Health, Illness & Behaviour 2

7/23/2019 Health, Illness & Behaviour 2

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12/27/15 1

HEALTH, ILLNESS

AND ILL BEHAVIOR

Dr. Santosh kumar

Assistant Professor

Dept. of Psychiatry



12/27/15 2

P A T I E N T

Importance of Patient

PATIENT

Primary importance

in our life

All learning &

teaching

Ultimate goal—

To treat patient

Treat the patient

Not the illness



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H E A L T H

!"# $efinition %

"ealth is a state of complete physical' mentalan$ social (ell )eing an$ not merely the

a)sence of $isease or infirmity. * Important components of health are % Physical fitness

Psychological (ell )eing Appropriate social relationships E+pecte$ le,el of functioning



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Disease , Illness and Illbehavior Disease is a characteristic grouping of

physical signs an$ symptoms' it is gi,en a

specific name an$ can often )e trace$ to a

specific causal agent.

Eg. -iral "epatitis



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Disease , Illness and Illbehavior Illness is a )roa$er term that in,ol,es

peoples beliefs a)out the state of their

physical or psychological (ell )eing.

Eg % -iral "epatitis causing /aun$ice.

A person of hepatitis )elie,es that 0aun$ice is $ue to some supernatural 1

non human factors.



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Disease , Illness and Illbehavior Illness )eha,ior refers to the (ay' the symptoms are

percei,e$' e,aluate$' an$ acte$ upon )y the patient.

E+amples

Same patient of hepatitis seeking spiritual treatment fromfaith healers' instea$ of going to $octor.

A person' $iagnose$ as a case of Angina pectoris'refuses to take treatment (ith a )elief that he has got noillness an$ $oes not re2uire any treatment.

A person suffering from mil$ chest pain $ue to skeletalmuscle spasm paying fre2uent ,isits to a car$iacemergency' inspite )eing tol$ )y $octors that he has nocar$iac pro)lem



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Disease , Illness and Ill

behavior It inclu$es%

3onsulting $octors

Taking me$ications

4i,ing up inappropriate acti,ities

Seeking help from relati,es an$ frien$s



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Disease , Illness and Ill

behavior These )eha,iours are a$apti,e in the early

stages of illness' )ut may )ecome

mala$apti,e if persist into the stage of

reco,ery' (hen the patient shoul$ )e)ecoming in$epen$ent.

Illness )eh% results from the persons con,iction

that he is ill rather than from the o)0ecti,epresence of $isease' an$ it may $e,elop

(hen no $isease is not present.



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Disease , Illness and Illbehavior Illness )eh% (ithout $isease is an important

pro)lem in the general practice' an$ once

firmly esta)lishe$ it is $ifficult to treat.

The concept of illness )eh% o,erlaps (ith that

of sick role )ut t(o are $escri)e$ separately

)1c they ha,e $ifferent origins.



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Disease , Illness and Illbehavior Sick role% Society )esto(s a special role for the people

(ho are ill' (hich is ma$e up of t(o pri,ileges

an$ t(o $uties% E+emption from certain social responsi)ilities The right to e+pect help an$ care from others

The o)ligation to seek an$ cooperate (ithtreatment

The e+pectation of a $esire to reco,er



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Disease , Illness and Illbehavior !hile the person ill' the sick role is a$apti,e.

If people continue in the sick role after illness

is o,er' reco,ery is $elaye$ since they

continue to a,oi$ responsi)ilities an$ $epen$

on others instea$ of )ecoming in$epen$ent.



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Case No. 1 A young man consults his family physician for the

complaints of %

cough since one (eek

fe,er since three $ays

chest pain since one $ay

After e+amination' the $octor re,eals that he is suffering

from chest infection. "e prescri)es certain $rugs an$asks him to pay a follo( up ,isit after t(o $ays.



