Zaporozhye State Medical University Department of Psychiatry, Psychotherapy, General and Medical Psychology, Narcology and Sexol
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Zaporozhye State Medical University Department of psychiatry, psychotherapy, general and medical psychology, narcology and sexology Approved on the methodical conference of department psychiatry, psychotherapy, general and medical psychology, addiction and sexology Head of the Chair MD, professor V.V.Chuhunov ________________________________ “______”_______________2015 year METHODOLOGICAL DEVELOPMENTS for practical sessions on topics №3, №4 «The concept of psychosomatic disorders and somatopsychic. Sex, age and profile features of patients "for the 4th year students of the Medical Faculty (specialty "medicine") Zaporozhye 2015 THEME: "Psychosomatic disorders and somatopsychic surgical patients" Background: The term "Psychosomatics" was first used in the early XIX century. J.Heinroth (1818). A century in the medical lexicon introduced the concept of "Psychosomatic Medicine". The term "psychosomatic" first began to merge diseases such as coronary heart disease, hypertension, gastric ulcer and duodenal ulcer, asthma, psoriasis and others., A significant role in the pathogenesis of which play an adverse psychological effects. In modern medicine section psychosomatics are clinical, psychological, epidemiological and laboratory studies that illuminate the role of stress in the etiopathogenesis of systemic diseases patoharakterolohichnyh communication and behavioral characteristics with sensitivity or resistance to certain somatic diseases, addiction response to illness (sickness behavior) of type personal storage, the effect of some treatments (surgery, hemodialysis, etc.) on mental state. Practical skills possession identify psychological factors of psychosomatic diseases is necessary for the professional activity of the modern doctor. Overall objective: To be able to recognize the psychological features of patients respond to various diseases, psychosomatic disorders detect and determine the tactics of the patient. Educational goals and interdisciplinary integration Specific objectives: know how Objectives entry level: know as 1. To determine the 1. Conduct research traits of psychological characteristics of patients (Department of Psychology) patients with psychosomatic diseases. and anamnesis and clinical studies of patients with somatic disorders (Department of Internal Medicine 1 Propaedeutics) 2. Diagnose and correct personal 2. Conduct patopsihologicheskih qualities that lead to the emergence of and psycho-diagnostic research to psycho - somatic diseases. Identify the identify emotions of anxiety and type and characteristics of depression. To determine the type of psychological reactions to disease and relationship to disease (Psychology) the factors affecting it 3. Evaluate the objective severity 3. Identify complaints, medical of the disease on the basis of history, conduct a physical examination complaints, objective research and data of the patient, (Department of Internal advisory opinions. Medicine Propaedeutics) 4. To ground the tactics of 4. Interpret data additional patients with psychosomatic diseases research methods (department of radiation surgery) The content and structure of employment Theoretical questions: 1.Psychosomatic approach as a principle of therapeutic activity. 2.Emotional stress as a factor in the pathogenesis of psychosomatic disorders. 3.The influence of psychological factors on the course of somatic disorders. 4.Theories psychosomatic relationships. 5.Mechanisms of psychological protection of the individual. 6.The concept of adaptation and exclusion. 7.Classification of psychosomatic disorders. 8.Nepatolohichni psychosomatic reaction. 9.Principles of prophylaxis of psychosomatic disorders. 10.Psychological changes in infectious diseases, tuberculosis, AIDS. 2 11.Psychological changes in female patients in the gynecological hospital. 12.Features of the psychology of sick children and the elderly. 13.Psychological characteristics of patients in the surgical hospital in pre- and postoperative period in orthopedics and traumatology. 14.Psychological characteristics of patients in dentistry, ophthalmology, otolaryngology. 