psychosomatic disorder

Bodily ailment or symptom, caused by mental or emotional disturbance, in which psychological stresses adversely affect physiological (somatic) functioning to the point of distress. Psychosomatic disorders may include hypertension, respiratory ailments, gastrointestinal disturbances, migraine and tension headaches, sexual dysfunctions, and dermatitis. Many patients with psychosomatic conditions respond to a combination of drug therapy and psychotherapy. See also hypochondriasis.

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Any illness with a psychological origin, manifested either in symptoms of emotional distress or in abnormal behaviour. Most mental disorders can be broadly classified as either psychoses or neuroses (see neurosis; psychosis). Psychoses (e.g., schizophrenia and bipolar disorder) are major mental illnesses characterized by severe symptoms such as delusions, hallucinations, and an inability to evaluate reality in an objective manner. Neuroses are less severe and more treatable illnesses, including depression, anxiety, and paranoia as well as obsessive-compulsive disorders and post-traumatic stress disorders. Some mental disorders, such as Alzheimer disease, are clearly caused by organic disease of the brain, but the causes of most others are either unknown or not yet verified. Schizophrenia appears to be partly caused by inherited genetic factors. Some mood disorders, such as mania and depression, may be caused by imbalances of certain neurotransmitters in the brain; they are treatable by drugs that act to correct these imbalances (see psychopharmacology). Neuroses often appear to be caused by psychological factors such as emotional deprivation, frustration, or abuse during childhood, and they may be treated through psychotherapy. Certain neuroses, particularly the anxiety disorders known as phobias, may represent maladaptive responses built up into the human equivalent of conditioned reflexes.

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Abnormality or disease of the prostate gland. About half of all men over 60 have some nonmalignant enlargement, or benign prostatic hyperplasia (BPH). The gland may eventually compress the urethra, causing problems urinating. Severe cases can lead to infection, bladder stones, obstruction, and kidney failure. Prostate cancer, also found mainly in older men, can be deadly but usually grows so slowly that most patients die of something else before the cancer spreads. Since surgery and radiation therapy often lead to incontinence and impotence, many cases are monitored (through prostate-specific antigen, or PSA, tests) and treated only if necessary. Gonorrhea and other bacterial infections involving the prostate are treated with antibiotics.

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Psychological reaction occurring after a highly stressful event and typically characterized by flashbacks, recurrent nightmares, and avoidance of reminders of the event; depression and anxiety are often present. Traumatic events that can lead to PTSD include automobile accidents, rape or assault, military combat, torture, and such natural disasters as floods, fires, or earthquakes. Long-term effects can include marital and family problems, difficulties at work, and abuse of alcohol and other drugs. Antidepressant medication and psychotherapy, including group therapy, are used in treating the disorder.

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Mental disorder that is marked by deeply ingrained and lasting patterns of inflexible, maladaptive, or antisocial behaviour to the degree that an individual's social or occupational functioning is impaired. Rather than being illnesses, personality disorders are enduring and pervasive features of the personality that deviate markedly from the cultural norm. They include the dependent, histrionic, narcissistic, obsessive-compulsive, antisocial, avoidant, borderline (unstable), paranoid, and schizoid types. The causes appear to be both hereditary and environmental. The most effective treatment combines behavioral and psychotherapeutic therapies (see behaviour therapy; psychotherapy).

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Mental disorder in which an individual experiences obsessions or compulsions, either singly or together. An obsession is a persistent disturbing preoccupation with an unreasonable idea or feeling (such as of being contaminated through shaking hands with someone). A compulsion is an irresistible impulse to perform an irrational act (such as repeatedly washing the hands). The two phenomena are usually, but not always, linked in the obsessive-compulsive person. Onset of the illness has been linked to malregulation of the neurotransmitter serotonin as well as to the ill effects of high stress.

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formerly multiple personality disorder

Rare condition indicated by the absence of a clear and comprehensive identity. In most cases two or more independent and distinct personality systems develop in the same individual. Each personality may alternately inhabit the person's conscious awareness to the exclusion of the others, but one is usually dominant. The various personalities typically differ from one another in outlook, temperament, and body language and might assume different first names. The condition is generally viewed as resulting from dissociative mental processes—that is, the splitting off from conscious awareness and control of thoughts, feelings, memories, and other mental components in response to situations that are painful, disturbing, or somehow unacceptable to the person experiencing them. Treatment is aimed at integrating the disparate personalities back into a single and unified personality.

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formerly hysteria

In psychology, a neurosis marked by extreme emotional excitability and disturbances of psychic, sensory, vasomotor, and visceral functions. The earlier concept of hysteria was used frequently in the first half of the 20th century to explain a wide variety of symptoms and behaviours observed particularly in women. (The term hysteria derives from the Greek word for womb, reflecting the Greeks' belief that the condition resulted from disturbances of the uterus.) Disorders with symptoms similar to those of conversion disorder include factitious disorder, dissociative identity disorder, and personality disorder (histrionic type).

