ArticlePDF Available

Abstract

Stigmata are one of the most ancient and fascinating mysteries of the Christian religion. The word "stigmata" derives by the Greek "stigma", that means sign, mark. Classically, stigmata are the sores inflicted on Jesus Christ during his passion and crucifixion. Today, the term stigmatized has been extended to designate several cases of individuals, who show skin sores similar to those of Christ. The Authors report a brief history of stigmata, trying to give an explanation to such a fascinating phenomenon..
ISSN 0393-974X/2016
journal of
L._
2015
OSI) IMPACT
FACTOR
1.469
BIOLOGICAL REGUATORS
& Homeostatic Agents
JBRHA
SUPPLEMENT
Volume 31, No 2 (S2), Aprii
-
June, 2017
'News on the Bio Medical Sciences 2017 - selected concepts and emerging therapies"
Guest Editor - Prof. Torello Lotti
Deputy Guest Editor -Dr Jacopo Lotti, PhD
~lé
100
Te
lemaco
S
ig
no
r
in
i -
Merc
ia
io
a
La
Sp
ez
ia,
185
9 (
de
ta
i
l)
Published by
Biolife
www.biolifesas.org
JOURNAL OF BIOLOGICAL REGULATORS & HOMEOSTATIC AGENTS
Vol. 31, no. 2 (S2), 45-52 (2017)
STIGMATA IN THE HISTORY: AMONG FAITH, MYSTICISM AND SCIENCE
S. GIANFALDONI', J. LOTTI
2
, M.G. ROCCIA
3
, M. FIORANELLE
R. GIANFALDONI', and T. LOTTI'
'Department of Dermatology, University of Rome "G. Marconi", Rome, Italy;
2
Department of
Nuclear, Subnuclear and Radiation Physics, University of Rome "G. Marconi", Rome, Italy;
'University B.I.S. Group of Institutions, Punjab Technical University, Punjab, India;
4
Chair of
Dermatology, University of Rome "G. Marconi", Rome, Italy
Stigmata are one of the most ancient and fascinating mysteries of the Christian religion. The word
"stigmata" derives by the Greek "stigma", that means sign, mark. Classically, stigmata are the sores
inflieted on Jesus Christ during his passion and crucifixion. Today, the term stigmatized has been extended
to designate several cases of individuals, who show skin sores similar to those of Christ. The Authors
report a brief history of stigmata, trying to give an explanation to such a fascinating phenomenon.
Stigmata are one of the most ancient and
fascinating mysteries of Christian religion.
Classically, stigmata are the sores inflicted on Jesus
Christ, caused by the traumas he suffered during his
passion and crucifixion (Table I) (1). Nowadays in the
medicai field, the term
stigmata
has been extended
to designate a series of cases of difficult explanation
in which individuals manifest cutaneous lesions
(similar to those present in Christ's iconography) as a
divine sign. In a translated meaning, today, the word
stigma
also refers to psycho-physical or social signs
left on individuals and collectivities from adverse
events of different nature.
Stigmata in the History
The word
stigma
derives from the Greek (stima,
which means mark, sign. Originally, it indicated a
sign imprinted with an incandescent iron on animals
or slaves. In Ancient Greece and in Ancient Rome,
this practice was used to mark as a sign of belonging
or condemnation domestic animals, slaves and
malefactors condemned to forced labor. In Imperia!
Rome, it was used to mark slaves and soldiers to
indicate their ownership. Even in ancient oriental
populations, marking was used as a sign of belonging,
either to a particular tribe or to a divinity. The purpose
of the religious mark was to indicate the consecration
to divinity and to obtain its protection, such as the
tattoos practiced in Ancient Egypt. The stigma was
a sign of the full membership of a man to God in
Ancient Israel also; the practice, initially prohibited
by Law (Lv 19:28), became legitimate only when God
himself impressed this mark as a sign of protection.
