Doctors often encounter such patients in their outpatient clinics
1. general discomfort with complaints of multiple systems
2.Symptoms and signs do not match, and various tests are negative
3. Repeatedly visited the clinic for several times, with poor treatment results
Also accompanied by
Fatigue, lack of energy, sleep disorders, emotional instability, often clinically diagnosed as “neurasthenia”, “phytodysfunction”, a certain “functional disorder” “syndrome” and so on; ask the medical history, some people have a variety of mental stimulation or stress these people, often suffering from mental illness.
I. Depression (Depression)
Also known as depressive neurosis (Depressive Neurosis), or poor mood disorder.
Core symptoms.
Depressed mood, lack of interest, lack of energy, fatigue
It can be accompanied by low self-esteem, guilt, sleep disorders (difficulty falling asleep, early awakening), aggression, loss of confidence in life, reduced thinking ability, reduced concentration, agitation symptoms, sometimes the thought of death, unexplained physical symptoms; time over 2 weeks at least 250,000 people die by suicide each year in China (equivalent to a county-level city), 75% of which are caused by depression.
Depression is not limited by occupation, wealth, race, gender, age, and there is no shortage of celebrities who suffer from depression. For example: Van Gogh, Hemingway, Churchill, Marilyn. Monroe, Princess Diana, Yasunari Kawabata, Sanso, Pauline Chan, Leslie Cheung, and the Chinese-American writer who just committed suicide on November 9, 2004, Chunru Zhang.
Childhood depression: extremely easy to be ignored. Symptoms are atypical.
Depression in women: very easy to be misdiagnosed. Menopausal symptoms are easily confused with depression.
Anxiety Disorders
1.Generalized anxiety
Anxiety, nervousness, but no clear object and specific content, distraction, excessive worry, panic of foreboding, motor restlessness, handful of hands and feet, walking back and forth; often accompanied by a variety of vegetative symptoms, such as dizziness, sweating, tremor, dry mouth, shortness of breath, etc.
2, panic disorder, also known as acute anxiety attack
The attack is unpredictable because there is no objective danger in the environment or there is no obvious fixed trigger for the attack. In the interval between attacks, there are no obvious symptoms except for fear. Suddenly feel strong fear, frequent sense of death, sense of loss of control, often accompanied by vegetative symptoms, peaking in 10 minutes, usually not more than 1 hour, clear consciousness during the attack, can recall afterwards, anticipatory anxiety due to fear of attack, often take avoidance behavior, such as afraid to go out.
Three, phobia
1, social fear (social anxiety disorder)
Fear of being watched or evaluated, fear of embarrassment, think that others can see his unnatural expressions, anticipate the evaluation of others is negative or contempt, avoidance of social situations, anxiety or pain because of social. Many scholars suggest replacing “social fear” with “social anxiety disorder”.
2.Place fear
Fear of specific environments, such as high places, squares or more crowded places, often out of fear and avoidance behavior. People say “fear of heights” is the place fear. Patients know that this fear is unreasonable, excessive, should not be, but this understanding still can not prevent the occurrence of fear.
3, specific phobia
The object of fear is a specific object or situation, such as animals, lightning, darkness, blood, flight, closed space, etc.. The triggering scenario is relatively single and specific. It usually appears in childhood or early adulthood and can last for decades if left untreated. Minors should not watch horror movies also to reduce this fear.
Fourth, obsessive-compulsive disorder
The main clinical phase is obsessive-compulsive symptoms, characterized by the coexistence of conscious self-compulsions and counter-compulsions, and the acute conflict between the two makes the patient anxious and distressed. The patient realizes that this idea or conflict originates from the ego, but against his or her will, so he or she resists desperately, but is unable to get rid of it. Ritualized actions are often used to alleviate the pain, such as repeated examination and washing, and social functioning is impaired. Obsessive-compulsive disorder can include: obsessive-compulsive ideas, obsessive-compulsive thinking, obsessive-compulsive emotions, obsessive-compulsive intentions, obsessive-compulsive actions, obsessive-compulsive behavior, etc., often one kind of predominant, several conditions coexist.
V. Hypochondria
Patients are worried about suffering from one or more serious somatic diseases and repeatedly seek medical attention, describing somatic diseases. Various medical tests are negative, and the doctor’s explanations are unable to dispel the doubts, and unnecessary medical visits and meaningless diagnostic tests are conducted. The patient shows persistent preoccupation, often accompanied by various physical symptoms.
Anxiety, depression and pain due to suspicion.
Somatoform disorders
Somatic symptoms that last for a long time, are diverse, recurrent and change from time to time. Symptoms can involve any system or part of the body. The patient has been seen several times and has had many negative test results or even nothing on surgical probing.
Somatic discomfort does exist.
Psychological disorders are now prevalent in general hospitals, especially in cardiology, gastroenterology, neurology, endocrinology and oncology departments. Psychological disorders have the same incidence and morbidity as other diseases such as hypertension and diabetes mellitus, which also have biochemical abnormalities and cannot be controlled by subjective willpower. In fact, up to 80% of patients with psychological disorders do not consult psychiatry, but go to general hospital departments, because the primary psychological disorders themselves, such as depression, anxiety, neurosis, hypochondria and phobia, can take the form of various physical disorders or dysfunctions, and the patient’s psychological factors are hidden in these somatization symptoms.
Therefore, both doctors and patients themselves should pay attention to not only somatic discomfort but also psychological discomfort, to see both the “disease” and the “person”, and to choose the perfect psychosomatic treatment, which can well relieve the pain and speed up the recovery of somatic diseases, and at the same time reduce the economic and mental burden and improve the quality of life.