trials only reported mean change in symptoms and did not give standard deviations of this change. REVIEWER'S CONCLUSIONS: Psychological intervention in the form of psychodynamic psychotherapy and cognitive behavioral therapy may be useful in the treatment of NUD. However, we need more trials to assess dyspepsia symptom scores and also psychological intervention in order to give us a clearer picture of the role of psychological intervention in NUD.


43: Williamson J.W., McColl R., Mathews D., Mitchell J.H., Raven P.B., Morgan W.P.

Brain activation by central command during actual and imagined handgrip under hypnosis.
J Appl Physiol 2002 Mar;92(3):1317-24.
The purpose was to compare patterns of brain activation during imagined handgrip exercise and identify cerebral cortical structures participating in "central" cardiovascular regulation. Subjects screened for hypnotizability, five with higher (HH) and four with lower hypnotizability (LH) scores, were tested under two conditions involving 3 min of 1) static handgrip exercise (HG) at 30% of maximal voluntary contraction (MVC) and 2) imagined HG (I-HG) at 30% MVC. Force (kg), forearm integrated electromyography, rating of perceived exertion, heart rate (HR), mean blood pressure (MBP), and differences in regional cerebral blood flow distributions were compared using an ANOVA. During HG, both groups showed similar increases in HR (+13 +/- 5 beats/min) and MBP (+17 +/- 3 mmHg) after 3 min. However, during I-HG, only the HH group showed increases in HR (+10 +/- 2 beats/min; P < 0.05) and MBP (+12 +/- 2 mmHg; P < 0.05). There were no significant increases or differences in force or integrated electromyographic activity between groups during I-HG. The rating of perceived exertion was significantly increased for the HH group during I-HG, but not for the LH group. In comparison of regional cerebral blood flow, the LH showed significantly lower activity in the anterior cingulate (-6 +/- 2%) and insular cortexes (-9 +/- 4%) during I-HG. These findings suggest that cardiovascular responses elicited during imagined exercise involve central activation of insular and anterior cingulate cortexes, independent of muscle afferent feedback; these structures appear to have key roles in the central modulation of cardiovascular responses.


44: Bryant R.A., Mallard D.

Hypnotically induced emotional numbing: a real-simulating analysis.
J Abnorm Psychol 2002 Feb;111(1):203-7.
This study compared 20 real, hypnotized and 20 simulating, unhypnotized participants who were administered a hypnotic induction and then presented with emotionally distressing and neutral visual images. Half were administered a hypnotic suggestion for emotional numbing. Reals and simulators who received the emotional numbing suggestion reported comparably less responsivity to distressing stimuli than others. Whereas emotionally numb reals displayed little change in electromyographic (EMG) activity during the distressing stimuli, simulators displayed marked reduction in EMG activity. Reals (not simulators) displayed a dissociation between their affective response and awareness of the negative content of the stimuli following the numbing suggestion.


45: Brent R.

Medical, social, and legal implications of treating nausea and vomiting of pregnancy.
Am J Obstet Gynecol 2002 May;185(5 Suppl Understanding):S262-6.
This article will deal with medical, social, and legal implications of treating nausea and vomiting of pregnancy (NVP). Clinical problems occur when the symptoms become exaggerated and result in debilitation, dehydration, and hospitalization. The treatment of NVP in its early stages has the implication that it will prevent the more serious complications, including hospitalization. Therapeutic modalities discussed in this conference that have been used or are being tested are primarily symptomatic treatments (antihistamines, Bendectin (Merrell Dow; Cincinatti, Ohio), phenothiazines, hypnosis, accupressure, relaxation behavioral modification, audiogenic feedback training, newer medications, diet, and nutritional support). Bendectin is probably the most studied medication with regard to its reproductive effects, and the studies clearly demonstrate that therapeutic doses of Bendectin have no measurable reproductive risks to the mother or the fetus. In spite of Bendectin's record of safety, numerous nonmeritorious congenital malformation lawsuits were filed and went to trial, and that junk science was presented at these trials. The Bendectin era focused our attention on the area of nonmeritorious litigation and junk science, which could have an effect on any new or less well-studied therapies, because such a high percentage of women are treated for NVP. Because 3% of the offspring will be affected with birth defects, the potential for litigation is immense. The solutions are (1) for legal problems, the medical community should focus their attention on junk scientists and their junk science, over which physicians should have some authority, and (2) for the treatment problem, it would seem most logical that a major research effort should be directed toward brain receptors that are involved in these physiologic effects. Furthermore, it would be imperative to study the array of molecules, both natural and manufactured, that can interact with these receptors for the amelioration of nausea. Until we understand the mechanism and specific therapy for NVP, it would appear that the reintroduction of Bendectin is the logical intermediate course to follow. We should also accompany the introduction of Bendectin with an educational campaign with regard to the lack of reproductive risks for this medication. The Food and Drug Administration has set the stage for the reintroduction of Bendectin by republishing their conclusion that Bendectin does not represent an increase in reproductive risks to the fetuses of pregnant women.