However, some believers, in opposition to the pagan
cult of tattoos, preferred to practice circumcision to
mark the seal of the covenant with God (2).
In the Bible, the word
stigmata
(or its Latin
equivalent,
signum)
appears severa! times. In the Old
Testament (Ge 4:15), Cain, after the murder of Abel,
was marked in an unknown way by God to avoid that
people who meet him would murder him as well:
Dixitque ei Dominus: "Nequaquam ita fiet, sed omnis
qui occiderit Cain, septuplum punietur! ". Posuitque
Dominus Cain
signum,
ut non eum interJiceret omnis
qui invenisset eum.
The first time where stigmata are quoted is in the
Key words: stigmata, marks, faith, evidences, medical science
Mailing address:
Dr. Serena Gianfaldoni,
Department of Dermatology,
University of Rome "G. Marconi", Rome, Italy
e-mail: serena.gianfaldoni@gmail.com
45(S2)
0393-974X (2016)
Copyright by BIOLIFE, s.a.s.
This publication and/or article is for individuai use only and may noi be further
reproduced without written permission from the copyright holder.
Unauthorized reproduction may result in financial and other penalties
DISCLOSURE: ALL AUTHORS REPORT NO CONFLICTS OF
INTEREST RELEVANT TO THIS ARTICLE.
46 (S2)
S. GIANFALDONI ET AL.
New Testament, in St. Paul's Letter to the Galatians:
De cetero nemo mihi molestus sit ego enim
stigmata
Jesu in corpore meo porto.
Although the meaning of the sentence is unknown,
it is believed that St. Paul refers to his scars due to
ill-treatment suffered as a follower of God. Again in
the New Testament, an important quotation about
the stigma is in the Gospel of John, in the passage
describing the non-believer Saint Thomas (John
20:25-29):
Dicebant ergo ei alii discipuli: "Vidimus
Dominum!". Ille autem dixit eis: "Nisi videro in
manibus eius
signum
clavorum et mittam digitum
meum in
signum
clavorum et mittam manum meam
in latus eius, non credam". Et post dies octo iterum
erant discipuli eius intus, et Thomas cum eis. Venit
Iesus ianuis clausis et stetit in medio et dixit: "Pax
vobis!". Deinde dicit Thomae: "Infer digitum tuum
huc et vide manus meas et affer manum tuam et mute
in latus meum; et noli fieri incredulus sed fidelis!".
Respondit Thomas et dixit ei: "Dominus meus et Deus
meus!". Dicit ei lesus: "Quia vidisti me, credidisti.
Beati, qui non viderunt et crediderunt!".
Analyzing
the text,
stigmata
are used as a tangible sign of faith.
In the first period of Christianity, stigmata were
carried out to remind the Christians that they were
militating, like soldiers under God. Christians
then tattooed the sign of the cross or the name of
Jesus on the hand or arms. In fact, in Christian
antiquity, because the humanity of Christ was not
contemplated, the term
stigmata,
such as those
lesions that spontaneously appeared similar to those
of Jesus, did not exist.
During the middle Ages everything changed.
The first recorded case of stigmata was in the year
1222, by a man named Stephen Langton of England.
Another testimony is found in the letter of Elijah of
Assisi about the death of St. Francis. On September
14, 1224, two years before his death, St. Francis -
after a mystic vision while he was praying on Mount
Verna, was exposed to stigmata on his hands, feet and
trunk. Since then, an increasing number of stigmata
phenomena have been reported (Table II).
Stigmata
Stigmatized people often show the five Holy
Wounds inflicted 011 Jesus during the Crucifixion:
hands and feet perforated and a stabbed rib. Some
stigmatized saints show wounds on the head similar
to those caused by the crown of thorns (e.g. St. Rita
da Cascia). Others have wounds on the back as
flagellation signs. Finally, there are extraordinary
cases of chest transverberation, characterized by
signs printed on the heart of the subject, visible only
in a post-mortem autopsy (e.g. St. Theresa d'Avila).