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Case No. 2 A 56 yrs ol$ man seeks treatment from a $octor for three

months history of nonspecific symptoms like hea$ache')o$y aches' (eakness' e+haustion' a feeling of

gi$$iness. "e has )een treate$ )y a num)er of $octors)ut his symptoms still persist. "e has also ha$ se,eralin,estigations $one in this regar$. After a thoroughphysical e+amination an$ a $etaile$ ,ie( of his reports'the $octor conclu$es that there is no physical

a)normality.. The patient $oes not get satisfie$ an$$eci$es to go for a secon$ opinion to another specialist7



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!hat is the $ifference in illness of the patient in case

no 8 & case no 9:

Is there a $ifference )et(een $isease' illness an$ ill)eha,ior :



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Somati;ation is the psychological mechanism

(here)y psychological $istress is e+presse$ in

the form of physical symptoms.In somati;ation' $istress is referre$ to' an$

e+presse$ )y' the )o$y mostly $ue to

un$erlying psychological factors.

S O M A T I Z A T I O N



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FACTS ABOUT

SOMATIZATION The pre,alence of somati;ation at the clinic of a

primary care physicians range$ from 86< to 56<

Somati;ation is consi$ere$ to )e more pre,alent inour culture as compare$ to $e,elope$ nationsreasons )einglo( socio economic status' illetracy'lack of a(areness a)out psychological illnesses'paucity of ,er)al e+pression of stresses

Somati;ation is more common in females an$chil$ren.



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HPOCHOND!IASIS !rong )elief or preoccupation of min$ (ith

the presence of a physical illness' (hich infact is not there.

No or minimal physical symptoms arepresent )ut patient ,isits fre2uently to$ifferent $octors' ho(e,er a )ackgroun$ may)e present.

Eg = A man (hose father ha$ $ie$ ofmyocar$ial infarction' recently' has got astrong )elief that he may $ie of same illness.



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CON"E!SION DISO!DE!

#H$s%eria& 3on,ersion Disor$er is a psychological $isor$er (herepeople e+perience motor or sensory symptoms that arepsychological in origin an$ cannot )e e+plaine$ )y ame$ical con$ition. E+amples

Su$$en )ut transient loss of speech Su$$en )ut transient )ut loss of ,ision >oss of sensation in some parts of )o$y >oss of po(er in some parts of )o$y Atypical fits

Un$erlying psychological factors are responsi)le



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Case No' ( #n getting up from )e$ an$ preparing to go

to school' a stu$ent of class t(o complains

that he is feeling se,ere pain in a)$omenan$ is una)le to go to school. The parents

feel he is not (ell an$ ask him to take some

rest. After a (hile his pain su)si$es an$ in

an hour or t(o he is happily (atching

cartoons..



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MALIN)E!IN)

?alingering is the act of intentionally feigning

or e+aggerating physical or psychological

symptoms for personal gain. Person is likely to get some gains or

e+emptions )y a$opting this fake )eha,ior.

-ery commonly seen phenomenon.



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O*r a++roah %o-ards a

o.+lain% / Imagine you ha,e a slight cramp in your

stomach

!hat attri)ution (ill you make: @(hy $i$ it

occur:

!hat (ill your self $iagnosis )e:

!hat (ill you $o a)out it:

!hat factors that influence your perception

an$ interpretation of symptoms:



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PERCEIVING & INTERPRETING

SYMPTOMS Bno(le$ge

Past e+perience

Personality

E+pectations

3ultural )eliefs

?oo$ Discussion (ith someone

Differences in point of ,ie(



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SOCIAL ACTORS!

a) AGE

<5 5-14 15-44 45-64 65-74 75+

N u m

b e r o

f D o c

t o r V i s i t s P e r

Y e a r



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"# Ge$%e

P e r c e n

t a

t i n !

" e a

# t $ a s

% E & c e

# # e n

t ' o r

% V e r (

G o o

) '



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O%her "ariables c ?arital Status :

$ e$ucation me$ical care increase$ (ith

e$ucation

e family si;e care $ecreases (ith increase$

si;e

f socioeconomic statuslo( socioeconomic

status is proportionate (ith in increase$$isease )ur$en an$ less care



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'(a) *a+)os %e)e-$e

)(e (ea-$ 0o+ess 3ultural $ifferences

Place)o effect Celiefs

aith healing



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DELAIN) "S'

TA0IN) ACTION

Notice

symptoms

Am I

ill?

Do I need

professional

care?

Is that care

worth the

cost?

Enter

treatment

Appraisal

delay

Illness

delay

Utilization

delay

Health, Illness & Behaviour 2

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