How mental health impacts physical health

How does psychological factors impact physical health 

1. Course of medical condition affected 

2. Interference with treatment 

3. Increased health risk 

4. Influenced pathophysiology 

Factors affecting the way people react to illness 1 

Affected by transference + attachment / modelling  Modelling:  Parental modelling + differential attention reinforce body preoccupation + health anxiety  Maladaptive coping modelling → alcohol, withdrawal, anger

Temperament:  Style/ natural disposition of relating to events/ world  → can be adaptive/ maladaptive

Locus of control: different people have different locus of control  Internal: feeling like they can control much  External: feeling like they can’t control much  → harder for ppl with large internal locus of control to cope with chronic illness ( X control )

Factors affecting the way people react to illness 2

Socio-cultural  Sick role Illness + care seeking attitudes  Stigma of certain illness → loss of physical function vs mental health  Medical professional authority

Biological:  Neuronal sensitisation to pro-inflammatory cytokines  Dysregulated hypothalamic pituitary adrenal ( HPA ) axis → long term sensitisation due to trauma/ early activation  Altered neuroreceptor system

Clinical presentation of depression 

1. Down 

2. Low 

3. Empty 

4. Irritable 

5. Black cloud 

6. Reduced hedonic tone - Anhedonia 

7. Hopeless/ helpless/ worthless

8. Neurovegetative features 

→ sleep/ eating/ libido/ motivation/ concentration

1. Psychomotor function → slowness to movement

Atypical presentation of depression

1. Poor capacity to tolerate symptoms 

2. Irritability 

3. Increased complaints of pain 

4. Substance use

5. Non-adherence to treatments 

6. Difficulty making decisions 

7. Negative cognitions

Risk factors

1. Younger 

2. Female 

3. Lack of social support 

4. Economic adversity 

5. Past psychiatric history 

6. Chronic pain 

7. Fatigue 

8. Treatment side effects

How to know if it is adjustment vs depression 

1. Weight up risk factors for depression 

2. Quality + severity of mood disturbance → pervasively impaired capacity for pleasure suggestive of depression 

3. Persistence of symptoms ? 

4. Emergence of guilt/ worthlessness/ helplessness/ hopelessness ( depression ) 

5. Diurnal mood variation + early morning waking ( depression )

Somatization disorder definition + examples

Definition: tendency to report psychological distress in form of physical symptoms 

Examples: 

1. Somatic symptom disorder 

2. Illness anxiety disorder 

3. Functional neurological disorder 

→ concurrent w/ non-functional neurological disorders 

Aetiology: 

1. Higher levels of concurrent physical symptoms 

2. Medical + psychiatric comorbidity 

3. Higher rates of childhood sexual + physical abuse 

4. Social stressors: unemployment 

5. Personality: high neuroticism / low openness 

Mx of somatization disease

1. Psychoeducation

→ genuine disorder + treatable + involuntary 

→ software glitch 

2. Use of pos physical signs for edu + openness → moving concentration away from the symptoms → show patient that the disorder can be treated 

3. Motor retraining + graded exercise 

4. Psychological therapy for illness beliefs + behaviours

Factitious disorder meaning

→ on self / others 

→ Falsification of physical/ psychological signs/ symptoms → present self/ others as ill/ impaired + deceptive behaviour is evident even w/o external rewards 

→ X malingering → for financial reward

How to foster resilience in patients

1. Sense of coherence 

2. Self efficacy 

3. Internal locus of control 

4. Self esteem 

5. Sense of optimism