Stigmata can be classified as invisible and visible
(Fig. 1) (2, 3). The formers are characterized by a
feeling of pain at the feet, hands and head, with no
clinical manifestation. The subject thinks that the
feeling is a spiritual gift, not medically treatable, that
allows him to participate in the passion of Christ.
Visible stigmata are characterized by signs printed
on the body. They can be of three types: imitative,
figurative and epigraphic. Imitative are characterized
by signs on the body of the subject, which recali
the wounds of Jesus. Figurative stigmas are cross-
shaped, heart-shaped, crown-shaped or ostia-
shaped. Epigraphic stigmas consist of sentences of
Scriptures, which are printed in different parts of
the body. A special form of visible stigmata is the
bright one, which consists of diverse brilliant signs
(e.g. St. Caterina de' Ricci). Stigmata may vary from
subject to subject, and may also vary over time in the
same subject. They may be circular (e.g. on hands,
feet, shoulders), stretched (e.g. on the chest), or
may consist of spontaneous bleeding with no signs
of cutaneous injury (e.g. face marks). The duration
of stigmata, as well as the associated bleeding, is
extremely variable. Sometimes, stigmas with a
particular "scent of holiness" have been reported.
Stigmas can be also associated with mysterious
diseases or phenomena (e.g. levitation, ecstasy,
bloody tears etc.).
The mystety of stigmata
1.
What kind of cutaneous lesions are stigmata?
Stigmata are not traumatic wounds. In fact, they
appear spontaneously without being caused by a
vulnerable agent, and heal without scar. They do
not tend to heal in physiological times and do not
tend to be infected despite the absence of antiseptic
precautions. Stigmata are not penetrating wounds,
as in no cases has damage of interna! organs been
(S2) 47
Journal of Biological Regulators & Homeostatic Agents
Table L
Jesus Christ.'s stigmata.
Type of Stigmas
Localizations
Five Holy Wounds
Crown of thorns
Signs of nails on hands and feet;
Sign of stabbed rib
Wounds on the forehead
St. Caterina da Siena
XIV century
St. Theresa d'Avila
1515-1582
St. Rita da Cascia
XV century
St. Caterina de' Ricci
XVI century
St. Carlo da Sezze
XVII century .
Signs a flagellation
I
Table II.
Some of the most famous people with stigmas.
Back
Sister Maria de León Bello y Delgado
St. Maria Francesca delle Cinque Piaghe
Beata Anna Katharina Emmerick
1643-1731
17
15-1791
1774-1824
St. Gemma Galgani
1878 — 1903
Beata Elena Aiello
1895-1961
St. Pio of Pietraleina
1887-1968
Friar Elia Cataldo
1962-
Figurative
stigmata
E0graphtc
stigmita
Brighi
stgmata
The Science
48 (S2)
S. GIANFALDONI ET AL.
Stigmata
Not
visible
Fig. 1.
Cataloguing ofstigmata.
Christian religion:
Sons of Jacob
Israel Tribe
Biblica
l Minor Prophets
Age of Jesus when he goes
to the Tempie
Apostles
Baskets f dieci with leftovers
during the miracle of the
multiplication of loaves and
fishes
References in the apocalypse
of John (European Flag,
Number of redeemets )
DOOCS
of Heavenly lerusalem
Via Crucis
IewishReligion:
lucifer is
ari
angel with 12
wfrigs
Other religions,
«go.•
Fig. 2.
Symbolic value ofnumber 12.
Fig. 3.
The four main interpreters ofstigmata.
Journal of Biological Regulators & Homeostatic Agents
(S2) 49
descnbed. Stigmas are not even skin ulcers. They
Only affect the epidermis and lack serous secretion.
Finally, they do not respond to medical treatment.
2.
How do stigmas form and how do they solve?
Unfortunately, there is no answer. There are no
reliable cases where scientists have seen developing
stigmata. No experiments have been made to determine
if lesions disappear naturally or after a cause.
