1/4. patients' fantasies about physical illness.All patients with physical illness have an underlying fantasy concerning why they became sick. This fantasy can be elicited by the consulting psychiatrist and the treating physician. The meaning of the fantasy is consistent with the psychodynamic theory of human behavior. Also, once the fantasy is understood, it can be applied in the patient's therapy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. life change and illness onset: importance of concepts for family physicians.The questions of illness susceptibility and the how and why of the onset of illness are of great concern to family physicians, who are constantly presented with a bewildering array of maladies. This paper presents a model of illness onset as related to life change which is felt to be a highly relevant and useful concept for family physicians. This model has been developed over many years and proposes that illness onset is predictably related to life change, which in turn is a reflection of the amount of coping required. The specific development of these concepts is presented in detail including the development and quantitation of the social readjustment rating scale which quantifies life changes.- - - - - - - - - - ranking = 6keywords = physician (Clic here for more details about this article) |
3/4. The family in crisis. A case study of overwhelming illness and stress.During a period of 7 1/2 years, one family encountered life-threatening illness, psychiatric disability, juvenile delinquency, and multiple episodes of trauma, infection, and surgery. Cancer developed in three of the seven children, the mother had five suicide attempts, and the only daughter had a pregnancy of wedlock with complications during labor and delivery. Chronologically, the stressful events show patterns of interaction and recurring dysfunction between members of the family. Options for the physician caring for such a family are limited. Early recognition of the family dynamics can help the physician set realistic goals and anticipate recurring crises.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
4/4. Effective utilization of home-video recordings for the evaluation of paroxysmal events in pediatrics.In young children, differentiating seizures from nonepileptic "spells" by history alone can be difficult, even for the specialist. Nonepileptic spells may be psychogenic (rare in the young child) or physiologic in origin. Physiologic spells misidentified as epileptic may be treated with antiepileptic medication where none is needed. Recording spells on video provides a potentially valuable supplement to the clinical history in arriving at a correct diagnosis. In practice, however, most home-video recordings prove difficult to interpret. Simple instructions to parents on the manner in which spells should be recorded will greatly increase the usefulness of home-video recordings. A systemic analysis of precipitating factors and the evolution and resolution of the spell will very often exclude seizures. The widespread availability of home-video recordings provides the pediatrician with an opportunity to visually examine a child's spells, often avoiding unnecessary investigations and referrals and allowing the physician to more confidently offer reassurance to the parents.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |