From stress to functional syndromes: an internist's point of view

European Journal of Internal Medicine
Daniela Lucini, Massimo Pagani

Abstract

In this brief review we address schematically the relationship between two emerging issues in clinical medicine: stress and functional syndromes. It is becoming increasingly clear that they demand a multidimensional approach, considering simultaneously elements of behavioral therapy with traditional pharmacological treatment, guided by a better physiopathological understanding including autonomic assessment. New techniques, based on innovative analysis of continuous segments of electrocardiogram and non invasive arterial pressure recordings capable to extract hidden oscillations, provide quantitative indices of sympathetic and vagal modulation of the cardiovascular system. This more complete diagnostic process facilitates explanation of symptoms and reassurance of patients, based on functional evidence. The described clinical approach implies in addition an active collaboration of patients requiring the implementation of a creative alliance. Physical exercise, eating habits and muscular-mental relaxation are combined with pharmacological tools as needed.

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Citations

Aug 2, 2013·Current Pain and Headache Reports·Marcio BernikLucas Gandarela
Feb 12, 2014·Brain, Behavior, and Immunity·Dan HuDeling Yin
Jan 20, 2017·European Journal of Clinical Investigation·Roberto SalaDaniela Lucini
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Jan 8, 2018·Psychotherapy and Psychosomatics·Peter HenningsenFrancis Creed
Aug 19, 2015·Terapevticheskiĭ arkhiv·E S AkarachkovaS V Vershinina
May 10, 2018·Frontiers in Physiology·Daniela LuciniMassimo Pagani
May 23, 2019·Frontiers in Physiology·Nadia SolaroDaniela Lucini
Jan 28, 2021·International Journal of Environmental Research and Public Health·Daniela Lucini, Massimo Pagani

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