3.
Why do stigmata affect such particular
anatomica! sites?
Signs of passion (wounds on hands and feet)
appear in the centre of the palmo-piantar areas,
like the traditional iconography of Jesus crucified.
Historical documents regarding crucifixions, report
that people that are nailed to the cross are tied at
the wrists. In fact, a nailed hand would not have the
strength to support the weight of a body without
tearing and fracturing its own bones.
4.
Who are the stigmatized?
Stigmata are clearly dependent on the cultural
background of subjects: there are no known examples
of non-Christian people stigmatized.
5.
Are stigmata just a cultural event?
Although there is no answer to this question,
before Stephen Langton of England (English Cardinal
of the Roman Catholic Church and Archbishop of
Canterbury) in 1222 there are no documentations or
references to the stigmata phenomenon.
6.
How many are the real cases of stigmatization?
There are no reliable data (2). Antoine Imbert-
Gourbeyre (1818-1912) compiled a list of 321
stigmatized people (4). However, for Father Agostino
Gemelli, president of the Pontifica! Academy of
Sciences from 1937 to 1959, only St. Francis of
Assisi can be considered a true stigmatized. It is
interesting how, according to a mystic belief, it is said
that stigmatized people are 12, a number considered
important for Christians and not only for them (Fig. 2).
7.
How are stigmata ínterpreted? (1)
There are 4 main hypotheses: the ones approved
by the church, the mystic, the scientific and finally,
the mixed ones (Fig. 3).
Different interpretations of stigmata
I.
Christian mysticism
In theology, a subject receives stigmata when he
enters in a state of perfect union with suffering Jesus
by divine grace, until he physically identifies with
Him. The subject feels united with Jesus, feels all of
his sufferings and relives his passion (1).
II.
The Church
Although the Church recognizes the same
theological value of stigmata, it speaks about the
various phenomena with caution. The Church
lets historians, medical doctors and theologians
express their opinions. Moreover, the Church never
pronounced itself about stigmas definitely and
investigates each singular person who receives those
signs individually (2).
III.
Science
The scientific community has elaborated various
hypotheses on the nature of stigmata (Fig. 4).
One of the main hypotheses is the
purpura
factitia,
which explains most of the cases of stigmas.
The subject voluntarily self-induces lesions (e.g. by
scratching, pinching, or dicumarolics therapy). The
causes of this behavior vary, such as an unregulated
inclination to suffering, an ascetic motivation, the
desire to attract attention and fraudulent reasons (5,
6). In particular, there is the Munchausen syndrome,
a psychological disorder that drives the individuai
to obtain medical care for an acute and often severe
illness which does not exist, or that has been induced
by the subject himself. Patients are usually children
or people who have a dose association with the
medical profession, people who have a sense of
superiority towards medical staff and attention
seekers. (7, 8).
Some Authors have even hypothesized an organic
origin of the phenomenon. For example, Edward
Hartung, while analyzing St. Francis' stigmas, stated
that visual disturbances may be associated with
trachoma, while skin manifestations with malaria.
Other authors have described stigma as a
phenomenon related to dissociative identity disorder
(DID). Patients live two or more distinct identities.
This fact involves an alteration of their self-sense,
with emotional, conscience, memory, perception and
sense-motor functions alterations. Some physicians
think that the disease is more common in believers
with malnutrition or for psychiatric or natural reasons
(e.g. war and famine) (9, 10, 11).
1>S5003D
e
perS0n3lity
disorder
Munchause
n syndrome
Organic
disease
Sornant o
phenomem
Hernorrhagic
pressure
urticaria
50(S2)
S. GIANFALDONI ET AL.
Fig. 4.
Main medicai hypotheses about stigmata.
Another historical hypothesis defines stigmata as
a hysteric disease. First described by Sigmund Freud,
hysteria was then renamed "conversion disorder".
