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Personality disorder ppt MENTAL HEALTH NURSINGvihang tayde
Most definition of normal personality includes some or all of the following features,
Present since adolescence.
Stable overtime despite fluctuations in mood.
Manifest in different environment.
Recognizable to friends and acquaintance.
SCHIZOPHRENIA:
slide 1: A long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.
slide 14: Types:
• Paranoid-type schizophrenia is characterized by delusions and auditory hallucinations (hearing voices that don't exist) but relatively normal intellectual functioning and expression of emotions. People with paranoid-type schizophrenia can exhibit anger, aloofness, anxiety, and can be argumentative.
• Disorganized-type schizophrenia is characterized by speech and behavior that are disorganized or difficult to understand, and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh inappropriately for no apparent reason, make illogical statements, or seem preoccupied with their own thoughts or perceptions. Their disorganized behavior may disrupt normal activities, such as showering, dressing, and preparing meals.
• Undifferentiated-type schizophrenia is characterized by some symptoms seen in all of the above types, but not enough of any one of them to define it as another particular type of schizophrenia.
• Residual-type schizophrenia is characterized by a past history of at least one episode of schizophrenia, but the person currently has no "positive" symptoms (such as delusions, hallucinations, disorganized speech, or behavior). It may represent a transition between a full-blown episode and complete remission, or it may continue for years without any further psychotic episodes.
Catatonic Schizophrenia
This type of schizophrenia includes extremes of behavior, including:
Catatonic excitement - overexcitement or hyperactivity, in which the patient may mimic sounds (echolalia) or movements (achopraxia) around them.
Catatonic stupor - a dramatic reduction in activity in which the patient cannot speak, move or respond. Virtually all movements stops.
Conclusion
It is clear now, through the use of genetic linkage studies and microbiology, that schizophrenia does indeed have a biological explanation. However, the biological explanation is only part of the story. A yet unknown combination of intense stress, sociocultural situations, and cognitive processes may lead to the actual onset of schizophrenia aided by natural precursors. The most compelling explanation seems to be that a genetically inherited biological abnormality gives rise to hallucinations/delusions as a result of intense stress and eventually leads to other negative symptoms in reaction to the hallucinations/ delusions. At any rate, the current understanding of schizophrenia explains that the symptoms, however easily identifiable, are the result of a complex interaction between nature and nurture that can be treated adequately through the use of atypical anti psychotic drugs and psychotherapy.
somatoform disorders are characterized by persistent requests for medical attention because of physical complaints that cannot be sufficiently explained by medical causes.
Personality disorder ppt MENTAL HEALTH NURSINGvihang tayde
Most definition of normal personality includes some or all of the following features,
Present since adolescence.
Stable overtime despite fluctuations in mood.
Manifest in different environment.
Recognizable to friends and acquaintance.
SCHIZOPHRENIA:
slide 1: A long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.
slide 14: Types:
• Paranoid-type schizophrenia is characterized by delusions and auditory hallucinations (hearing voices that don't exist) but relatively normal intellectual functioning and expression of emotions. People with paranoid-type schizophrenia can exhibit anger, aloofness, anxiety, and can be argumentative.
• Disorganized-type schizophrenia is characterized by speech and behavior that are disorganized or difficult to understand, and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh inappropriately for no apparent reason, make illogical statements, or seem preoccupied with their own thoughts or perceptions. Their disorganized behavior may disrupt normal activities, such as showering, dressing, and preparing meals.
• Undifferentiated-type schizophrenia is characterized by some symptoms seen in all of the above types, but not enough of any one of them to define it as another particular type of schizophrenia.
• Residual-type schizophrenia is characterized by a past history of at least one episode of schizophrenia, but the person currently has no "positive" symptoms (such as delusions, hallucinations, disorganized speech, or behavior). It may represent a transition between a full-blown episode and complete remission, or it may continue for years without any further psychotic episodes.
Catatonic Schizophrenia
This type of schizophrenia includes extremes of behavior, including:
Catatonic excitement - overexcitement or hyperactivity, in which the patient may mimic sounds (echolalia) or movements (achopraxia) around them.
