By Richard Mayou, Michael Sharpe, Alan Carson
This ebook presents either the proof and the advice to permit medical professionals to enhance their evaluate and administration of the mental and behavioural points of the commonest difficulties providing regularly remedy. It summarises the hot study proof and gives good judgment assistance on how mental and psychiatric features of disorder might be addressed in the scientific session.
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Extra resources for ABC of Psychological Medicine
Reassurance and explanation Most patients are reassured by being told that the symptoms they have are common and rarely associated with disease and that their doctor is familiar with them. This is especially so if accompanied by the promise of further review should the symptoms persist. Reassurance needs to be used carefully, however. It is essential to elicit patients’ specific concerns about their symptoms and to target reassurance appropriately. The simple repetition of bland reassurance that fails to address patients’ fears is ineffective.
Detail of Very Slippy Weather by James Gillray (1757-1815) Lifetime prevalence of specific traumatic events (n=2181) Type of trauma Assault Serious car or motor vehicle crash Other serious accident or injury Fire, flood, earthquake, or other natural disaster Other shocking experience Diagnosed with a life threatening illness Learning about traumas to others Sudden, unexpected death of close friend or relative Any trauma Prevalence 38% 28% 14% 17% 43% 5% 62% 60% 90% Immediate effects of frightening trauma x Causes a varied picture of anxiety, numbness, dissociation (feeling distanced from events, having fragmentary memories), and sometimes apparently inappropriate calmness x Those who believe they are the innocent victims of others’ misbehaviour are often angry, and this may be exacerbated by subsequent frustrations x The term “acute stress disorder” is now used for a combination of distress, intrusive memories (flashbacks, nightmares), avoidance, and numbing in the months after the trauma.
Functional somatic symptoms and syndromes Patients with functional symptoms can be detected by maintaining an awareness of the problem when seeing new patients and by the use of somatic symptom questionnaires (large numbers of symptoms are more likely to be functional). Management Although it is essential to consider disease as the cause of the patient’s symptoms an approach exclusively devoted to this can lead to difficulties if none is found. Making explicit from the start the possibility that the symptoms may turn out to be functional keeps the option of a wider discussion open.