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Ancient Chinese medicine in mental illness
Oral Presentations / European Journal of Integrative Medicine 4S (2012) 9–123
ment and interpersonal conflict resolution–in which meditation techniques and psychological and sociological tools have been successfully integrated. The programme began in 2002 at the University of Siena and included several post-graduate official courses (three PhDs, five master’s and 10 annual certificates) and many other shorter courses for professionals (medical doctors, paramedicals, teachers, company managers, etc.). It is well known that the word ‘meditation’ has many different meanings, that dozens of different meditation techniques exist and that even their purposes are different in different traditions. In our programme, we used and tested several meditation techniques, coming from different traditions were tested, and their use was directed to develop self-awareness and the awareness of the others, intending the former as the skill of recognising one’s own emotions, beliefs, thought patterns, character traits, communication patterns, etc., and the latter as the skill of recognising the others’ emotions, beliefs, thought patterns, character traits, communication patterns, etc. http://dx.doi.org/10.1016/j.eujim.2012.07.660 OP-166 The pulse diagnosis according to anthroposophical medicine in the treatment of anxious–depressive pathologies Di Paolo Giovanni SIMA, Rome, Italy Ayurvedic medicine is a preventive treatment of the corporal disorders, its fundamental objective is to keep the physiological homeostasis and the re-establishment of the normal organic functions. To obtain a correct Ayurvedic treatment, we have to identify the specific constitutions of the human body: Vata, Pitta and Kapha. Ayurvedic Nadi Vigyan (Ayurvedic pulse reading) finds its principal basis in the recognition of the dosha, sub-dosha and dhatu points. With the Ayurvedic pulse reading, we can measure the harmony between the ‘accomplished’, the physique, and the ‘unfinished’, the consciousness, the self of the patient. Nadi Vigyan is the easier, natural and precise method to find and check the derangement of three doshas, responsible for the state of health. The ancient discipline of Nadi Vigyan forms the core of Ayurvedic teaching and develops the correlation between consciousness and physiology. The pulse is consciousness-beating value in the body. The Vedic science with Ayurveda evolved in the Occident with Hippocratic medicine, then alchemy and finally with anthroposophy, which postulates the existence of an objective, intellectually comprehensible spiritual world accessible to direct experience through inner development. In its investigations of the spiritual world, anthroposophy aims to attain the precision and clarity attained by the natural sciences in their investigations of the physical world. Comparing with Ayurvedic pulse reading, we can find many analogies with anthroposophical pulse investigation and we also find in it the constitutions in the quadripartite and the tripartite body. With this study, we intend to explain the comparison and the relationship between these two investigational medical methods of the reality of the human being. In this
81
way, the anxious–depressive pathologies can be diagnosed with anthroposophical pulse reading and to provide a good anthroposophical treatment after the identification of the right organ. The organ is detected in its completeness, by its physique, ‘etheric’ and ‘astral’ consistencies and by deep, medium and superficial pulses, respectively. http://dx.doi.org/10.1016/j.eujim.2012.07.661 OP-167 Post-traumatic stress disorder: an integrative East–West psychosomatic approach Maric-Oehler Walburg Deutsche Ärztegesellschaft für Akupunktur (DÄGfA), Bad Homburg, Germany As long as post-traumatic stress disorder (PTSD) is defined as a separate pattern in psychotherapeutic medicine, it is diagnosed increasingly often in medical, psychotherapeutic practice. Research in neuroscience is focussed more and more on this subject. Neuroscience suggests that the effect of acupuncture is based on various mechanisms and processes in the central nervous system. Combining the two facts, there must be a connection between the Western and the Oriental medical theory and practice of PTSD. The Chinese medical understanding of (psychic) shock, injury and traumatic experience is psychosomatic in the unique way of this medical system. PTSD will be explained by concepts of Chinese medicine, for