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disorders + treatments

general

psychological disorder: clinically significant disturbance is an individual’s cognition, emotion regulation, or behavior (must affect the person’s life every day to be considered a disorder)

medical model: the concept that psychological disorders are caused by physical things and diagnosed, treated, and often cured through treatment in a hospital

biopsychosocial approach to psychological disorders: the concept that psychological disorders are caused by a variation of by biological (evolution, genes, brain structure & chemistry), psychological (stress, trauma, mood), and social-cultural (roles, expectations, definition of what’s normal versus abnormal) factors

DSM-5: the American Psychiatric Association’s Diagnostic and Statistical Manual of mental disorders, 5th edition; widely used to classify psychological disorders (critics say that this labels normal behaviors as disordered behavior, causing over-medication and more)

anxiety disorders

anxiety disorders: psychological disorders that cause distress and persistent anxiety, or maladaptive behavior that reduces anxiety

generalized anxiety disorder: an anxiety disorder that causes continuous stress and tenseness

panic disorder: an anxiety disorder that causes unpredictable minutes-long episodes of intense dread or fear

phobias: an anxiety disorder that causes persistent irrational fear of something specific

social anxiety disorder: an anxiety disorder that causes an intense fear of social situations, leading to avoiding them to prevent being judged or embarrassed

agoraphobia: an anxiety disorder that causes a fear of situations or locations where panic has ensued before, leading to avoiding them

obsessive-compulsive disorder (OCD): an anxiety disorder that cause unwanted repetitive thoughts and/or actions; caused by deficit of serotonin and too much epinephrine

post-traumatic stress disorder (PTSD): an anxiety disorder that is caused by a traumatic experience, leading to haunting flashbacks to the event (PTSD is not guaranteed after a traumatic event, factors such as how traumatic it was and the person’s genes + limbic system sensitivity affect if PTSD develops and how long it lasts)

post-traumatic growth: positive psychological effects of struggling with trauma (ex. becoming more strong mentally)

neurodevelopmental disorders

neurodevelopmental disorders: a category of disorders that typically emerge during the time we are developing (childhood and adolescence), are inherited through genes, and usually involve dysfunctions in personal, social, academic, and/or occupational areas

autism spectrum disorder (ASD): a neurodevelopmental disorder that affects behavior and communication; symptoms appear at around two years old and they include difficulty communicating, overly-focused interests, and repetitive behaviors

attention-deficit hyperactivity disorder (ADHD): a neurodevelopmental disorder that causes persistent attention difficulties, hyperactive behavior, impulsivity, and being fidgety

schizophrenic disorders

schizophrenia spectrum disorder: serious mental illnesses that affect how a person thinks, feels, and behaves; seem ‘disconnected’, symptoms include delusions, hallucinations, disorganized speech, disorganized behavior, disorganized thoughts, and reduced emotional expression

schizophrenia: a psychological disorder and form of psychosis characterized by delusions, hallucinations (usually hearing a voice that is insulting them or giving them orders), disorganized speech, disorganized thoughts (inability to focus on a single stimuli and differentiate between significant and irrelevant stimuli, such as being too focused on a brick wall’s grooves to listen to the person talking to you), and/or diminished or inappropriate emotional expression (ex. smiling when told bad news (inappropriate) or not reacting at all (diminished))

  • have a hard time maintaining relationships of any kind

  • usually strikes during the transition into adulthood

  • can be gradual or immediate/sudden (a recovery is unlikely when gradual and more likely when sudden because the immediate version is more responsive to therapy)

  • positive version (presence of inappropriate behavior) and negative version (lack of appropriate behavior); most people experience both

  • too many dopamine receptors cause positive symptoms (hallucinations, delusions)

  • low brain activity in frontal lobes

  • hallucinations cause an increase of activity in the thalamus while paranoia cause an increase of activity in the amygdala