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A large group of disorders arising during development that cause abnormality of the human body. Most are due to genetic factors such as inherited or spontaneous mutations, whereas others are caused by environmental influences during pregnancy such as exposure to harmful chemicals. The most severe and lethal disorders arise during the first 28 days of development and include gross brain anomalies and heart defects. The mildest malformations occur in the late stages of development and are often the result of dominant inheritance, whereas complex congenital syndromes are often the result of recessive inheritance. Seealso birth defect; Down syndrome.

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Syndrome caused by chromosome abnormality. Normally, humans have 23 pairs of chromosomes, including one pair of sex chromosomes. Any variation from this pattern causes abnormalities. A chromosome may be duplicated (trisomy) or absent (monosomy); one or more extra full sets of chromosomes can be present (see ploidy); or part of a chromosome may be missing (deletion) or transferred to another (translocation). Resulting disorders include Down syndrome, intellectual disability, heart malformation, abnormal sexual development, malignancies, and sex-chromosome disorders (e.g., Turner syndrome, Klinefelter syndrome). Chromosomal disorders occur in 0.5percnt of births; many can now be diagnosed before birth by amniocentesis.

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or manic-depressive psychosis

Mental illness characterized by the alternation of manic and depressive states. Depression is the more common symptom, and many patients experience only a brief period of overoptimism and mild euphoria during the manic phase. The condition, which seems to be inheritable, probably arises from malregulation of the amines norepinephrine, dopamine, and 5-hydroxytryptamine. It is most commonly treated with lithium carbonate.

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formerly hyperactivity

Behavioral syndrome in children, whose major symptoms are inattention and distractibility, restlessness, inability to sit still, and difficulty concentrating on one thing for any period of time. It occurs in about 5percnt of all schoolchildren, and it is three times more common in boys than in girls. It can adversely affect learning, though many children with ADD can learn to control their behaviour sufficiently to perform satisfactorily in school. It appears to be caused by a combination of genetic and environmental factors. Certain aspects of the syndrome may persist into adulthood. Treatment usually entails counseling and close parental supervision, and it may also include prescription medication.

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Mental disorder characterized by dramatic changes or extremes of mood. Affective disorders may include manic or depressive episodes less severe than those of bipolar disorder, such as anxiety and depression. Symptoms include elevated, expansive, or irritable moods, with hyperactivity, pressured (rapid and forced) speech, and inflated self-esteem; or dejected moods, characterized by lack of interest in life, sleep disturbances, agitation, and feelings of worthlessness or guilt.

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Pica is a medical disorder characterized by an appetite for largely non-nutritive substances (e.g., coal, soil, feces, chalk, paper, soap, ash, etc.) or an abnormal appetite for some things that may be considered foods, such as food ingredients (e.g., flour, raw potato, starch, ice cubes). In order for these actions to be considered pica, they must persist for more than one month at an age where eating such objects is considered developmentally inappropriate. The condition's name comes from the Latin word for magpie, a bird which is reputed to eat almost anything Pica is seen in all ages, particularly in pregnant women and small children, especially among children who are developmentally disabled, where it is the most common eating disorder

Pica in children, while common, can be dangerous. Children eating painted plaster containing lead may suffer brain damage from lead poisoning. There is a similar risk from eating dirt near roads that existed prior to the phaseout of tetra-ethyl lead in gasoline or prior to the cessation of the use of contaminated oil (either used, or containing toxic PCBs or dioxin) to settle dust. In addition to poisoning, there is also a much greater risk of gastro-intestinal obstruction or tearing in the stomach. This is also true in animals. Another risk of dirt eating is the possible ingestion of animal feces and the accompanying parasites.


The scant research that has been done on the root causes of pica suggests that the majority of those afflicted tend to suffer some biochemical deficiency, and more often, iron deficiency. The association between pica and iron deficiency anemia is so strong that most patients with iron deficiency will admit to some form of pica. Often the substance eaten by those with the disorder contains the mineral of deficiency. If a mineral deficiency is not identified as the cause of pica, it often leads to a diagnosis of a mental disorder.

Pica may also be a symptom of iron deficiency anemia secondary to hookworm infection. Symptoms may also include a pinkish hue to the skin, particularly around the mouth.

Unlike in humans, in dogs or cats, pica may be a sign of immune-mediated hemolytic anemia, especially when it involves eating substances such as tile grout, concrete dust, and sand. Dogs exhibiting this form of pica should be tested for anemia with a CBC or at least hematocrit levels.


Treatment emphasizes psychosocial, environmental, and family guidance approaches. Treatment options include: discrimination training between edible and inedible items, self-protection devices that prohibit placement of objects in the mouth, sensory reinforcement involving screening (covering eyes briefly), contingent aversive oral taste (lemon), contingent aversive smell sensation (ammonia), contingent aversive physical sensation (water mist), brief physical restraint, and overcorrection (punishment when child eats non-food items).

This involves associating negative consequences with eating non-food items and good consequences with normal behavior. Medications may be helpful in reducing the abnormal eating behavior if pica occurs in the course of a developmental disorder, such as mental retardation or pervasive developmental disorder. These conditions may be associated with severe behavioral disturbances, including pica. These medications enhance dopaminergic functioning, which is believed to be associated with the occurrence of pica.


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