concept of Psychomedical Treatment - that is, the approach
that emphasis the interrelation of mind and body in the
genesis of symptom and disorder calls for a greatly sharing
of responsibility among various profession. If one views
disease from a multicausal point of view, every disease
can be considered psychosomatic, since every disorder
is affected in some fashion by emotional factors. Anxiety,
depression and hostility, in varying proportions, are
at the root of most psychosomatic disorders. Psychosomatic
medicine is principally concerned with those illnesses
that present primarily somatic manifestations.
The presenting complain is usually physical as you know very
well; patients rarely complain of their anxiety or depression
or tension, but, rather, of their vomiting or diarrhea or anorexia
or premature ejaculation to their respective consultants.
Types of patients
A special evaluation of the psychological and somatic factors
of three major groups of medical patients is generally observed.
Psychosomatic Illness Group
Patients in this group suffer from such disorders as peptic
ulcers, asthma, ulcerative colitis, irritable bowel syndrome
etc. or children suffering from learning disability or nocturnal
enuresis. In these disease processes one cannot foist a strictly
psychogenic explanation, since the particular set of emotional
factors found, for example, in the typical ulcer case may also
appear in patient with no history of ulcer.
Patients in this group do have actual organic disorders, but
they also suffer from an associated psychological disturbance.
For example, a patient with a heart disease or renal disease
or with menopausal symptoms may have a reactive anxiety or depression
regarding their condition. The anxiety, in turn, may produce
physical manifestations that complicate the somatic situation.
Patients in this group suffer from physical disturbances caused
by psychological illness, rather than physical illness. Their
somatic disabilities may be real (objective) or unreal. When
real, the disability involves the voluntary nervous system and
is termed a conversion disorder, previously called a conversion
hysteria. Among the unreal disabilities are hypochondriasis
and delusional preoccupation with physical functioning, which
is often seen in schizophrenic patients.
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INSTITUTE OF BEHAVIOURAL SCIENCES (NIBS)