Sv: Re: Sv: Traumer og kroniske sykdommer
Rober C. Scaer, nevrolog. Det ser ut for meg som om han mener at klassifikasjonene av psykiatriske sykdommer i stedet er utallige avarter av traumer, post traumatisk stressyndrom. Om han har rett, så er jo diagnosemanualen temmelig ubrukelig, ikke sant? det kommer tydelig frem i boken hans "The body bears the burden".
Her er en artikkel http://www.uib.no/insuhc/files/scaer.pdf Jeg kan dessverre ikke påta meg å oversette den, men dette er potent stoff!
Sitat:
...This attempt to return to the concepts of a relatively broadly-based response of the
organism to traumatic stress is critical to our consideration of the neurophysiology of
trauma and its effects not only on systems of the brain and endocrine systems, but also on
the body itself. When one accepts the tenet that the clinical expressions of a multitude of
psychiatric syndromes derive not only de novo or through gene expression, but perhaps
also through life experience and its lasting effects on brain physiology, one must return to
the concept of a physiological continuum between many psychiatric diagnoses.
Sitat:
This model of disease in trauma would predict that vasomotor symptoms and signs would
be likely, with both trophic and dystrophic components, the latter reflecting
vasoconstriction and ischemia. Cardiac, pulmonary, bowel and exocrine gland
dysfunction should be predictable. Abnormalities of strength, muscle tone and endurance
should be common. Lowering of serum cortisol in late stages of trauma might lead to
relative lack of immune inhibition, and therefore to hyperimmune syndromes. One
would also expect these syndromes in some cases to manifest remarkable periods of
exacerbation and remission based on autonomic oscillation, and to be specifically
sensitive to exacerbation by external stress. Fluctuating symptoms of cognitive
impairment especially related to attention and memory would be common in many of
these conditions. One would expect an unusual association of the emotional symptoms of
late trauma, including affect dysregulation, dissociation, somatization, depression,
hypervigilance and denial/avoidance. A psychosocial trauma history in many cases
might reflect a history of substantial life trauma, especially in childhood.
Among other manifestations, these diseases would at least in part show evidence of
abnormal parasympathetic tone, perhaps along with sympathetic vasoconstrictive
dystrophic and ulcerative phenomenona. Diseases and syndromes of the gastrointestinal
system that fall into this general concept of diseases of trauma include peptic ulcer and
gastroesophageal reflux disease, irritable bowel syndrome, Crohn’s disease (regional
ileitis) and ulcerative colitis. All reflect organ hypermotility, excessive glandular
secretion and in some, ulcerative features. Cardiac syndromes would likely reflect the
cardiac abnormalities associated with DVC dominance, and be associated with a variety
of tachy- and bradyarrythmias, including those seen in mitral valve prolapse. Bronchial
asthma, a syndrome primarily manifested by stress and hyperimmune-induced abnormal
organ-specific parasympathetic events (bronchospasm and hypersecretion) has many of
the criteria predictable in diseases of trauma. Interstitial cystitis is a condition
characterized by pain, spasm and ulceration of the bladder wall, combining the
parasympathetic/dystrophic elements of many of these syndromes.
One of the most perplexing and controversial chronic syndromes that may fall into this
category is that of fibromyalgia/chronic fatigue.
