Criteria of Patients in Psychosomatic Clinics
-
Psychiatric illness secondary to other medical conditions either pathophysiological related (e.g. Psychotic disorder due to brain tumor or depression due to steroids), or psychological related (e.g. adjustment disorder due to recent diagnosis with serious medical illness).
-
Major primary psychiatric illness coincident with another serious intrusive medical illness e.g. Schizophrenia in patient with ESRD or post transplantation, perinatal psychiatric conditions…etc.
-
Somatic and related disorders e.g. Somatic symptom disorder, illness anxiety disorder, conversion disorder, psychological factors affecting the course of other medical conditions.
Medical and Psychological Factors in Illness
- Medical factors/illnesses may affect individual vulnerability, course, & outcome of ANY psychiatric disorder.
- Psychosocial factors/illnesses may affect individual vulnerability, course, & outcome of ANY type of disease.
- Psychological factors may operate to facilitate, sustain, or modify the course of medical disease, even though their relative weight may vary…
- from illness to illness !..
- from one individual to another !..
- between 2 different episodes of the same illness in the same individual! .
Illness Vs. Disease
-
Illness:
- The response of the individual and his/her family to symptoms
- Subjective !, psychosocial, cultural, religious factors
-
Disease:
- Defined by physicians and associated with pathophysiological processes and documented lesions
- Objective !
-
Implications !!
Illness Behavior
- The manner in which individuals monitor their bodies, define and interpret their symptoms, take remedial actions, and utilize the health care system
- Variety of factors
- Achievement of objectives
- Abnormal illness behavior:
- Inappropriate or maladaptive mode of perceiving, evaluating or acting in relation to one’s own health status
Illness affirming…illness denying
Quality of Life and Illness Intrusiveness for Chronic / Life-Threatening Diseases
- Disease related factors
- Treatment related factors
- Psycho-social factors
- Control
- Illness intrusiveness
- Subjective well-being
(G. Devins, 1994)
Example of Psychosocial Factors Affecting a Medical Condition (CHD)
According to The Interheart study, the population attributable risk factor for MI of Hypertension was 17.9%, while the psychosocial risk factors were responsible about:
- a) 5%
- b) 10%
- c) 15%
- d) 20%
- e) >30%
Stress Vs CHD
According to The Interheart study, the population attributable risk factor for MI of Hypertension was 17.9%, while the psychosocial risk factors were responsible about:
- a) 5%
- b) 10%
- c) 15%
- d) 20%
- e) >30%