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The homeopath's personality profile
ARTICLE IN PRESS 188
Abstracts / European Journal of Integrative Medicine 1 (2009) 181–221
a
Kliniken Essen-Mitte, Internal and Integrative Medicine, Essen, Germany b Karl and Veronica Carstens Foundation, Biometry, Essen, Germany c Immanuel Krankenhaus, Innere Medizin/Naturheilkunde, Berlin, Germany
Concepts and Systems OP-013 The homeopath’s personality profile M.B. Rise, A. Steinsbekk
Question: Metabolic syndrome has an increasing prevalence worldwide and there is an urgent need for improvement of medical treatment. In traditional medical systems bloodletting is a frequently recommended therapy in subjects with obesity and vascular disease. Recent randomized studies showed that bloodletting improves insulin sensitivity in patients with diabetes mellitus and increased ferritin concentration and might be beneficial in younger patients with peripheral arterial vascular disease. We aimed to test if traditional bloodletting has beneficial effects in patients with metabolic syndrome. Methods: A randomized controlled study with a study period of 3 months was conducted in 64 self-referred subjects that had a confirmed diagnosis of metabolic syndrome as defined by recent guidelines. Thirty-three subjects (6077 yr; BMI 32.875.5 kg/m2) were allocated to the bloodletting intervention group and 31 subjects (57710 yr; BMI 32.575.6 kg/m2) to the control group (waiting list). In the intervention group two phlebotomies with removal of 300–400 ml of venous blood were performed at day 1 and after 4 weeks. Primary outcomes were the course of seated systolic blood pressure and of insulin sensitivity as measured by HOMA-Index. Secondary endpoints included diastolic blood pressure, ferritin, serum iron, hematocrit, HbA1c, LDL/HDLquotient and blood glucose. Results: Baseline characteristics were balanced between groups. Seated systolic blood pressure dropped from 148.5712.3 to 130.5711.8 mmHg in the intervention group and from 144.7714.4 to 143.8711.9 mmHg in the control group (group difference 16.6 mmHg, 95% CI:20.7 to 12.5; po0.001). HOMA-index after 3 months was not different between groups (p ¼ 0.251). Diastolic blood pressure, heart rate, blood glucose, HbA1c and LDL/HDL were significantly decreased by bloodletting. Bloodletting led to reductions of serum iron concentration, plasma ferritin and a slight decrease in hematocrit with no serious adverse events. Conclusions: Phlebotomy (bloodletting) effectively decreases blood pressure and improves metabolic parameters in patients with metabolic syndrome. Larger studies should test the longer-term efficacy of bloodletting in metabolic syndrome, hypertension and lipid disorders. 10.1016/j.eujim.2009.08.082
Norwegian University of Science and Technology, Department of Public Health and General Practice, Trondheim, Norway
Background: Research has indicated several specific characteristics of the homeopathic consultations and their patients. Homeopaths treat more children; their consultations are longer and encompass a whole-person-approach to a greater degree than in general medical practice. This is likely to indicate a difference in treatment philosophy, but might also be indication of difference in personality traits. Personality profiles of different occupational groups have been studied and include investigations on the personality traits of doctors, medical students, surgical residents, urology residents, and psychotherapists, and on personality as a prognostic factor for speciality choice in medicine. However, to date no study has investigated the personality trait of homeopaths. Aim: The aim of this study was thus to describe the personality traits of homeopaths in Norway, and to compare these traits to the Norwegian population. Methods: A cross-sectional survey among all members of the Norwegian association for homeopaths was conducted in the fall 2007. Personality was measured using the Norwegian translation of the Revised NEO Personality Inventory (NEO-PI-R). The NEO-PI-R questionnaire is based on the Five Factor Model and consists of a 240-item self-report questionnaire that describes five personality traits: Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness. Results: In total 325 homeopaths were invited to participate and 130 homeopaths (40%) agreed and returned completed questionnaires. The analysis shows that compared to the average Norwegian population, the homeopaths had a significantly lower score on Extraversion (difference 1.7 points, 95% CI 3.1 to 0.3, p ¼ 0.017) and a significantly higher score on Openness (4.7, 3.3–6.2, po0.001), Agreeableness (8.0, 6.5–9.6, po0.001), and Conscientiousness (2.3, 0.9–3.7, p ¼ 0.001). There was no significant difference for Neuroticism (0.3, 1.9–1.2, p ¼ 0.663). Conclusion: The homeopaths in this study had significantly higher scores on the trait Agreeableness. Agreeableness describes the way a person relates to other people. A high score might characterise a person who is trusting, kind, altruistic, and caring. The abilities to listen, understand, care, and comfort are probably vital in therapeutic work. Persons with a relatively high score
