HYPNOSE
BINNEN DE MEDISCHE PRAKTIJK
BEPERKT LITERATUUROVERZICHT.
Ria
Willemsen en Nicole Ruysschaert
Dr
Ria Willemsen is dermatoloog en bestuurslid Vlaamse
Wetenschappelijke Hypnose Vereniging
Dr Nicole Ruysschaert is psychiater–psychotherapeut
en bestuurslid van de Vlaamse Wetenschappelijke Hypnose
Vereniging en bestuurslid van ESH European Society of
Hypnosis
Hypnose werd vaker bestudeerd dan men zou verwachten.
Een opzoeking in de database PubMed - National Library of
Medicine met het woord “ Hypnosis “ levert op
moment van dit schrijven ( september 2004) 10111 artikels
op. Het zullen er ondertussen meer zijn. We hebben er ter
info een aantal recentere publicaties uitgepikt, zowel
klinische rapporten als overzichtsartikels. We willen
absoluut benadrukken dat deze beperkte selectie geen
volledig overzicht kan geven van de literatuur rond hypnose
bij medische aandoeningen. Dat zou onmogelijk zijn.
De hier weergegeven studies werden wel geselecteerd omwille
van hun diversiteit en hun wetenschappelijke waarde. De
nadruk ligt iets meer op de gerandomiseerde “
dubbelblinde “ studies wegens hun grootste
wetenschappelijke overtuigingskracht maar bij gebrek
daaraan, voor sommige indicaties, werden ook andere
artikels opgenomen.
Enkel de recentere artikels aangaande medische aandoeningen
werden geselecteerd.
GENEESKUNDE
ALGEMEEN
Pinell
en Covino publiceerden een zeer uitgebreid kritisch
overzicht van diverse studies voor uiteenlopende
indicaties. De auteurs geven bovendien aan in welke mate
studies rond hypnose beperkt zijn qua methodologie. Ze
vertonen eerst en vooral een grote heterogeniciteit in de
gebruikte “hypnotische” suggesties ( bvb
hypnotic-relaxation of hypnotic-guided imagery, ...) en
talrijke variaties in de bepaling van de graad van
hypnotiseerbaarheid. Bovendien werden diverse studies
uitgevoerd met een beperkt aantal personen of werden ze
niet gerandomiseerd.
Ook het werkingsmechanisme van hypnose dient dringend
verder bestudeerd te worden volgens deze auteurs.
Ook het gezaghebbende Britisch Medical Journal (BMJ) wijdde
een overzichtsartikel aan hypnose en relaxatietechnieken.
Het artikel geeft een overzicht van alle gerandomiseerde
studies en concludeert dat voor hypnose vooral gunstig
effect werd bewezen voor astma en irritable bowel syndroom.
Hypnose blijkt efficiënt in de aanpak van angst, pijn,
misselijkheid en braken bij kankerpatiënten.
We laten u tenslotte meegenieten een overzichtsartikel
aangaande het gebruik van hypnose binnen het terrein van de
urgentie geneeskunde.
Int
J Clin Exp Hypn. 2000 Apr;48(2):170-94.
Empirical
findings on the use of hypnosis in medicine: a critical
review.
Pinnell CM, Covino NA.
Arizona School of Professional
Psychology, USA.
Recent changes in health care have been characterized by an
increased demand for empirically supported treatments in
medicine. Presently, there is moderate support for the
integration of hypnotic techniques in the treatment of a
number of medical problems. This critical review of the
research literature focuses on the empirical research on
the effectiveness of hypnotic treatments as adjuncts to
medical care for anxiety related to medical and dental
procedures, asthma, dermatological diseases,
gastrointestinal diseases, hemorrhagic disorders, nausea
and emesis in oncology, and obstetrics/gynecology. Wider
acceptance of hypnosis as an intervention to assist with
medical care will require further research.
Publication type: review
BMJ. 1999 Nov 20;319(7221):1346-9.
ABC of
complementary medicine. Hypnosis and relaxation therapies.
Vickers A, Zollman C.
Geen
abstract
Emerg Med Clin North Am. 2000 May;18(2):327-38, x.
The use of
hypnosis in emergency medicine.
Peebles-Kleiger MJ.
Karl
Menninger School of Psychiatry and Mental Health Sciences,
Menninger Clinic, Topeka, Kansas, USA.
peeblemj@menninger.edu
Hypnosis can be a useful adjunct in the emergency
department setting. Its efficacy in various clinical
applications has been replicated in controlled studies.
Application to burns, pain, pediatric procedures, surgery,
psychiatric presentations (e.g., coma, somatoform disorder,
anxiety, and posttraumatic stress), and obstetric
situations (e.g., hyperemesis, labor, and delivery) are
described. Negative effects are discussed.
Publication Types: Review
CHIRURGISCHE
INTERVENTIES
Het
pijnstillende en angstwerende effect van hypnose wordt
geïllustreerd bij diverse medische ingrepen. Hypnose,
toegevoegd aan locale anesthesie, verhoogt het comfort van
de patiënten, werkt angstverminderend en pijnstillend en
kan het gebruik van pijnstillers en angstverminderende
medicaties doen afnemen.
Studies bespreken zowel de hypnotische aanpak bij algemene
chirurgie als bij meer specifieke interventies zoals
orthopedische handchirurgie, radiologische en
gynaecologische interventies of ruggenmergprikken.
Het laatste geselecteerde artikel betreft het gebruik van
hypnose ter verbetering wondheling bij borstoperaties.
Pain.
1997 Dec;73(3):361-7.
Psychological
approaches during conscious sedation. Hypnosis versus
stress reducing strategies: a prospective randomized study.
Faymonville ME, Mambourg PH, Joris J, Vrijens B, Fissette
J, Albert A, Lamy M.
Department of Anesthesia and
Intensive Care Medicine, University Hospital of Liege,
Belgium.
Stress reducing strategies are useful in patients
undergoing surgery. Hypnosis is also known to alleviate
acute and chronic pain. We therefore compared the
effectiveness of these two psychological approaches for
reducing perioperative discomfort during conscious sedation
for plastic surgery. Sixty patients scheduled for elective
plastic surgery under local anesthesia and intravenous
sedation (midazolam and alfentanil upon request) were
included in the study after providing informed consent.
They were randomly allocated to either stress reducing
strategies (control: CONT) or hypnosis (HYP) during the
entire surgical procedure. Both techniques were performed
by the same anesthesiologist (MEF). Patient behavior was
noted during surgery by a psychologist, the patient noted
anxiety, pain, perceived control before, during and after
surgery, and postoperative nausea and vomiting (PONV).
Patient satisfaction and surgical conditions were also
recorded. Peri- and postoperative anxiety and pain were
significantly lower in the HYP group. This reduction in
anxiety and pain were achieved despite a significant
reduction in intraoperative requirements for midazolam and
alfentanil in the HYP group (alfentanil: 8.7 +/- 0.9 microg
kg(-1)/h(-1) vs. 19.4 +/- 2 microg kg(-1)/h(-1), P <
0.001; midazolam: 0.04 +/- 0.003 mg kg(-1)/h(-1) vs. 0.09
+/- 0.01 mg kg(- 1)/h(-1), P < 0.001). Patients in the
HYP group reported an impression of more intraoperative
control than those in the CONT group (P < 0.01). PONV
were significantly reduced in the HYP group (6.5% vs.
