Psychosomatic Illness

It is a condition of dysfunction or structural damage in bodily organs through inappropriate activation of the involuntary (Autonomic) nervous system and glands of internal secretion.

Psychosomatic Illness

A disorder that involves both mind and body is called a psychosomatic illness. In other words, the illness may be emotional or mental in origin but have physical symptoms. Psychosomatic illnesses are not imaginary. They are physical disorders in which both emotions and thought patterns are believed to play a central role, and usually develop when a person’s disease-fighting ability is weakened due to stress. After a particularly stressful event, like the loss of a loved one, for example, an individual might develop high blood pressure shortly afterward or even have a heart attack. In another person, the same situation might lead to a peptic ulcer or a series of asthma attacks. A third individual, equally as grief-stricken, might not get sick at all. For a psychosomatic illness to occur, a person must first be vulnerable in a particular body system. It’s important for these illnesses to be recognized and treated as soon as they occur.

Mental conditions either can cause or can make the physical illness worse.

Psycho- Physiological disorders.

• Skin disorders  ( Eczema, skin pigmentation, etc)
• Musculoskeletal disorders ( Aches and pains, etc)
• Respiratory disorders ( Asthma, Atopy, Etc)
• Cardiovascular disorders (Heart condition, etc)
• Genitourinary disorders ( frequency, urgency, etc)
• Endocrine disorders ( Thyroid, Diabetes, etc)
• Disorders of organ of special sense – Chronic conjunctivitis
• Disorder of other types – Disturbances in the nervous system in which emotional factors play a significant role, such as multiple sclerosis

Hypochondriasis

It is  “Unrealistic preoccupation with a fear or believe (non delusional) of having a serious disease based on the individual interpretation of physical signs or sensations as evidenced by the physical illness. In addition appropriate physical evaluation does not support the diagnosis of any physical disorder which can account for the physical signs or sensations or for the individual’s unrealistic interpretation of them. The fear of having, or belief that one has a disease, persists despite sufficient explanation and medical reassurance.”

It Occurs between age 20-30 and affect both sex equally and Diagnostic Criteria require it should last for  6 months

Somatoform Disorders.

Classification of Somatoform disorder and dissociative disorders

Differentiating points between Somatizations disorder and Physical illness

1-    Involvement of multiple organ systems

2-    Early onset and chronic course without development of physical signs and structural abnormalities.

3-    Absence of Characteristic Laboratory abnormalities of the suggested physical disorder.

• Describe symptoms in dramatic and emotional terms
• Seek care from more than one physician at the same time
• Describe symptoms in vague terms
• Lack signs of defined medical illness
• Have complaints that medical tests fail to support

People with somatization disorder do get diagnosable medical illness too It is very important to  R/O Actual physical disorder.

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Score of 300+: At risk of illness.

Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).

Score of 150-: Only have a slight risk of illness.