ARTICLE IN PRESS Abstracts / European Journal of Integrative Medicine 1 (2009) 181–221
on Agreeableness might be more prone to choose homeopathy as a vocation. 10.1016/j.eujim.2009.08.091
OP-014 Integrative medicine and whole systems approaches: From heterogeneous practice to comprehensive scientific concepts P. Heusser University of Witten/Herdecke, Center for Integrative Medicine, Herdecke, Germany
Background: So far, the integrative medicine mostly consists of a pragmatic inclusion of heterogeneous practices from diverse historical and cultural backgrounds into research and practice of conventional medicine. Conceptually, complementary or alternative medical theories remain largely unrelated to the molecular models of conventional medicine; and a rational integration of diverse medical theories is elusive. Objective: To develop a common, intersubjectively testable basis for diverse medical systems concerned with integrative or whole systems approaches, based on observation and thinking. Method: An epistemological analysis of the relation between observable phenomena and their corresponding rational concepts, applicable to all possible fields of experience: external and internal, physical, organic, emotional, mental, and spiritual.
Results: 1. A common conceptual ground for diverse medical systems can only be found on the basis of observation and thinking, not on mere theories (e.g. of holism or reductionism). 2. Observation cannot be restricted to external physical observation, but may also encompass emotional, mental, or spiritual observations. 3. The concepts applied to the contents of observation should not be speculative, but exactly and evidently describe the observed inner or external phenomena. 4. In this way the difference between mere molecular or holistic thought models and observed facts become apparent in an intersubjectively testable way, and the need to ‘‘reduce’’ higher order phenomena of a ‘‘whole’’ to the properties of its parts becomes unnecessary. 5. This could facilitate mutual understanding between disciplines and lay the basis for common concepts.
Conclusions: 1. Integrative medicine has led to a pragmatic integration of conventional and complementary methods in practice and research, but a conceptual integration is lacking.
189
2. A phenomenological method of observation and thinking is suggested to bridge this conceptual gap.
This could facilitate mutual understanding and common concepts between disciplines and lay the basis for their conceptual integration.
10.1016/j.eujim.2009.08.088
OP-015 Western and alternative medicine: A comparison of paradigms and methods R. Hoenders, F. Willgeroth, M. Appelo
Lentis, Center for Integrative Psychiatry, Groningen, Netherlands
Background: Although the practical integration of western medicine (WM) and complementary and alternative medicine (CAM) seems to be growing, their paradigms and therapeutic methods seem, at first sight, almost impossible to reconcile. Is the integration of WM and CAM really an illusion or is the presumed gap mainly related to our points of view? Method: A literature search through Medline, PsychLit, books, internet resources and in-depth interviews with several experts on this subject. Results: We found 12 main differences between WM and CAM, which can be ordered into 5 factors: paradigm, perspective, organisation, procedure and scientific method. These distinctions do not seem to be categorical but rather dimensional; except for the factor ‘paradigm’ (mechanism versus vitalism), which is categorical and has been one of the greatest controversies in philosophy. This absolute contrast is of a meta-theoretical nature and therefore cannot be solved through standard scientific logic. Supporters of each viewpoint cannot be convinced by scientific evidence to the contrary because their points of view concerns an existential premise, a conviction regarding the question of ‘why’ things are as they are. Conclusion: The presumed gap between WM and CAM seems to consist only of different paradigms, so it seems mainly related to our point of view. The biopsychosocial model as proposed by Engel seems valuable in bridging this presumed gap. 10.1016/j.eujim.2009.08.089
