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Physical illness due to psychosomatic

This comprehensive review discusses the concepts of physical illness due to psychosomatic factors, exploring the biopsychosocial models of illness, the impact of chronic illness on individuals and families, and the theories on stress and disease.

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Physical illness due to psychosomatic

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  1. Physical illness due to psychosomatic Elective Block Psychosomatic Medicine Dept of Psychiatry Faculty of Medicine GadjahMada University 2015

  2. Patofisiologi/mekanisme Respon Stres Hope Reward Nor Epinephrine ………………. Dopamine MANIPULASI/RANGSANG Serotonin SENSOR Hipothalamus Gastric 5-HT3, 5-HT4 MEMORI RESEPTOR WAKTU KehidupanManusia HPA Axis Dyspepsia Disease PERSEPSI (Lobus) Cortisol Angiotensin Dysfunction DISTRESS/STRESS Imunitas DenyutJantung Balanced Neurotransmiter Physiological compensatory

  3. Biopsychosocial model of Illness/disease Hazard Illness (well-being) Disease Psychosocial Factors Attitudes Behaviour Quality of Life

  4. Stages in the development of the concept for health and illness • Empirical-sensory knowledge • Humoral concept • Mechanical-systemic concept • Biomedical (etiological)concept • Ecological concept • Psycho-social concept • Holistic concept • Socio-medical concept

  5. Socio-medical concept In order for health and illness be understood in light of this concept, we need to answer the following questions: • Where does health (respectively illness) start and end? • Is health (illness) a condition of the organism or a process? • Is health (illness) a feature of the organism or just an expression of the influence of various factors? • How is health measured? • What is health as a social category – a value, right or a goal? • Can health serve to measure vitality, wellbeing?

  6. The Impact of Chronic Illness – The Individual • Initial Impact • Shock • Denial • Loss and grief • Anxiety and depression • 20-25% experience psychological symptoms • If these reactions last too long, they can have an negative effect on the illness • Must adjust to: • Symptoms of the disease • Stress of Treatment • Feelings of vulnerability • Loss of Control • Threat to self-esteem • Financial Concerns • Changes in family structure

  7. The Impact of Chronic Illness - The Family • Must adjust to: • Increased stress • Change in the nature of the relationship • Change in family structure/roles • Lost income all have impact • Different issues for different relationships • Adult children of ill parents • Spouse of ill person • Parents of ill children

  8. JOURNAL OF ADOLESCENT HEALTH 1995;17:83-90

  9. psychosocial factors may influence specific behaviors that are predictive of STDs in adolescent females such as family support and peer behavior • Being Type B, angry, pessimistic, depressed, dissatisfied with paid work and having little social support and self-esteem

  10. Low social class, low educational attainment, the double loads of work and family, chronic troubling emotions and lack of social support emerge as documented risk factors in women • low socioeconomic status (low social class, low educational attainment) and excess mortality from CHD and other health problems • Soc. Sci. Med. Vol. 42, No. 10, pp. 1351-1365, 199

  11. psychosocial factors play a significant role in symptom perception and reporting in patients with dyspeptic symptoms and may play a role in ulcer formation • Acute physiological stress is associated with increased gastric acid secretion, decreased mucosal blood flow and gastric mucin production, and gastroduodenal ulceration

  12. 5–20% of patients with gastric or duodenal ulcer have no clear etiology and are labeled as having an idiopathic ulcer disease • The increase in gastric acid secretion was paralleled by increases in blood pressure and self-report measures of anxiety, anger, and tension • Induction of anxiety led to decreased gastric acid secretion

  13. White, male, socioeconomically privileged subjects to determine the effects of exercise on the incidence of self reported diagnosis of ulcer disease • Exercise, age, BMI, and alcohol and tobacco use, physical activity was associated with a moderately reduced risk for the development of duodenal ulcer but not gastric ulcer • M.P. Jones / Journal of Psychosomatic Research 60 (2006) 407– 412