  • often determined by a person’s prenatal environment (low birth weight, oxygen deprivation during birth), which determines whether the related genes activate or not

psychosis: a psychological disorder in which a person loses contact with reality, experiencing irrational ideas and distorted perceptions

delusions: false beliefs that may accompany psychotic disorders

hallucination: a false sensory experience, such as seeing something that is not really there

mood disorders

mood disorders: psychological disorders characterized by emotional extremes

major depressive disorder: a mood disorder in which a person experiences five or more depression symptoms (which must include depressed mood and lack of interest/pleasure) for two weeks or longer

mania: a mood disorder marked by a hyperactive, wildly optimistic state

bipolar disorder: a mood disorders in which a person alternates between hopelessness + the lethargy of depression and the overexcited state of mania

biological approach to mood disorders: often run in the family, depression is the outcome of numerous genes interacting, a depressed state diminishes brain activity while a manic state causes more activity, there is too little norepinephrine when depressed and too much when manic

social-cognitive approach to mood disorders: depressed people focus on negative experiences while diminishing the positive ones, experience rumination (overthinking about problems and their causes), and believe themselves entirely when something goes wrong

dissociative disorders

dissociative disorders: disorders in which conscious awareness becomes separated (dissociated) from previous thoughts, memories, and feelings

dissociative identity disorder (DID): a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities

eating disorders

anorexia nervosa: an eating disorder in which a person (commonly an adolescent female) maintains a starvation diet despite being significantly underweight

  • typically grow up with critical and protective families with parents who focus on their own weight as well as their child’s

bulimia nervosa: an eating disorders in which a person alternates between binge-eating with purging (vomiting or laxative use), excessive exercise, or fasting

  • typically grow up with obesity and a negative self-evaluation

binge-eating disorder: significant binge-eating episodes, followed by distress or guilt but no purging

genes influence susceptibility to eating disorders, as well as cultural beauty standards

personality disorders

personality disorders: psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning

antisocial personality disorder: exhibits a lack of conscience for wrongdoing, even towards loved ones; may be aggressive or clever

  • signs usually show at an early age, including lying, fighting, etc.

  • influenced by biological, social , and psychological factors

  • very little fear of everything

  • antisocial behavior and childhood neglect/abuse

  • hyper-active dopamine reward center drives impulsive behavior

other disorders

somatic symptom disorder: a psychological disorder in which the symptoms take a somatic (bodily) form without an apparent physical cause

conversion/functional neurological symptom disorder: a disorder in which a person experiences very specific genuine physical symptoms for which no actual physiological reason can be found (ex. unexpected paralysis, blindness, inability to swallow, etc.)

illness anxiety disorder: a disorder in which a person interprets normal physical sensations as symptoms of a disease (ex. thinking a normal stomach cramp is food poisoning)

therapy

psychotherapy: treatment involving psychological techniques; consists of interactions between a trained therapist and the patient/client

biomedical therapy: prescribed medications/procedures that act directly on the patient’s physiology

eclectic approach: an approach to psychotherapy that uses various techniques from different forms for therapy based on the patient’s problem

insight therapies

insight therapies: variety of therapies that aim to improve psychological functioning by increasing the patient’s awareness of underlying motives and defenses (ex. psychoanalysis, psychodynamic, humanistic)

psychoanalysis: freud’s therapeutic technique; patient’s free associations, resistances, dreams, etc. reveal repressed feelings/motives

  • conflict between id, ego, and superego causes distress and revealing that distress helps the patient

  • focuses on how childhood formed the person the patient is today

  • resistance: in psychoanalysis, the deliberate blocking from consciousness of something that brings anxiety

  • interpretation: in psychoanalysis, how the therapist sees things the client says or doesn't say and what they do or what they don’t do and how it reveals something about them

  • transference: in psychoanalysis, the patient’s transfer of emotions linked with other relationships to the therapist (ex. hate for a parent transfers to hate for your therapist)

  • not commonly used in modern times due to its lack of evidence/objectivity

psychodynamic therapy: therapy derived from psychoanalysis that views people as responding to unconscious forces and childhood experiences, seeks to enhance self-insight

