Basic psychopathological

phenomena and research methods

in psychosomatic medicine

ASHOK SINGH SEERVI 9632

What scales are used to screen psychopathological
phenomena in psychosomatic medicine?
Beck's depression scale was developed on the basis of clinical
observations, which revealed a limited set of the most relevant and
significant symptoms of depression. This scale contains 21 questions, 4
answer options, the patient takes from 20 minutes to one hour to
complete the self-questionnaire, depending on the condition.
How do self-questionnaires differ from
clinical scales?
Two subscales: cognitive-affective (items 1-13) and somatic
manifestations of depression (items 14-21).
• Cognitive-affective symptoms: mood; pessimism; feelings of
inadequacy; dissatisfaction; guilt; feeling that I will be punished; self-
loathing; ideas of self-blame; suicidal thoughts; tearfulness;
irritability; violation of social ties; indecision
• Somatic manifestations: violation of body image; loss of working
capacity; sleep disturbance; fatigue; loss of appetite; weight loss;
being caught up in bodily sensations; loss of libido.
What methods can be used to determine the level
of anxiety and depression at the same time?
Hospital Anxiety and Depression Scale (HADS)
HADS has high validity for two phenomena: anxiety and depression; it is
used to identify and assess the severity of these symptoms in the
context of the general somatic network. The advantages of this scale
are ease of use and processing (filling out the scale does not require a
long time and does not cause difficulties for the patient).
Tools for diagnosing anxiety
• Clinical manifestations of pathological anxiety can be divided into
mental and somatic symptoms. Mental symptoms usually include
anxiety, fear, worry over small things, inability to relax, difficulty falling
asleep and staying asleep at night, feeling nervous and on the verge of
breakdown, rapid fatigue, as well as inability to concentrate and
memory impairment, which are sometimes identified as cognitive
anxiety.
Tools for diagnosing depression
The main manifestation of depression is a change in mood. Patients are sad,
tearfulness, sadness, irritability periodically occur. Aggressiveness and
hostility towards others may also occur. At the same time, it is necessary to
distinguish depression from the normal physiological reaction of a person to
various stressful and social situations, in which there is a decrease in the
emotional background. In such cases, there is sadness and annoyance at
irritants or somatic diseases. It is often very difficult to draw a clear line in
such situations, so the doctor's art is needed in making the correct diagnosis.
An established diagnosis of depression requires the earliest possible
appointment of antidepressants to stop the main manifestations of the
disease. In other situations, mood correction can occur independently or with
the appointment of light sedatives.
What is the difference between fear and
anxiety?
Fear is an emotion, the cause of which a person has realized. Anxiety
does not have a clearly defined object, fear does. Fear is the result of
the interaction of anxiety and thinking. It is very bad when a person is
panickingly afraid of anesthesia and/or surgery. She may die suddenly
from fear during intubation. In order to prevent fear, especially of
doctors and treatment, the child cannot be intimidated by doctors and
medical procedures during the education process. Worried about a sick
child during treatment, parents should not transfer their fear to them.
On the other hand, the doctor's fear and anxiety for the fate of the
patient can lead to wrong actions or inaction and harm the patient.
Anxiety in psychosomatics
Somatic manifestations of anxiety are multisystemic in nature. Thus, the
realization of anxiety in the nervous system can be represented by dizziness,
nausea, tremors, tremors, paresthesias, and muscle twitching. Anxiety in the
cardiovascular system usually looks like tachycardia, extrasystole, cardialgia,
fluctuations in blood pressure, acrocyanosis, waves of heat and chills. Lack of air,
attacks of choking and suffocation, feeling of a coma in the throat, yawning and
loss of automaticity of breathing are a reflection of anxiety in the respiratory
system. The appearance of nausea, vomiting, belching, flatulence, dry mouth,
abdominal pain, constipation or diarrhea in a patient with anxiety indicates the
involvement of the gastrointestinal system. Accordingly, anxiety in the urogenital
system is itching and pain in the perineal area, cystalgia and polyuria. Even the
thermoregulatory system has somatic equivalents of anxiety: non-infectious low-
grade fever, chills, and hyperhidrosis. Anxious excitement is determined by
general motor restlessness, anxiety, fear, agitation of varying degrees of severity.
Depression in psychosomatics
Depression is a complex psychopathological condition characterized by a triad of
symptoms: a depressed, depressed, anxious or anxious mood, a decrease in
mental activity and a decrease in motor activity of varying degrees of
expressiveness. The term depression comes from the Latin word deprimo, which
means "to oppress.” This triad is the core of the clinical picture. Depression can
be accompanied by various clinical symptoms. Among them, the most common
are loss of appetite, weight loss, heart rhythm disturbances, and constipation.
Sleep is disturbed, libido is absent, sexual function is disturbed. In some cases,
depression is accompanied by a disorder, then the so-called agitated depression
occurs. Depressive excitement is manifested by motor excitement with a feeling
of immense despair and painful, unbearable boredom. Also, depression may
overlap with psychotic manifestations and/or suicidal ideation.