Health, Illness & Behaviour

7/23/2019 Health, Illness & Behaviour

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12/27/15 1

HEALTH,ILLNESSAND ILL BEHAVIOR

Dr. Sohail Ahmed Assistant Professor

Dept. of Psychiatry

Miss Sabira Yousuf linical Psycholo!ist



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What is health?

Nine dimensions of health: "ot#ill $n spite of disease As a reser%e As a beha%ior Physical fitness &itality Social relationships 'unction Psychosocial (ell bein!



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Case No. 1

A youn! man consults his family physician for the

complaints of )

cou!h since one (ee*

fe%er since three days

chest pain since one day

After e+amination, the doctor re%eals that he is sufferin!

from chest infection. -e prescribes certain dru!s andas*s him to pay a follo( up %isit after t(o days.



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Case No. 2

A yrs old man see*s treatment from a doctor for threemonths history of nonspecific symptoms li*e headache,body aches, (ea*ness, e+haustion, a feelin! of

!iddiness. -e has been treated by a number of doctorsbut his symptoms still persist. -e has also had se%eralin%esti!ations done in this re!ard. After a thorou!hphysical e+amination and a detailed %ie( of his reports,the doctor concludes that there is no physical

abnormality.. 0he patient does not !et satisfied anddecides to !o for a second opinion to another specialist



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hat is the difference in

illness of the patient incase no 1 3 case no 24

$s there a difference

bet(een disease, illness

and sic*ness4



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Disease & illness

Disease is a characteristic !roupin! of physical

si!ns and symptoms, it is !i%en a specific name

and can often be traced to a specific causal

a!ent.

$llness is a broader term that in%ol%es peoples

beliefs about the state of their physical (ell bein!

and the resultin! behaviors they en!a!e in.

hat is illness beha%ior4

illness beha%ior refers to the (ay that symptoms

are percei%ed, e%aluated, and acted upon by the

patient



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Somati6ation is the psycholo!ical mechanism(hereby psycholo!ical distress is e+pressed inthe form of physical symptoms.

0(o (ays of e+plainin! distress)

1. $n somati6ation, distress is referred to, and

e+pressed by, the body) there is somethin!(ron! (ith the person8s heart, stomach, etc.

2$n psycholo!i6ation 9or psycho socialization,there is somethin! (ron! (ith the person8s mindand social relations ## s/he is sad, family

problems e+ist, and so forth. 0hus, somati6ationcontrasts to psycholo!i6ation 9:irmayer, 1;<=.

hat reasons do you thin* leads tosomati6ation4

What is soati!ation?



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"ACTS ABO#T

SO$ATI%ATION 0he pre%alence of somati6ation by

e+aminin! %isits to primary carephysicians ran!ed from 1> to >

0he "$M- ?pidemiolo!ic atchment Area study 91;<= reported thepre%alence, for (omen, as .> and .1>in the !eneral population.

A lar!e body of e%idence su!!ests thatsomati6ation, e.!., recurrent complaintsof pain, is relati%ely common in childrenand adolescents



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Case No.

@n !ettin! up from bed and preparin! to !o to

school, a student of class =th complains that he

is feelin! se%ere pain in abdomen and is unableto !o to school. 0he parents feel he is not (ell

and as* him to ta*e some rest. After a (hile his

pain subsides and in an hour or t(o he is

happily (atchin! cartoons..



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What is malingering? malin!erin! is the act of intentionally fei!nin! or

e+a!!eratin! physical or psycholo!icalsymptoms for personal !ain.

What is factitious disorder? 'actitious disorders are a !roup of mental

disturbances in (hich patients intentionally actphysically or mentally ill (ithout ob%ious benefits.

What is conversion disorder/hysteria? on%ersion Disorder is a psycholo!ical disorder

(here people e+perience motor or sensorysymptoms that are psycholo!ical in ori!in andcannot be e+plained by a medical condition.



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$ma!ine you ha%e a sli!ht cramp in

your stomach# hat attribution (ill you ma*e4

9(hy did it occur4

hat (ill your self dia!nosis be4 hat (ill you do about it4

hat factors that influence your

perception and interpretation of

symptoms4



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What a'e the in(i)i(*al (i++e'enesthat ont'i-*te in inte''etin/s0tos?

PERCEIVING !"P#$" ensory vs% &ffective/"otivational 'ifferences Com(eting Environmental timuli Neuroticism and negative affectivity

#y(e & (ersonality Cultural 'ifferences tress "ood

IN#ERPRE#ING !"P#$" ) Past e*(erience E*(ectations learning e*(erience 'ifferences in (oint of vie+



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SOCIAL "ACTORSa, &GE

-. .01 0.11 1.21 2.31 3.4

N u m

5 e r o

f ' o c

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

! e a r



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- 3en(e'

P e r c e

n t R a

t i n g

6 e a l

t h a s

7 E * c e

l l e n

t 8 o r

7 V e r y

G o o

d 8



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c) Marital Status

Com(ared to married (eo(le

unmarried individuals:

Re(ort more sym(toms #a9e more as(irin

Perceive themselves to 5e in

+orse health



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d, education# medical care

increased (ith education

e, family sie # care decreases(ith increased si6e

f, socioeconomic status



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C*lt*'al (i++e'enes in 'eo'tin/

s0tos ola91;52 found that $talian Americans

reported more no of symptoms as compared to

$rish Americans. $rish patients tend to limit their symptoms ,often

denyin! pain. $n contrast, $talian patients (ere

more li*ely to dramati6e their problems in*ed to

se%eral body parts.



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What +ato's (ete'ine the

healin/ 'oess? ultural differences

Placebo effect Beliefs

'aith healin!



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DELAYING VS. TAKING

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

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