心身疾病psychosomatic-disease.ppt

1 PsychosomaticDisease 心身疾病 2 Tomatodietkillssix stonemodel AYOUNGmodelwholivedonadietofapplesandtomatoeshasdiedofanorexia 神经性厌食症 AnaCarolinaReston 21 aBrazilianwhohadworkedforGiorgioArmani was5ft7intallbutweighedonlysixstonewhenshediedonTuesday 174cm 40kgBMI 13 4 3 objectives 1 Tomastertheconceptofpsychosomaticdiseases etiology 病因学 pathogenesis diagnosis andtreatmentprinciples 2 Tobefamiliarwithavarietyofcommonpsychosomaticdiseases 4 introduction Psychosomaticmedicinehasitsrootsintheearliestwritingsofthehistoryofmedicine awarenessofbody mindlinkageswasrecordedbyancientphilosophersandphysiciansmanycenturiesago Bodyandmindwerealwaysinseparablyconnected Currentunderstandingofpsychosomatictakesintoaccounttheinteractionbetweenphysicalandpsychic 精神的 心灵的 inalldisordersanddiseases 5 Theprinciplefeaturesinclude1 2 3 p71 6 HistoryanddefinitionofpsychosomaticPathogenicmechanismandprocessofpsychosomaticdiseasesClinicworkinpsychosomaticdiseasesTypicalpsychosomaticdiseases content 7 Historyanddefinitionofpsychosomatic 1 Historyofpsychosomaticmedicine2 Definitionofpsychosomaticmedicine3 Conceptofpsychosomaticdiseases 4 Morbidityrate 患病率 andpopulationcharacteristicofpsychosomaticdiseases 8 psychosomaticdiseasereferstophysicalsymptomsorillnessesthatresultfromtheinterplayofpsychosocialandphysiologicalprocesses 9 Classificationaccordingsystem 1 Cardiovascularsystemcoronaryheartdisease CHD essentialhypertensionCardiacarrhythmias2 Respiratorysystembronchialasthmahyperventilationsyndrome 10 Classificationaccordingsystem 3 Gastrointestinalsystempepticulcerulcerativecolitis4 Endocrinesystemdiabetesmellitushyperthyroidism 11 Classificationaccordingsystem 5 Musculoskeletalsystemrheumatoidarthritislowbackpain6 Neurologicalsystemmigraineheadachetensionheadache 12 Whydosomepeoplewhoareunderstressgetsickwhereasothersdonot 13 TypeAandTypeBbehaviorpatterns Thediscoveryof typeA MeyerFriedmanandRayRosenmanwerestudyingdietarydifferencesincholesterol 胆固醇 intakebetweenmaleheatdiseasevictimsandtheirwives Ifyoureallywanttoknowwhatisgivingourhusbandsheartattacks Iwilltellyou Itisstress thestresstheyreceiveintheirwork Focusingonthesubjects stressandbehavioralcharacteristics 14 TypeAbehaviorpatternItconsistsofthreecharacteristicsCompetitiveachievementorientationTimeurgencyAnger hostility 15 CompetitiveachievementorientationTypeAindividualstendtobeveryself criticalandtostrivetowardgoalswithoutfeelingasenseofjoyintheireffortsHardworkers 16 TimeurgencyTypeApeopleseemtobeinaconstantstruggleagainsttheclock Theyquicklybecomeimpatientwithdelays schedulecommitmentstootightly andtrytodomorethanonethingatatime suchasreadingwhileeatingorwatchingTV 17 Anger hostilityTypeAindividualstendtobeeasilyarousedtoangerorhostility whichtheymayormaynotexpressovertly 18 TypeBbehaviorpatternlowlevelsofcompetitiveness timeurgencyandhostility Tendingtobemoreeasygoingandphilosophicalaboutlife theyaremoreliketo stopandsmelltheroses 19 MeasuringTypeAandTypeB Doyouwanttoknowwhatpatternsyoubelongto 20 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 21 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 Doyougetannoyedwhenyou reinacrowdedcarorrestaurant 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 22 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 Doyoufeelyou dratherbepracticalthaninnovateorreform 23 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 24 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 25 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 26 ThisisthequestionnaireoftypeA Iftheanswers yes aremorethanhalf youshouldchangeyourhabits andslowdown 27 HowdoesTypeAinfluencethehealth TypeAindividualsreactdifferentlytostressorthandothosewiththeTypeBpattern Respondingmorequicklyandstronglytostress ofteninterpretingstressorsasthreats Increasingtheperson slikelihoodofencounteringstressfulevents tendtohavemoreaccidents 28 Westerncooperativegroupstudy WCGS 1960 1969 基线 3524名36 59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 29 StressandCardiovasculardisorders CHD coronaryheartdisease 冠心病 Hypertension 高血压 30 CHD AdiseaseofmodernizedsocietiesRateofCHDishigherintechnologicallyadvancedcountriesthaninothernationsLivelonger beinglesslikelytodieofinfectiousdiseasesHavingcertainriskfactorsforCHD obesityandlowlevelsofphysicalactivity 31 CHD TypeASt