Psychological impact ofchronic illness Dr. Amal Yassien Haikal Lecturer of psychiatry Faculty of medicine- Mansoura University 2
Chronic illness is considered as a stressful event. Definition of stress:The cognitive appraisal of external events in relation toone’s coping resources & its physiological responses in the individual. 3
• Fear of death , surgery , disfigurement, dependency, incontinence, severe pain • more in young patients Anxiety • Fear of loss, separation from family • Loss of physical activity • Changes in physical appearance • The effect of surgeryDepression • Debilitating effect of radiotherapy (5-15%) 8
• Guilt from dependency, excessive demandGuilt • Illness represented to the & patient as a punishment for previous wrong doingsanger • Anger displaced to medical staff 9
Denial• Adaptive (calms patient)• maladaptive (refuse medical care) Dependency • adaptive (comply with ttt) • maladaptive (burden on caregiver) Displacement anger towards medical staff Acceptance • role of staff through good communication 10
Denial & isolation “Something is wrong, shock” AngerAcceptance “Why me? displaced…. Stages of emotional reaction to chronic illness Depression Bargaining “hopelessness, isolati (partial on, sleep problems acceptance) 11
help patients adjust to their illness and take a more active approachMultimodal interventions using a variety of techniques but with same general goal increasing familypain management stress management coping skills 13 communication
Chronic illness involves more than physicalsymptoms. There are the psychological andemotional symptoms as well.The psychological effects of chronic illness can beprofound.Chronic illness can strongly disrupt social life and putstrains on social support networks.Individuals with chronic illness are more likely to bedepressed, especially those who experience greaterlevels of pain and disability.
Emotional disturbance “e.g., depression”interferes with compliance to ttt and worsenprognosisPatients who become unmotivated to improvetheir illness-related coping tend to have greaternumbers of hospital admissions and poorerhealth.There is substantial diversity in individuals’adjustment to chronic diseasemagority: positive adjustmentminority: significant distress or life disruption.