SlideShare a Scribd company logo
1 of 15
PRESENTED BY
UJJWAL SHARMA
M.Sc. NURSING 2ND YEAR
MENTAL HEALTH NURSING
 Pain disorder is one of the several somatoform disorders.
Pain disorder is classified as a mental disorder because
psychological factors play an important role in the onset,
severity, worsening or maintenance of pain.
 negative or distorted cognition,
such as feeling helpless or hopeless with
respect to pain and its management
 inactivity, passivity, and/or disability
 increased pain requiring clinical intervention
 insomnia and fatigue
 disrupted social relationships at home, work, or school
 depression and/or anxiety
 A psychiatrist will ask some questions and will
make the decision.
 The psychiatrist will determine the cause of the
pain and/or the severity of the pain.
 They will also determine
whether the pain is acute
or chronic.
 Medicine: Antidepressants,
Analgesics
 The treatment may change
according to the severity of the pain.
 Acute pain- goal is to relieve pain with
 medicine
 Chronic pain-combination of medicine and
therapy
 Cognitive-behavioral therapy
 Other Treatments: Acupuncture, Transcutaneous
Electrical Nerve Stimulation (TENS), Trigger Point
Injections, Massage, Nerve Blocks,
Surgical Ablation (Removal Of A Part or
Pathway), Meditation, Exercise, Yoga, Music And
Art Therapy.
 Hypochondriasis or Hypochondria refers to excessive
worry about having serious illness. The belief and fear of
serious illness which lasts for six months, beyond and
despite medical reassurance.
 Men and women are equally affected by
hypochondriasis
 Onset of symptoms occur at any age, the disorder
most commonly appears in person 20-30 years of
age.
 Beliefs: may have a difficult time tolerating uncertainty
over uncomfortable or unusual body sensations
 Family: may be more likely to have health anxiety if
someone had parents who worried too much about their
own health or their child’s health.
 Past experience: may have had experience with serious
illness in childhood, so physical sensations may be
frightening.
 Being preoccupied with having or getting a serious
disease or health condition
 Worrying that minor symptoms
or body sensations of having a serious illness
 Worrying excessively about a specific medical
condition or risk of developing a medical condition
because it runs in the family
 Repeatedly checking body for signs of illness or disease
 Frequently making medical appointments for
reassurance or avoiding medical care for fear of being
diagnosed with a serious illness
 Avoiding people, places or activities for fear of health
risks
 Constantly talking about health and possible illnesses
 The course of hypochondriasis is usually episodic:
the episodes from last months to years
 A good prognosis associated with high
socioeconomic status, treatment responsive anxiety
and depression, sudden onset of symptoms, the
absence of personality disorder and the absence of a
related non-psychiatric medical condition.
 Cognitive therapy
 Exposure and response
prevention
 Behavioral stress Management
 Group psychotherapy
 Pharmacotherapy alleviate :-
hypochondrial symptoms only
when a patient has an
underlying drug-responsive
condition.
0 Relationship or family problems because excessive worrying
can frustrate others
0 Work-related performance problems or excessive absences
0 Problems functioning in daily life, possibly even resulting in
disability
0 Financial problems due to excessive health care visits and
medical bills
0 Having another mental health disorder, such as somatic
symptom disorder, other anxiety disorders, depression or a
personality disorder
THANK
YOU

More Related Content

What's hot

Delusional Disorders
Delusional DisordersDelusional Disorders
Delusional Disorders
Tosca Torres
 
Schizophrenia & other psychotic disorder
Schizophrenia & other psychotic disorderSchizophrenia & other psychotic disorder
Schizophrenia & other psychotic disorder
Hussein Ali Ramadhan
 
Interpersonal psychotherapy
Interpersonal psychotherapyInterpersonal psychotherapy
Interpersonal psychotherapy
Nursing Path
 
Dissociative Disorders
Dissociative DisordersDissociative Disorders
Dissociative Disorders
Tosca Torres
 

What's hot (20)

Post traumatic stress disorder (PTSD)
Post traumatic stress disorder (PTSD) Post traumatic stress disorder (PTSD)
Post traumatic stress disorder (PTSD)
 
Dissociative disorder
Dissociative disorderDissociative disorder
Dissociative disorder
 
Introduction to psychiatry
Introduction to psychiatryIntroduction to psychiatry
Introduction to psychiatry
 
Psychodynamic therapies
Psychodynamic therapiesPsychodynamic therapies
Psychodynamic therapies
 
Major depressive disorder (MDD) ppt
Major depressive disorder (MDD) ppt Major depressive disorder (MDD) ppt
Major depressive disorder (MDD) ppt
 
Psychotherapy
PsychotherapyPsychotherapy
Psychotherapy
 
Interpersonal psychotherapy
Interpersonal psychotherapyInterpersonal psychotherapy
Interpersonal psychotherapy
 
Psychotic disorders
Psychotic disordersPsychotic disorders
Psychotic disorders
 
POST TRAUMATIC STRESS DISORDER
POST TRAUMATIC STRESS DISORDERPOST TRAUMATIC STRESS DISORDER
POST TRAUMATIC STRESS DISORDER
 