  • no mention of id, ego, and superego

  • face-to-face, a couple times a week for a few weeks/months

  • explores thoughts that are usually defended against/blocked out

  • interpersonal psychotherapy: a variation of psychodynamic therapy but less focused on past experiences and more focused on current emotions and relationships

humanistic therapy: aims to boost self-fulfillment through increased self awareness; promotes growth rather than “curing” the problem, responsibility of feelings/actions rather than uncovering their hidden motives, conscious thoughts are more important than unconscious ones, focus on the present + future rather than the past

  • client-centered/person-centered therapy: a humanistic therapy developed by Carl Rogers in which the therapist uses techniques such as active listening within a genuine environment to facilitate the patient’s growth

    • non-directive; therapist listens and refrains from guiding the patient anywhere specific

    • patient’s guard gradually goes down because they know that someone is actually listening

    • active listening: in client-centered therapy, where the therapist emphatically listens and only interrupts to restate, clarify, or echo/validate

    • unconditional positive regard: caring and nonjudgmental attitude that Carl Rogers believed helps patients develop self-awareness/acceptance

behavior, cognitive, and group therapies

behavior therapy: therapy that applies learning principles to the elimination of unwanted behaviors

  • counter-conditioning: behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behavior; including exposure therapy and aversive conditioning

    • exposure therapies: behavioral techniques, such as systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imagination or in real life) to the things they fear or avoid

      • systematic desensitization: a type of exposure therapy that associates a pleasant state with gradually increasing anxiety-triggering stimuli; commonly used to treat phobias

      • virtual reality exposure therapy: a type of exposure therapy that progressively exposes people to electronic simulations of their fear; used when actually acting it out is inaccessible

    • aversive conditioning: a type of counter-conditioning that associates an unpleasant state with an unwanted behavior (ex. painting bitter nail polish on your nails to stop yourself from biting them); less effective in the long run

token economy: an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for treats/prizes

cognitive therapy: therapy that teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions to them

  • rational-emotive behavior therapy (REBT): a confrontational cognitive therapy developed by albert ellis that vigorously challenges people’s illogical, self-defeating attitudes

  • cognitive-behavioral therapy: a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

    • ex. when a person with OCD feels an urge coming on, they take a walk instead

group therapy: therapy conducted with groups rather than individuals, permitting benefits of being in a group (feeling less alone, feeling seen)

  • family therapy: therapy that treats the family as a system; views an individual’s unwanted behavior as influenced by or directed at family members; aims to heal familial relationships by providing a means to communicate and resolve conflict

psychotherapy’s effectiveness can be tested in the most objective sense by comparing the results of people who have been treated with psychotherapy versus people who haven’t; research has found that it is generally helpful as it speeds up recovery

biomedical therapies

psychopharmacology: the study of the effect of drugs on the mind and behavior

anti-psychotic drugs: drugs used to treat schizophrenia and other forms of psychosis by causing less responsiveness to irrelevant stimuli; side effects include sluggishness, tremors, twitches

anti-anxiety drugs: drugs used to control anxiety and agitation by depressing central nervous system activity; can become an addiction and cause withdrawal effects

antidepressant drugs: drugs used to treat depression, anxiety disorders, OCD, and PTSD by acting as selective serotonin reuptake inhibitors (SSRIs) and agonists

  • increase availability of certain neurotransmitters like norepinephrine and serotonin

  • side effects include dry mouth and weight gain, which can be reduced by administration through a patch

  • most useful for severe cases of depression

mood stabilizers: stabilize emotional extremes such as the ones present with bipolar disorder (ex. lithium)

electroconvulsive therapy (ECT): a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient; often used for people who are unresponsive to drugs, side effects include seizure and memory loss

transcranial magnetic stimulation: a form of ECT that includes the application of pulses of magnetic energy to the brain; used stimulate nerve cells that are suppressed due to depression and calm the parts that are overactive, no anesthesia needed and no serious side effects

psychosurgery: surgery that removes or destroys brain tissue in an effort to change behavior

  • lobotomy: a psychosurgical procedure that was once used to calm uncontrollably emotional or violent patients by cutting the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain

  • mostly replaced by medical treatments nowadays

A

disorders + treatments

general

psychological disorder: clinically significant disturbance is an individual’s cognition, emotion regulation, or behavior (must affect the person’s life every day to be considered a disorder)

medical model: the concept that psychological disorders are caused by physical things and diagnosed, treated, and often cured through treatment in a hospital

biopsychosocial approach to psychological disorders: the concept that psychological disorders are caused by a variation of by biological (evolution, genes, brain structure & chemistry), psychological (stress, trauma, mood), and social-cultural (roles, expectations, definition of what’s normal versus abnormal) factors

DSM-5: the American Psychiatric Association’s Diagnostic and Statistical Manual of mental disorders, 5th edition; widely used to classify psychological disorders (critics say that this labels normal behaviors as disordered behavior, causing over-medication and more)

anxiety disorders

anxiety disorders: psychological disorders that cause distress and persistent anxiety, or maladaptive behavior that reduces anxiety

generalized anxiety disorder: an anxiety disorder that causes continuous stress and tenseness

panic disorder: an anxiety disorder that causes unpredictable minutes-long episodes of intense dread or fear

phobias: an anxiety disorder that causes persistent irrational fear of something specific

social anxiety disorder: an anxiety disorder that causes an intense fear of social situations, leading to avoiding them to prevent being judged or embarrassed

agoraphobia: an anxiety disorder that causes a fear of situations or locations where panic has ensued before, leading to avoiding them

obsessive-compulsive disorder (OCD): an anxiety disorder that cause unwanted repetitive thoughts and/or actions; caused by deficit of serotonin and too much epinephrine

post-traumatic stress disorder (PTSD): an anxiety disorder that is caused by a traumatic experience, leading to haunting flashbacks to the event (PTSD is not guaranteed after a traumatic event, factors such as how traumatic it was and the person’s genes + limbic system sensitivity affect if PTSD develops and how long it lasts)

post-traumatic growth: positive psychological effects of struggling with trauma (ex. becoming more strong mentally)

neurodevelopmental disorders

neurodevelopmental disorders: a category of disorders that typically emerge during the time we are developing (childhood and adolescence), are inherited through genes, and usually involve dysfunctions in personal, social, academic, and/or occupational areas

autism spectrum disorder (ASD): a neurodevelopmental disorder that affects behavior and communication; symptoms appear at around two years old and they include difficulty communicating, overly-focused interests, and repetitive behaviors

attention-deficit hyperactivity disorder (ADHD): a neurodevelopmental disorder that causes persistent attention difficulties, hyperactive behavior, impulsivity, and being fidgety

schizophrenic disorders

schizophrenia spectrum disorder: serious mental illnesses that affect how a person thinks, feels, and behaves; seem ‘disconnected’, symptoms include delusions, hallucinations, disorganized speech, disorganized behavior, disorganized thoughts, and reduced emotional expression

schizophrenia: a psychological disorder and form of psychosis characterized by delusions, hallucinations (usually hearing a voice that is insulting them or giving them orders), disorganized speech, disorganized thoughts (inability to focus on a single stimuli and differentiate between significant and irrelevant stimuli, such as being too focused on a brick wall’s grooves to listen to the person talking to you), and/or diminished or inappropriate emotional expression (ex. smiling when told bad news (inappropriate) or not reacting at all (diminished))

  • have a hard time maintaining relationships of any kind

  • usually strikes during the transition into adulthood

  • can be gradual or immediate/sudden (a recovery is unlikely when gradual and more likely when sudden because the immediate version is more responsive to therapy)

  • positive version (presence of inappropriate behavior) and negative version (lack of appropriate behavior); most people experience both

  • too many dopamine receptors cause positive symptoms (hallucinations, delusions)

  • low brain activity in frontal lobes

  • hallucinations cause an increase of activity in the thalamus while paranoia cause an increase of activity in the amygdala