46: Borckardt J.J., Nash M.R.

How practitioners (and others) can make scientifically viable contributions to clinical-outcome research using the single-case time-series design.
Int J Clin Exp Hypn 2002 Apr;50(2):114-48.
Although clinicians typically possess considerable interest in research, especially about which interventions do and do not work, all too often they dismiss the notion that they themselves can make viable scientific contributions to the outcome literature. This derives from an unfortunate assumption that the only true experiment is a between-groups experiment. There is another form of true experiment that is perfectly compatible with real-world clinical practice: the single-case time-series design. Intensive and systematic tracking of one or a few patients over time can yield viable inferences about efficacy, effectiveness, and, under some circumstances, mechanism of change. This paper describes how clinicians working with hypnosis can carry out such research. The rationale and essential features of time-series studies are outlined; each design is illustrated with actual studies from the hypnosis literature; and new methods of statistical analysis, well within the statistical competence of practitioners, are described.


47: Rucklidge J.J., Saunders D.

The efficacy of hypnosis in the treatment of pruritus in people with HIV/AIDS: a time-series analysis.
Int J Clin Exp Hypn 2002 Apr;50(2):149-69.
Pruritus, or generalized itch, is a source of serious discomfort and distress in a significant minority of people living with AIDS. Anecdotal reports suggest hypnosis might be a useful treatment, leading to reductions in distress and improvements in the condition. But empirical examination of the question is notably lacking. This time-series study reports results of a 6-session self-hypnosis treatment (relaxation, deepening, imagery, and home practice) for 3 HIV-positive men suffering from pruritus, related to disease progression and/or HIV medications. Posttreatment, all 3 patients reported significant reductions in daily itch severity and extent of sleep disturbance due to itch. One patient also evidenced significantly less itch distress. Another also experienced significantly less time bothered by itch. For the 2 patients on which 4-month follow-up data were available, treatment benefit across variables was stable or further improved.


48: Elsig C., Schopper C., Anthony M., Gramigna R., Boker H.

[In-patient hypnotherapeutic trauma exposure for posttraumatic stress disorder: a case report]
Psychiatr Prax 2002 Mar;29(2):97-100.
This paper describes the treatment of a patient with the diagnoses of a borderline personality disorder and posttraumatic stress disorder (DSM-IV and ICD-10) within the setting of a psychiatric ward spezializing in depression. For purposes of controlled re-exposure to the patient's trauma, a hypnotherapeutic method was chosen. A significant reduction of symptoms, in particular the intrusions and the hyperarousal, was observed. Of great importance in the successful outcome of this case is the integration of hypnotherapy into a multi-dimensional treatment concept including group therapy, physical therapy and anxiety-reducing self-management therapy. This approach facilitated the development of trust and security in the patient required for the hypnotherapeutic intervention and minimized the splitting tendencies specific to borderline patients. Further discussion is centered on the difficulties arising in the context of an emergency ward setting with its high intensity atmosphere encompassing the danger of retraumatization of this special group of patients. Finally several aspects of the clinical implications of this method are addressed.