Catatonic stupor - a dramatic reduction in activity in which the patient cannot speak, move or respond. Virtually all movements stops.
Conclusion
It is clear now, through the use of genetic linkage studies and microbiology, that schizophrenia does indeed have a biological explanation. However, the biological explanation is only part of the story. A yet unknown combination of intense stress, sociocultural situations, and cognitive processes may lead to the actual onset of schizophrenia aided by natural precursors. The most compelling explanation seems to be that a genetically inherited biological abnormality gives rise to hallucinations/delusions as a result of intense stress and eventually leads to other negative symptoms in reaction to the hallucinations/ delusions. At any rate, the current understanding of schizophrenia explains that the symptoms, however easily identifiable, are the result of a complex interaction between nature and nurture that can be treated adequately through the use of atypical anti psychotic drugs and psychotherapy.
somatoform disorders are characterized by persistent requests for medical attention because of physical complaints that cannot be sufficiently explained by medical causes.
Concept of Neurosis and Psychosis. Differences between these psychiatric disorders. It is an important topic for students belongs disciplines such as psychiatry, psychology, psychiatric nursing and psychiatric social work.
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
SO GUYS ONCE AGAIN HERE I PRESENT U THE OWN MADE PRESENTATION ON THE TOPIC DEMENTIA I HOPE U LIKE THAT IT IS BEEN USEFUL U WHILE MAKING PSYCHIATRIC PRESENTATION
The word delirium means “out of one’s furrow” which refers to the dramatic behavior changes that the person may experience. Some have called delirium "brain failure” because it may represent a variety of caused such as heart failure does in cardiac health.
Delirium is an outcome of a general medical condition, head injury and drug intoxication or withdrawal.
chronic health issues are common, they are also a substantial risk factor for poor mental health and reduced quality of life.
poor mental health can increase the risk of disability, poor treatment compliance, and mortality.
Concept of Neurosis and Psychosis. Differences between these psychiatric disorders. It is an important topic for students belongs disciplines such as psychiatry, psychology, psychiatric nursing and psychiatric social work.
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
SO GUYS ONCE AGAIN HERE I PRESENT U THE OWN MADE PRESENTATION ON THE TOPIC DEMENTIA I HOPE U LIKE THAT IT IS BEEN USEFUL U WHILE MAKING PSYCHIATRIC PRESENTATION
The word delirium means “out of one’s furrow” which refers to the dramatic behavior changes that the person may experience. Some have called delirium "brain failure” because it may represent a variety of caused such as heart failure does in cardiac health.
Delirium is an outcome of a general medical condition, head injury and drug intoxication or withdrawal.
chronic health issues are common, they are also a substantial risk factor for poor mental health and reduced quality of life.
poor mental health can increase the risk of disability, poor treatment compliance, and mortality.
Mental health includes our emotional ,psychological, and social well-being. It affects how we think, feel and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.
To know more about mental health care click on the below link
https://docmode.org/about/
https://docmode.org/lectures/
This PPT aims to help learner about mental health, Causes of Mental health, Types of Mental illness, Anxiety disorder, Mood disorder, Personality Disorder, schizophrenia, Eating Disorder, substance use Disorder, obsessive-Compulsive Disorder.
Do you really want to understand what doctors mean when they talk about depression? Do you know that in everyone on earth, 2 out of 3 suffers depression on a daily basis.
The somatoform disorders are a group of psychological disorders in which a patient experiences physical symptoms that are inconsistent with or cannot be fully explained by any underlying general medical or neurologic condition. Medically unexplained physical symptoms account for as many as 50% of new medical outpatient visits. [1] Physical symptoms or painful complaints of unknown etiology are fairly common in pediatric populations. [2] Many healthy young children express emotional distress in terms of physical pain, such as stomachaches or headaches, but these complaints are usually transient and do not effect the child's overall functioning. The somatoform disorders represent the severe end of a continuum of somatic symptoms.
