Psychophysiological Disorders

Question 1

Psychophysiological Disorders

hyperventilation

hypertension

fibromyalgia

migrains

PMS

Answer 1

Psychophysiological disorders: physical symptoms that are caused, maintained or exacerbated by emotional factors.

1. most involve a singe organ system
2. related to Autonomic Nervous System (ANS)
   
   1. hyperactivity of sympathetic underlies essential hypertension and migraine headache
   2. over activity of parasympathetic linked to ulcerative colitis.
3. Psychological Factors Affecting Medical Condition (DSM)

Question 2

Hyperventilation

Answer 2

Hyperventilation Syndrome: rapid deep-breathing attack that produces a drop in CO₂, leading to respiratory alkalosis and cerebral hypoxia.

1. chest pain, paresthesia (tingling/numbness in hands and feet), dizziness, impaired concentration and memeory, and tinnitus.
2. mimics asthma and coronary heart disease
3. relieved by relaxation or paper bag or sedation

Question 3

Hypertension

Answer 3

Hypertension:

Primary (essential) Hypertension:

1. high blood pressure not due to a known physiological cause.
2. 85-90% of cases.
3. results in cardiovascular disease, heart attack, kidney failure, and stroke.
4. often asymptomatic, ‘silent killer’.
5. caused by obesity, cigarettes, table salt, stress, and old age.
6. most common in men and blacks.

**Secondary Hypertension: **

1. elevated blood pressure due to a known disease.

Treatment: lifestyle modifications (diet, exercise, salt and alcohol reduction), diuretic, beta blocker or other blood pressure medicine.

blood pressure biofeedback and relaxation training, breathing retraining.

Question 4

Fibromyalgia

Answer 4

Fibromyalgia:

1. general muscle aches, tenderness, and stiffness, fatigue, and sleep distrubances.
2. females mostly in middle age
3. physical and psychological cause, so behavioral treatments helpful.

Question 5

Migraine Headaches

Answer 5

Migraines: severe, recurrent throbbing headache usually limited to one side of the head, accompanied by nausea, vomiting, diarrhea/constipation, and sensitivity to light, noise and odors, bending/lifting or jarring motions.

1. Classic Migraine: starts with aura (focal neurological symptoms).
2. Common Migraine: no aura, but signaled by gastrointestinal or other symptoms.
3. Caused/Aggrevated by menstruation, stress, relaxation after stress, changes in barometric pressure, alcohol, decongestant/analgesic overuse, foods with tyramine, PKU or nitrates.
4. more in females
5. linked to perfectionism, orderliness, neuroticism, inflexibility, ambitiousness.

Question 6

…More Migraines

Answer 6

Etiology: constriction and dilation of blood vessels in the brain and linked to low serotonin levels.

Treatments: nonsteroidal anti-inflammatory drugs (combo of tylenol, aspirin, caffeine), serotonin receptor drugs in the cranial blood vessels (ergotamin, sumatriptan, SSRI), and beta-blockers.

thermal biofeedback and autogenic training helpful to some.

Question 7

Headache Types

Answer 7

1. Cluster Headache: excruciating burning pain, that occurs in clusters (one or more a day) over two-three month period. Non-throbbing pain usually located behind an eye and may also involve the face and temple.
2. Tension Headache: nonthrobbing pain, on both sides of head, back of neck and face. Band of pressure or tightness around the head. Stress, muscle tension and dilation of blood vessel related
3. Sinus Headache: infection of the frontal sinuses over the eyes. fullness, tension or throbbing ache. most severe in themorning and by bending forward.

Question 8

Prementral Syndrome

PMS

Answer 8

PMS: ansiety, depression, emotional lability, fluid retention, backache and headache, abdominal pain, and food cravings.

1. after ovulation and ends just before menstruation.
2. cyclic production of ovarian hormones at cause.
3. 75% of women have minor symptoms
4. 20-50% have PMS
5. 3-5% have DSM for Premenstrual Dysphoric Disorder.
6. responds well to placebos, SSRI and CBT.