Skip to main content Accessibility help
×
Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-24T13:14:34.849Z Has data issue: false hasContentIssue false

4 - Understanding psychological reactions to physical illness

from Part I - Basic skills

Published online by Cambridge University Press:  10 December 2009

Geoffrey Lloyd
Affiliation:
Priory Hospital, London
Elspeth Guthrie
Affiliation:
University of Manchester
Get access

Summary

People react to illness in a manner that reflects a complex and evolving interaction of several factors. These include their premorbid personality, previous experience of ill health, interpersonal relationships, perceived threat of the illness, the physical treatment required and their interaction with medical and nursing staff to whom they turn for treatment. Most illnesses, except the very trivial, require a period of adjustment and a reappraisal of lifestyle, ability to work and engagement in leisure activities.

Coping strategies

The great majority of people cope constructively with illness in the sense that they seek medical advice appropriately and co-operate with treatment in a manner which maximizes their chances of recovery. If an illness is chronic and associated with permanent disability, lifestyle changes are made which enable a realistic adjustment to take place. Coping is a dynamic process. Most people have a range of coping strategies which they can use flexibly, according to the particular problems that their illness creates at the time. Some cope by involving themselves closely with the treatment plan, seeking out information about their illness not only from their doctor but also from medical textbooks and websites. They may become involved in medical charities devoted to their illness and in the case of rare conditions some become so well informed that they know more about the illness than their doctor.

In sharp contrast to this strategy some people cope by distancing themselves from the emotional implications of their illness.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ballard, C. G., Stanley, A. K. and Brockington, I. F. (1995). Post-traumatic stress disorder (PTSD) after childbirth. British Journal of Psychiatry, 166, 525–8.Google Scholar
Cavanaugh, S. V. (1983). The prevalence of emotional and cognitive dysfunctions in a general medical population: using the MMSE, GHQ and BDI. General Hospital Psychiatry, 14, 28–34.Google Scholar
Cavanaugh, S. V., Clarke, D. C. and Gibbons, R. D. (1983). Diagnosing depression in the hospitalised medically ill. Psychosomatics, 84, 809–15.Google Scholar
Creed, F., Morgan, R., Fiddler, M., et al. (2002). Depression and anxiety impair health-related quality of life and are associated with increased costs in general medical inpatients. Psychosomatics, 43, 302–9.Google Scholar
Dickens, C. M., Percival, C., McGowan, L., et al. (2004). The risk factors for depression in first myocardial infarction patients. Psychological Medicine, 34, 1083–92.Google Scholar
Dickens, C. M., McGowan, L., Percival, C., et al. (2006). Contribution of depression and anxiety to impaired health-releated quality of life following first myocardial infarction. British Journal of Psychiatry, 189, 367–72.Google Scholar
ENRICHD Investigators. (2003). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomised trial. Journal of the American Medical Association, 289, 3106–16.
Fairburn, C. G. and Harrison, P. J. (2003). Eating disorders. Lancet, 361, 407–16.Google Scholar
Feldman, E., Mayou, R., Hawton, K., et al. (1987). Psychiatric disorder in medical inpatients. Quarterly Journal of Medicine, 63, 405–12.Google Scholar
Frasure-Smith, N., Lesperance, F. and Talajic, M. (1993). Depression following myocardial infarction: impact on 6 month survival. Journal of the American Medical Association, 270, 1819–25.Google Scholar
Frasure-Smith, N. and Lesperance, F. (2003a). Depression and other psychological risks following myocardial infarction. Archives of General Psychiatry, 60, 627–36.Google Scholar
Frasure-Smith, N. and Lesperance, F. (2003b). Depression – a cardiac risk factor in search of a treatment. Journal of the American Medical Association, 289, 3171–3.Google Scholar
Halligan, P. W., Bass, C. and Oakley, D. A. (2003). Wilful deception as illness behaviour. In Malingering and Illness Deception, ed. Halligan, P. W., Bass, C. and Oakley, D. A.. Oxford: Oxford Unversity Press, pp. 3–28.
Harris, E. C. and Barraclough, B. (1994). Suicide as an outcome for medical disorders. Medicine (Baltimore), 73, 281–96.Google Scholar
Harris, E. C. and Barraclough, B. (1998). Excess mortality of mental disorder. British Journal of Psychiatry, 173, 11–53.Google Scholar
Karch, F. E. and Lasagna, L. (1975). Adverse drug reactions: a critical review. Journal of the American Medical Association, 234, 1236–41.Google Scholar
Koenig, H. G. and Kuchibatla, M. (1998). Use of health services by hospitalised medically ill depressed elderly patients. American Journal of Psychiatry, 155, 871–7.Google Scholar
Lipowski, Z. J. (1969). Psychosocial aspects of disease. Annals of Internal Medicine, 71, 1197–206.Google Scholar
Mayou, R. and Bryant, B. (2001). Outcome in consecutive emergency department attenders following a road traffic accident. British Journal of Psychiatry, 179, 528–34.Google Scholar
Mayou, R. A. and Smith, K. A. (1997). Post traumatic symptoms following medical illness and treatment. Journal of Psychosomatic Research, 43, 121–3.Google Scholar
Michie, S., Bobrow, M. and Marteau, T. M. (2001). Predictive genetic testing in children and adults: a study of emotional impact. Journal of Medical Genetics, 38, 519–26.Google Scholar
Nightingale, S., Holmes, J., Mason, J., et al. (2001). Psychiatric illness and mortality after hip fracture. Lancet, 357, 1264–5.Google Scholar
Pohjasvaara, T., Vataja, R., Leppavuori, A., et al. (2001). Depression is an independent predictor of poor long-term functional outcome post-stroke. European Journal of Neurology, 8, 315–19.Google Scholar
Roose, S., Glassman, A. H. and Seidman, S. N. (2001). Relationship between depression and other medical illnesses. Journal of the American Medical Association, 286, 1687–90.Google Scholar
Royal College of Physicians and Royal College of Psychiatrists. (2003). The Psychological Care of Medical Patients: a Practical Guide. London: RCP and RCPsych.
Steel, J. M., Young, R. J., Lloyd, G. G., et al. (1987). Clinically apparent eating disorders in healthy young diabetic women: associations with painful neuropathy and other complications. British Medical Journal, 294, 859–62.Google Scholar
Tarzi, S., Kennedy, P., Stone, S., et al. (2001). Methicillin-resistant Staphylococcus aureus: psychological impact of hospitalisation and isolation in an older adult population. Journal of Hospital Infection, 49, 250–4.Google Scholar
Tedstone, J. E. and Tarrier, N. (2003). Posttraumatic stress disorder following medical illness and treatment. Clinical Psychology Reviews, 23, 409–48.Google Scholar
Turjanski, N. and Lloyd, G. G. (2005). Psychiatric side-effects of medications: recent developments. Advances in Psychiatric Treatment, 11, 58–70.Google Scholar
Unutzer, J., Small, G. and Gunay, I. (2002). Geriatric medicine. In Textbook of Consultation-liaison Psychiatry, 2nd edn, ed. Wise, M. G. and Rundell, J. R.. Washington: American Psychiatric Publishing, pp. 853–69.

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×