30.8%, P < 0.001). Surgical conditions were better in
the HYP group. Less signs of patient discomfort and pain
were observed by the psychologist in the HYP group (P <
0.001). Vital signs were significantly more stable in the
HYP group. Patient satisfaction score was significantly
higher in the HYP group (P < 0.004). This study suggests
that hypnosis provides better perioperative pain and
anxiety relief, allows for significant reductions in
alfentanil and midazolam requirements, and improves patient
satisfaction and surgical conditions as compared with
conventional stress reducing strategies support in patients
receiving conscious sedation for plastic surgery.
Publication Types: Randomized Controlled Trial
Int J Clin Exp Hypn. 1999 Apr;47(2):144-61.
Medical
hypnosis and orthopedic hand surgery: pain perception,
postoperative recovery, and therapeutic comfort.
Mauer MH, Burnett KF, Ouellette EA, Ironson GH, Dandes HM.
University of Miami, Coral
Gables 33124, USA.
Orthopedic hand-surgery patients experience severe pain
postoperatively, yet they must engage in painful exercises
and wound care shortly after surgery; poor patient
involvement may result in loss of function and
disfigurement. This study tested a hypnosis intervention
designed to reduce pain perception, enhance postsurgical
recovery, and facilitate rehabilitation. Using a
quasiexperimental research design, 60 hand-surgery patients
received either usual treatment or usual treatment plus
hypnosis. After controlling for gender, race, and
pretreatment scores, the hypnosis group showed significant
decreases in measures of perceived pain intensity (PPI),
perceived pain affect (PPA), and state anxiety. In
addition, physician's ratings of progress were
significantly higher for experimental subjects than for
controls, and the experimental group had significantly
fewer medical complications. These results suggest that a
brief hypnosis intervention may reduce orthopedic
hand-surgery patients' postsurgical PPI, PPA, and anxiety;
decrease comorbidity; and enhance postsurgical recovery and
rehabilitation. However, true experimental research designs
with other types of controls must be employed to determine
more fully the contribution of hypnosis to improved
outcome.
Publication Types: Clinical Trial
Lancet. 2000 Apr 29;355(9214):1486-90.
Adjunctive
non-pharmacological analgesia for invasive medical
procedures: a randomised trial.
Lang EV, Benotsch EG, Fick LJ, Lutgendorf S, Berbaum ML,
Berbaum KS, Logan H, Spiegel D.
Beth
Israel Deaconess Medical Center/Harvard Medical School,
Department of Radiology, Boston,
MA 02215, USA. elang@caregroup.harvard.edu
BACKGROUND : Non-pharmacological behavioural adjuncts have
been suggested as efficient safe means in reducing
discomfort and adverse effects during medical procedures.
We tested this assumption for patients undergoing
percutaneous vascular and renal procedures in a
prospective, randomised, single-centre study.
METHODS : 241 patients were randomised to receive
intraoperatively standard care (n=79), structured attention
(n=80), or self-hypnotic relaxation (n=82). All had access
to patient-controlled intravenous analgesia with fentanyl
and midazolam. Patients rated their pain and anxiety on
0-10 scales before, every 15 min during and after the
procedures.
FINDINGS : Pain increased linearly with procedure time in
the standard group (slope 0.09 in pain score/15 min,
p<0.0001), and the attention group (slope 0.04/15 min;
p=0.0425), but remained flat in the hypnosis group. Anxiety
decreased over time in all three groups with slopes of -
0.04 (standard), -0.07 (attention), and -0.11 (hypnosis).
Drug use in the standard group (1.9 units) was
significantly higher than in the attention and hypnosis
groups (0.8 and 0.9 units, respectively). One hypnosis
patient became haemodynamically unstable compared with ten
attention patients (p=0.0041), and 12 standard patients
(p=0.0009). Procedure times were significantly shorter in
the hypnosis group (61 min) than in the standard group (78
min, p=0.0016) with procedure duration of the attention
group in between (67 min). INTERPRETATION : Structured
attention and self-hypnotic relaxation proved beneficial
during invasive medical procedures. Hypnosis had more
pronounced effects on pain and anxiety reduction, and is
superior, in that it also improves haemodynamic stability.
Int
J Clin Exp Hypn. 2002 Jan;50(1):17-32.
Brief
presurgery hypnosis reduces distress and pain in excisional
breast biopsy patients.
Montgomery GH, Weltz CR, Seltz M, Bovbjerg DH.
Ruttenberg Cancer Center, Mount
Sinai School of Medicine, New York, NY 10029-6574, USA.
guy.montgomery@mssm.edu
Each year, hundreds of thousands of women undergo
excisional breast biopsies for definitive diagnosis. Not
only do these patients experience pain associated with the
procedure, but they also endure distress associated with
the threat of cancer. Hypnosis has been demonstrated as
effective for controlling patients' pain in other surgical
settings, but breast surgery patients have received little
attention. To determine the impact of brief presurgical
hypnosis on these patients' postsurgery pain and distress
and to explore possible mediating mechanisms of these
effects, 20 excisional breast biopsy patients were randomly
assigned to a hypnosis or control group (standard care).
Hypnosis reduced postsurgery pain and distress. Initial
evidence suggested that the effects of hypnosis were
mediated by presurgery expectations.
Publication Types: Randomized Controlled Trial
Am J Clin Hypn. 2003 Apr;45(4):333-51.
Can medical
hypnosis accelerate post-surgical wound healing? Results of
a clinical trial.
Ginandes C, Brooks P, Sando W, Jones C, Aker J.
Department of Psychology,
Harvard Medical School, McLean Hospital, 115 Mill Street
Belmont,
MA 02478, USA. carol_ginandes@hms.harvard.edu
Although medical hypnosis has a long history of myriad
functional applications (pain reduction, procedural
preparation etc.), it has been little tested for
site-specific effects on physical healing per se. In this
randomized controlled trial, we compared the relative
efficacy of an adjunctive hypnotic intervention, supportive
attention, and usual care only on early post-surgical wound
healing.
Eighteen healthy women presenting consecutively for
medically recommended reduction mammaplasty at an
ambulatory surgery practice underwent the same surgical
protocol and postoperative care following preoperative
randomization (n = 6 each) to one of the three treatment
conditions: usual care, 8 adjunctive supportive attention
sessions, or 8 adjunctive hypnosis sessions targeting
accelerated wound healing. The primary outcome data of
interest were objective, observational measures of incision
healing made at 1,7 weeks postoperatively by medical staff
blind to the participants' group assignments. Data included
clinical exams and digitized photographs that were scored
using a wound assessment inventory (WAI). Secondary outcome
measures included the participants' subjectively rated
pain, perceived incision healing (VAS Scales), and baseline
and post-surgical functional health status (SF-36).
Analysis of variance showed the hypnosis group's
objectively observed wound healing to be significantly
greater than the other two groups', p < .001, through 7
postoperative weeks; standard care controls showed the
smallest degree of healing. In addition, at both the 1 and
7 week post-surgical observation intervals, one-way
analyses showed the hypnosis group to be significantly more
healed than the usual care controls, p < 0.02. The mean
scores of the subjective assessments of postoperative pain,
incision healing and functional recovery trended similarly.
