Psychosomatic illness
Classification & external resources | ICD-10 | F45 | | ICD-9 | 306.9 | Psychosomatic disorder, now more commonly referred to as psychophysiologic illness, is an illness whose symptoms are caused by mental processes of the sufferer rather than immediate physiological causes. If a medical examination can find no physical or organic cause, or if an illness appears to result from emotional conditions such as anger, anxiety, depression or guilt, then it might be classified as psychosomatic. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...
The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ...
The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...
The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ...
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History
THE EARLY HISTORY OF THE WORD "PSYCHOSOMATIC "* Edward L. Margetts, M.D.t Montreal, Que.
What is mind? No matter. What is matter? Never mind!
(Attributed to Thomas Hewitt Key, 1799-1875, Headmaster of University School, London.) (Someone later added What is soul? It is immaterial!).
We hear much these days about the "new"word psychosomatic, and the "new specialty"of psychosomatic medicine. Most psychiatrists dislike the adjective psychosomatic and decry the loose use of it: as C. B. Farrar said, it is"a term that should be superfluous".9 We all know that it tends to emphasize the dichotomy or duality of psyche and soma, whereas most of us find it more practical and theoretically more satisfying to consider mind and body as a biological unity, the psyche and the soma being inseparable aspects of the individual organism.In spite of a very excellent article some yearsago by Gregory Zilboorg23 b, c on the history of psychosomatic medicine, many doctors, even psychiatrists, do not realize the antiquity of theterm psychosomatic or of the psychosomatic concept,and persist in regarding the present floodof publications in this branch of medicine as something new. It is not my intention to discuss the history of the mind-body relationship in this paper.Nor is it my intention to deline psychosomatic medicine, which to me has never meant anything new, and has merely implied good medicine, which takes into account every facet of the sick person -mind and body as one. The word,which is certainly unsatisfactory, is so deeply entrenched in the literature that it will never be eradicated. However, let us hope that over the years it will be used less frequently or at least used more accurately, and that it will not point out another "sub-specialty" of medicine. A great deal remains to be written on the history of psychosomatic medicine, and this essay is to treat only of a very small part of it, namely the early use of the term psychosomatic.
A number of authors have pointed out that in 1838, Christian Friedrich Nasse (1778-1851) and Maximilian Jacobi(1775-1858) founded a new periodical entitled"Zeitschrift fur die Beurtheilung und Heilungder krankhaften Seelenzustiinde ". G. Reiiner in Berlin published the journal, and only one volume, for the year 1838, ever reached print. This book contained 19 essays, written by F.Nasse, M. Jacobi, C. F. Flemming, P. W. Jessen,
All the contributors were disciplesof the "somatic" school which flourishedin Germany during the first half of the 19thcentury. Each of the first two articles24a, 15b inthe new publication contained the word somatisch-psychischen in the titles, and in the firstpaper the reverse term, psychisch-somatisch, occurred in the text. Nasse24a stated stated:"the business of recognizing, preventing and treating conditions of mental disorder (Irreseyn)rests upon the fundamental investigation of thesimultaneously psychic and somatic activity ofman. Here it finds its scientific support, fromhere on it gains light and learns the road "
Most of Nasse'swritings were not as broad as this statement,which could be cited as a very excellent statementof psychosomatic medicine as we like tothink of it today. Usually he took a rigidlyorganic view of mental illness.The year 1838 should not go down as the dateat which psychosomatic medicine started, becausethe principle of the organism-as-a-whole,mind and body together, is almost as old ashistory itself. Nor should 1838 be taken as theyear in which the adjective psychosomatic wasfirst used. When and where the term originatedis impossible to say, but it would probably besafe enough to state that it came into vogue soonafter the commencement of the 19th century,and it is probably of German or English origin.
