心身疾病ppt课件

PsychosomaticDisease,心身疾病,1,Tomatodietkillssix-stonemodel,AYOUNGmodelwholivedonadietofapplesandtomatoeshasdiedofanorexia（神经性厌食症）.AnaCarolinaReston,21,aBrazilianwhohadworkedforGiorgioArmani,was5ft7intallbutweighedonlysixstonewhenshediedonTuesday.(174cm,40kgBMI:13.4),2,objectives,1.Tomastertheconceptofpsychosomaticdiseases,etiology（病因学）,pathogenesis,diagnosis,andtreatmentprinciples.2.Tobefamiliarwithavarietyofcommonpsychosomaticdiseases.,3,introduction,Psychosomaticmedicinehasitsrootsintheearliestwritingsofthehistoryofmedicine,awarenessofbody-mindlinkageswasrecordedbyancientphilosophersandphysiciansmanycenturiesago.Bodyandmindwerealwaysinseparablyconnected.Currentunderstandingofpsychosomatictakesintoaccounttheinteractionbetweenphysicalandpsychic（精神的、心灵的）inalldisordersanddiseases.,4,Theprinciplefeaturesinclude1.2.3.,p71,5,HistoryanddefinitionofpsychosomaticPathogenicmechanismandprocessofpsychosomaticdiseasesClinicworkinpsychosomaticdiseasesTypicalpsychosomaticdiseases.,content,6,Historyanddefinitionofpsychosomatic,1.Historyofpsychosomaticmedicine2.Definitionofpsychosomaticmedicine3.Conceptofpsychosomaticdiseases.4.Morbidityrate（患病率）andpopulationcharacteristicofpsychosomaticdiseases.,7,psychosomaticdiseasereferstophysicalsymptomsorillnessesthatresultfromtheinterplayofpsychosocialandphysiologicalprocesses.,8,Classificationaccordingsystem,1.Cardiovascularsystemcoronaryheartdisease(CHD)essentialhypertensionCardiacarrhythmias2.Respiratorysystembronchialasthmahyperventilationsyndrome,9,Classificationaccordingsystem,3.Gastrointestinalsystempepticulcerulcerativecolitis4.Endocrinesystemdiabetesmellitushyperthyroidism,10,Classificationaccordingsystem,5.Musculoskeletalsystemrheumatoidarthritislowbackpain6.Neurologicalsystemmigraineheadachetensionheadache,11,Whydosomepeoplewhoareunderstressgetsickwhereasothersdonot?,12,TypeAandTypeBbehaviorpatterns,Thediscoveryof“typeA”MeyerFriedmanandRayRosenmanwerestudyingdietarydifferencesincholesterol（胆固醇）intakebetweenmaleheatdiseasevictimsandtheirwives.“Ifyoureallywanttoknowwhatisgivingourhusbandsheartattacks,Iwilltellyou.Itisstress,thestresstheyreceiveintheirwork.”Focusingonthesubjectsstressandbehavioralcharacteristics.,13,TypeAbehaviorpatternItconsistsofthreecharacteristicsCompetitiveachievementorientationTimeurgencyAnger/hostility,14,CompetitiveachievementorientationTypeAindividualstendtobeveryself-criticalandtostrivetowardgoalswithoutfeelingasenseofjoyintheireffortsHardworkers,15,TimeurgencyTypeApeopleseemtobeinaconstantstruggleagainsttheclock.Theyquicklybecomeimpatientwithdelays,schedulecommitmentstootightly,andtrytodomorethanonethingatatime,suchasreadingwhileeatingorwatchingTV.,16,Anger/hostilityTypeAindividualstendtobeeasilyarousedtoangerorhostility,whichtheymayormaynotexpressovertly.,17,TypeBbehaviorpatternlowlevelsofcompetitiveness,timeurgencyandhostility.Tendingtobemoreeasygoingandphilosophicalaboutlifetheyaremoreliketo“stopandsmelltheroses”.,18,MeasuringTypeAandTypeB,Doyouwanttoknowwhatpatternsyoubelongto?,19,Answerthesesquestionswithyesorno1.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?,20,Answerthesesquestionswithyesorno5.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？Doyougetannoyedwhenyoureinacrowdedcarorrestaurant?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?,21,9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？Doyoufeelyoudratherbepracticalthaninnovateorreform?,22,14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?,23,19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?,24,23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?,25,ThisisthequestionnaireoftypeA.Iftheanswers“yes”aremorethanhalf,youshouldchangeyourhabits,andslowdown.,26,HowdoesTypeAinfluencethehealth?,TypeAindividualsreactdifferentlytostressorthandothosewiththeTypeBpattern.Respondingmorequicklyandstronglytostress,ofteninterpretingstressorsasthreats.Increasingthepersonslikelihoodofencounteringstressfulevents.(tendtohavemoreaccidents),27,Westerncooperativegroupstudy(WCGS,19601969)基线：3524名3659岁男性，113人有CHD，TABP占71%剔除患者，8年半系统追踪，期间257人患CHD，TABP是TBBP的2.37倍（2.7%和1.1%）控制年龄、血脂、血压、吸烟等因素，TABP患CHD的危险性是TBBP的2倍。结论：TABP是CHD的危险因素。1978年，世界心肺和血液研究学会确认TABP与CHD有关。,28,StressandCardiovasculardisorders,CHD(coronaryheartdisease)（冠心病）Hypertension（高血压）,29,CHD,AdiseaseofmodernizedsocietiesRateofCHDishigherintechnologicallyadvancedcountriesthaninothernationsLivelonger,beinglesslikelytodieofinfectiousdiseasesHavingcertainriskfactorsforCHD,obesityandlowlevelsofphysicalactivity,30,CHD,TypeAStres