As it is suggestive, hysterical people will create
dramatic and exhibitionistic situations designed to
attract attention (12, 13).
A less accredited theory is that stigmas affect
patients with phobias that would lead to irrational
behavior (14).
Another theory is that stigmatization is a
somatization phenomenon produced by an
exceptional stressor (e.g. mystic ecstasy). Somatic
symptom disorder (SSD) is quite a common
disorder, characterized by the presentation of
physical symptoms that are either disproportionate
or inconsistent with medicai findings. First
developed by Johann Joseph von Gorres (1776-
1848), the theory stili finds a rational explanation
based on the evidence of a psycho-neuro-immuno-
endocrinological system, which considers mind and
body in a holistic way (15, 16, 17).
Some authors explain stigmas with Achenbac
syndrome. It is a rare, benign condition of unknow
etiology. Clinically, it is characterized by painft
hematomas on palmar regions and fingers. Lesior
may appear spontaneously or after a minor traurm
typically they resolve without any treatments (18
Some people think that Achenbach's syndrom
as well as the stigmata, are a form of hemorrhag
pressure urticarial, which is a chronic form
urticarial evoked by a physical stimulus such
pressure onto the skin (19, 20).
Thus, why should not it be a form of skin vasculiti
Clinically, it is characterized by symmetric skin lesio
of various types (e.g. purpura, papules, nodules, etc
which are more often localized in the distai limbs ai
sometimes associated with generai symptoms (e
fever, arthralgia, myalgia, etc.) (19, 21).
Finally, the most credited hypothesis is t
Gardner and Diamond syndrome (also known
Journai of Biological Regulators & Homeostatic Agents
(S2) 51
autoerythrocyte sensitization syndrome). It is a rare
condition, most commonly described in women
undergoing an acute emotionally stressful event or
having a psychiatric disorder, such as depression
or obsessive-compulsive behavior. Clinically, it is
characterized by a subcutaneous erythematous with
a hard and painful nodule, which evolves into a
bruise. Lesions are generally localized on the limbs
and heal without scarring. They may be associated
with symptoms of generai malaise (e.g. fever,
headaches, nausea, vomiting, syncope and diplopia).
Gardner and Diamond syndrome is an autoimmune
reaction to a component of the patient's erythrocytes,
probably the phosphatidylserine. A small bloodshed
in the patient causes an allergie response, with further
bloodshed and bruising (22, 23, 24).
IV. Mixed theories: a compromise between faith
and science
Some authors strongly believe in the ability to
describe both mystic and scientific phenomena. Alois
Mager, for example, distinguishes two different
causes of stigmatization: hysterical personality and
contemplation of the Passion of Jesus. Cardinal
Charles Journet's opinion is different: stigmatization
is caused by divine intervention, which may or may
not have need of the psycho-physiological processes
of the individuai (2).
CONCLUSIONS
Nowadays, stigmata are stili one of the greatest
mysteries. Faith and science are not two different
currents, but two complementary entities that can
and must explain the occurrence of the phenomenon.
A famous quotation of A. Einstein says: "Science
without religion is lame, religion without science is
blind" and the quantum mechanics is revealing how
much these words are significant.
Apart from cases of voluntary fraud, we must
admit the existence of pathological forms of stigmas
and of others that stili do not have a scientific
explanation: can they be defined miraculous?
REFERENCES
1. De Vincentiis A. Estasi, stimmate ed altri fenomeni
mistici. Avverbi 1999; 130.
2.
Pierre A. Stigmates. Dictionnaire de spiritualité
ascetique et mystique, doctrine et histoire. Viller
M, Baumgartner C, Rayez A, ed. Beauchesne,
Paris 1953.
3.
Orlandi PA. I fenomeni fisici del misticismo.
Gribaudi 1996; 248.
4.
Maitre Jacques. Imbert-Gourbeyre (Antoine). La
Stigmatisation Paris 1894. Archives de sciences
sociales des religions. 1996; 96:156-7.