A large number of medical terms having Greek roots came into common use at that time, very likely because it was the era when it became acceptable for medical writers to switch from Latin to their native tongues, particularly to German, French, Italian, and English. Psyche and soma and psychic and somatic were used independently lorg before they were combined. Even more commonly used were soul and body, mind and body, mind and matter, spirit and flesh, soul and flesh, mental and physical, moral and corporeal, moral and physical, functional and organic, psychic and corporeal. The combined terms psycho-physical and psycho-organic were frequently used prior to the introduction of the term psychosomatic. Psychical medicine and mental medicine were also employed, as were psychic and psychotherapy. In the first quarter of the 19th century there were hot discussions going on -in England about matter, life, mind and "organization". These arguments were extremely complicated because many of the participants had rigid and pious minds which resulted in a confusion of religion and philosophy with medicine and common sense. John Abernethy (1764-1831) in 18151 during his lectures before the Royal College of Surgeons in London spoke of the Greek soma (body), psyche (vital principle or life) and nous (mind or spirit). Thomas Forster (1789-1860), under the pseudonym " Philostratus' '27 wrote a small volume based on the writings and lectures of Abernethy and others concerning life and organization, and compounded the terms in his book "Somatopsychonoologia . . . etc." This meant the science of body, life and mind. As an early tract on psychosomatics, this book is well worth reviewing. An anonymous reply to Philostratus appeared in 1823.3 There were several uses of the term psychischsomatisch prior to 1838, e.g., by Friedrich Groos" (1768-1852) and John Baptist Friedreich' 0 (1796-1862). Farrar,9b in discussing Groos's writings, translated the term into English as psycho-somatic. Groos must be credited with a very practical psycho-somatic approach for his day. He utilized what we might call a hierarchical epigenetic layer concept to formulate a happy medium in the no-man's land between psyche and soma which existed at that time. Groos considered that the normal mind constantly tried to realize "good". A weakening or absence of this drive constituted the basis of insanity. This basic factor he called the "psychic negative". To this negative it was necessary that a "somatic positive", in the form of an organic abnormality, be added so that a mental illness would result. In this way he postulated that both psychic and somatic factors played parts as a psycho-somatic basis for insanity. Friedreich 's work is a classic, and contains a very full discussion of the Psychic and Somatic schools in Germany. It would be valuable to have this book translated into English.
Nasse24b as early as 1822 used the combined term "psycho-somatologie". The earliest reference to the term psychischsomatisch which the author has so far been able to find occurs in Heinroth'S3 "Lehrbuch . . ." of 1818, part 2, paragraph 313, p. 49 (vide infra). Johan Christian August Heinroth (1773-1843) was Professor of Psychiatry at Leipzig, and the leader of the so-called " Spiritualistic" or "Psychic" school of psychiatry in Germany at the time. Heinroth's chief opponent in the battle of mind and matter was Maximilian Jacobi, head of the Siegburg Asylum and the generally acknowledged leader of the " Somatic" or "Organic" school. According to Leupoldt,21 Jacobi "committed infanticide by killing Heinroth's psychiatry ". Heinroth (ref. 13, and frequently quoted by others) was responsible for great advances in psychiatry, although some of his religious explanations of mental mechanisms and insanity were bitterly attacked. He regarded the body and soul as one, madness as a disease of the entire being. Mental health was harmony of thought and desire, disease a loss of this balance. The soul was a free force, excited by stimulation and through provocation, and endowed with the power of choice between good and evil. The body was the external part of the ego, the organ of the soul, and the senses were the intermediary, "the witness that body and soul are one ". Madness was a wild destroying activity of the will, an unfree state of the soul, and all unfree states of soul were due to sin and evil passions, i.e., fall from grace. The only prophylactic against insanity was Christian faith, and the final treatment was a pious life with absolute devotion to God. Because of Heinroth's statement that sin and evil were the roots of insanity, he had to explain why so many of the vicious and criminal population did not fall prey to madness. He did this by postulating that vice and insanity were each the goals of two divergent paths or developments which both had sin for their point of departure. In spite of Heinroth's Bible pounding, he was apparently a very fine clinical psychiatrist, who did not practise too closely that which he preached. Amdur2 summarized this very concisely: " It seems that his tendency toward moral discourses left him. when he deserted the field of theory and approached the patient. He admonished his students to observe, classify and treat". A glance at the passage from Heinroth translated in this paper will indicate the care and thought which he at all times exercised in his therapy. It is easy to see how he aroused opposition, and probably his most outspoken enemies spoke out after the poor man was dead. For instance, after quoting a passage from Heinroth 's "Lehrbuch", Bucknill and Tuke5 stated, "It would seem impossible to compress within a single paragraph a larger amount of false and mischievous teaching. It should only be retailed after being duly labelled 'Poison'." Bucknill and Tuke of course were organically inclined, extremists at the somatic end of the psychosomatic see-saw.