Somatization in children consists of the persistent experience and complaints of somatic distress that cannot be fully explained by a medical diagnosis. They can be represented by a wide spectrum of severity, ranging from mild self-limited symptoms, such as stomachache and headache, to chronic disabling symptoms, such as seizures and paralysis. These psychological disorders are often difficult to approach and complex to understand. It is important to note that these symptoms are not intentionally produced or under voluntary control.
In somatoform disorders, somatic symptoms become the focus of children and their families. They generally interfere with school, home life, and peer relationships. These youngsters are more likely to be considered sickly or health impaired by parents and caretakers, to be absent from school, and to perform poorly in academics. Somatization is often associated temporarily with psychosocial stress and can persist even after the acute stressor has resolved, resulting in the belief by the child and his or her family that the correct medical diagnosis has not yet been found. Thus, patients and families may continue to seek repeated medical treatment after being informed that no acute physical illness has been found and that the symptoms cannot be fully explained by a general medical condition. When somatization occurs in the context of a physical illness, it is identified by symptoms that go beyond the expected pathophysiology of the physical illness.
Recurrent complaints often present as diagnostic and treatment dilemmas to the primary care practitioner (PCP) who is trying to make sense of these symptoms. The PCP may feel poorly prepared and/or may have little time to assess or treat the somatic concerns. While the more disabling somatic complaints are more likely to be referred to a mental health professional, these youngsters presenting with these disabling physical symptoms bridge both medical and psychological domains and present a puzzling quandary for professionals from either field if working with them alone. [3] The nature of these symptoms requires an integrated medical and psychiatric treatment approach to successfully decrease the impairment caused by these disorders.
This is the Final for Dr. Bachman's Psychopathology Course for Webster University. This has been uploaded to assist with studying for the Counselor's Examination.
TalkToAngel can help with teen depression. TalkToAngel is an online counseling platform that provides access to licensed therapists who specialize in treating mental health issues, including depression. Teen depression is a serious mental health concern that can affect a young person's emotional, social, and academic functioning.
Millions of people worldwide suffer from the mental health illness known as depression. It is marked by enduring melancholy, pessimism, and a lack of interest in once-pleasant pursuits.
https://www.talktoangel.com/area-of-expertise/depression
MY DEAR COLLEAGUES HERE IS MY LITTLE INITIATIVE TO HELP U ALL PRESENTING INFRONT OF YOU THE TOPIC SOMATOFORM DISORDER, IT IS VERY ESSENTIAL IN THE FIELD OF PSYCHIATRY........
This slide contains information regarding human behavior. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
This slide contains information regarding Introduction to Psychology. This can be helpful for proficiency level and bachelor level nursing students and may also somewhere be help for those trying to understand what psychology is (basic idea). Your feedback is highly appreciated. Thank you!
This slide contains information regarding Electro Convulsive Therapy. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
This slide contains information regarding Childhood Psychiatric Disorders (Enuresis, Encopresis and Pica). This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Emotional disorder (Separation anxiety and School Phobia)nabina paneru
This slide contains information regarding Childhood Psychiatric Disorders (Emotional disorder: Separation anxiety and school phobia). This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
This slide contains information regarding Childhood Psychiatric Disorders (Mental Retardation and Attention Deficit Hyperactive Disorder). This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
This slide contains information regarding Psychiatric Emergencies (Anger, Aggression and violence, Stupor and Catatonia) . This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
This slide contains information regarding Lithium Toxicity. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
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This slide contains information regarding HIV, ARV. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. Introduction
• Psychosomatic means mind and body.
• A psychosomatic disorder is a disease involving both mind
and body.
• Psychosomatic also called Psycho – physiologic disorder,
condition in which psychological stresses adversely affect
physiological (somatic) functioning to the point of distress.
3. Definition
• A group of mental ailments in which emotional stress is a
contributing factor to physical problems involving an organ
system under involuntary control.
- Bimala Kapoor, 1994
• Disorders in which psychic elements are significant in
initiating alteration in chemical, physiological or structure of
the individual resulting in physical symptoms.
- Sreevani R
4. Classification
Psychosomatic illnesses can be classified in three general forms:
• The first form includes those who experience both a mental illness and
a medical one; these illnesses complicate the symptoms and
management of each other.