Delusional Disorders
Delusional DisordersDelusional Disorders
Delusional Disorders
 
Cognitive behaviour therapy
Cognitive behaviour therapyCognitive behaviour therapy
Cognitive behaviour therapy
 
Schizophrenia & other psychotic disorder
Schizophrenia & other psychotic disorderSchizophrenia & other psychotic disorder
Schizophrenia & other psychotic disorder
 
Personality disorders
Personality disorders Personality disorders
Personality disorders
 
Conversion disorder
Conversion disorderConversion disorder
Conversion disorder
 
Cognitive behavioral therapy
Cognitive behavioral therapyCognitive behavioral therapy
Cognitive behavioral therapy
 
Bipolar Disorder
Bipolar DisorderBipolar Disorder
Bipolar Disorder
 
Personality disorders
Personality disordersPersonality disorders
Personality disorders
 
Interpersonal psychotherapy
Interpersonal psychotherapyInterpersonal psychotherapy
Interpersonal psychotherapy
 
Dissociative Disorders
Dissociative DisordersDissociative Disorders
Dissociative Disorders
 
Other Psychotic Disorders
Other Psychotic DisordersOther Psychotic Disorders
Other Psychotic Disorders
 

Similar to Pain disorder

Background Information
Background InformationBackground Information
Background Information
Pat87
 
Defining Mental Disorders What Is AbnormalMental disorder P.docx
Defining Mental Disorders What Is AbnormalMental disorder P.docxDefining Mental Disorders What Is AbnormalMental disorder P.docx
Defining Mental Disorders What Is AbnormalMental disorder P.docx
randyburney60861
 
Chapter 14 Lecture Disco 4e
Chapter 14 Lecture Disco 4eChapter 14 Lecture Disco 4e
Chapter 14 Lecture Disco 4e
professorbent
 

Similar to Pain disorder (20)

Somatoform Disorders
Somatoform DisordersSomatoform Disorders
Somatoform Disorders
 
SOMATOFORM AND DISSOCIATIVE DISORDERS
SOMATOFORM AND DISSOCIATIVE DISORDERSSOMATOFORM AND DISSOCIATIVE DISORDERS
SOMATOFORM AND DISSOCIATIVE DISORDERS
 
SOMATOFORM DISORDER (BY PRANAY)
SOMATOFORM DISORDER (BY PRANAY)SOMATOFORM DISORDER (BY PRANAY)
SOMATOFORM DISORDER (BY PRANAY)
 
Background Information
Background InformationBackground Information
Background Information
 
Depression.docx
Depression.docxDepression.docx
Depression.docx
 
Importance of physiotherapy in 11.pptx
Importance of physiotherapy in 11.pptxImportance of physiotherapy in 11.pptx
Importance of physiotherapy in 11.pptx
 
Conversion and dissoociative disorder.pptx
Conversion and dissoociative disorder.pptxConversion and dissoociative disorder.pptx
Conversion and dissoociative disorder.pptx
 
Health psychology
Health psychologyHealth psychology
Health psychology
 
Scott Hirsch, MD
Scott Hirsch, MDScott Hirsch, MD
Scott Hirsch, MD
 
Types of Stress and Their Symptoms and Treatment
Types of Stress and Their Symptoms and Treatment Types of Stress and Their Symptoms and Treatment
Types of Stress and Their Symptoms and Treatment
 
Medically unexpalined symptoms
Medically unexpalined symptomsMedically unexpalined symptoms
Medically unexpalined symptoms
 
Medically unexpalined symptoms
Medically unexpalined symptomsMedically unexpalined symptoms
Medically unexpalined symptoms
 
Out-patient Primary and Specialty Palliative Care
Out-patient Primary and Specialty Palliative CareOut-patient Primary and Specialty Palliative Care
Out-patient Primary and Specialty Palliative Care
 
Conversion and dissoociative disorder.pptx
Conversion and dissoociative disorder.pptxConversion and dissoociative disorder.pptx
Conversion and dissoociative disorder.pptx
 
Defining Mental Disorders What Is AbnormalMental disorder P.docx
Defining Mental Disorders What Is AbnormalMental disorder P.docxDefining Mental Disorders What Is AbnormalMental disorder P.docx
Defining Mental Disorders What Is AbnormalMental disorder P.docx
 
DEPRESSION.pptx
DEPRESSION.pptxDEPRESSION.pptx
DEPRESSION.pptx
 
Ascitis and psychiatric disorders
Ascitis and psychiatric disordersAscitis and psychiatric disorders
Ascitis and psychiatric disorders
 
Mood Disorder and Suicide
Mood Disorder and SuicideMood Disorder and Suicide
Mood Disorder and Suicide
 
Depression
DepressionDepression
Depression
 
Chapter 14 Lecture Disco 4e
Chapter 14 Lecture Disco 4eChapter 14 Lecture Disco 4e
Chapter 14 Lecture Disco 4e
 

More from Ujjwal Sharma (14)

legal issue in nursing.
legal issue in nursing.legal issue in nursing.
legal issue in nursing.
 