Abstracts / European Journal of Integrative Medicine 1 (2009) 181–221
a
Kliniken Essen-Mitte, Internal and Integrative Medicine, Essen, Germany b Karl and Veronica Carstens Foundation, Biometry, Essen, Germany c Immanuel Krankenhaus, Innere Medizin/Naturheilkunde, Berlin, Germany
Concepts and Systems OP-013 The homeopath’s personality profile M.B. Rise, A. Steinsbekk
Question: Metabolic syndrome has an increasing prevalence worldwide and there is an urgent need for improvement of medical treatment. In traditional medical systems bloodletting is a frequently recommended therapy in subjects with obesity and vascular disease. Recent randomized studies showed that bloodletting improves insulin sensitivity in patients with diabetes mellitus and increased ferritin concentration and might be beneficial in younger patients with peripheral arterial vascular disease. We aimed to test if traditional bloodletting has beneficial effects in patients with metabolic syndrome. Methods: A randomized controlled study with a study period of 3 months was conducted in 64 self-referred subjects that had a confirmed diagnosis of metabolic syndrome as defined by recent guidelines. Thirty-three subjects (6077 yr; BMI 32.875.5 kg/m2) were allocated to the bloodletting intervention group and 31 subjects (57710 yr; BMI 32.575.6 kg/m2) to the control group (waiting list). In the intervention group two phlebotomies with removal of 300–400 ml of venous blood were performed at day 1 and after 4 weeks. Primary outcomes were the course of seated systolic blood pressure and of insulin sensitivity as measured by HOMA-Index. Secondary endpoints included diastolic blood pressure, ferritin, serum iron, hematocrit, HbA1c, LDL/HDLquotient and blood glucose. Results: Baseline characteristics were balanced between groups. Seated systolic blood pressure dropped from 148.5712.3 to 130.5711.8 mmHg in the intervention group and from 144.7714.4 to 143.8711.9 mmHg in the control group (group difference 16.6 mmHg, 95% CI:20.7 to 12.5; po0.001). HOMA-index after 3 months was not different between groups (p ¼ 0.251). Diastolic blood pressure, heart rate, blood glucose, HbA1c and LDL/HDL were significantly decreased by bloodletting. Bloodletting led to reductions of serum iron concentration, plasma ferritin and a slight decrease in hematocrit with no serious adverse events. Conclusions: Phlebotomy (bloodletting) effectively decreases blood pressure and improves metabolic parameters in patients with metabolic syndrome. Larger studies should test the longer-term efficacy of bloodletting in metabolic syndrome, hypertension and lipid disorders. 10.1016/j.eujim.2009.08.082
Norwegian University of Science and Technology, Department of Public Health and General Practice, Trondheim, Norway
Background: Research has indicated several specific characteristics of the homeopathic consultations and their patients. Homeopaths treat more children; their consultations are longer and encompass a whole-person-approach to a greater degree than in general medical practice. This is likely to indicate a difference in treatment philosophy, but might also be indication of difference in personality traits. Personality profiles of different occupational groups have been studied and include investigations on the personality traits of doctors, medical students, surgical residents, urology residents, and psychotherapists, and on personality as a prognostic factor for speciality choice in medicine. However, to date no study has investigated the personality trait of homeopaths. Aim: The aim of this study was thus to describe the personality traits of homeopaths in Norway, and to compare these traits to the Norwegian population. Methods: A cross-sectional survey among all members of the Norwegian association for homeopaths was conducted in the fall 2007. Personality was measured using the Norwegian translation of the Revised NEO Personality Inventory (NEO-PI-R). The NEO-PI-R questionnaire is based on the Five Factor Model and consists of a 240-item self-report questionnaire that describes five personality traits: Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness. Results: In total 325 homeopaths were invited to participate and 130 homeopaths (40%) agreed and returned completed questionnaires. The analysis shows that compared to the average Norwegian population, the homeopaths had a significantly lower score on Extraversion (difference 1.7 points, 95% CI 3.1 to 0.3, p ¼ 0.017) and a significantly higher score on Openness (4.7, 3.3–6.2, po0.001), Agreeableness (8.0, 6.5–9.6, po0.001), and Conscientiousness (2.3, 0.9–3.7, p ¼ 0.001). There was no significant difference for Neuroticism (0.3, 1.9–1.2, p ¼ 0.663). Conclusion: The homeopaths in this study had significantly higher scores on the trait Agreeableness. Agreeableness describes the way a person relates to other people. A high score might characterise a person who is trusting, kind, altruistic, and caring. The abilities to listen, understand, care, and comfort are probably vital in therapeutic work. Persons with a relatively high score
