Author: Roberto Patarca-Montero File Type: pdf Learn how a patients behavior can factor into the prognosis of medically unexplainable illness! The Psychopathology of Functional Somatic Syndromes examines the link between mental illness and physical syndromes that lack organic disease explanations, including chronic fatigue syndrome, fibromyalgia, premenstrual dysphoria, irritable bowel, and Gulf War illness. The author has evaluated the best research work of the past 20 years to determine the association between psychopathology and functional illness, the biological gradient between somatic and psychological symptoms, and the manifestations of dysfunctional coping. The Psychopathology of Functional Somatic Syndromes challenges recent conceptualizations of functional somatic syndromes as brain disorders connected to affective spectrum disorder, serotonin deficiency, cerebral hypoperfusion or abnormal hypothalamic-pituitary-adrenal function and highlights the importance of abnormal illness behavior, sexual victimization, and maladaptive coping for the production and maintenance of these disorders. The Psychopathology of Functional Somatic Syndromes explores observations on the neurobiology and the personality abnormalities of patients made from structured data collected over a period of several years. It describes modern perceptions of functional somatic syndromes and how they have evolved into a tightly knit family of self-standing syndromes with a common core. The book examines the correlation between the burden of psychopathology and the physical features of these illnesses reviews advances made in the appraisal of the neuroanatomy, neuropsychology, and neurochemistry of functional syndromes and focuses on the connection between measurable dimensions of personality, coping, and illness behavior and the prognosis of medically unexplainable illnesses. The Psychopathology of Functional Somatic Syndromes examines ullpsychiatric morbidity llbrain perfusion llpost-traumatic stress in Gulf War illness llthe spectrum of mood disorders llthe hypothalamatic-pituitary-adrenal axis llthe sexual victimization of patients lland much more! lulThe Psychopathology of Functional Somatic Syndromes is an essential resource for psychiatrists and psychologists working in outpatient practice.From The New England Journal of MedicineThis book summarizes many recent studies of illnesses characterized by symptoms that, as yet, have no clear pathophysiology chronic fatigue syndrome, fibromyalgia, Gulf War illness, irritable bowel syndrome, and premenstrual dysphoria. Although the clinical manifestations of these illnesses are not identical, they have in common increased sensitivity to pain, sleep disturbance, difficulty with concentration, and labile mood. Indeed, many patients meet criteria for several of the illnesses. The book cites hundreds of recent publications and will serve as a road map for anyone interested in these common and perplexing illnesses. For each illness, Manu presents a synthesis of the literature regarding clinical manifestations, the prevalence of psychiatric diagnoses, personality profiles, abnormal behavior associated with the illness, cognitive testing, and neurobiologic (e.g., neuroimaging, neurotransmitter, and neuroendocrine) studies. Because it involves many different disciplines, pulling together this large and complex body of literature was no small task. Manus review is thorough. Although he has previously argued that these syndromes are probably manifestations of a primary affective disorder, in this book he concludes otherwise. In particular, he notes that a substantial portion of patients with these disorders do not have a mood disorder. Manu cites many studies indicating that patients often believe that they are suffering from an organic illness, even though no well-recognized organic illness has been diagnosed, and he suggests that this constitutes abnormal illness behavior. He also states that the literature supports a connection between the functional somatic syndromes and somatization disorder. However, the literature he cites indicates that most patients with these syndromes do not meet the criteria for somatization disorder. Indeed, if symptoms have an organic basis, then they cannot be said to stem from a somatization disorder, and a patients belief that his or her suffering is due to an organic illness cannot be called abnormal behavior. Hence, the central question Do these functional disorders have an organic basis? What is the evidence? Manu summarizes many neurobiologic studies that have found objective, biologic abnormalities in patients with these syndromes (e.g., abnormal patterns on magnetic resonance imaging and on single-photon-emission computed tomography abnormal responses on the testing of several hypothalamic-pituitary axes), in contrast to matched, healthy subjects and patients with psychiatric disorders, particularly major depression. Perhaps the most interesting question raised by this book is this What are functional somatic syndromes? The question is never explicitly addressed or answered. For many physicians, the word functional implies an illness that probably has no biologic cause, with symptoms that reflect a weakness of character or outright malingering. The literature summarized in this book argues that such inferences are unfounded. Indeed, in my view, the continued use of the term functional by mental health professionals perpetuates an archaic notion of mind-body dualism. The symptoms of these functional illnesses probably have biologic underpinnings, even though the articulation of a patients suffering clearly is influenced by personal experiences and cultural values. Although we are a long way from identifying the precise pathophysiology of these illnesses, there is considerable evidence that they have an underlying biologic basis. Anthony L. Komaroff, M.D. 2004 Massachusetts Medical Society. The New England Journal of Medicine is a registered trademark of the MMS. ReviewCOMPREHENSIVE AND INFORMATIVE. This book is ESSENTIAL READING for students of mind-body and illness. -- John DeLuca, PhD, Director of Neuroscience Research, Kessler Medical Rehabilitation Research and Education Corporation Professor, UMDNJ-New Jersey Medical SchoolPerhaps THE MOST COMPREHENSIVE TEXT EVER WRITTEN on the functional somatic syndromes. -- Harold G. Koenig, MD, Editor, International Journal of Psychiatry in Medicine Author of Chronic Pain Biomedical and Spiritual Approaches Associate Professor of Psychiatry and Medicine, Duke University Medical Center

Author: Loran M. Whitelock File Type: pdf Few other plants, with the possible exception of palms, can rival cycads for variety of foliage, size, and form. In spite of such diversity, however, cycads represent an ancient lineage whose fossil history extends over 200 million years. Cycads are tough and durable, not only as survivors but also as ornamental plants of great intrinsic interest. Yet cycads in the wild are endangered. Whitelock has spent decades studying cycads in their natural habitats around the world and in cultivation. Through his efforts, a well-documented program of propagation has made an increasing variety of cycads available to those who wish to grow and know more about them.**