The subject, its biology, and the chronic recurrent cystitis

Experience of a tertiary-level urology center in the clinical urological events of rare and very rare incidence. III. Psychourological events: 2. Phobia of renal failure due to loin pain

Background

End-stage renal disease and loin pain are prevalent nephrourological topics with unfavorable reputations among populations. We aimed to present our center’s experience with the cases of phobia of renal failure in relation to loin pain.

Methods

It is a retrospective study of phobia of renal failure among the patients who presented with loin pain to our center between July 1991 and June 2017. Description of perception of renal failure risk was guided by the modified Common Sense Model of Illness Representation.

Results

Of more than 64, 000 patients who presented with loin pain, only 78 patients (0.12%) had phobia of renal failure. Mean age ± SD (Range) was 41.12 ± 9.58 (23–60) years. Sixty-four patients (82.1%) expressed directly fear of renal failure. Physical examination and investigations revealed no risks of renal failure in all patients. High percentages of phobia of renal failure were associated with the female gender (73.1%), the presence of a relative patient with renal failure (83.3%), and low socioeconomic levels: education (89.7%), residential (75.6%), and economic status (88.5%) levels. The modified Common Sense Model of Illness Representation revealed predominant emotional representations and unreal cognitive domains with altered perception of renal failure risk.

Conclusions

Phobia of renal failure is very rare. It is a consequence of the altered perception of risk of renal failure due to unconscious attribution of loin pain to renal failure. Female gender, the presence of a relative with renal failure, and low socioeconomic levels could be suggested as risk factors for phobia of renal failure.

Experience of a tertiary-level urology center in the clinical urological events of rare and very rare incidence. III. Psychourological events: 2. Phobia of renal failure due to loin pain

Background

End-stage renal disease and loin pain are prevalent nephrourological topics with unfavorable reputations among populations. We aimed to present our center’s experience with the cases of phobia of renal failure in relation to loin pain.

Methods

It is a retrospective study of phobia of renal failure among the patients who presented with loin pain to our center between July 1991 and June 2017. Description of perception of renal failure risk was guided by the modified Common Sense Model of Illness Representation.

Results

Of more than 64, 000 patients who presented with loin pain, only 78 patients (0.12%) had phobia of renal failure. Mean age ± SD (Range) was 41.12 ± 9.58 (23–60) years. Sixty-four patients (82.1%) expressed directly fear of renal failure. Physical examination and investigations revealed no risks of renal failure in all patients. High percentages of phobia of renal failure were associated with the female gender (73.1%), the presence of a relative patient with renal failure (83.3%), and low socioeconomic levels: education (89.7%), residential (75.6%), and economic status (88.5%) levels. The modified Common Sense Model of Illness Representation revealed predominant emotional representations and unreal cognitive domains with altered perception of renal failure risk.

Conclusions

Phobia of renal failure is very rare. It is a consequence of the altered perception of risk of renal failure due to unconscious attribution of loin pain to renal failure. Female gender, the presence of a relative with renal failure, and low socioeconomic levels could be suggested as risk factors for phobia of renal failure.

Caloric vestibular stimulation as a treatment for conversion disorder: a case report and medical hypothesis

Conversion disorder is a medical condition in which a person has paralysis, blindness, or other neurological symptoms that cannot be clearly explained physiologically. To date, there is neither specific nor conclusive treatment. In this paper, we draw together a number of disparate pieces of knowledge to propose a novel intervention to provide transient alleviation for this condition. As caloric vestibular stimulation has been demonstrated to modulate a variety of cognitive functions associated with brain activations, especially in the temporal-parietal cortex, anterior cingulate cortex, and insular cortex, there is evidence to assume an effect in specific mental disorders. Therefore, we go on to hypothesize that lateralized cold vestibular caloric stimulation will be effective in treating conversion disorder and we present provisional evidence from one patient that supports this conclusion. If our hypothesis is correct, this will be the first time in psychiatry and neurology that a clinically well-known mental disorder, long considered difficult to understand and to treat, is relieved by a simple or common, non-invasive medical procedure.