The sentence in which Heinroth used the term psychisch-somatisch reads as follows: "Gewohnlich sind die Quellen der Schlaflosigkeit psychisch- somatisch, doch kann auch jede Lebenssphiire fur sich allein den vollstandigen Grund derselben enthalten". The complete paragraph containing this sentence is of considerable interest, and it is felt than an English translation of it will prove useful: "Even the ancients paid much attention to insomnia in mental conditions as is proved to us by the laws which Celsus compiled on this subject. And indeed insomnia helps to perpetuate excitement in mental illness. It is not enough to investigate only into the various sources of insomnia-which however is necessary to eliminate it completely. One also has to see to the effects and end-results of insomnia, in order to see in what way these might not only be disadvantageous but also of therapeutic value; and, having arrived at such conclusions one has to formulate one 's future course (of treatment). As a general rule, the origin of insomnia is psycho-somatic, but it is possible that every phase of life can itself provide the compTete reason for insomnia. Even when we are well we do not sleep if some object keeps our interest vividly occupied; in the same way does sleep escape us when an irritation of the blood stream, of the nerves, of the skin, or of the abdomen keeps us in a perpetual state of excitement; when irritations of both kinds (mental excitement or physical irritation) coincide the result is the worse. The same is the case in psychopathological states: hence the so-called sleepinducing media, 'the narcotica', rarely serve their purpose; and hence, through the lack of thorough investigation of the origins, one can seldom overcome insomnia in mentally-ill individuals. Likewise one cannot eliminate insomnia even when one is seeking the psychic stimuli as well as the somatic ones in an irritated circulatory or nervous system, or gastrointestinal tract, or in the skin, or in the sexual organs, etc. But does one actually know what demands one makes on oneself and on Nature when one tries to remove insomnia? It is true: in the long run insomnia exhausts the patient, taxes his strength, the organs themselves, and worsens his general condition, and drives him to his last resort: but who is to know if this exacerbation and ultimate tension of the pathological condition will not introduce a state of relaxation and bring about once more a return to normality? Experience has often shown us that through insomnia the most violent manic conditions and similar states are brought down from their peaks (intensities) to a state of relaxation and rest and ultimately to sleep itself; it would be more detrimental to attempt to alleviate the patient's tension forcefully to the point of inducing sleep than to have him remain awake. Therefore, in cases where it is not obvious that irritations which can be removed keep away sleep, it is better, at least in the beginning, to disregard the illeffects but to closely observe its effects. If however one desires to render help, one has to clearly realize the location of the irritation. Sometimes alleviation is brought about by evacuation of the gastro-intestinal tract, at others by blood-letting, or blistering, or a glass of matured wine, which opium and similar drugs rarely do. The diagnostics of the somatic physician teach us how to differentiate." The clinical judgment, diagnostic acumen and therapeutic skill of the author as evidenced in this passage cannot be doubted. In it may be discerned a true psychosomatic approach, and an understanding of what might be paralleled to our modern concept of "homeostasis". SUMMARY This paper consists of a discussion of the early use of the term psychosomatic, emphasizing Heinroth's use of it in 1818, and commienting upon some of his psychological concepts relative to his ideas of body and soul.