example, Five Phases, Zang Fu, the concept of Qi, the concept of Hun Po and the meridian theory. The knowledge and experience of Chinese medicine will be connected with Western understanding, ideas and concepts in medicine, psychosomatics and psychotherapy. It may be helpful to combine Western psychotherapeutic diagnostic procedures with the diagnostics of Oriental medical systems. This makes it possible to combine treatment procedures of both systems, not just in parallel but in a specific way, different forms of psychotherapy with different forms of acupuncture and other methods of Chinese/Oriental medicine. In this way, patients with PTSD can be treated with an extended integrative trauma therapy. http://dx.doi.org/10.1016/j.eujim.2012.07.662 OP-168 Ancient Chinese medicine in mental illness Brotzu Rosa FISA-Centro Studi Xin Shu, Rome, Italy The Gui points have been described for the first time by Sun Si Miao, great Taoist physician (590–682 BC), the author of Qian jin yao fang, which proposes the treatment of mental illnesses, Dian Kuang, caused by 100 pathogens. The physician, and he who practices the medical arts as I do, frequently finds himself confronted with strange symptoms and pathologies that have to deal with psychic disturbances such as anxiety, depres-
82
Oral Presentations / European Journal of Integrative Medicine 4S (2012) 9–123
sion, etc., which are frequently not based on an organic nature. Dian Kuang includes various mental illnesses characterised by loss of mental capacity to understand reality: perception, understanding and behaviour that show a large shift is reflected in the social relations of the subject. Gui points are 13 and should be treated in a predetermined order one after the other according to the symptoms of the patient. They are generally divided into four groups: 1) 26GV, 11LU, and 1SP, 2) 7PC, 62BL, and 1SP, 3) 6ST, 24CV, 8PC and 4)23GV, 1CV, 11LI and Hai Quang. Treatment with the Gui points is shown particularly in mental illness with sudden onset. The various authors of the alchemical tradition describe different ways of treating mental illness with the assumption that it is essential to help the patient find their own individual personalities in order to modify the disease. http://dx.doi.org/10.1016/j.eujim.2012.07.663 OP-169 Long-term treatment of bipolar disorder with radio electric asymmetric conveyor (REAC) Mannu Piero, Gamba William, Mele Gianni, Sias Francesco, Zoncu Daniele Centro di Medicina Integrata ISCUB Aim: The aim of this study was to evaluate the long-term effectiveness of the radio electric asymmetric conveyer (REAC) brain stimulation device associated with lithium versus routine treatments in subjects with bipolar disorder I and II, evaluated as the number of recurrences compared to the period of illness preceding REAC-–ithium treatment. Methods: The charts of 56 bipolar patients attending our institute were retrospectively evaluated. REAC treatment was administered following the standard Rinaldi-Fontani Institute protocol. Add-on treatments were allowed in case of manic or depressive recurrence. Eight patients (group 1) were followed up for 30.2 ± 3.0 months, 14 patients (group 2) for 25.3 ± 3.3 months, 25 patients (group 3) for 20.3 ± 1.6 months and nine patients (group 4) for 16.2 ± 0.5 months. Results: After REAC–lithium treatment, the number of manic and depressive episodes has changed (1) in group 1 from 2.1 ± 0.6 and 3.0 ± 0.7 to 0.12 ± 0.0 and 0.8 ± 0.4, respectively; (2) in group 2 from 2.4 ± 0.6 and 3.9 ± 0.7 to 0.14 ± 0.2 and 0.0 ± 0.0, respectively; (3) in group 3 from 2.6 ± 0.8 and 3.6 ± 0.9 to 0.04 ± 0.0 and 0.0 ± 0.0, respectively; and (4) in group 4 from 2.6 ± 1.1 and 3.7 ± 1.0 to 0.1 ± 0.0 and 0.0 ± 0.0, respectively. All results were statistically significant. Conclusions: Small size, naturalistic and flexible dose design, maintenance of lithium and lack of accurate assessments are the main limitations of this study. Nevertheless, REAC has showed great efficacy in both manic and depressive phases of bipolar disorder, and in the prevention of recurrences/relapses. It is clear that the findings drawn from this study supply only preliminary information that require further confirmation by means of studies performed with more accurate analysis meth-