  14. How Does Stress Affect our Health? • Psychophysiological process Phase 1 Alarm Stage Phase 2 Resistance Phase 3 Exhaustion Autonomic Nervous system activated Damage occurs, adaptation process Organism dies or suffer irreversible damage

  15. Physical symptoms can be caused by or worsened by emotional distress • The category recognizes that a broad range of diseases involving the circulatory, respiratory, digestive and central nervous systems can be influenced by stress • Autonomic Nervous System - control all our automatic bodies responses • Sympathetic Nervous System - turns on the stress response - Alarm Phase • Parasympathetic Nervous System - turns off the stress response - Resistance phase

  16. Theory on Stress and Disease • Biological Theory • Somatic-Weakness theory holds that a weak organ system may be susceptible to disruption by stress • Specific-Reaction theory suggests that people respond to stress in unique ways, some organ systems show greater reactivity than do other systems • Psychological Theory • Psychoanalytic view holds that specific conflicts give rise to psychophysiological disorders • Cognitive-Behavioral view proposes that humans have higher cognitive functions which can amplify and extend the duration of arousal of our bodies

  17. Impacts of Stress on Body Sytems • Immune system • Cardiovascular system • Gastrointestinal system • Neuronal system • Musculoskeletal system • Endocrine system

  18. Allergies/Asthma • Chronic stress – the immune system is weakened. • With a weakened immune system, the body has more difficulty to withstand the antigen (invaders). • This increases our allergic responses. • A strong immune system creates antibodies to fend off the antigens abilities to release histamines (mucus and cell swelling causing chemicals). • Rheumatoid arthritis • Stresses role again focuses on the immune response. During prolonged stress, the body has a more difficult time managing its immune response and in this case, the immune response turns against its own cells (an autoimmune response).

  19. Immune system Impact • Stress can decrease your white blood cell count which will lead to poor health. • Immunological system includes the following white blood cell groups which identify and destroy foreign substances: • Phagocytes-destroyers • Lymphocytes • T cells • B cells

  20. Cardiovascular system • Hypertension • Stressful conditions produce a short-term increase in blood pressure . These increases return to baseline when the stressor is withdrawn • Anger is most strongly linked to elevated blood pressure • Coronary heart disease • Psychological diatheses for CHD include: • Type A behavior pattern (time urgency, competitive, aggressive/hostile) • High levels of anger • Cynicism • Type D personality: high levels of anger, anxiety and depression as well as low levels of emotional expression • Biological diatheses: focus is on reactivity

  21. Gastrointestinal system • Ulcer • Decreased blood flow and constriction/bracing of the smooth muscles of the digestive tract, enabling the bacteria to attain a better foothold against the host – in turn – creating an ulcer. • An ulcer is a cut or fissure in the wall of the stomach, duodenum or other part s the intestines.

  22. Neuronal system • Migrane • Constriction of blood vessels of the peripheral skin. • Tension • muscle tension accompanying stress. The muscle tension may include the forehead, jaw and neck. • Stroke • lack of oxygen in the brain resulting form a blockage or rupture of one of the arteries that supply it

  23. Musculoskeletal SYstem • Backache • Muscles to lose their elasticity and fatigue easily. Bracing may lead to muscle spasms and back pain. This constant muscular contraction is found in people who are competitive, angry, and apprehensive • Temporo Mandibular Joint (TMJ) • facial pain, clicking or popping sounds when they open or close their mouth, migraine headaches, earaches, ringing in the ears, dizziness or sensitive teeth. The most common cause is clenching and grinding ones teeth due to stress.

  24. Endocrine system • Cancer • under chronic stress, ones Cortisol levels continue to be elevated, decreasing the individuals ability to heal and repair and decreasing the production of white blood cells, in turn, leaving the person more susceptible to cancerous cell take over. • Cholesterolemia • High level of serum cholesterol, rigidity of blood vessel caused by stress

  25. Summary • Stresses impact to body system • Diseases may occur caused by stress such as • Allergies/asthma • Hypertension • Coronary heart disease • Ulcer • Migrane • Tension headache • Cance

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