• The second form includes those who experience a psychiatric issue that
is a direct result of a medical illness or its treatment; having depression
due to cancer and its treatment for example.
• The third form of psychosomatic illness is, 'somatoform,' disorders.
Somatoform disorders are psychiatric ones that are displayed through
physical issues.
5. Somatoform disorder
Somatoform disorders are mental illness characterize by the presentation
of physical symptoms with no medical explanations. The symptoms are
severe enough to interfere with the patients ability to function in social or
occupational activities.
6. Types of Somatoform disorder
1. Somatization disorder: Multiple somatic symptoms in absence of
any physical disorder. The symptoms are recurrent and chronic (at
least 2 year duration is needed for diagnosis). It begins before age 30.
2. Conversion Disorder: An expression of psychological conflict or
need that involves an alteration or loss of physical functioning that
suggests a bodily cause in the absence of a medical reason.
7. Contd.
3. Body Dysmorphic Disorder: An obsession or preoccupation with an
imaginary or minor flaw such as wrinkles, small breasts, or the size or
shape of another part of the person's body. Body dysmorphic disorder
causes severe anxiety and might impact a person's ability to function
as usual in their daily life.
10. Contd.
5. Pain disorder: Preoccupation with pain in the absence of an adequate
physical basis for it.
11. Etiology
1. Individual exhibit specific physiological responses to certain
emotions. E.g. in person to the emotion of anger, person may
experience peripheral vasoconstriction, resulting in an increase in
blood pressure.
12. Contd.
2. Personality Theory: individuals with specific personality traits are
predisposed to certain disease processes:
Personality Characters Psychosomatic disorder
1. Dependence personality Asthma
2. Repressed, anger Peptic ulcer and HTN
3. Aggressive, ambitious Coronary heart disease
4. Compulsive and perfectionist Migraine
5. Self sacrificing & inhibited Rheumatoid arthritis &
ulcerative colitis
13. Contd.
3. Family Dynamic Theory: Pathogenic family pattern in childhood,
stressful and conflicting interpersonal relationship among family
members.
4. Biological theory: (Genetic predisposition): First degree relatives,
monozygotic twins are prone to develop psychosomatic disorders.
14. Possible progression of psychosomatic disorders
Prolonged anxiety
Persistent psycho – physiological reactions
Structural alteration, cellular disease and functional
impairment
Psychosomatic Disorders
15. Some Important Psychosomatic Disorders
1. Bronchial Asthma
Asthmatic symptoms are induced by emotional stress. Bronchial asthma is
common in fear, rejection, and mourning or pent op emotion, upset in
dependency need.
16. Contd.
2. Cardiovascular Disorders
- Hypertension, coronary heart disease (CHD). The most deadly and well
– known form of coronary heart disease is myocardial infarction (MI).
- Hypertension increases the risk for CHD, as well as other serious
disorders such as stroke.
- Type “A” personality is found to be linked with coronary heart disease
(CHD). Type “A” personality includes excessive ambition, high
performance standards, persistent urgency, competitiveness,
aggressiveness and hostility.
17. Contd.
3. Peptic ulcer
Stress and emotional disturbances adreno – cortical secretion
increased acidity progressive erosion of the mucosal wall in
esophagus, stomach, duodenum or jejunum increased inflammation
and severe laceration ulcer
18. Contd.
4. Irritable Bowel Syndrome (IBS)
- Stress and anxiety may make the mind more aware of spasms in the
colon.
- IBS may be triggered by the immune system which is affected by
stress.
19. Contd.
5. Ulcerative colitis
- Patients with a predominance of compulsive personality traits, and
narcissistic personality traits, and are neat orderly and clean, punctual,
hyper intellectual and inhibited in expressing their anger are associated
with individuals who have ulcerative colitis.
- Disturbed personal relationship resulting in feeling off helplessness and
hopelessness
- Stress Grief, anxiety, disappointment, guilt, frustration, emotion
suppression triggers hypothalamic pituitary thyroid and adrenal axis
Lower immunity.