ods and, particularly, for longer follow-up, conducted on larger populations. http://dx.doi.org/10.1016/j.eujim.2012.07.664 OP-170 Mental health and CAM: an opportunity to increase the perception of cure efficiency Balzola Maria Antonietta, Savino Cristina The use of complementary allopathic and nonconventional medicine as an answer to mental illness, within the health service, assuring an integral therapy in the field of mental health therapy could bring improvements to the psychiatric services by paying attention to the illness of each individual patient. This may permit cost savings based on a higher and more complete attention is being paid to patients taken into care. Orientation from a psychiatric point of view is that of anthropoanalytical psychiatry, ‘Daseinanalysis’. This recognises the existentialism of the patients and their possible symptoms such as temporality, spatiality and coexistence. It is necessary to take mental illness back to it existential foundations so as to see the man or the woman who suffers, in their complexity. Therefore, it is possible to have a vision of the illness placed within the sphere of existence as a possibility of the person being liberated from an idealistic and biological concept. In this theoretical picture, to analyse the perception of the cure by the meeting of health sociology and narrative medicine, which could be very fruitful, the analysis of the context of the relationship in which the user of mental health services is placed, the medical history acquired and the narrative and the systematic description of therapeutic relationships within the clinical cure is a subject of well-consolidated sociological research. In fact, health sociology analyses illness and health as a social and relational fact: of its origin, in the relationships produced, and in the systematic processes in which the binomial health/illness is inserted. Reported are qualitative data resulting from a research regarding the perception of cure efficiency in two mental health territorial services in Milan, one using only allopathic medicine and the other offering also complementary and alternative medicine (CAM). The aim is to achieve a pedagogical reading of the connection between cure and rehabilitation to reinvent, in psychiatry, a health model centred on the person, on a sustainable medicine, which istransparent and honest for every single citizen, questioning the necessity of integrate operative units (M.C. and M.N.C.), as well as epidemical and research units aimed at the analysis of interaction between the various medicines. http://dx.doi.org/10.1016/j.eujim.2012.07.665
ment and interpersonal conflict resolution–in which meditation techniques and psychological and sociological tools have been successfully integrated. The programme began in 2002 at the University of Siena and included several post-graduate official courses (three PhDs, five master’s and 10 annual certificates) and many other shorter courses for professionals (medical doctors, paramedicals, teachers, company managers, etc.). It is well known that the word ‘meditation’ has many different meanings, that dozens of different meditation techniques exist and that even their purposes are different in different traditions. In our programme, we used and tested several meditation techniques, coming from different traditions were tested, and their use was directed to develop self-awareness and the awareness of the others, intending the former as the skill of recognising one’s own emotions, beliefs, thought patterns, character traits, communication patterns, etc., and the latter as the skill of recognising the others’ emotions, beliefs, thought patterns, character traits, communication patterns, etc. http://dx.doi.org/10.1016/j.eujim.2012.07.660 OP-166 The pulse diagnosis according to anthroposophical medicine in the treatment of anxious–depressive pathologies Di Paolo Giovanni SIMA, Rome, Italy Ayurvedic medicine is a preventive treatment of the corporal disorders, its fundamental objective is to keep the physiological homeostasis and the re-establishment of the normal organic functions. To obtain a correct Ayurvedic treatment, we have to identify the specific constitutions of the human body: Vata, Pitta and Kapha. Ayurvedic Nadi Vigyan (Ayurvedic pulse reading) finds its principal basis in the recognition of the dosha, sub-dosha and dhatu points. With the Ayurvedic pulse reading, we can measure the harmony between the ‘accomplished’, the physique, and the ‘unfinished’, the consciousness, the self of the patient. Nadi Vigyan is the easier, natural and precise method to find and check the derangement of three doshas, responsible for the state of health. The ancient discipline of Nadi Vigyan forms the core of Ayurvedic teaching and develops the correlation between