ARTICLE IN PRESS Abstracts / European Journal of Integrative Medicine 1 (2009) 181–221
on Agreeableness might be more prone to choose homeopathy as a vocation. 10.1016/j.eujim.2009.08.091
OP-014 Integrative medicine and whole systems approaches: From heterogeneous practice to comprehensive scientific concepts P. Heusser University of Witten/Herdecke, Center for Integrative Medicine, Herdecke, Germany
Background: So far, the integrative medicine mostly consists of a pragmatic inclusion of heterogeneous practices from diverse historical and cultural backgrounds into research and practice of conventional medicine. Conceptually, complementary or alternative medical theories remain largely unrelated to the molecular models of conventional medicine; and a rational integration of diverse medical theories is elusive. Objective: To develop a common, intersubjectively testable basis for diverse medical systems concerned with integrative or whole systems approaches, based on observation and thinking. Method: An epistemological analysis of the relation between observable phenomena and their corresponding rational concepts, applicable to all possible fields of experience: external and internal, physical, organic, emotional, mental, and spiritual.
Results: 1. A common conceptual ground for diverse medical systems can only be found on the basis of observation and thinking, not on mere theories (e.g. of holism or reductionism). 2. Observation cannot be restricted to external physical observation, but may also encompass emotional, mental, or spiritual observations. 3. The concepts applied to the contents of observation should not be speculative, but exactly and evidently describe the observed inner or external phenomena. 4. In this way the difference between mere molecular or holistic thought models and observed facts become apparent in an intersubjectively testable way, and the need to ‘‘reduce’’ higher order phenomena of a ‘‘whole’’ to the properties of its parts becomes unnecessary. 5. This could facilitate mutual understanding between disciplines and lay the basis for common concepts.
Conclusions: 1. Integrative medicine has led to a pragmatic integration of conventional and complementary methods in practice and research, but a conceptual integration is lacking.
189
2. A phenomenological method of observation and thinking is suggested to bridge this conceptual gap.
This could facilitate mutual understanding and common concepts between disciplines and lay the basis for their conceptual integration.
10.1016/j.eujim.2009.08.088
OP-015 Western and alternative medicine: A comparison of paradigms and methods R. Hoenders, F. Willgeroth, M. Appelo
Lentis, Center for Integrative Psychiatry, Groningen, Netherlands
Background: Although the practical integration of western medicine (WM) and complementary and alternative medicine (CAM) seems to be growing, their paradigms and therapeutic methods seem, at first sight, almost impossible to reconcile. Is the integration of WM and CAM really an illusion or is the presumed gap mainly related to our points of view? Method: A literature search through Medline, PsychLit, books, internet resources and in-depth interviews with several experts on this subject. Results: We found 12 main differences between WM and CAM, which can be ordered into 5 factors: paradigm, perspective, organisation, procedure and scientific method. These distinctions do not seem to be categorical but rather dimensional; except for the factor ‘paradigm’ (mechanism versus vitalism), which is categorical and has been one of the greatest controversies in philosophy. This absolute contrast is of a meta-theoretical nature and therefore cannot be solved through standard scientific logic. Supporters of each viewpoint cannot be convinced by scientific evidence to the contrary because their points of view concerns an existential premise, a conviction regarding the question of ‘why’ things are as they are. Conclusion: The presumed gap between WM and CAM seems to consist only of different paradigms, so it seems mainly related to our point of view. The biopsychosocial model as proposed by Engel seems valuable in bridging this presumed gap. 10.1016/j.eujim.2009.08.089