Balasubramani, N (2011) A Study of Psychiatric Morbidity and Stressful Life Events in Psoriasis. Masters thesis, Thanjavur Medical College, Thanjavur.
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Abstract
Introduction: Psychosomatic medicine emphasizes the unity of mind and body and the Interaction between them. The general notion is that psychological factors are Important in the development of all diseases. The history of psychosomatic Medicine has its roots in ancient beliefs that the body can be affected by External forces. For example, in Bible (Isamuel 5:4-38) ‘Nabal’ has been Regarded the first recorded psychosomatic death from myocardial infarction. ‘Walter canon’ in the early part of the twentieth century conducted first Systematic study of the relation of stress to disease. Harold Wolft, Hans selye, Helen Deutsch, Adolph Mayer, Leven Eisenberg were among the few who Contributed much to the psychosomatic medicine. According to the contemporary psychiatric research, Mind or body Responds not only to biological factors but also to the social factors. Psychosomatic medicine includes a wide range of diseases, but the most Common diseases include those affecting the gastro intestinal, respiratory, Endocrine and cutaneous system. A relationship between dermatological conditions and psychological Factors has long been observed. It has been estimated that approximately a Third of the patients presenting with dermatological disorders have some Psychological comorbidity (Rostenberg, 1960). Several possible mechanisms Explain this association. The dermis and brain share a common embryological Origin. Also, because the skin is exposed to view, dermatological conditions That affect appearance may elicit reaction from other people that has impact on The sufferer (Van moffaert, 1992). The term psychocutaneous disorder describes several distinct psychiatric Disorders in which the skin is affected. Koblenzer (1999) has proposed that These conditions can be loosely grouped into: Psychiatric disorders in which the skin is the focus of symptoms. Dermatological disorders in which psychological distress Contributes to the degree of severity. Psychiatric disorders secondary to chronic dermatological or Disfiguring conditions. SKIN DISORDERS Among the various psychosomatic diseases, skin diseases are the most Important because of the following factors I) Skin does more than presenting one’s face to the world. As our most Ancient interface, skin retains the ability to respond to both Exogenous and endogenous stimuli, sensing and integrating Environmental cues while transmitting intrinsic condition to the Outside world (Richard 1988). Ii) Sulzberger (1983) stated that of all illnesses, skin diseases affect the Mind the most and can be a great handicap in work and social Settings. The recognition and management of psychological factors Have become part of dermatological practice because of the complex Interaction between the skin and psyche. Psoriasis Psoriasis is an inflammatory, non infectious proliferative disease of the Skin characterized by chronic well defined scaly plaques, predominantly on the Extensor aspect of the body and scalp. Incidence may range from 0.1-2.8% (Ginsburg, 1989). The disease can virtually affect any age group. The course of the disease Is unpredictable, but it is usually chronic with exacerbations and remissions. Exact etiology is unknown but the factors involved may be genetic, Biochemical and immunopathological ones. Precipitating factors include Trauma, infection, sunlight, drugs and emotion. Various types like Palmoplantar, psoriasis vulgaris, pustular, guttate, and elephantine and Erythrodermic varieties have been described. Treatment is mainly in the form Of topical steroids, PUVA, methotrexate and tazoretene and retinoids. Although many skin diseases produce psychological morbidity, only Psoriasis is chosen because, I) Prevalence of psychiatric morbidity is high in psoriasis and only Few Indian studies are available. (Mattoo, sharma 2001). Ii) Stressful life events may exacerbate psoriasis, acne, eczema and Urticaria. Among the above mentioned discussions, only psoriasis Has shown consistent association with stress.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Psychiatric Morbidity ; Stressful Life Events ; Psoriasis. |
| Subjects: | MEDICAL > Psychiatry |
| Depositing User: | Subramani R |
| Date Deposited: | 19 Aug 2017 02:40 |
| Last Modified: | 19 Aug 2017 02:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1916 |
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