Results of this preliminary trial indicate that use of a
targeted hypnotic intervention can accelerate postoperative
wound healing and suggest that further tests of using
hypnosis to augment physical healing are warranted.
Publication Types: Randomized Controlled Trial
PIJN
Hypnose is werkzaam ter
vermindering van zowel acute als chronische pijn.
Er bestaan veel gevalsbeschrijvingen in de literatuur. We
selecteerden enkele specifiekere indicaties: hoofdpijn,
fantoompijn, artrose pijn en tenslotte pijncontrole bij
brandwonden.
HOOFDPIJN
een
overzichtsartikel
J
Pediatr Psychol. 1999 Apr;24(2):91-109.
Empirically
supported treatments in pediatric psychology: recurrent
pediatric headache.
Holden EW, Deichmann MM, Levy JD.
University of Maryland School
of Medicine, USA. wholden@macroint.com
OBJECTIVE : To review the empirical research examining
behavioral treatments for recurrent pediatric headache.
METHODS : Thirty-one investigations published after 1980
were reviewed using predetermined criteria to evaluate the
adequacy of research methodologies. A modification of
criteria proposed for evaluating the efficacy of
psychological interventions for adults (Task Force on
Promotion and Dissemination of Psychological Procedures,
1995) was used to evaluate the adequacy of evidence
available for individual intervention strategies.
RESULTS : Sufficient evidence exists to conclude that
relaxation/self-hypnosis is a well-established and
efficacious treatment for recurrent headache. Furthermore,
enough evidence exists to conclude that thermal biofeedback
alone is a probably efficacious treatment. Other promising
interventions have been tested that combine relaxation and
biofeedback or integrate other cognitive-behavioral
treatment approaches, but are limited by inadequate
research methodologies. CONCLUSIONS: We discuss the
importance of developmentally based conceptual models and
the impact of diagnostic heterogeneity and offer specific
recommendations for future intervention research in the
area of recurrent pediatric headache.
Publication Types: Review Literature
FANTOOMPIJN
een
overzichtsartikel
Clin
Rehabil. 2002 Jun;16(4):368-77.
Hypnotic
imagery as a treatment for phantom limb pain: two case
reports and a review.
Oakley DA, Whitman LG, Halligan PW.
Department of Psychology,
University College London, UK. oakley@the-croft.demon.co.uk
OBJECTIVE : To provide a theoretical background, to review
existing literature and to present new case material
relevant to the treatment of phantom limb pain using
hypnotic imagery.
METHOD : This paper presents two new case reports involving
the use of hypnotic imagery procedures in the alleviation
of phantom limb pain and reviews 10 previous clinical
studies which have involved a similar approach. The earlier
studies were identified by electronic and manual searches
of the relevant literature.
RESULTS : Two main treatment strategies can be identified:
(1) ipsative/imagery-based approaches and (2)
movement/imagery-based approaches. A common finding is the
need to treat the phantom limb as a 'real' body part, to
accept its existence as a valid mental representation and
to avoid treating the amputation stump as the sole source
of the phantom
pain sensations.
CONCLUSION : Hypnotic procedures appear to be a useful
adjunct to established strategies for the treatment of
phantom limb pain and would repay further, more systematic,
investigation. Suggestions are provided as to the factors
which should be considered for a more systematic research
programme.
Publication Types: Review
ARTHROSE EN
RHEUMA
Hypnose blijkt niet alleen de
pijnsensatie bij artrose en reuma patiënten te verminderen
maar kan bovendien de inname van medicatie
doen afnemen en een
gunstig effect hebben op de biologische parameters. Jammer
genoeg wordt er in de medische wereld amper of geen gebruik
gemaakt van deze aanpak.
Eur
J Pain. 2002;6(1):1-16.
Differential effectiveness of psychological interventions
for reducing osteoarthritis pain: a comparison of Erikson
[correction of Erickson] hypnosis and Jacobson relaxation.
Gay MC, Philippot P, Luminet O.
Psychology Department,
Universite de Paris X, 200 avenue de la Republique,
Nanterre, 92000,
France. marieclaire.gay@free.fr
The present study investigates the effectiveness of Erikson
hypnosis and Jacobson relaxation for the reduction of
osteoarthritis pain. Participants reporting pain from hip
or knee osteoarthritis were randomly assigned to one of the
following conditions: (a) hypnosis (i.e. standardized
eight-session hypnosis treatment); (b) relaxation (i.e.
standardized eight sessions of Jacobson's relaxation
treatment); (c) control (i.e. waiting list). Overall,
results show that the two experimental groups had a lower
level of subjective pain than the control group and that
the level of subjective pain decreased with time. An
interaction effect between group treatment and time
measurement was also observed in which beneficial effects
of treatment appeared more rapidly for the hypnosis group.
Results also show that hypnosis and relaxation are
effective in reducing the amount of analgesic medication
taken by participants. Finally, the present results suggest
that individual differences in imagery moderate the effect
of the psychological treatment at the 6 month follow-up but
not at previous times of measurement (i.e. after 4 weeks of
treatment, after 8 weeks of treatment and at the 3 month
follow-up). The results are interpreted in terms of
psychological processes underlying hypnosis, and their
implications for the psychological treatment of pain are
discussed.
Copyright 2002 European Federation of Chapters of the
Association for the Study of Pain
Publication Types: Randomized Controlled Trial
Psychology and Health, 14 (6), 1089-1104..
The effect of
hypnosis therapy on the symptoms and disease activity in
rheumatoid arthritis .
Horton-Hausknecht J.; Mitzdorf U.; Melchart D.
(2000).
In this study we aimed to assess the effectiveness of
clinical hypnosis on the symptoms and disease activity of
rheumatoid arthritis (RA). 66 RA patients participated in a
controlled group design. 26 patients learnt the hypnosis
intervention, 20 patients were in a relaxation control
group, and 20 patients were in a waiting-list control
group. During hypnosis , patients developed individual
visual imagery aimed at reducing the autoimmune activity
underlying the RA and at reducing the symptoms of joint
pain, swelling, and stiffness. Subjective assessments of
symptom severity and body and joint function, using
standardized questionnaires and visual analogue scales,
were obtained.
Objective measures of disease activity via multiple blood
samples during the therapy period and at the two follow-ups
were also taken. These measurements were of erythrocyte
sedimentation rate, Creactive protein, hemoglobin, and
leukocyte total numbers. Results indicate that the hypnosis
therapy produced more significant improvements in both the
subjective and objective measurements, above relaxation and
medication. Improvements were also found to be of clinical
significance and became even more significant when patients
practiced the hypnosis regularly during the follow-up
periods.
BRANDWONDEN
Het
gebruik van hypnotische technieken ter pijncontrole voor de
pijnlijke, dagelijkse verbandwisselingen bij brandwonden
werd gedocumenteerd in talrijke studies. We geven U een
gerandomiseerde studie afkomstig van ons eigen Belgisch
brandwondencentrum en een eerder verschenen pilootstudie.
Deze studies tonen aan dat hypnose een duidelijke
vermindering geeft van angst en pijn.
Burns.
2001 Dec;27(8):793-9.
Psychological approaches during dressing changes of burned
patients: a prospective randomised
study comparing hypnosis against stress reducing strategy.
Frenay MC, Faymonville ME, Devlieger S, Albert A,
Vanderkelen A.
