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| Psychosomatic disorders |
Psychosomatic disorders can be interpreted as a reaction to the soul on the physical (soma). According to the American Psychosomatic Society (2005), psychosomatic disorders comes from the Greek (psyche = soul and Soma = physical), so it can be interpreted as psychosomatic physical and mental relationship. There is a very close relationship between physical factors, psychological factor, and social to the journey of a disease.
Psikomatic disturbance this might reply, "Why can one have a heart attack after an argument with his boss?, Rheumatic Why so much pain when disabling stress?, Why heart disease mortality is influenced by presence or absence of depression?"
A disease can arise due to many factors. The disease can arise as a result of environmental or social factors. The disease can arise also due to genetic factors and heredity. Various factors will interact with the complex.
Psychological factors can trigger the emergence of a physical disorder, such as sleep disturbance due to anxiety, stress-related neck muscle pain or diarrhea and heartburn caused by fear.
Psychological factors can also affect the clinical course of disease, such as stroke patients with depression will have a relatively functional status worse than without stress, coronary heart disease mortality is influenced by the presence or absence of depression.
Psychological factors affecting various organs of the body through a complex mechanism of neural factors, hormonal, and immunological. Chronic stress can affect the activation of the sympathetic nervous system and hormonal system (axis hypothalamus-pituitary-adrenal).
Racing adrenal hormone system that lasted long been associated with suppression of the immune system (immune system) due to steroid hormones. This explains why someone with chronic stress is more easily hurt. Racing sympathetic nervous system to explain the emergence of hypertension, stroke and coronary heart disease caused by emotional stress.
In some cases, psychosomatic disorders may appear strange conversion reaction and can not be explained by medical science. Sudden blind, paralysis, or tingling commonly encountered strange nature. Patients are generally young, mostly women and preceded by a clear stressor. These patients will undergo various examinations with normal results. The author met a few times conversion cases, and actions cure the patient psychotherapy is very helpful.
In general patients with psychosomatic disorders is believed that sources of the pain really comes from the organs in the body. In everyday clinical practice, health providers are often faced with the patient and family requests for laboratory examination and imaging (x-ray).
Imaging examination can help to reduce anxiety in patients and their families. When the results of the examination is normal, then there should be no excessive worries about a serious disease conditions. Consider the example of Miss E above, he will not consulted the psychologist or psychiatrist because he was very confident that the source of the pain is physical and not psychological.
Why did this happen? Sociological studies by Nettleton (2006) illustrates that patients "would prefer to suffer pain that are real." Most patients will also be very resistant when told that the pain associated with psychosocial stressors.
Human nature would not like to live in uncertainty, so that patients will still find out what the exact cause of his illness. This makes the search for organic causes will continue to be done. A patient of chronic primary headache is likely to undergo an MRI examination, head CT scan, EEG and other laboratory examinations to search for answers "something is wrong with me".
The author has conducted a study presented at a national meeting of Indonesian Pain Society (August 2007). The study hopes to reveal the primary chronic headache patients (mostly muscle tension type headache). Muscle tension type headache is a form of psychosomatic disorders which are common.
The results demonstrated that the main thing patients want is to "figure out where it originated headache." This search process can be very costly and resource intensive. This research study is similar to Davies, et al (2005) in 52 patients with headache in a tertiary pain clinic. Results showed that 77% of patients would still like to know the source of head pain and 33% still want the additional examination.
How does one with psychosomatic disorders can be treated?
A health officer must see the patient or client as being physical, psychological, social, and spiritual whole. Complaints of a patient should be taken seriously (no matter how strange these complaints).
The research showed that psychosomatic patients are often dissatisfied with what he got medical care due to physician responses that are not serious about his illness. This patient will tend to move the doctor or hospital without success.
A patient will be more comfortable and satisfied if given a clear explanation about the illness, information and instructions are clear, and careful examination (Verbeck, 2005).
Consider the words of Hippocrates, a patient will feel more comfortable with greetings, smiles, and when heard with empathy. Good communication should be established to explore the existence of a stressor, and often required counseling actions. Research shows that clinical psychological intervention is very helpful in many cases. Multidisciplinary cooperation is necessary for the good of the patient.
So if you frequently experience a variety of complaints but when I checked also found no disease problems, maybe the answer is an interruption occurs psikomatic more towards psychological issues.
Source: dr Rizaldy Pinzón, MKes, SPS