Health and welfare committees
Health and welfare committeesHealth and welfare committees
Health and welfare committees
 
Consumer protection act.pptx final
Consumer protection act.pptx finalConsumer protection act.pptx final
Consumer protection act.pptx final
 
Accrediation, lisence,renwl
Accrediation, lisence,renwlAccrediation, lisence,renwl
Accrediation, lisence,renwl
 
Performance appraisal
Performance appraisalPerformance appraisal
Performance appraisal
 
Motivation
MotivationMotivation
Motivation
 
3. nursing audit
3. nursing audit3. nursing audit
3. nursing audit
 
2. standards
2. standards2. standards
2. standards
 
quality assurance
quality assurancequality assurance
quality assurance
 
Childhood disorders
Childhood disordersChildhood disorders
Childhood disorders
 
Sexual disorder
Sexual disorderSexual disorder
Sexual disorder
 
Dissociative disorder
Dissociative disorderDissociative disorder
Dissociative disorder
 
Anger ppt
Anger pptAnger ppt
Anger ppt
 
Individual psychotherapy
Individual psychotherapyIndividual psychotherapy
Individual psychotherapy
 

Recently uploaded

❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
Rashmi Entertainment
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan 087776558899
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
amritaverma53
 
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
chanderprakash5506
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
rajnisinghkjn
 

Recently uploaded (20)

Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
 
Bhopal❤CALL GIRL 9352988975 ❤CALL GIRLS IN Bhopal ESCORT SERVICE
Bhopal❤CALL GIRL 9352988975 ❤CALL GIRLS IN Bhopal ESCORT SERVICEBhopal❤CALL GIRL 9352988975 ❤CALL GIRLS IN Bhopal ESCORT SERVICE
Bhopal❤CALL GIRL 9352988975 ❤CALL GIRLS IN Bhopal ESCORT SERVICE
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
 
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
 
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
 
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
 
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
 
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
 

Pain disorder

  • 1. PRESENTED BY UJJWAL SHARMA M.Sc. NURSING 2ND YEAR MENTAL HEALTH NURSING
  • 2.  Pain disorder is one of the several somatoform disorders. Pain disorder is classified as a mental disorder because psychological factors play an important role in the onset, severity, worsening or maintenance of pain.
  • 3.  negative or distorted cognition, such as feeling helpless or hopeless with respect to pain and its management  inactivity, passivity, and/or disability  increased pain requiring clinical intervention  insomnia and fatigue  disrupted social relationships at home, work, or school  depression and/or anxiety
  • 4.  A psychiatrist will ask some questions and will make the decision.  The psychiatrist will determine the cause of the pain and/or the severity of the pain.  They will also determine whether the pain is acute or chronic.
  • 5.  Medicine: Antidepressants, Analgesics  The treatment may change according to the severity of the pain.  Acute pain- goal is to relieve pain with  medicine  Chronic pain-combination of medicine and therapy
  • 6.  Cognitive-behavioral therapy  Other Treatments: Acupuncture, Transcutaneous Electrical Nerve Stimulation (TENS), Trigger Point Injections, Massage, Nerve Blocks, Surgical Ablation (Removal Of A Part or Pathway), Meditation, Exercise, Yoga, Music And Art Therapy.
  • 7.  Hypochondriasis or Hypochondria refers to excessive worry about having serious illness. The belief and fear of serious illness which lasts for six months, beyond and despite medical reassurance.
  • 8.  Men and women are equally affected by hypochondriasis  Onset of symptoms occur at any age, the disorder most commonly appears in person 20-30 years of age.
  • 9.  Beliefs: may have a difficult time tolerating uncertainty over uncomfortable or unusual body sensations  Family: may be more likely to have health anxiety if someone had parents who worried too much about their own health or their child’s health.  Past experience: may have had experience with serious illness in childhood, so physical sensations may be frightening.
  • 10.  Being preoccupied with having or getting a serious disease or health condition  Worrying that minor symptoms or body sensations of having a serious illness  Worrying excessively about a specific medical condition or risk of developing a medical condition because it runs in the family
  • 11.  Repeatedly checking body for signs of illness or disease  Frequently making medical appointments for reassurance or avoiding medical care for fear of being diagnosed with a serious illness  Avoiding people, places or activities for fear of health risks  Constantly talking about health and possible illnesses
  • 12.  The course of hypochondriasis is usually episodic: the episodes from last months to years  A good prognosis associated with high socioeconomic status, treatment responsive anxiety and depression, sudden onset of symptoms, the absence of personality disorder and the absence of a related non-psychiatric medical condition.
  • 13.  Cognitive therapy  Exposure and response prevention  Behavioral stress Management  Group psychotherapy  Pharmacotherapy alleviate :- hypochondrial symptoms only when a patient has an underlying drug-responsive condition.
  • 14. 0 Relationship or family problems because excessive worrying can frustrate others 0 Work-related performance problems or excessive absences 0 Problems functioning in daily life, possibly even resulting in disability 0 Financial problems due to excessive health care visits and medical bills 0 Having another mental health disorder, such as somatic symptom disorder, other anxiety disorders, depression or a personality disorder