REFERENCES 1. ABERNETHY, J.: An Enquiry into the Probability and Rationality of Mr. Hunter's Theory of Life; being the Subject of the First Two Anatomical Lectures Delivered before the Royal College of Surgeons, of London, Longman, Hurst, Rees, Orme & Brown, London, p. 53, 1814. 2. AMDUR, M. K.: Am. J. Psychiat., 100: 205, 1943. 3. Anti-Philostratus: London Med. Repo&, 19: 368, 1823. 4. BALL, B.: La medecine mentale a travers les siecles. Lecon d'ouverture du cours de clinique des maladies mentales (16 novembre 1879), Asselin & Cie, Paris, 1879. 5. BUCKNILL, J. C. AND TUKE, D. H.: A Manual of Psychological Medicine (etc.), John Churchill, London, 4th ed., p. 36, 1879. 6. BUNKER, H. A.: American psychiatric literature during thq past one hundred years; pp. 195-271 in: "One Hundred Years of American Psychiatry". (Published for the American Psychiatric Association). Columbia University Press, New York, p. 197, 1944. 7. DALLEMAGNE, J.: Deg6n6r6s et desequilibres, H. Lamertin, Bruxelles, 1894. Cited by Ref. 8. 8. DUBOIS, P.: The Psychic Treatment of Nervous Disorders. (The Psychoneuroses and Their Moral Treatment). Translated and Edited, by S. E. Jelliffe and W. A. White, Funk & Wagnalls, New York, p. 443, 1905. 9. FARRAR, C. B.: awnad. Hosp., 26: 39, 1949; Am. T. Inan., 66: 277, 1909. 10. FRIEDREIcH, J. B.: Historisch-kritische Darstellung der Theorien tiber das Wesen- und den Sitz der psychischen Krankheiten, 0. Wigand, Leipzig, p. 301, 1836. 11. GRoos, F.: Entwurf einer philosophischen Grundlage fUr die Lehre von den Geisteskrankheiten, Karl Groos, Heidelberg und Leipzig, p. 92, 1828. 12. HAESER, H.: Lehrbuch der Geschichte der Medicin und der Epidemischen Krankheiten, Hermann Dufft, Jena, 2: p. 1034, 1875, 1881. 13. HEINROTH, J. C. A.: Lehrhuch der St6rungen des Seelenlebens oder der Seelenstorungen und ihrer Behandlung, F. C. W. Vogel, Leipzig, part 2, para. 313, p. 49, 1818. 14. IDELER, K. W.: Grundriss der Seelenheilkunde, T. C. F. Enslin, Berlin, 2: 113, 1835, 1838. 15. JACOBI, K. W. M.: (a) Sammlungen fUr die Heilkunde der Gemuthskrankheiten, Schonian, Elberfeld, vol. 1: p. VII and p. 91, and vol. 3. (b) Fortgesetzte Er6- rterungen zur Begrundung der somatisch-psychischen Heilkunde, Zeitschr, f. d. Beurtheilung and Heilung der krankhaften Seelenzustande, 1: 34-118, 1838. 16. KORNFELD, S.: Geschichte der Psychiatrie, "Handbuch der Geschichte der Medizin", Begrilndet von Th. Puschmann, Gustav Fischer, Jena, 3: 675, 1905. 17. KRAFFT-EBING, R. VON: (a) Lehrhuch der Psychiatrie auf klinischer Grundlage fur Praktische Arzte und Studierende. Siebente vermehrte und verbesserte Auflage. Ferdinand Enke, Stuttgart, p. 40, 1903. (b) Textbook of Insanity Based on Clinical Observations for Practitioners and Students of Medicine. Translated by Chaddock, C. G., F. A. Davis Co., Philadelphia, p. 44, 1904. 18. LASGUE, E. C. AND MOREL, B. A.: Ann. med.-p,sychol., 4: 1 and 157, 1844. 19. LEIDESDORF', M.: Lehrbuch der psychischen Krankheiten. Zweite, umgearbeitete und wesentlich vermehrte Auflage der Pathologie und Therapie der Psychischen Krankheiten (1860-E.L.M.) Ferdinand Enke, Erlangen, 1865. 20. LEURET, F.: Du traitement moral de la folie, J.-B. Baillie6re, Paris, p. 146, 1840. 21. LEUPOLDT, J. M.: Erlangen, 1833. 22. LEWIN, B. D.: Imago, 14: 441, 1928. 