5.
Stefanini M, Baumgart ET. Purpura factitia. An
analysis of criteria for its differentiation from auto-
erythrocyte sensitization purpura. Arch Dermatol
1972; 106:238-41.
6.
Yates GP, Feldman MD. Factitious disorder: a
systematic review of 455 cases in the professional
literature. Gen Hosp Psychiatry 2016; 41:20-8.
7.
Ali SN, Ali AN, Ali MN. Miinchausen syndrome by
proxy: the overlooked diagnosis. J Ayub Med Coli
Abbottabad 2015; 27:489-91.
8.
Kinns H, Housley D, Freedman DB. Miinchausen
syndrome and factitious disorder: the role of the
laboratory in its detection and diagnosis. Ann Clin
Biochem 2013; 50:194-203.
9.
Cortese RE. Attachment, trauma and dissociation:
The genesis of the dissociated personality. Vertex
2016; XXVII:109-124.
10.
Leonard D, Tiller J. Dissociative identity disorder
(DID) in clinical practice - what you don't see may
hurt you. Australas Psychiatry 2016; 24:39-41.
11.
Farrington A, Waller G, Neiderman M, Sutton V,
Chopping J,
Laik
B. Dissociation in adolescent
girls with anorexia: relationship to comorbid
psychopathology. J Nerv Ment Dis 2002; 190:746-51.
12.
Kanaan RA. Freud's hysteria and its legacy. Handb
Clin Neurol 2017; 139:37-44.
13.
Levenson JL, Sharpe M. The classification of
conversion disorder (functional neurologic symptom
disorder) in ICD and DSM. Handb Clin Neurol 2017;
139:189-192.
14.
Saurat JH, Saurat M. Manifestazioni psicocutanee.
In: Dermatologia e malattie sessualmente
trasmesse 2000.
15.
Malas N, Ortiz-Aguayo R, Giles L, Ibeziako
P. Pediatric Somatic Symptom Disorders. Curr
Psychiatry Rep 2017; 19:11.
52 (S2)
S. GIANFALDONI ET AL.
16.
Rohlof HG, Knipscheer JW, Kleber RJ. Somatization
in refugees: a review. Soc Psychiatry Psychiatr
Epidemiol 2014; 49:1793-804.
17.
Lotti T, Hercogova J, Wollina U, et al. Treating
skin diseases according to the low dose medicine
principles. Data and hypotheses. J Biol Regul
Homeost Agents 2015; 29(S1):47-51.
18.
Sigha B, Josselin L, Gatfosse M, Fardet L. Paroxysmal
finger haematoma (Achenbach syndrome). Ann
Dermatol Venereol 2016; 143:130-3.
19.
Kazandjieva J, Antonov D, Kamarashev J, Tsankov
N. Acrally distributed dermatoses: Vascular
dermatoses (purpura and vasculitis). Clin Dermatol
2017; 35:68-80.
20.
Greaves MW. Pathology and classification ofurticaria.
Immunol Allergy Clin North Am 2014; 34:1-9.
21.
Gianfaldoni S, D'Erme AM, Hercogova J, Lotti
T. Cutaneous Vasculitis. European Handbook of
Dermatological Treatments 2015.
22.
Ivanov OL, Lvov AN, Michenko AV, Kiinzel J, Mayser
P, Gieler U. Autoerythrocyte sensitization syndrome
(Gardner-Diamond syndrome): review of the literature.
J Eur Acad Dermatol Venereol 2009; 23:499-504.
23.
Uthman IW, Moukarbel GV, Salman SM, Salem ZM,
Taher AT, Khalil IM. Autoerythrocyte sensitization
(Gardner-Diamond) syndrome. Eur J Haematol
2000; 65:144-7.
24.
Ratnoff OD. Psychogenic purpura (autoerythrocyte
sensitization): an unsolved dilemma. Am J Med
1989; 87(3N):16-21.