Burn
Centre, Military Hospital Queen Astrid, Rue Bruyn, 1, 1120,
Brussels, Belgium.
A prospective study was designed to compare two
psychological support interventions in controlling
peri-dressing change pain and anxiety in severely burned
patients. Thirty patients with a total burned surface area
of 10-25%, requiring a hospital stay of at least 14 days,
were randomised to receive either hypnosis or stress
reducing strategies (SRS) adjunctively to routine
intramuscular predressing change analgesia and anxiolytic
drugs. Visual analogue scale (VAS) scores for anxiety,
pain, pain control and satisfaction were recorded at 2-day
intervals throughout the 14-day study period, before,
during and after dressing changes. The psychological
assistance was given on days 8 and 10 after hospital
admission. The comparison of the two treatment groups
indicated that VAS anxiety scores were significantly
decreased before and during dressing changes when the
hypnotic technique was used instead of SRS. No difference
was observed for pain, pain control and satisfaction,
although VAS scores were always better in the hypnosis
group. The study also showed that, overall, psychological
support interventions reduced pain and increased patient
satisfaction.
These results confirm the potential benefits of
psychological assistance during dressing changes in burned
patients.
Publication Types: Randomized Controlled Trial
Burns
Including Thermal Injuries, 14, 399-404.
Hypnosis and pain in patients with severe burns: A pilot
study.
Van der Does, A. J.; Van Dyck, R.; Spijker, R. E. (1988).
ABSTRACT : Presents a pilot
study on the effectiveness of hypnosis in the control of
pain during dressing changes of burn patients. Eight
patients were treated, and all evaluated the interventions
as beneficial. The treatment of four patients was more
closely analyzed by obtaining pain and anxiety ratings
daily. Results show a 50%-64% decrease in reported pain
level for three patients and a 52% increase of pain for one
patient. The mean decrease for these four patients was 30%
(for overall as well as worst pain during dressing
changes). A 30% reduction of anxiety level and a modest
reduction of medication use were achieved concurrently. It
is concluded that hypnosis is of potential value during
dressing changes of burn patients. Comparison of global
evaluations and daily pain ratings shows that systematic
research in some cases leads to conclusions opposite from
clinical observations. Follow-up recommendations for future
studies are given.
PEDIATRIE
Volgende artikels betreffen
enerzijds de aanpak van angst en pijn bij chirurgische
interventies (mergpuncties, fractuur) specifiek bij
kinderen en jongeren. Tevens geven we een rapport over
zelfhypnose bij buikpijn.
Een artikel aangaande hypnose gebruik bij
ademhalingsproblemen werd
ondergebracht bij
“pneumologie”.
Int J
Clin Exp Hypn. 2003 Jan;51(1):4-28.
Clinical
hypnosis in the alleviation of procedure-related pain in
pediatric oncology patients.
Liossi C, Hatira P.
Department of Psychology,
University of Wales, Swansea, UK. C.Liossi@swansea.ac.uk
This prospective controlled trial investigated the efficacy
of a manual-based clinical hypnosis intervention in
alleviating pain in 80 pediatric cancer patients (6-16
years of age) undergoing regular lumbar punctures. Patients
were randomly assigned to 1 of 4 groups: direct hypnosis
with standard medical treatment, indirect hypnosis with
standard medical treatment, attention control with standard
medical treatment, and standard medical treatment alone.
Patients in the hypnosis groups reported less pain and
anxiety and were rated as demonstrating less behavioral
distress than those in the control groups. Direct and
indirect suggestions were equally effective, and the level
of hypnotizability was significantly associated with
treatment benefit in the hypnosis groups.
Therapeutic benefit degraded when patients were switched to
self-hypnosis. The study indicates that hypnosis is
effective in preparing pediatric oncology patients for
lumbar puncture, but the presence of the therapist may be
critical.
Publication Types: Randomized Controlled Trial
J Emerg Med. 1999 Jan-Feb;17(1):53-6.
Hypnosis for
pediatric fracture reduction.
Iserson KV.
Arizona Bioethics Programs and
Section of Emergency Medicine, University of Arizona
College of Medicine, Tucson 85718, USA.
Hypnosis can diminish pain and anxiety for many emergency
patients during examinations and procedures. While hypnosis
has been used for millennia and was demonstrated to be of
use in clinical medicine more than a century ago, modern
physicians have been reluctant to adopt this technique in
clinical practice. This article describes four children
with angulated forearm fractures who had no possible access
to other forms of analgesia during reduction, and in whom
hypnosis was used successfully. A simple method for
hypnotic induction is described.
Clin Pediatr (Phila). 2001 Aug;40(8):447-51.
Self-hypnosis
for the treatment of functional abdominal pain in
childhood.
Anbar RD.
Department of Pediatrics, State
University of New York, Upstate Medical University,
Syracuse 13210, USA.
Functional abdominal pain, defined as recurrent abdominal
pain in the absence of an identifiable physiologic cause,
can respond to psychological intervention in appropriate
patients. In this patient series, functional abdominal pain
of 4 of 5 pediatric patients resolved within 3 weeks after
a single session of instruction in self-hypnosis. The
potential impact of widespread application of such
hypnotherapy may be large, because abdominal pain is
thought to be the most common recurrent physical symptom
attributable to psychological factors among children and
adolescents.
DIVERSE
MEDISCHE INDICATIES
CARDIOLOGIE
Er is
weinig terug te vinden in de recentere literatuur. Ziehier
wel een boeiende gerandomiseerde studie rond
hartchirurgie.
J
Altern Complement Med. 1995 Fall;1(3):285-90.
The effects
of self-hypnosis on quality of life following coronary
artery bypass surgery: preliminary
results of a prospective, randomized trial.
Ashton RC Jr, Whitworth GC, Seldomridge JA, Shapiro PA,
Michler RE, Smith CR, Rose EA, Fisher S, Oz MC.
Department of Surgery, College
of Physicians & Surgeons, Columbia University, New
York, NY, USA.
The effects of complementary techniques and alternative
medicine on allopathic therapies is generating much
interest and research. To properly evaluate these
techniques, well controlled studies are needed to
corroborate the findings espoused by individuals practicing
complementary medicine therapies. To this end, we evaluated
the role of one of these therapies, self-hypnosis
relaxation techniques, in a prospective, randomized trial
to study its effects on quality of life after coronary
artery bypass surgery. Subjects were randomized to a
control group or a study group. Study group patients were
taught self-hypnosis relaxation techniques the night prior
to surgery. The control group received no such treatment.
Patients then underwent routine cardiac management and
care. The main endpoint of our study was quality of life,
assessed by the Profile of Moods Scale.
Results demonstrated that patients undergoing self-hypnosis
the night prior to coronary artery bypass surgery were
significantly more relaxed than the control group (p =
0.0317). Trends toward improvement were also noted in
depression, anger, and fatigue. This study demonstrates the
beneficial effects of self-hypnosis relaxation techniques
on coronary surgery. This study also identifies endpoints
and a study design that can be used to assess complementary
medicine therapies. Results of this preliminary
investigation are encouraging and demonstrate a need for
further well-controlled studies.