23. LEwis, N. D. C.: A Short History of Psychiatric Achievement with a Forecast for the Future, W. W. Norton & Co., New York, p. 92, 1941. 24. NAssE, F.: (a) Zeitschr. f. d. Beurtheilung und Heilung der krankh,aften Seelenzustdnde, 1: 1, 1838. (b) Zeitschr. f. Psychische Aerzte., 5: 1, 1822. 25. NEUBURGER, M.: Bull. Hist. Med., 18: 121, 1945. 26. OVERHOLSTER, W.: Ment. Hyg., 32: 226, 1948. 27. Philostratus (pseudonym of Thomas Forster): Somatopsychonoologia, R. Hunter, London, 1823. 28. PRICHARD, J. C.: A Treatise on Insanity and Other Disorders Affecting the Mind, Sherwood, Gilbert and Piper, London, p. 236, 1835. 29. SCHULE, H.: Handbuch der Geisteskrankheiten. Zweite umgeiinderte Auflage, F. C. W. Vogel, Leipzig, 1880. 30. TANZI, E.: A Textbook of Mental Diseases, translated from the Italian by Robertson, W. F. and Mackenzie, T. C., Rebman Co., New York, p. 773, 1909. 31. TUKE, D. H. (Editor): A Dictionary of Psychological Medicine, (etc.) J. & A. Churchill, London, 1: 231, 545, 1892. 32. ZILBOORG, G.: (a) A History of Medical Psychology, W. W. Norton & Co., New York, p. 470, 1941. (b) J. Nerv. & Meat. Dis., 98: 414, 1943. (c) Psychosom. Med., 6: 3, 1944. Dr. Alfred Cox Dr. Alfred Cox, formerly Secretary of the British Medical Association, has written the story of his life in his own straight-forward fashion.* It is a story that should appeal to doctors everywhere, since almost his whole professional life has been devoted to the idea of having doctors work together for the good of their patients as well as their own. One might say that from his earliest days he seemed predestined to be a secretary and organizer. He came into medicine the hard way. First he was an unqualified assistant, then graduated after four years of study at the University of Durham serving during these years as dispenser-assistant to a physician for his board, lodging and £1 a month. After graduation came general practice in Gateshead just over the river from Newcastle. He succeeded in forming the first Gateshead Medical Association
- Among the Doctors. Alfred Cox, formerly Medical Secretary of the British Medical Association, 224 pp.$3.00. Christopher Johnson, London W.C.1, 1950. The Ryerson Press, Toronto.
Sigmund Freud famously studied psychosomatic illnesses, which informed his theories of the unconscious mind and repression. Many identifiable illnesses have previously been labelled as 'hysterical' or 'psychosomatic', for example asthma, allergies, false pregnancy, and migraines. Some illnesses are under debate, including multiple chemical sensitivity, Gulf War syndrome, and chronic fatigue syndrome. Some people suggest that stigmatics suffer a psychosomatic illness based on identifying with the biblical crucified Jesus. Image File history File links Download high resolution version (1092x1536, 712 KB) Summary Sigmund Freud Published in the U.S. after 1923, but public domain because copyright was not renewed. ...
Image File history File links Download high resolution version (1092x1536, 712 KB) Summary Sigmund Freud Published in the U.S. after 1923, but public domain because copyright was not renewed. ...
Sigmund Freud (IPA: ), born Sigismund Schlomo Freud (May 6, 1856 – September 23, 1939), was an Austrian neurologist and psychiatrist who co-founded the psychoanalytic school of psychology. ...