ResearchGate has not been able to resolve any citations for this publication.
Article
Full-text available
Somatic symptom disorder (SSD) is a common disorder encountered in pediatric medicine. It involves the presentation of physical symptoms that are either disproportionate or inconsistent with history, physical examination, laboratory, and other investigative findings. SSDs result in significant impairment with considerable increase in healthcare utilization, school absenteeism, and the potential for unnecessary diagnostic evaluation and treatment intervention. Patients and families often feel dismissed and may worry that a serious condition has been missed. Primary care providers are frequently frustrated due to a lack of a successful approach to patients and families impacted by SSD. The result is often a cycle of disability, frustration and missed opportunities for collaboration towards enhanced patient functionality. This review summarizes the current evidence-based understanding, as well as insights from clinician experience, on the evaluation and management of pediatric SSD.
Article
Full-text available
Objective: Patients with factitious disorder (FD) fabricate illness, injury or impairment for psychological reasons and, as a result, misapply medical resources. The demographic and clinical profile of these patients has yet to be described in a sufficiently large sample, which has prevented clinicians from adopting an evidence-based approach to FD. The present study aimed to address this issue through a systematic review of cases reported in the professional literature. Method: A systematic search for case studies in the MEDLINE, Web of Science and EMBASE databases was conducted. A total of 4092 records were screened and 684 remaining papers were reviewed. A supplementary search was conducted via GoogleScholar, reference lists of eligible articles and key review papers. In total, 372 eligible studies yielded a sample of 455 cases. Information extracted included age, gender, reported occupation, comorbid psychopathology, presenting signs and symptoms, severity and factors leading to the diagnosis of FD. Results: A total of 66.2% of patients in our sample were female. Mean age at presentation was 34.2 years. A healthcare or laboratory profession was reported most frequently (N=122). A current or past diagnosis of depression was described more frequently than personality disorder in cases reporting psychiatric comorbidity (41.8% versus 16.5%) and more patients elected to self-induce illness or injury (58.7%) than simulate or falsely report it. Patients were most likely to present with endocrinological, cardiological and dermatological problems. Differences among specialties were observed on demographic factors, severity and factors leading to diagnosis of FD. Conclusions: Based on the largest sample of patients with FD analyzed to date, our findings offer an important first step toward an evidence-based approach to the disorder. Future guidelines must be sensitive to differing methods used by specialists when diagnosing FD.
Article
Full-text available
Münchausen Syndrome by Proxy (MSBP) is a psychiatric disorder characterised by the adoption of bizarre behavioural-patterns by caregivers in which diseases or disorders are fabricated in individuals, usually children, for purposes which span feelings of superiority derived from deceit of persons deemed superior to the caregiver, or attention seeking. The patient under discussion was a 6 year old male brought to the hospital by his mother with complaints of repetitive and unceasing passing of stones per urethra. Upon inspection of stone specimens brought in by the parents and physical examination, the stones in question were observed to be common stones, with no reason to suggest a urolithiatic origin, leading to the suspicion of MSBP. Further questioning of both the mother and father revealed more information regarding the cause of her child's illness and strongly suggested that the stones were being physically inserted into the child's urethra by the mother--often in the father's absence--after administration of sedative-hynotic drugs.
Article
Full-text available
Cytokines, hormones and growth factors, also defined with the collective name of “signaling molecules” are key regulating agents of physiological (and also pathological) functions according to the principles of Psycho-Neuro-Endocrine-Immunology (P.N.E.I.). From the latest evidences in the fields of Molecular Biology, P.N.E.I. and nano-concentration, a new medical approach surfaces: the Low Dose Medicine (LDM), a new tool for the study and the design of therapeutic strategies based on immune rebalance interventions. LDM suggest the use of low-doses of activated signaling molecules in order to restore P.N.E.I. homeostatic conditions and an increasing number of scientific evidences of LDM approach efficacy and safety support LDM-based therapeutic approach for the treatment of many dermatological diseases such as Psoriasis Vulgaris, Vitiligo and Atopic Dermatitis.