20. Contd.
6. Migraine and tension typed headache
A severe recurring headache, usually affecting only one side of the head,
that is characterized by sharp, throbbing pain and is often accompanied by
nausea, vomiting, sensitivity to light and visual disturbances. Vasodilation
in the brain causes inflammation that results in pain, but the exact cause is
unknown.
21. Contd.
7. Pain disorders: A pain disorder is characterized by the presence of, and focus on,
pain in one or more body sites and is sufficiently severe to come to clinical attention.
- Patients experiencing bodily pain without identifiable and adequate physical causes
may be symbolically expressing and intra – psychic conflict through the body.
- Pain behaviors are reinforced when rewarded and are inhibited when ignored or
punished.
- Means for manipulating and gaining advantage in interpersonal relationships. Such
secondary gain is most important to patients with pain disorder.
- Serotonin and endorphins play a role in pain disorders.
22. Contd.
8. Malingering:
- Involves the intentional reporting of physical or psychological
symptoms in order to achieve personal gains.
- Common external motivations include avoiding the police, receiving
room and board, obtaining narcotics, and receiving monetary
compensation.
9. Factitious Disorder:
- Occurs when physical or psychological symptoms are intentionally
produced or feigned to gain attention.
- Sole purpose is to draw others’ attention because of their sickness.
23.
24. Clinical features
• Specific sensations, such as pain or shortness of breath, or more
general symptoms, such as fatigue or weakness
• Unrelated to any medical cause that can be identified, or related to a
medical condition such as cancer or heart disease, but more significant
than what's usually expected
• A single symptom, multiple symptoms or varying symptoms
• Mild, moderate or severe
25. Contd.
• Constant worry about potential illness
• Viewing normal physical sensations as a sign of severe physical illness
• Fearing that symptoms are serious, even when there is no evidence
• Thinking that physical sensations are threatening or harmful
• Feeling that medical evaluation and treatment have not been adequate
26. Contd.
• Fearing that physical activity may cause damage to your body
• Repeatedly checking your body for abnormalities
• Frequent health care visits that don't relieve your concerns or that make
them worse
• Being unresponsive to medical treatment or unusually sensitive to
medication side effects
• Having a more severe impairment than is usually expected from a
medical condition
27. Treatment
• A major role of psychiatrists and other physicians working with
patients with psychosomatic disorders is mobilizing the patient to
change behavior in ways that optimize the process of healing.
• This may require a general change in lifestyle (e.g., taking vacations)
or a more specific behavioral change (e.g., giving up smoking).
Whether or not this occurs depends in large measure on the quality of
the relationship between doctor and patient.
28. Contd.
• Failure of the physician to establish good rapport accounts for much of
the ineffectiveness in getting patients to change.
• Ideally, both physician and patient collaborate and decide on a course
of action. At times this may resemble a negotiation in which doctor and
patient discuss various options and reach a compromise about an
agreed-on goal.
29. Contd.
• Direct education: Explain the problem, goals, and methods to achieve
goals. Every effort should be made to convey to belligerent patients
both understanding and tolerance for their feelings.
30. Contd.
• Third-party intervention: Family members, friends, and other
clinicians can provide support and encourage the patient to follow a
course of action
31. Contd.
• Exploration of options: There may be alternative methods for
achieving a desired goal. For example, quitting smoking can be done
with support groups, nicotine patches or gum, psychotropic drugs
32. Contd.
• Provision of sample treatment If a patient fears a particular course of
action or considers change impossible, a treatment trial can be
implemented. The patient always may opt out of the prescribed
program.
• Control sharing: Some patients resent any approach that appears to be
authoritarian. They may wish to set the pace of a withdrawal program
or titrate their medication depending on adverse effects.
33. Contd.
• Concession making: The clinician
may grant the patient something that he
or she wants as a bargaining chip to get
the patient to comply with advice.
• Empathic confrontation: Patients who
resist change may do so because of fear
or other uncomfortable emotions of
which they are unaware.
36. Contd.
• PROBLEM SOLVNIG : The final step is problem-solving in which
patients basically try to apply the best solution to the problem situation
and then review their progress with the therapist.