Publication Types: Randomized Controlled Trial
DERMATOLOGIE
Het
beste overzichtsartikel is dit van Shenefelt. Het
beschrijft de resultaten van een Medline search vanaf
januari 1966 tot december 1998 rondom hypnose bij
huidziekten. De auteur beschrijft de verschillende typen
studies( gevalsbesprekingen, gerandomiseerde studies ...)
voor alle mogelijke
dermatologische indicaties waarbij ooit hypnose gebruikt
werd en dat zijn er blijkbaar heel veel : acné, stress
gebonden haarverlies, eczema, puisten op het lichaam,
herpes, pijn na zona, brandende tong, overvloedig zweten,
jeuk, psoriasis, netelroos, wratten en vitiligo.
Verdere informatie rond het gebruik van hypnose in de
dermatologie kan U vinden in een overzichtsartikel
opgenomen op deze website.
Arch
Dermatol. 2000 Mar;136(3):393-9.
Hypnosis in
dermatology.
Shenefelt PD.
Department of Internal
Medicine, College of Medicine, University of South Florida,
Tampa 33612,
USA. pshenefe@hsc.usf.edu
BACKGROUND : Hypnosis is an alternative or complementary
therapy that has been used since ancient times to treat
medical and dermatologic problems.
OBJECTIVE : To describe the various uses for hypnosis as an
alternative or complementary therapy in dermatologic
practice.
METHODS : A MEDLINE search was conducted from January 1966
through December 1998 on key words related to
hypnosis and skin disorders.
RESULTS : A wide spectrum of dermatologic disorders may be
improved or cured using hypnosis as an alternative or
complementary therapy, including acne excoriee, alopecia
areata, atopic dermatitis, congenital ichthyosiform
erythroderma, dyshidrotic dermatitis, erythromelalgia,
furuncles, glossodynia, herpes simplex, hyperhidrosis,
ichthyosis vulgaris, lichen planus, neurodermatitis,
nummular dermatitis, postherpetic neuralgia, pruritus,
psoriasis, rosacea, trichotillomania, urticaria, verruca
vulgaris, and vitiligo.
CONCLUSION : Appropriately trained clinicians may
successfully use hypnosis in selected patients as
alternative or
complementary therapy for many dermatologic disorders.
Publication Types: Review
PNEUMOLOGIE
of LONGAANDOENINGEN
We
selecteerden een klinische studie rond de aanpak van
ademhalingsproblemen bij kinderen en jongeren en een
gerandomiseerde studie betreft astma.
Pediatrics. 2001
Feb;107(2):E21.
Self-hypnosis
for management of chronic dyspnea in pediatric patients.
Anbar RD.
Department of Pediatrics, State
University of New York Upstate Medical University,
Syracuse,
New York 13210, USA. anbarr@mail.upstate.edu
INTRODUCTION : Hypnotherapy can be useful in the management
of anxiety, discomfort, and psychosomatic symptoms, all of
which may contribute to a complaint of dyspnea. Therefore,
instruction in self-hypnosis was offered to 17 children and
adolescents with chronic dyspnea, which had not resolved
despite medical therapy, and who were documented to have
normal lung function at rest. This report documents the
result of this intervention.
METHODS : A retrospective chart review identified all
patients followed by a single pediatric pulmonologist
(R.D.A.), with a chief complaint of chronic dyspnea from
April 1998 through December 1999. These patients had been
evaluated and treated for medical diseases according to
their history, physical examination, and laboratory
investigations. The pulmonologist offered to teach
self-hypnosis to all of these patients, who comprise the
cohort in this report. Chronic dyspnea was defined as
recurrent difficulty breathing or shortness of breath at
rest or with exertion, which had existed for at least 1
month in patients who had not suffered within a month from
an acute pulmonary illness. The pulmonologist was trained
in hypnosis through his attendance at three 20-hour
workshops. Hypnosis was taught to individual patients in 1
or two 15- to 45-minute sessions. Patients were taught
hypnotic selfinduction techniques and imagery to achieve
relaxation. Additionally, imagery relating to dyspnea was
developed by coaching patients to change their imagined
lung appearance from a dyspneic to a healthy state.
Patients were encouraged to practice self-hypnosis
regularly and to use lung imagery to eliminate dyspnea if
it occurred.
RESULTS : Seventeen patients (13 males and 4 females) with
chronic dyspnea were documented to have normal pulmonary
function at rest. Their mean age was 13.4 years (range:
8-18 years). Twelve of the 17 previously were diagnosed
with other conditions, such as allergies, asthma, and
gastroesophageal reflux. Fifteen of the 17 manifested at
least 1 other symptom associated with their dyspnea,
including an anxious appearance (4 patients); chest
tightness or pain (5); cough (4); wheeze (3); difficulty
with inspiration (2); hyperventilation (1); inspiratory
noise, such as stridor, gasping, rasping, or squeak (8);
dizziness (1); feeling something is stuck in the throat
(2); parasthesias (4); and tachycardia (3). Of the 17
patients, 2 complained of dyspnea at rest only, 13
complained of dyspnea with activity only, and 2 complained
of dyspnea both at rest and with activity. Nine patients
reported that they frequently needed to discontinue their
physical activity because of dyspnea. The mean duration of
their dyspnea before learning selfhypnosis was 2 years
(range: 1 month to 5 years). The dyspnea was of <6
months duration for 4 of the patients. For 9 of the 17
patients a potential psychosocial association with their
dyspnea was identified: 3 developed symptoms at school
only; 2 with exercise during competitive races only; 3
after a major disagreement between their parents; and 1
developed symptoms each time his family moved to a new
neighborhood. Before presentation, 7 of the 17 patients
received chronic inhaled antiinflammatory therapy, and 3
were using inhaled albuterol, as needed. All 17 patients
had normal physical examinations, with the exception of
healed scars on the chest and abdomen of 1 patient, a
repaired cleft palate in 1 patient, and rhinitis in
another. Four of the 17 underwent pulmonary function
testing before and after exercise, 6 had chest radiographs,
and 3 had electrocardiograms. All of these tests were
normal. A patient with a history of psychogenic cough
declined to learn self-hypnosis. Thirteen of the remaining
16 patients were taught to use selfhypnosis in 1 session. A
second session was provided to 3 patients within 2 months.
Thirteen of the 16 patients reported their dyspnea and any
associated symptoms had resolved within 1 month of their
final hypnosis instruction session. Eleven believed that
resolution of their dyspnea was attributable to hypnosis,
because their symptoms cleared immediately after they
received hypnosis instruction (5 patients) or with its
regular use (6). Two did not attribute resolution of
dyspnea to hypnosis because they did not use it at home.
The remaining 3 reported that their dyspnea had improved.
Patients were followed for a mean 9 months (range: 2-15
months) after their final hypnosis session.
Ten of the 16 regularly used self-hypnosis at home for at
least 1 month after the final hypnosis session. There was
no recurrence of dyspnea, associated symptoms, or onset of
new symptoms in patients in whom the dyspnea resolved.
Under supervision of the pediatric pulmonologist, 2 of 7
patients discontinued their chronic antiinflammatory
therapy when they became asymptomatic after hypnosis.
Subsequently, their pulmonary function remained normal.
DISCUSSION :
(ABSTRACT TRUNCATED)
Publication Types: Clinical Trial
Br Med J (Clin Res Ed). 1986 Nov 1;293(6555):1129-32.
Improvement
in bronchial hyper-responsiveness in patients with moderate
asthma after treatment with a hypnotic technique: a
randomised controlled trial.
Ewer TC,
Stewart DE.