This article does not adequately cite its references or sources. ...
Psychological repression, or simply repression, is the psychological act of excluding desires and impulses (wishes, fantasies or feelings) from ones consciousness and attempting to hold or subdue them in the subconscious. ...
Hysteria is a diagnostic label applied to a state of mind, one of unmanageable fear or emotional excesses. ...
This article needs cleanup. ...
False pregnancy, also known as pseudopregnancy or pseudocyesis, is a psychological condition causing a woman to believe she is pregnant. ...
Multiple chemical sensitivity (MCS) is described as a chronic condition characterized by a patients belief that they are experiencing several adverse and variable affects from exposure to otherwise low levels of multiple chemicals in modern human environments. ...
Gulf War syndrome (GWS) or Gulf War illness (GWI) is the name given to an illness with symptoms including increases in the rate of immune system disorders and birth defects, reported by combat veterans of the 1991 Persian Gulf War. ...
Chronic fatigue syndrome (CFS) is one of several names given to a poorly understood, highly debilitating disorder of uncertain cause, which is thought to affect approximately 4 per 1,000 adults[1] in the United States and other industrialized countries, and a smaller fraction of adolescents. ...
Francis of Assisi, an early stigmatic. ...
Modern connotations The term "psychosomatic" has developed a negative connotation in modern medicine, being confused with malingering, mental illness or outright fakery. Psychosomatic pain is difficult to differentiate from the above conditions but actual psychosomatic pain is real pain caused by unconscious mind rather than symptoms of illness or injury. Psychosomatic illness can result from problems with relationships, stress or other non-physical causes, often influenced by external factors or individuals. Malingering is a medical and psychological term that refers to an individual fabricating or exaggerating the symptoms of mental or physical disorders for a variety of motives, including getting financial compensation (often tied to fraud), avoiding work, obtaining drugs, getting lighter criminal sentences, or simply to attract attention or sympathy. ...
A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ...
This article does not adequately cite its references or sources. ...
This article needs more context around or a better explanation of technical details to make it more accessible to general readers and technical readers outside the specialty, without removing technical details. ...
This article does not cite any references or sources. ...
In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ...
Treatment Various types of psychotherapy and alternative therapies are used to treat psychosomatic disorders. In some cases, psychosomatic problems may improve or disappear following suggestion by a recognized authority. Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. ...
Alternative medicine is defined as any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula taught in the United States and Britain.[1] Complementary medicine is defined as any of the practices (as acupuncture) of alternative medicine accepted...
Treatment is typically anti-anxiety medications and/or anti-depressants in conjuntion with therapy of some kind. Unlike hypochondria (which some mistakenly think is the same thing as psychosomatic illness), sufferers of a psychosomatic illness are experiencing real pain, real nausea, or other real physically felt symptoms, but with no diagnosable cause. Hypochondria (or hypochondriasis, sometimes referred to as health anxiety/health phobia) refers to an excessive preoccupation or worry about having a serious illness. ...
Diagnosing psychosomatic illness is simple, yet most doctors don't do it. A doctor can diagnose it simply by prescribing 2-3 low level tranquilizers and tell the patient to take them the next time the pain (or associated symptom) is happening - if the symptom goes away, it is a physical presentation of high stress, if it doesnt go away, the patient should begin seeing specialists who can look for a more hard to find rare condition.
See also Illness as Metaphor is a nonfiction work written by Susan Sontag and published in 1978. ...
This article is considered orphaned, since there are very few or no other articles that link to this one. ...
For other uses, see Placebo (disambiguation). ...
// In its original application, nocebo had a very specific meaning in the medical domains of pharmacology, and nosology, and aetiology. ...
The technical term placebo is precisely applied in the specialized medical domains of pharmacology, nosology, and aetiology to denote the pharmacologically inert, dummy simulator of an active drug that serves as a scientific control in clinical trials designed to determine the clinical efficacy of that particular drug. ...
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