  • often determined by a person’s prenatal environment (low birth weight, oxygen deprivation during birth), which determines whether the related genes activate or not

psychosis: a psychological disorder in which a person loses contact with reality, experiencing irrational ideas and distorted perceptions

delusions: false beliefs that may accompany psychotic disorders

hallucination: a false sensory experience, such as seeing something that is not really there

mood disorders

mood disorders: psychological disorders characterized by emotional extremes

major depressive disorder: a mood disorder in which a person experiences five or more depression symptoms (which must include depressed mood and lack of interest/pleasure) for two weeks or longer

mania: a mood disorder marked by a hyperactive, wildly optimistic state

bipolar disorder: a mood disorders in which a person alternates between hopelessness + the lethargy of depression and the overexcited state of mania

biological approach to mood disorders: often run in the family, depression is the outcome of numerous genes interacting, a depressed state diminishes brain activity while a manic state causes more activity, there is too little norepinephrine when depressed and too much when manic

social-cognitive approach to mood disorders: depressed people focus on negative experiences while diminishing the positive ones, experience rumination (overthinking about problems and their causes), and believe themselves entirely when something goes wrong

dissociative disorders

dissociative disorders: disorders in which conscious awareness becomes separated (dissociated) from previous thoughts, memories, and feelings

dissociative identity disorder (DID): a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities

eating disorders

anorexia nervosa: an eating disorder in which a person (commonly an adolescent female) maintains a starvation diet despite being significantly underweight

  • typically grow up with critical and protective families with parents who focus on their own weight as well as their child’s

bulimia nervosa: an eating disorders in which a person alternates between binge-eating with purging (vomiting or laxative use), excessive exercise, or fasting

  • typically grow up with obesity and a negative self-evaluation

binge-eating disorder: significant binge-eating episodes, followed by distress or guilt but no purging

genes influence susceptibility to eating disorders, as well as cultural beauty standards

personality disorders

personality disorders: psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning

antisocial personality disorder: exhibits a lack of conscience for wrongdoing, even towards loved ones; may be aggressive or clever

  • signs usually show at an early age, including lying, fighting, etc.

  • influenced by biological, social , and psychological factors

  • very little fear of everything

  • antisocial behavior and childhood neglect/abuse

  • hyper-active dopamine reward center drives impulsive behavior

other disorders

somatic symptom disorder: a psychological disorder in which the symptoms take a somatic (bodily) form without an apparent physical cause

conversion/functional neurological symptom disorder: a disorder in which a person experiences very specific genuine physical symptoms for which no actual physiological reason can be found (ex. unexpected paralysis, blindness, inability to swallow, etc.)

illness anxiety disorder: a disorder in which a person interprets normal physical sensations as symptoms of a disease (ex. thinking a normal stomach cramp is food poisoning)

therapy

psychotherapy: treatment involving psychological techniques; consists of interactions between a trained therapist and the patient/client

biomedical therapy: prescribed medications/procedures that act directly on the patient’s physiology

eclectic approach: an approach to psychotherapy that uses various techniques from different forms for therapy based on the patient’s problem

insight therapies

insight therapies: variety of therapies that aim to improve psychological functioning by increasing the patient’s awareness of underlying motives and defenses (ex. psychoanalysis, psychodynamic, humanistic)

psychoanalysis: freud’s therapeutic technique; patient’s free associations, resistances, dreams, etc. reveal repressed feelings/motives

  • conflict between id, ego, and superego causes distress and revealing that distress helps the patient

  • focuses on how childhood formed the person the patient is today

  • resistance: in psychoanalysis, the deliberate blocking from consciousness of something that brings anxiety

  • interpretation: in psychoanalysis, how the therapist sees things the client says or doesn't say and what they do or what they don’t do and how it reveals something about them

  • transference: in psychoanalysis, the patient’s transfer of emotions linked with other relationships to the therapist (ex. hate for a parent transfers to hate for your therapist)

  • not commonly used in modern times due to its lack of evidence/objectivity

psychodynamic therapy: therapy derived from psychoanalysis that views people as responding to unconscious forces and childhood experiences, seeks to enhance self-insight

