1/10. Psychiatric consultation for physically ill children.In addition to age-appropriate information about his physical condition and its treatment, the child needs help with the feelings associated with being ill or injured. If the feelings are so powerful that a state of despair exists, or are strongly defended against with self-defeating and unresponsive behavior, consultation with the child psychiatrist should be requested.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/10. Prematurity and adult minor illness.The long term impact of being born premature has received limited scientific investigation. Studies that have been carried out, focus on outcomes in childhood, with very few considering the impact on adult physical health. Three case studies are presented here, investigating differences in adult minor illness and psychological variables between adult participants born preterm, fullterm but small and fullterm with normal birthweight. This is a retrospective design using questionnaires and checklist to gather relevant information. Minor illness symptoms, daily hassles, anxiety, depression and general self-efficacy were measured. The participant born preterm scored higher on all measures. Data were applied to the Equilibrium Model for Minor Illness. Being born early appears to have a greater impact on later adult outcomes measured than being born fullterm but small or fullterm but of normal weight. In this article the authors reflect upon possible explanations for the different outcomes of each of the participants within the foetal origins of disease theory.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
3/10. Maladaptive denial of physical illness: a proposal for DSM-IV.Denial of physical illness is a commonly encountered problem in consultation-liaison psychiatry. Although there is an extensive literature on denial, it has virtually ignored the diagnostic issues raised by the individual whose denial of physical illness is clearly maladaptive. The authors propose that DSM-IV include a subtype of adjustment disorder called "with maladaptive denial of physical disorder." They discuss this new category, its differential diagnosis, and the benefits to clinical practice of this proposed addition to diagnostic classification.- - - - - - - - - - ranking = 1.4keywords = physical (Clic here for more details about this article) |
4/10. Which patients are responsible for their illnesses?physicians must regularly make judgments as to the extent to which patients should be considered responsible for their symptoms. Such judgments have important social and treatment consequences for both physically and mentally disordered patients. A conceptual framework for assessing this type of responsibility is presented and the manner in which ascribing responsibility influences treatment is discussed.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
5/10. Silence as resistance to medical intervention.A group of 47 individuals initially silent about their physical symptoms and/or dysfunction were studied after they finally had come to medical attention. They were then interviewed, using the associative anamnesis technique, to evaluate the psychologic aspects of their silence. It was found to be a key element in the defensive complex directed against intense neurotic feelings activated by the patient's current physical condition. The tendency toward silence appeared to have been reinforced by emotionally traumatic experiences involving physical illness or injuries in early life. Also found associated with silence were such different factors as a series of ostrich-like denying rationalizations, a fanatic commitment to cultist beliefs, a conviction that emotional conflict is the primary cause of organic illness, and motivations linked to retention of power in reality situations. Clinical examples drawn from these categories are given. Means of increasing the awareness that such silence exists and methods of dealing with it are discussed.- - - - - - - - - - ranking = 0.6keywords = physical (Clic here for more details about this article) |
6/10. Psychoanalytic observations on vulnerability to physical disease.The psychological indicators discussed in this paper are not per se predictors of physical illness; yet they represent specific genetic-dynamic forces and occur too frequently to be coincidental and of no significance. Rather, they are warning cues to vulnerability to somatic illness and supplementary to the risk factors derived from physical data. The list of vulnerability cues includes exposure to stress. This is an alerting cue; past modes of reaction to stress in the form of physical patterns (but not conversion reactions); regressive shifts of defenses in the direction of resomatization; mounting aggression that is not directly verbalized; diminution of psychologically expressed guilt, though guilt would be expected and indeed becomes manifest in physical form; psychological versions of transference reactions replaced by expressions in body language; dreams in which stimuli from early physical dysfunction are recurrently part of the daily residue and give a somatic cast to current conflicts; identification with important objects that is increasingly expressed in somatic terms. These cues tend to be accompanied by a growing perception of, and preoccupation with, the body. The more such indicators are present and noted, the greater their usefulness in predicting physical illness.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
7/10. The role of family therapy in treating physical illness.Family relationships, behavior patterns, and the manner of responding to stress are important causal factors in physical illness and in health. Using case examples from his own practice as well as a review of the literature, he demonstrates ways that families help create and complicate physical illness. elements of his family therapy program that he feels contribute to its success include helping the family focus on the past in relation to present concerns, investigating ways the family reacts to the illness, asking the patient why he is ill, conducting classes in stress release, and helping the family change patterns of interaction.- - - - - - - - - - ranking = 1.2keywords = physical (Clic here for more details about this article) |
8/10. 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 = physical (Clic here for more details about this article) |
9/10. Physical illness diagnosed as psychiatric: patients at special risk.Recent research has further confirmed the significant incidence of undiagnosed physical illness in patients presenting psychiatric symptoms. Such research has generally involved psychiatric inpatient or outpatient populations. As a liaison psychiatrist in a general hospital, the author defines two especially high-risk groups for such missed diagnoses and emphasizes the fact that psychiatric symptoms are not illness specific. An approach to the clinical evaluation of such patients is discussed, mentioning the inherent medicolegal implications.- - - - - - - - - - ranking = 0.2keywords = physical (Clic here for more details about this article) |
10/10. Use of a psychodynamic life narrative in the treatment of depression in the physically ill.depression, unlike grief, is a maladaptive response to the crisis of illness. This crisis has certain characteristics: (a) psychic disequilibrium with confusion and uncertainty; (b) regression with intensified transferences; and (c) a tendency to examine the trajectory of one's life. This situation makes the patient not only more vulnerable but also more responsive to intervention. These characteristic reactions of illness can be considered in designing a therapeutic maneuver to treat depression. Three cases are used for illustration. In each case a depressed patient was presented a statement that placed his physical illness in the context of his life trajectory and demonstrated the psychodynamic logic of his depression. We call this intervention a "psychodynamic life narrative." The therapeutic effect of such a narrative and the type of patient most likely to benefit from such an intervention are discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
| | Next -> |