consciousness and physiology. The pulse is consciousness-beating value in the body. The Vedic science with Ayurveda evolved in the Occident with Hippocratic medicine, then alchemy and finally with anthroposophy, which postulates the existence of an objective, intellectually comprehensible spiritual world accessible to direct experience through inner development. In its investigations of the spiritual world, anthroposophy aims to attain the precision and clarity attained by the natural sciences in their investigations of the physical world. Comparing with Ayurvedic pulse reading, we can find many analogies with anthroposophical pulse investigation and we also find in it the constitutions in the quadripartite and the tripartite body. With this study, we intend to explain the comparison and the relationship between these two investigational medical methods of the reality of the human being. In this
81
way, the anxious–depressive pathologies can be diagnosed with anthroposophical pulse reading and to provide a good anthroposophical treatment after the identification of the right organ. The organ is detected in its completeness, by its physique, ‘etheric’ and ‘astral’ consistencies and by deep, medium and superficial pulses, respectively. http://dx.doi.org/10.1016/j.eujim.2012.07.661 OP-167 Post-traumatic stress disorder: an integrative East–West psychosomatic approach Maric-Oehler Walburg Deutsche Ärztegesellschaft für Akupunktur (DÄGfA), Bad Homburg, Germany As long as post-traumatic stress disorder (PTSD) is defined as a separate pattern in psychotherapeutic medicine, it is diagnosed increasingly often in medical, psychotherapeutic practice. Research in neuroscience is focussed more and more on this subject. Neuroscience suggests that the effect of acupuncture is based on various mechanisms and processes in the central nervous system. Combining the two facts, there must be a connection between the Western and the Oriental medical theory and practice of PTSD. The Chinese medical understanding of (psychic) shock, injury and traumatic experience is psychosomatic in the unique way of this medical system. PTSD will be explained by concepts of Chinese medicine, for example, Five Phases, Zang Fu, the concept of Qi, the concept of Hun Po and the meridian theory. The knowledge and experience of Chinese medicine will be connected with Western understanding, ideas and concepts in medicine, psychosomatics and psychotherapy. It may be helpful to combine Western psychotherapeutic diagnostic procedures with the diagnostics of Oriental medical systems. This makes it possible to combine treatment procedures of both systems, not just in parallel but in a specific way, different forms of psychotherapy with different forms of acupuncture and other methods of Chinese/Oriental medicine. In this way, patients with PTSD can be treated with an extended integrative trauma therapy. http://dx.doi.org/10.1016/j.eujim.2012.07.662 OP-168 Ancient Chinese medicine in mental illness Brotzu Rosa FISA-Centro Studi Xin Shu, Rome, Italy The Gui points have been described for the first time by Sun Si Miao, great Taoist physician (590–682 BC), the author of Qian jin yao fang, which proposes the treatment of mental illnesses, Dian Kuang, caused by 100 pathogens. The physician, and he who practices the medical arts as I do, frequently finds himself confronted with strange symptoms and pathologies that have to deal with psychic disturbances such as anxiety, depres-
82
Oral Presentations / European Journal of Integrative Medicine 4S (2012) 9–123
sion, etc., which are frequently not based on an organic nature. Dian Kuang includes various mental illnesses characterised by loss of mental capacity to understand reality: perception, understanding and behaviour that show a large shift is reflected in the social relations of the subject. Gui points are 13 and should be treated in a predetermined order one after the other according to the symptoms of the patient. They are generally divided into four groups: 1) 26GV, 11LU, and 1SP, 2) 7PC, 62BL, and 1SP, 3) 6ST, 24CV, 8PC and 4)23GV, 1CV, 11LI and Hai Quang. Treatment with the Gui points is shown particularly in mental illness with sudden onset. The various authors of the alchemical tradition describe different ways of treating mental illness with the assumption that it is essential to help the patient find their own individual personalities in order to modify the disease. http://dx.doi.org/10.1016/j.eujim.2012.07.663 OP-169 Long-term treatment of bipolar disorder with radio electric asymmetric conveyor (REAC) Mannu Piero, Gamba William, Mele Gianni, Sias Francesco, Zoncu Daniele Centro di Medicina Integrata ISCUB Aim: The aim of this study was to evaluate the long-term effectiveness of the radio electric asymmetric conveyer (REAC) brain stimulation device associated with lithium versus routine treatments in subjects with bipolar disorder I and II, evaluated as the number of recurrences compared to the period of illness preceding REAC-–ithium treatment. Methods: The charts of 56 bipolar patients attending our institute were retrospectively evaluated. REAC treatment was administered following the standard Rinaldi-Fontani Institute protocol. Add-on treatments were allowed in case of manic or depressive recurrence. Eight patients (group 1) were followed up for 30.2 ± 3.0 months, 14 patients (group 2) for 25.3 ± 3.3 months, 25 patients (group 3) for 20.3 ± 1.6 months and nine patients (group 4) for 16.2 ± 0.5 months. Results: After REAC–lithium treatment, the number of manic and depressive episodes has changed (1) in group 1 from 2.1 ± 0.6 and 3.0 ± 0.7 to 0.12 ± 0.0 and 0.8 ± 0.4, respectively; (2) in group 2 from 2.4 ± 0.6 and 3.9 ± 0.7 to 0.14 ± 0.2 and 0.0 ± 0.0, respectively; (3) in group 3 from 2.6 ± 0.8 and 3.6 ± 0.9 to 0.04 ± 0.0 and 0.0 ± 0.0, respectively; and (4) in group 4 from 2.6 ± 1.1 and 3.7 ± 1.0 to 0.1 ± 0.0 and 0.0 ± 0.0, respectively. All results were statistically significant. Conclusions: Small size, naturalistic and flexible dose design, maintenance of lithium and lack of accurate assessments are the main limitations of this study. Nevertheless, REAC has showed great efficacy in both manic and depressive phases of bipolar disorder, and in the prevention of recurrences/relapses. It is clear that the findings drawn from this study supply only preliminary information that require further confirmation by means of studies performed with more accurate analysis meth-
ods and, particularly, for longer follow-up, conducted on larger populations. http://dx.doi.org/10.1016/j.eujim.2012.07.664 OP-170 Mental health and CAM: an opportunity to increase the perception of cure efficiency Balzola Maria Antonietta, Savino Cristina The use of complementary allopathic and nonconventional medicine as an answer to mental illness, within the health service, assuring an integral therapy in the field of mental health therapy could bring improvements to the psychiatric services by paying attention to the illness of each individual patient. This may permit cost savings based on a higher and more complete attention is being paid to patients taken into care. Orientation from a psychiatric point of view is that of anthropoanalytical psychiatry, ‘Daseinanalysis’. This recognises the existentialism of the patients and their possible symptoms such as temporality, spatiality and coexistence. It is necessary to take mental illness back to it existential foundations so as to see the man or the woman who suffers, in their complexity. Therefore, it is possible to have a vision of the illness placed within the sphere of existence as a possibility of the person being liberated from an idealistic and biological concept. In this theoretical picture, to analyse the perception of the cure by the meeting of health sociology and narrative medicine, which could be very fruitful, the analysis of the context of the relationship in which the user of mental health services is placed, the medical history acquired and the narrative and the systematic description of therapeutic relationships within the clinical cure is a subject of well-consolidated sociological research. In fact, health sociology analyses illness and health as a social and relational fact: of its origin, in the relationships produced, and in the systematic processes in which the binomial health/illness is inserted. Reported are qualitative data resulting from a research regarding the perception of cure efficiency in two mental health territorial services in Milan, one using only allopathic medicine and the other offering also complementary and alternative medicine (CAM). The aim is to achieve a pedagogical reading of the connection between cure and rehabilitation to reinvent, in psychiatry, a health model centred on the person, on a sustainable medicine, which istransparent and honest for every single citizen, questioning the necessity of integrate operative units (M.C. and M.N.C.), as well as epidemical and research units aimed at the analysis of interaction between the various medicines. http://dx.doi.org/10.1016/j.eujim.2012.07.665