Study sheet: Stress and Psychosomatic Diseases

📋 Course Outline

1. Health and Psychosomatic Medicine
2. Stress and Pathophysiological Mechanisms
3. Digestive and Cardiovascular Manifestations
4. Neurological and Dermatological Manifestations
5. Urogenital Manifestations and Risk Factors
6. Diagnosis, Treatment, and Challenges

📖 1. Health and Psychosomatic Medicine

🔑 Key Concepts & Definitions

• Health : The association of an individual's physical, psychological, and social health.
• Psychosomatic medicine : Studies the interaction between somatic disorders and psychological disorders, including somatic disorders determined wholly or partly by the psyche.

★ Must-know

📌 A physical or somatic disease can cause psychological disorders and reduced social activity, whereas a psychological disorder rarely causes physical or somatic disorders.

Further detail

• Psychosomatic medicine became an individualized medical field during the first half of the 20th century.

💡 Memory Hook

Physical, psychological, and social health versus isolated disease

📖 2. Stress and Pathophysiological Mechanisms

🔑 Key Concepts & Definitions

• Stress : Hans Selye described stress as a nonspecific physiological process by which the organism adapts to an aggression.

📝 Essential Points

• Stress produces a defensive reaction against aggression and can be associated with functional and organic disorders.

• 🔄 Alexander's model links stress duration to three outcomes:

  1. Acute stress causes an emotional reaction with physical expression.
  2. Repetitive stress causes a functional physical disorder without an objective anatomical lesion.
  3. Permanent stress causes a lesional somatic disorder with an anatomopathological substrate.

📌 Functional psychosomatic disorders have no objective anatomical lesion, whereas lesional psychosomatic diseases have an anatomopathological substrate.

💡 Memory Hook

Acute stress → emotional reaction; repetitive stress → functional disorder; permanent stress → structural disease

📖 3. Digestive and Cardiovascular Manifestations

★ Must-know

• Digestive manifestations include:

  • vomiting
  • diarrhea
  • constipation
  • regurgitation
  • colic
  • gastralgia

• A gastric ulcer can be considered a lesional psychosomatic disease with an anatomopathological substrate in which the psychological factor is predominant.

• Cardiovascular manifestations include:

  • flushing
  • pallor
  • palpitations
  • angina-like neuralgia
  • hypotension
  • systolic blood-pressure peaks
  • tachycardia
  • bradycardia

• Myocardial infarction is widely regarded as a disease of civilization in which psychological factors are important and may act directly or indirectly; some infarctions occur during severe stress.

Further detail

• The psychological factor is considered in the etiopathogenesis of some digestive diseases, including ulcerative colitis.

📖 4. Neurological and Dermatological Manifestations

★ Must-know

• Neurological manifestations include:

  • headaches
  • dizziness
  • neuralgia
  • tingling
  • paresthesia
  • hyperesthesia or hypoesthesia
  • myoclonia
  • pseudoparalysis
  • pseudisensory deficits

• Dermatological manifestations include:

  • pruritus
  • some urticaria
  • some hair loss
  • acne

Further detail

• The etiopathogenesis of some inflammatory neurological diseases refers to a psychological factor.

• Psychological factors are implicated in the etiopathogenesis of some cases of alopecia, psoriasis, and vitiligo, and some vitiligo appears after an emotional shock.

📖 5. Urogenital Manifestations and Risk Factors

📝 Essential Points

• Urogenital manifestations include:

  • some dysuria
  • painful urination
  • pollakiuria
  • enuresis
  • partial or total impotence
  • frigidity
  • dyspareunia
  • menstrual-cycle disorders

• Constitutional factors can predispose certain organs or biological functions to dysfunction under psychological stress.

• Stress factors include:

  • life events
  • social conflicts
  • family conflicts
  • professional conflicts
  • different stressful situations

• Personality is considered the principal element in determining psychosomatic disorders, particularly in generally anxious individuals who react to stress.

📖 6. Diagnosis, Treatment, and Challenges

★ Must-know

• 🔄 Psychosomatic assessment proceeds by: analyzing the symptom, ordering the strictest necessary complementary examinations, determining the psychogenic origin or psychological contribution, treating the somatic component when necessary

• Psychological management may include: psychotropic treatment for anxious or depressive states, simple tranquilization, psychological support, socio-familial support

• Psychosomatic disorders are difficult for conventional medicine to treat effectively because healing would require acting effectively on the patient's stress, which is described as almost impossible.

Further detail

• Patients may reject the label of functional or psychosomatic disorder because they fear that an ultimate examination has not yet revealed an organic cause.

• The perceived global approach of non-conventional medicines helps explain their success among patients seeking treatment for psychosomatic disorders.

💡 Memory Hook

Analyze → investigate → identify psychogenic contribution → treat somatically and psychologically

📊 Synthesis Tables

Stress duration and psychosomatic outcome

Stress pattern	Outcome	Anatomical lesion
Acute stress	Emotional reaction with physical expression	Not specified
Repetitive stress	Functional physical disorder	Absent objectively
Permanent stress	Lesional somatic disease	Anatomopathological substrate present