  • no mention of id, ego, and superego

  • face-to-face, a couple times a week for a few weeks/months

  • explores thoughts that are usually defended against/blocked out

  • interpersonal psychotherapy: a variation of psychodynamic therapy but less focused on past experiences and more focused on current emotions and relationships

humanistic therapy: aims to boost self-fulfillment through increased self awareness; promotes growth rather than “curing” the problem, responsibility of feelings/actions rather than uncovering their hidden motives, conscious thoughts are more important than unconscious ones, focus on the present + future rather than the past

  • client-centered/person-centered therapy: a humanistic therapy developed by Carl Rogers in which the therapist uses techniques such as active listening within a genuine environment to facilitate the patient’s growth

    • non-directive; therapist listens and refrains from guiding the patient anywhere specific

    • patient’s guard gradually goes down because they know that someone is actually listening

    • active listening: in client-centered therapy, where the therapist emphatically listens and only interrupts to restate, clarify, or echo/validate

    • unconditional positive regard: caring and nonjudgmental attitude that Carl Rogers believed helps patients develop self-awareness/acceptance

behavior, cognitive, and group therapies

behavior therapy: therapy that applies learning principles to the elimination of unwanted behaviors

  • counter-conditioning: behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behavior; including exposure therapy and aversive conditioning

    • exposure therapies: behavioral techniques, such as systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imagination or in real life) to the things they fear or avoid

      • systematic desensitization: a type of exposure therapy that associates a pleasant state with gradually increasing anxiety-triggering stimuli; commonly used to treat phobias

      • virtual reality exposure therapy: a type of exposure therapy that progressively exposes people to electronic simulations of their fear; used when actually acting it out is inaccessible

    • aversive conditioning: a type of counter-conditioning that associates an unpleasant state with an unwanted behavior (ex. painting bitter nail polish on your nails to stop yourself from biting them); less effective in the long run

token economy: an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for treats/prizes

cognitive therapy: therapy that teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions to them

  • rational-emotive behavior therapy (REBT): a confrontational cognitive therapy developed by albert ellis that vigorously challenges people’s illogical, self-defeating attitudes

  • cognitive-behavioral therapy: a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

    • ex. when a person with OCD feels an urge coming on, they take a walk instead

group therapy: therapy conducted with groups rather than individuals, permitting benefits of being in a group (feeling less alone, feeling seen)

  • family therapy: therapy that treats the family as a system; views an individual’s unwanted behavior as influenced by or directed at family members; aims to heal familial relationships by providing a means to communicate and resolve conflict

psychotherapy’s effectiveness can be tested in the most objective sense by comparing the results of people who have been treated with psychotherapy versus people who haven’t; research has found that it is generally helpful as it speeds up recovery

biomedical therapies

psychopharmacology: the study of the effect of drugs on the mind and behavior

anti-psychotic drugs: drugs used to treat schizophrenia and other forms of psychosis by causing less responsiveness to irrelevant stimuli; side effects include sluggishness, tremors, twitches

anti-anxiety drugs: drugs used to control anxiety and agitation by depressing central nervous system activity; can become an addiction and cause withdrawal effects

antidepressant drugs: drugs used to treat depression, anxiety disorders, OCD, and PTSD by acting as selective serotonin reuptake inhibitors (SSRIs) and agonists

  • increase availability of certain neurotransmitters like norepinephrine and serotonin

  • side effects include dry mouth and weight gain, which can be reduced by administration through a patch

  • most useful for severe cases of depression

mood stabilizers: stabilize emotional extremes such as the ones present with bipolar disorder (ex. lithium)

electroconvulsive therapy (ECT): a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient; often used for people who are unresponsive to drugs, side effects include seizure and memory loss

transcranial magnetic stimulation: a form of ECT that includes the application of pulses of magnetic energy to the brain; used stimulate nerve cells that are suppressed due to depression and calm the parts that are overactive, no anesthesia needed and no serious side effects

psychosurgery: surgery that removes or destroys brain tissue in an effort to change behavior

  • lobotomy: a psychosurgical procedure that was once used to calm uncontrollably emotional or violent patients by cutting the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain

  • mostly replaced by medical treatments nowadays