title: From stress to functional syndromes: an internist's point of view.
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.
authors.affiliation: Centro di Ricerca Terapia Neurovegetativa e Medicina dell'Esercizio, Dipartimento Scienze Cliniche, Università degli Studi di Milano, Italy. daniela.lucini@unimi.it
authors.forename: Daniela
authors.initials: D
authors.lastname: Lucini
authors.forename: Massimo
authors.initials: M
authors.lastname: Pagani
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology; D015928:Cognitive Behavioral Therapy; D015673:Fatigue Syndrome, Chronic / Q000503:physiopathology / Q000523:psychology; D005356:Fibromyalgia / Q000503:physiopathology / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000503:physiopathology / Q000523:psychology; D008019:Life Style; D009043:Motor Activity; D013312:Stress, Physiological / Q000276:immunology / Q000502:physiology; D013315:Stress, Psychological / Q000276:immunology / Q000503:physiopathology / Q000628:therapy