心身疾病psychosomatic-disease

1PsychosomaticDisease心身疾病2Tomatodietkillssix-stonemodel•AYOUNGmodelwholivedonadietofapplesandtomatoeshasdiedofanorexia（神经性厌食症）.•AnaCarolinaReston,21,aBrazilianwhohadworkedforGiorgioArmani,was5ft7intallbutweighedonlysixstonewhenshediedonTuesday.(174cm,40kg•BMI:13.4)3objectives1.Tomastertheconceptofpsychosomaticdiseases,etiology（病因学）,pathogenesis,diagnosis,andtreatmentprinciples.2.Tobefamiliarwithavarietyofcommonpsychosomaticdiseases.4introductionPsychosomaticmedicinehasitsrootsintheearliestwritingsofthehistoryofmedicine,awarenessofbody-mindlinkageswasrecordedbyancientphilosophersandphysiciansmanycenturiesago.Bodyandmindwerealwaysinseparablyconnected.Currentunderstandingofpsychosomatictakesintoaccounttheinteractionbetweenphysicalandpsychic（精神的、心灵的）inalldisordersanddiseases.5Theprinciplefeaturesinclude1.2.3.p716HistoryanddefinitionofpsychosomaticPathogenicmechanismandprocessofpsychosomaticdiseasesClinicworkinpsychosomaticdiseasesTypicalpsychosomaticdiseases.content7Historyanddefinitionofpsychosomatic1.Historyofpsychosomaticmedicine2.Definitionofpsychosomaticmedicine3.Conceptofpsychosomaticdiseases.4.Morbidityrate（患病率）andpopulationcharacteristicofpsychosomaticdiseases.8•psychosomaticdisease•referstophysicalsymptomsorillnessesthatresultfromtheinterplayofpsychosocialandphysiologicalprocesses.9Classificationaccordingsystem1.Cardiovascularsystem•coronaryheartdisease(CHD)•essentialhypertension•Cardiacarrhythmias2.Respiratorysystem•bronchialasthma•hyperventilationsyndrome10Classificationaccordingsystem3.Gastrointestinalsystem•pepticulcer•ulcerativecolitis4.Endocrinesystem•diabetesmellitus•hyperthyroidism11Classificationaccordingsystem5.Musculoskeletalsystem•rheumatoidarthritis•lowbackpain6.Neurologicalsystem•migraineheadache•tensionheadache12•Whydosomepeoplewhoareunderstressgetsickwhereasothersdonot?13TypeAandTypeBbehaviorpatterns•Thediscoveryof“typeA”•MeyerFriedmanandRayRosenmanwerestudyingdietarydifferencesincholesterol（胆固醇）intakebetweenmaleheatdiseasevictimsandtheirwives.•“Ifyoureallywanttoknowwhatisgivingourhusbandsheartattacks,Iwilltellyou.Itisstress,thestresstheyreceiveintheirwork.”•Focusingonthesubjects’stressandbehavioralcharacteristics.14•TypeAbehaviorpattern•Itconsistsofthreecharacteristics–Competitiveachievementorientation–Timeurgency–Anger/hostility15•Competitiveachievementorientation–TypeAindividualstendtobeveryself-criticalandtostrivetowardgoalswithoutfeelingasenseofjoyintheirefforts–Hardworkers16•Timeurgency–TypeApeopleseemtobeinaconstantstruggleagainsttheclock.–Theyquicklybecomeimpatientwithdelays,schedulecommitmentstootightly,andtrytodomorethanonethingatatime,suchasreadingwhileeatingorwatchingTV.17•Anger/hostility–TypeAindividualstendtobeeasilyarousedtoangerorhostility,whichtheymayormaynotexpressovertly.18•TypeBbehaviorpattern–lowlevelsofcompetitiveness,timeurgencyandhostility.–Tendingtobemoreeasygoingandphilosophicalaboutlife–theyaremoreliketo“stopandsmelltheroses”.19MeasuringTypeAandTypeB•Doyouwanttoknowwhatpatternsyoubelongto?20Answerthesesquestionswithyesorno1.你说话时会刻意加重关键字的语气吗？Doyoudeliberatelyaccentuatethekeywords?2.你吃饭和走路时都很急促吗？Doyoueatandwalkquickly?3.你认为孩子自幼就该养成与人竞争的习惯吗？Doyouthinkthatchildrenshoulddevelopthehabitofcompetitionwhentheyareyoung?4.当别人慢条斯理做事时你会感到不耐烦吗？Doyougetimpatientwhenothersareslow?21Answerthesesquestionswithyesorno5.当别人向你解说事情时你会催他赶快说完吗？Doyourushhimoutwhensomeoneexplainsthingstoyou?6.在路上挤车或餐馆排队时你会感到激怒吗？Doyougetannoyedwhenyou'reinacrowdedcarorrestaurant?7.聆听别人谈话时你会一直想你自己的问题吗？Doyoualwaysthinkaboutyourproblemswhilelisteningtoothers?8.你会一边吃饭一边写笔记或做其他事吗？Doyouwritenotesordootherthingswhileyoueat?229你会在休假之前先赶完预定的一切工作吗？Doyouhavetofinisheverythingbeforeyouleave?10与别人闲谈事你总是提到自己关心的事吗？Doyoualwaystalkaboutthingsyoucareabout?11让你停下工作（或学习）休息一会时你会觉得浪费了时间了吗？Youwillfeelwastedwhenyoustopworking(orstudy)forawhile.12你是否会全心投入工作（或学习）而无暇欣赏周围的美景Areyouwillingtowork(orlearn)andhaveNotimetoappreciatethebeautyaroundyou.13你是否觉得宁可务实而不愿从事创新或改革的事？Doyoufeelyou'dratherbepracticalthaninnovateorreform?2314你是否尝试在时间限制内做出更多的事？Areyoutryingtodomoreinthetimelimit?15与别人有约时你是否绝对遵守时间？Areyouabsolutelypunctualwhenyouhaveanappointment?16表达意见时你是否握紧拳头以加强语气？Doyouclenchyourfisttostrengthenyourvoice?17你是否有信心再提升你的工作（学习）绩效？Doyouhavetheconfidencetoimproveyourperformance?18你是否觉得有些事等着你立刻去完成？Doyoufeelliketherearethingsyoucandorightaway?2419你是否觉得与人竞争时非赢不可？Doyoufeellikeyouhavetowinthecompetition?20你是否对自己的工作（学习）效率一直不满意？Areyoudissatisfiedwithyourworkefficiency?21你是否经常打断别人的话？Doyouofteninterruptothers?22看见别人迟到你是否会生气？Areyouangryatseeingotherslate?2523用餐时你是否一吃完就立刻离席？Doyouleaveimmediatelywhenyoufinisheating?24你是否经常有匆匆忙忙的感觉？Doyouoftenfeelrushed?25你是否对自己近来的表现不满意？Areyoudissatisfiedwithyourrecentperformance?26ThisisthequestionnaireoftypeA.Iftheanswers“yes”aremorethanhalf,youshouldchangeyourhabits,andslowdown.27HowdoesTypeAinfluencethehealth?•TypeAindividualsreactdifferentlytostressorthandothosewiththeTypeBpattern.–Respondingmorequicklyandstronglytostress,ofteninterpretingstressorsasthreats.–Increasingtheperson’slikelihoodofencounteringstressful