19. Psychosomatic Disorders Flashcards
What is the concept of Psychosomatic Medicine?
-
Approach medicine hollistically: Body and mind are a unit. In all diseases, consider psychological factors.
- Keep in mind complimentary and alternative medicine too.
Depression is a RF for what?
- Coronary heart disease
- Stroke
- Diabetes (# of depressive sx is related to # of diabetic sx)
Anxiety can make what diseases worse?
- Coronary artery disease
- Asthma
- Specific phobias
What is stress?
A circumstance that distrubs/can disturb NL physiological/psychological fx => stimulates ANS (sympathetic NS) => tachycardia, HTN, increased CO => stress.
How does the body respond to stress?
Responses to decrease impact of stressor and restore homeostasis.
NT responses to stress
- 1. Release catecholamines
- 2. Increase 5HT
- 3. Glucocorticoids
- 4. Increase DA
Immune responses to stress
inhibits immune functioning
SLE
- Medical sx
- Psychiatric sx
- Fever, HA, photosensitivity, butterfly rash, joint pain
- Depression, mood distrubances, psychosis, delusions, hallucinations
Multiple Sclerosis (MS)
- Medical sx
- Psychiatric sx
- MS: motor/sensory disturbances, impaired vision, neurosigns with resmissions and exacervations, slurred speech
- PS: anxiety and mania
RF for develpoment of coronary disease
- Depression
- Anxiety
- Type A behavior
- Hostility
- Anger
- Acute mental stress
What psychiatric symptoms do you experience when going through heart transplantation?
- Anxiety
- Depression
- Elation
- Coping with grief
30% of asthmatics meet criteria for
- Panic disorder
- Agoraphobia
Fear of dyspnea/SOB can trigger what?
- Asthma attacks
- Anxiety
What psychiatric illnesses are common in COPD?
- Anxiety disorder
- Panic disorder
Hypothyroidism
- Medical Sx
- Psychiatric Sx
- Medical sx: cold intolerance, dry skin, constipated, WG
- Psychiatric sx: Depressed, lethargy and paranoia
Hyperthyroidism
- Medical sx
- Psychiatric sx
- Medical sx: heat intolerance, sweatting, N/V/D, WL, tachycardia, palpiations,
- Psychiatric sx: nervous, excitable, irritable, pressured speech, insomnia, psychosis, visual hallucination
Diabetes Mellitus
- Medical sx:
- Psychiatric sx:
- Medical sx: ↑ urination/thirst, high glucose levels
- Psych: Depression, lonely, dejeection, frustation
Hyponatremia
- Medical sx
- Psychiatric sx
- medical sx: excessive thirst, polydipsia, stupor, coma, szrs
- psych: confusion, lethargy, personality changes
Thiamine deficiency
- Medical sx:
- Psychaitric sx:
- Neuropathy, cardiomyopathy, Wernicke-Korsakoff, malaise, common in alcoholics
- Psych: poor concentration, confusion, confabulation (making things up; not purposely lying)
Cobalamin (vit B12) deficiency
- Medical sx:
- Psychaitric sx:
- Medical sx: pallor, dizziness, peripheral neuropathy/tingling, dorsal column signs, ataxia
- Psych sx: irritable, inattentive, psychosis, demenitia
- Most common SE of antidepressants?
- Which antidepressants cause the highest rate of GI problems. Why?
- Whcih antidepressants have SE due to anticholingergic effects (constipation/dry mouth?
- GI problems
- SSRIs; bc alot of 5HT in the GI tract
- TCAs
Pancreatic cancer sx
- WL, abdominal pain, depression (lethargy, anhedonia, apathy, decreased NRG)
Patient has
- Abdominal pain, fever, N/V, peripheral neuropathy
- Psychosis (paranoia, visual hallucination), acute depression
Abdominal pain + psychosis = Acute Intermittent Porphyria
Hepatic encephalopthy
Medical sx:
Psychaitric sx:
- Asterexis, hyperreflexia, spider angioma, palamar erythema, enlarge liver
- Eurphoria, psychosis, depression
Sx of frontal lobe tumor
- Mood changes (irritable)
- Impaired memory
- Delirium
- Loss of speech/smell
- Facetious
Treatments for how to manage stress?
- Self-observation: daily diary to keep track of stressors and reactions
- Cognitive restructing: CBR to replace negative thoughts with (+)
- Relaxation techniques: muscles
- Mindfulness: focus on present
what is delirium?
medically induced confusion; you can be delirious with or w/o psychosis.
MCC of confision/disorientation in the hospital
delirium
Never give _______ to delirius elderly patients
benzos
Psyciatric sx of PCP
- Agitation with blank stare/Aggressive
- Anxiety
- Stupor
- Panic
- Bizarre behavior
Pt is on “IV corticosteroids”, what psychotic sx might they have?
- Steroid-induced psychosis (hallucinations)
- Mania
Why should antidepressants NOT be given to bipolar patients?
Cause mania