A
prospective, randomised, single blind, and controlled trial
of a hypnotic technique was undertaken in 39 adults with
mild to moderate asthma graded for low and high
susceptibility to hypnosis.
After a six week course of hypnotherapy 12 patients with a
high susceptibility score showed a 74.9% improvement (p
less than 0.01) in the degree of bronchial
hyper-responsiveness to a standardised methacholine
challenge test. Daily home recordings of symptoms improved
by 41% (p less than 0.01), peak expiratory flow rates
improved by 5.5% (p less than 0.01), and use of
bronchodilators decreased by 26.2% (p less than 0.05). The
improvement in bronchial hyperreactivity occurred without a
change in subjective appreciation of the degree of
bronchoconstriction.
A control group 17 patients and 10 patients undergoing
treatment with low susceptibility to hypnosis had no change
in either bronchial hyper-responsiveness or any of the
symptoms recorded at home.
This study shows the efficacy of a hypnotic technique in
adult asthmatics who are moderately to highly susceptible
to hypnosis.
Publication Types: Randomized Controlled Trial
GASTRO
ENTEROLOGIE
De
meeste rapporten handelen over “ spastisch colon
“, het actueel genoemde “ irritable bowel
syndroom”. Hypnose is niet enkel werkzaam op de
darmklachten maar ook op een aantal psychische parameters.
We tonen u een overzichtsartikel, een gerandomiseerde
studie en een longterm follow –up
studie.
Eur J
Gastroenterol Hepatol. 1996
Jun;8(6):525-9.
Use of hypnotherapy in gastrointestinal disorders.
Francis CY, Houghton LA.
Department of Medicine,
University Hospital of South Manchester, UK.
Medical history is full of anecdotal reports on the use of
hypnosis in the treatment of gastrointestinal and other
disorders. Unfortunately, much of the work published to
date consists mainly of short case reports or involves
small numbers of patients. They have, however, all broadly
given the same message: that patients symptoms improve and
they cope better with their condition after hypnotherapy.
More recently, controlled trials have shown that patients
with severe refractory irritable bowel syndrome or
relapsing duodenal ulcer disease respond well to
hypnotherapy. This article aims to give an overview of the
areas in gastroenterology where hypnotherapy has been
applied, discussing in particular what progress has been
made in the area of irritable bowel syndrome.
Publication Types: Review
Dig
Dis Sci. 2002 Nov;47(11):2605-14.
Hypnosis treatment for severe irritable bowel syndrome:
investigation of mechanism and effects on symptoms.
Palsson OS, Turner MJ, Johnson DA, Burnelt CK, Whitehead
WE.
University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina 27599-7080 USA.
Hypnosis improves irritable bowel syndrome (IBS), but the
mechanism is unknown. Possible physiological and
psychological mechanisms were investigated in two studies.
Patients with severe irritable bowel syndrome received
seven biweekly hypnosis sessions and used hypnosis
audiotapes at home. Rectal pain thresholds and smooth
muscle tone were measured with a barostat before and after
treatment in 18 patients (study I), and treatment changes
in heart rate, blood pressure, skin conductance, finger
temperature, and forehead electromyographic activity were
assessed in 24 patients (study II). Somatization, anxiety,
and depression were also measured. All central IBS symptoms
improved substantially from treatment in both studies.
Rectal pain thresholds, rectal smooth muscle tone, and
autonomic functioning (except sweat gland reactivity) were
unaffected by hypnosis treatment. However, somatization and
psychological distress showed large decreases. In
conclusion, hypnosis improves IBS symptoms through
reductions in psychological distress and somatization.
Improvements were unrelated to changes in the physiological
parameters measured.
Randomized Controlled Trial
Gut. 2003 Nov;52(11):1623-9.
Long term
benefits of hypnotherapy for irritable bowel syndrome.
Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ.
Department of Medicine,
University Hospital of South Manchester, Manchester, UK.
wgonsalkorale@compuserve.com
BACKGROUND AND AIMS : There is now good evidence from
several sources that hypnotherapy can relieve the symptoms
of irritable bowel syndrome in the short term. However,
there is no long term data on its benefits and this
information is essential before the technique can be widely
recommended. This study aimed to answer this question.
PATIENTS AND METHODS : 204 patients prospectively completed
questionnaires scoring symptoms, quality of life, anxiety,
and depression before, immediately after, and up to six
years following hypnotherapy. All subjects also
subjectively assessed the effects of hypnotherapy
retrospectively in order to define their "responder
status".
RESULTS : 71% of patients initially responded to therapy.
Of these, 81% maintained their improvement over time while
the majority of the remaining 19% claimed that
deterioration of symptoms had only been slight. With
respect to symptom scores, all items at follow up were
significantly improved on pre-hypnotherapy levels
(p<0.001) and showed little change from posthypnotherapy
values. There were no significant differences in the
symptom scores between patients assessed at 1, 2, 3, 4, or
5+ years following treatment. Quality of life and anxiety
or depression scores were similarly still significantly
improved at follow up (p<0.001) but did show some
deterioration. Patients also reported a reduction in
consultation rates and medication use following the
completion of hypnotherapy.
CONCLUSION : This study demonstrates that the beneficial
effects of hypnotherapy appear to last at least five years.
Thus it is a viable therapeutic option for the treatment of
irritable bowel syndrome.
GYNECOLOGIE
Indicaties voor het gebruik van
hypnose zijn divers: seksuele stoornissen, urineverlies,
chronische onderbuikpijn, zwangerschapsbegeleiding en
bevallingen. We geven een algemeen overzichtsartikel, een
meta-analyse van studies rond bevallingsarbeid afkomstig
van de gerenommeerde Cochrane database ( de groep die
nagaat voor welke aanpak evidence-based medecine criteria
gelden) en tenslotte een protocolstudie rond
bevallingsarbeid.
Birth.
1995 Mar;22(1):37-42.
Hypnosis in
reproductive health care: a review and case reports.
Baram DA.
Hypnosis has many applications
in the field of reproductive health care. This paper
describes its use in the treatment of sexual dysfunction,
urinary incontinence, chronic pelvic pain, hyperemesis
gravidarum, and pain relief in labor and delivery. Four
case reports are used for illustration.
Misconceptions about the risks and benefits of hypnosis are
discussed. Information about training for clinicians in
hypnosis is described.
Publication Types: Review
Cochrane Database Syst Rev. 2003;(2):CD003521.
Complementary
and alternative therapies for pain management in labour.
Smith CA, Collins CT, Cyna AM, Crowther CA.
Department of Obstetrics and
Gynaecology, The University of Adelaide, Women's and
Children's
Hospital, 72 King William Road, North Adelaide, Australia.
caroline.anne.smith@adelaide.edu.au
BACKGROUND : Many women would like to avoid pharmacological
or invasive methods of pain management in labour and this
may contribute towards the popularity of complementary
methods of pain management. This review examined currently
available evidence supporting the use of alternative and
complementary therapies for pain management in labour.
OBJECTIVES : To examine the effectiveness of complementary
and alternative therapies for pain management in labour on
maternal and perinatal morbidity.
SEARCH STRATEGY : We searched the Cochrane Pregnancy and
Childbirth Group trials register (July 2002), the Cochrane
Controlled Trials Register (The Cochrane Library Issue 2,
2002), MEDLINE (1966 to July 2002), EMBASE (1980 to July
2002) and CINAHL (1980 to July 2002).