Article
Full-text available
To present a review of the literature concerning medically unexplained physical symptoms in refugees. We outline a variety of definitions and explanations of somatization, as well as the role of culture in the concept of disease. In addition, we present a review of the epidemiological literature about somatization in refugees. Refugees from non-Western countries exhibit more unexplained somatic symptoms than the general Western population. Although different studies have employed different methodologies and are therefore difficult to compare, it can be concluded that refugees form a particular population in which somatization is prominent. Potential, not mutually exclusive, explanations of the high number of somatic symptoms in the refugee population include general psychopathology, specifically traumatisation, results of torture, and stigmatisation of psychiatric care. There are implications for assessment, clinical treatment and further research concerning somatization in refugees.
Article
In the present work we will deepen on the dissociative identity disorder (DID) and in the main current explanatory theory doomed to elucidate its genesis. The latter implies the interweaving of the notions of trauma, dissociation and attachment, relying on the psychoanalytic traditions and cognitive behavioral, generating an integrated perspective that transfigures the way how it was dealt with clinically and therapeutically this disorder. Under the perspective of the latter, the DID appears insert in the framework of the dissociative disorders of the personality, the same as the borderline organization, and in turn related to those dissociative disorders acquired in adulthood, which includes the post-traumatic stress disorder and some somatization disorders and conversion, which suggests the existence of an extended spectrum of dissociative disorders.
Article
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
Article
Objectives: To identify problems that interfere with the recognition, diagnosis and management of people with dissociative identity disorder (DID) presenting to psychiatric outpatient and inpatient services and suggest solutions. Method: Problems and suggested solutions associated with clinical presentations and management of people with DID are outlined with references to relevant literature. Results: Problems in the recognition and management of DID are described. These lead to delays in diagnosis and costly, inappropriate management, destructive to services, staff and patients alike. Problems include lack of understanding and experience and scepticism about the disorder, resulting in failure to provide appropriate treatment.Some suggestions to improve recognition and management are included. Conclusion: Better recognition, diagnosis and management of DID will lead to better and more cost effective outcomes.
Article
Chronic urticaria is defined as daily or almost daily urticaria for more than 6 weeks. Chronic urticaria is normally subdivided into physical urticaria (wheals evoked by a physical stimulus such as pressure friction or cold contact) and spontaneous urticaria. A patient with a history of less than 6 weeks is traditionally designated as having acute urticaria. Patients with chronic spontaneous urticaria have an increased frequency of HLA-DR and HLA-DQ alleles characteristically associated with autoimmune disease. Some of these patients have functional anti-FceR1 and/or anti-IgE autoantibodies which are considered to be the cause of the urticaria.
Article
The term Munchausen syndrome is used to describe the patient who chronically fabricates or induces illness with the sole intention of assuming the patient role. Such persons often have a close association with the medical profession and thus use their knowledge to falsify symptoms and laboratory specimens to mimic disease. Cases of factitious disease have appeared in the literature originating from all medical specialties, and include such rare disorders as phaeochromocytoma and Bartter's syndrome. The laboratory can play a key role in the detection and diagnosis of factitious disorders. Indeed discrepant biochemistry results may provide the first clue to the diagnosis. Laboratory staff should be particularly aware of highly variable test results and extreme abnormalities that are not consistent with the wider biochemical profile, suggesting sample tampering. Factitious disorder should also be included in the clinician's differential diagnosis when disease presentation is unusual or an underlying cause cannot be found. Investigation to exclude or confirm factitious disorder at an early stage can prevent unnecessary testing in the search for increasingly rare diseases. Appropriate analyses may include screening tests for the detection of surreptitious drug administration or replication of a fabricated sample to confirm the method used. In all cases close communication between the clinician and laboratory is essential. This will ensure that appropriate tests are conducted particularly with regard to time critical and repeat tests.