15.Psychological characteristics of patients with cancer. Count of logical structure of theme "Psychosomatic disorders. Psychological characteristics of patients with various diseases " Factors that cause the formation of psychosomatic diseases Specific personal General Congenital biological characteristics peculiar to properties of mind that vulnerability organs and certain patients lead to somatization systems (high content psyhosomatozy (specific mental stress pepsinohena ulcers, increased profiles for F.Danbar types (alexithymia, bronchioles reduction in of coronary behavior) somatopatiya for asthma, etc.) K.Shnayderom) Psychosomatic pathology Classic Somatisation Somatoge Nozogenii psyhosomatozy psychological disorders nies Psychological characteristics of patients with various diseases Therape Surgi Age Oncolo Defec utic pathology cal pathology features gical pathology ts of the body and organs of perception Patients sexological profile Obstetrical and gynecological pathology 3 During psychosomatic disorders mean disorders symptoms and syndromes of somatic sphere (different organs and systems), which are caused by individual psychological characteristics of man and stereotypes associated with his behavior, reactions to stress and means of the processing of internal conflict. Psychodynamic concepts and "specificity hypothesis" psychological factors in the genesis psyhosomatoziv. Search a meaningful, logical unambiguous connection between psychological phenomena and clinical symptoms called "psychosomatic hypothesis specificity" and become a basic explanatory principle Psychosomatic Medicine. Recently, this principle is more associated with a specific stress, which can be defined as unconscious conflict that causes disruption of homeostatic equilibrium and lead to disease. The theory of disease-specific psychodynamic conflicts Alexander. Alexander was a supporter of multifactor approach in psychosomatic medicine. He believed that the origin of the disease and is guided by three groups of variables. The first of these groups "personal disposition," which consists of childhood. The second group includes provoking emotiogenic life situation, when that - some experiences and facts preceding the illness, ozhyvlyuyuchy unconscious conflict. Alexander in the third group includes all physical conditions that make a constitution, "being subject to somatic" (Freud), or "organ inferiority" (Adler). This "vyrazkovist" body sometimes called "constitutional factor X" that defines "option symptoms." The concept of "personality profiles" Flarens Dunbar. F. Dunbar believed that emotion like that did not receive the appropriate expression, then chronic stress results in a chronic vegetative accompanying landslides. But unlike Alexander, she tried to find a correlation between somatic reactions and certain types of permanent personal parameters. 8 Dunbar describes personal konstellyatsiy "ulcer personality", "coronary personality", "arthritic personality", "a person who is prone to misery" and others. 4 The theory of conditioned reflexes and cortico - visceral theory. It has been experimentally shown that asthma attacks to the introduction of the antigen in the animals can be reflexively conditioned to associate with an acoustic signal in a few reinforcements. And if you get two of conditioned reflex of opposing reactions continue to provide appropriate stimuli at the same time, the experimental animals show behavioral and autonomic disorders to irreversible organic lesion (hypertension, myocardial infarction). Chronic nonspecific stress. By this concept known physiologist Hans Selye (1907 - 1982), used it to describe a universal physiological response of living things in a very strong load. He showed that regardless of the nature of the factor that vyzyvaye stress (physical overload, awareness of threats to life) in humans and animals included in the same processes that are designed to protect (the release of adrenal hormones, improve blood glucose, arterial hypertension and others.). H. Selye distinguished three phases of the response body: alarm reaction, reflecting the mobilization of reserves; phase resistance when it is possible to successfully overcome the difficulties in this phase the body is even more resistant to various harmful conduct (intoxication, blood loss, deprivation of food, pain, infections, cooling etc.) than in the normal state; exhaustion phase when due to excessive long or intense stress depleted adaptive capacity of the organism, reduces its resistance to disease and there are various signs of physical distress, loss of appetite, sleep disorders, disorders stool, weight loss, disorders of the cardiovascular system, gastro - intestinal tract and others. Stress is not synonymous with distress, vol. Is. sorrow, unhappiness, indisposition, poverty, exhaustion. Stress - the pressure, voltage, and not just nervous overload or a strong emotional arousal. In life stressor can be enjoyable, so the occurrence of stress at all no matter what the result will be the impact of stressors on the body, pleasant or unpleasant. Moderate stress activation is a positive force that not only trains the adaptation abilities, but also enrich their knowledge of a person of real opportunities ("eustres" - positive, constructive 5 stress). Only distress always unpleasant. In life, when people talk about stress, they have in mind a lot of stress, distress, when a person is experiencing grief.