SELECTION CRITERIA : The inclusion criteria included
published and unpublished randomised controlled trials
comparing complementary and alternative therapies with
placebo, no treatment or pharmacological forms of pain
management in labour. All women whether primiparous or
multiparous, and in spontaneous or induced labour, in the
first and second stage of labour were included.
DATA COLLECTION AND ANALYSIS : Meta-analysis was performed
using relative risks for dichotomous outcomes and weighted
mean differences for continuous outcomes. The outcome
measures were maternal satisfaction, use of pharmacological
pain relief and maternal and neonatal adverse outcomes.
MAIN RESULTS : Seven trials involving 366 women and using
different modalities of pain management were included in
this review. The trials included one involving acupuncture
(n = 100), one involving audio-analgesia (n = 25), one
involving aromatherapy (n = 22), three trials of hypnosis
(n = 189) and one trial of music (n = 30). The trial of
acupuncture decreased the need for pain relief (relative
risk (RR) 0.56, 95% confidence interval (CI) 0.39 to 0.81).
Women
receiving hypnosis were more satisfied with their pain
management in labour compared with controls (RR 2.33, 95%
CI 1.55 to 4.71). No differences were seen for women
receiving aromatherapy, music or audio analgesia.
REVIEWER'S CONCLUSIONS :
Acupuncture and
hypnosis may be beneficial for the management of pain
during labour. However, few complementary therapies have
been subjected to proper scientific study and the number of
women studied is small.
Publication Types: Review
American Journal of Clinical Hypnosis, 1998, 40 (4),
273-283.
Childbirth
preparation through hypnosis: The hypnoreflexogenous
protocol.
Schauble, Paul G.; Werner, William E. F.; Rai, Surekha H.;
Martin, Alice.
ABSTRACT : A verbatim protocol
for the "hypnoreflexogenous" method of preparation for
childbirth is presented wherein the patient is taught to
enter a hypnotic state and then prepared for labor and
delivery. The method provides a "conditioned reflex" effect
conducive to a positive outcome for labor and delivery by
enhancing the patient's sense of readiness and control.
Previous applications of the method demonstrate patients
have fewer complications, higher frequency of normal and
full-term deliveries, and more positive postpartum
adjustment. The benefit and ultimate cost effectiveness of
the method are discussed.
NEUROLOGIE
Ook
bij een beperkt aantal neurologische indicaties werd
hypnose gebruikt. We kunnen U echter geen gerandomiseerde
studies geven maar enkel gevalsbeschrijvingen. DeBenedettis
bespreekt de evolutie van 4 patiënten met spastische
torticollis waarbij hypnose gebruikt werd en geeft een
literatuuroverzicht aangaande deze aandoening. Ook
aangaande multiple sclerosis vonden we enkele
gevalsbesprekingen.
DeBenedittis,
Giuseppe De.
Hypnosis and spasmodic torticollis -- report of four cases:
A brief communication.
International Journal of
Clinical and Experimental Hypnosis,1996, 44 (4), 292-306.
ABSTRACT : Dystonia and particularly spasmodic torticollis
are neuromuscular disorders that are extremely resistant to
most therapies (physical, medical, or surgical).
Torticollis is a unilateral spasm of the neck muscles,
particularly of the sternocleidomastoid, that produces
violent, tonic turning of the head to one side. The
etiology remains uncertain, although the role of
psychogenic factors has been emphasized. This article
reviews the literature and reports four cases of spasmodic
torticollis treated successfully with hypnosis. In all four
cases, psychogenic causes were involved.
Postural hypnosis (i.e., hypnosis in the standing position)
was employed to counteract and minimize muscle spasms due
to postural reflexes. A hypnobehavioral approach was
adopted along with hypnotic strategies that included
hierarchical desensitization, sensory-imaging conditioning,
egoboosting suggestions, and hypnosis-facilitated
differential muscle retraining. In two cases, a combined
hypnosis and electromyographic-biofeedback approach was
used to equilibrate and
retrain affected neck muscles. Although the
hypnotherapeutic process took several months to induce and
stabilize significant changes, outcome results were good to
excellent in all cases, with marked reduction of the
torticollis and the hypertrophy of the neck muscles as well
as a reduced interference of symptoms in daily living.
Dane, Joseph R..
Hypnosis for pain and neuromuscular rehabilitation with
multiple sclerosis: Case summary, literature review, and
analysis of outcomes.
International Journal of
Clinical and Experimental Hypnosis, 1996,44 (3), 208-231.
ABSTRACT : Videotaped treatment sessions in conjunction
with 1-month, 1-year, and 8-year followup allow a unique
level of analysis in a case study of hypnotic treatment for
pain and neuromuscular rehabilitation with multiple
sclerosis (MS). Preparatory psychotherapy was necessary to
reduce the patient's massive denial before she could
actively participate in hypnosis. Subsequent hypnotic
imagery and posthypnotic suggestion were accompanied by
significantly improved control of pain, sitting balance,
and diplopia (double vision), and a return to ambulatory
capacity within 2 weeks of beginning treatment with
hypnosis. Evidence regarding efficacy of hypnotic
strategies included (a) direct temporal correlations
between varying levels of pain relief and ambulatory
capacity and the use versus nonuse of hypnotic strategies,
(b) the absence of pharmacological explanations, and (c)
the ongoing presence of other MS-related symptoms that
remained unaltered. In conjunction with existing literature
on hypnosis and neuromuscular conditions, results of this
case study strongly suggest the need for more detailed and
more physiologically based studies of the phenomena
involved.
ONCOLOGIE
Hypnose kan aangewend worden
ter controle van misselijkheid en braken bij chemotherapie.
Studies aangaande het gunstige effect van psychologische
interventies op immunologie van kankerpatiënten zijn tot op
heden controversieel. Onderstaande studie toonde wel een
gunstig effect aan van hypnose op de immuniteit en op de
psychische parameters bij oncologische patiënten.
Marchioro
G, Azzarello bG, Viviani F, Barbato F, Pavanetto M, Rosetti
F, Pappagallo GL, Vinante O.
Oncology.2000 Aug;59(2):100-4.
Hypnosis in
the treatment of anticipatory nausea and vomiting in
patients receiving cancer chemotherapy.
Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto
M, Rosetti F, Pappagallo GL, Vinante O.
Department of Oncology, Local
Health Unit No. 13, Noale, Italy.
AIMS AND BACKGROUND : In addition to nausea and vomiting
following chemotherapy treatment, cancer patients can
experience these side effects prior to a treatment session,
the so-called anticipatory nausea and vomiting. As various
psychological and neurophysiological aspects have been
claimed to be implied in its etiopathogenesis, the present
paper aims to shortly review the etiological,
epidemiological and therapeutical assumptions on the topic,
in particular the
psychological-behavioral therapies.
PATIENTS AND METHODS : The present study was carried out on
16 consecutive adult cancer patients affected by
chemotherapy-induced anticipatory nausea and vomiting who
had received at least four treatment cycles. All of them
were submitted to induction of relaxation followed by
hypnosis. RESULTS: In all subjects anticipatory nausea and
vomiting disappeared, and major responses to
chemotherapy-induced emesis control were recorded in almost
all patients.
CONCLUSIONS : The experience highlights the potential value
of hypnosis in the management of anticipatory nausea and
vomiting; furthermore, the susceptibility to anticipatory
nausea and vomiting is discussed under the psychoanalytic
point of view.
Copyright 2000 S. Karger AG, Basel.
Publication Types: Clinical trial
J Psychosom Res. 2002 Dec;53(6):1131-7.
The effect of
hypnotic-guided imagery on psychological well-being and
immune function in patients with prior breast cancer.
Bakke AC, Purtzer MZ, Newton P.
Department of Pathology, Oregon
Health and Science University, Portland, OR 97201, USA.
bakkea@ohsu.edu
OBJECTIVE : To determine the effect of hypnotic-guided
imagery on immune function and psychological parameters in
patients being treated for Stage I or II breast cancer.
METHODS : To determine the effects of hypnotic-guided
imagery on immune function and psychological parameters,
the following study was undertaken. Psychological profiles,
natural killer (NK) cell number and activity were measured
at baseline, after the 8-week imagery training program and
at the 3-month follow-up.
RESULTS : There were significant increases in improvement
in depression (P<.04) and increase in absolute number of
NK cells, but these were not maintained at the 3-month
follow-up.
Hypnotic-guided imagery did cause some transient changes in
psychological well-being and immune parameters. However,
these changes were not retained after the treatment ended.
CONCLUSIONS : Many studies during the last 15 years have
demonstrated interactions between the central nervous
and the immune systems. While a negative effect of stress
on immune responses has been demonstrated, there have also
been published reports that psychological treatments can
positively alter the immune system. However, given the
complexities of immune system kinetics, the transient
nature of any psychological effect and the insensitivity of
immune assays, our study indicates that there is a role for
hypnotic-guided imagery as an adjuvant
therapy.
IMMUNOLOGIE
Het
werkingsmechanisme van hypnose op medische aandoeningen is
momenteel nog onvoldoende opgehelderd. Waarschijnlijk
speelt de invloed op immunologische parameters een
belangrijke rol. Een aantal studies tonen het gunstige
effect van hypnotische suggesties op diverse immunologische
parameters.
Het artikel Van J. Gruzelier geeft een mooi overzicht van
de huidige literatuur maar we selecteerden er tevens twee
anderen waarin significant gunstige immunologische effecten
teruggevonden werden.
Stress.
2002 Jun;5(2):147-63.
A review of
the impact of hypnosis, relaxation, guided imagery and
individual differences on aspects of immunity and health.
Gruzelier JH.
Department of Cognitive
Neuroscience and Behaviour, Imperial College of Science,
Technology and
Medicine, London, UK. j.gruzelier@ic.ac.uk
This review considers psychological interventions involving
relaxation and guided imagery targeting immune functions.
The review provides evidence of immune control accompanied
by reports of enhanced mood and well-being. Three recent
investigations of the author and his colleagues with
self-hypnosis training incorporating imagery of the immune
system are outlined. In two studies, hypnosis buffered the
effects of stress on immune functions in medical students
at exam time, and the comparison of self-hypnosis with and
without immune imagery confirmed advantages to targeted
imagery for both immune function and mood, and importantly,
fewer winter viral infections. The implications for health
were investigated in a third study in patients with
virulent and chronic herpes simplex virus-2 HSV-2). Six
weeks of training almost halved recurrence, improved mood
and reduced levels of clinical depression and anxiety.
Immune functions were up-regulated, notably functional
natural killer cell activity to HSV-1. Individual
differences in hypnotic susceptibility and absorption have
typically been found to predict efficacy. New replicable
evidence is reviewed of the importance of cognitive
activation, a personality difference whose
neurophysiological underpinning is consistent with left
hemispheric preferential influences over the immune system.
Now that the validation of psychological interventions
includes advantages for health, this field of enquiry,
which has been characterised by modest, small scale,
largely preliminary studies, warrants a greater investment
in research.
Am J Clin Hypn. 2003 Jan;45(3):179-96.
Hypnosis,
differential expression of cytokines by T-cell subsets, and
the hypothalamo-pituitaryadrenal axis.
Wood GJ, Bughi S, Morrison J, Tanavoli S, Tanavoli S, Zadeh
HH.
University of Southern
California, USA. gwood@usc.edu
This investigation tested the hypothesis that hypnosis can
differentially modulate T-cell subsets, and that this
effect is mediated by changes in
hypothalamo-pituitary-adrenal (HPA) mediators.
Seven healthy, highly hypnotizable volunteers participated
in three one-day sessions, a baseline and two intervention
sessions. Hypnosis intervention entailed a standardized
induction, suggestions for ego strengthening and optimally
balanced functioning of the immune and neuroendocrine
systems, and post-hypnotic suggestions for stress
management and continued optimal balance of bodily systems.
Blood samples were drawn at five time points between 8:00
a.m. and 3:00 p.m. and were analyzed for T-cell activation
and intracellular cytokine expression (Interferon
(IFN)-gamma, Interleukin-2, Interleukin-4) and HPA axis
mediators (ACTH, cortisol, and beta-endorphin).
Following hypnosis intervention, statistically significant
immunological effects were noted.
Specifically, the proportion of T-cells expressing
IFN-gamma (p = .0001) and IL-2 (p = .013) were lower after
hypnosis. T-cell activation response to polyclonal
stimulation was positively correlated with ACTH (p = .01)
and beta-endorphin (p = .001) while IFN-gamma expression
was correlated with levels of cortisol (p < .001).
Further controlled studies utilizing hypnosis with patients
in treatment are warranted in order to examine whether an
altered T-cell response can be replicated in the presence
of disease.
J Consult Clin Psychol. 2001 Aug;69(4):674-82.
Hypnosis as a
modulator of cellular immune dysregulation during acute
stress.
Kiecolt-Glaser JK, Marucha PT, Atkinson C, Glaser R.
Department of Psychiatry, Ohio
State University College of Medicine, Columbus 43210, USA.
kiecolt-glaser.1@osu.edu
To assess the influence of a hypnotic intervention on
cellular immune function during a commonplace stressful
event, the authors selected 33 medical and dental students
on the basis of hypnotic susceptibility. Initial blood
samples were obtained during a lower stress period, and a
second sample was drawn 3 days before the first major exam
of the term. Half of the participants were randomly
assigned to hypnotic-relaxation training in the interval
between samples. Participants in the hypnotic group were,
on average, protected from the stress-related decrements
that were observed in control participants' proliferative
responses to 2 mitogens, percentages of CD3+ and CD4+
Tlymphocytes, and interleukin 1 production by peripheral
blood leukocytes. More frequent hypnoticrelaxation practice
was associated with higher percentages of CD3+ and CD4+
T-lymphocytes.
These data provide encouraging evidence that interventions
may reduce the immunological dysregulation associated with
acute stressors.
Publication Types: Randomized Controlled Trial
Eur J Gastroenterol Hepatol. 1996 Jun;8(6):520-4.
U leest het :
De werkzaamheid van hypnose op medische aandoeningen werd
wel degelijk goed
gedocumenteerd! Maar talrijke aspecten aangaande het
gebruik van hypnose voor medische aandoeningen werden tot
op heden onvoldoende onderbouwd of dienen verder
opgehelderd te worden.
Het is hopelijk aan U en aan ons om daar werk van te maken
...