Psychological factors can affect health

Two recent studies demonstrate how psychological factors can affect medical conditions.

The first study, published in the Annuals of Internal Medicine, studied the relationship between diabetes and depression. The author, Dr. Patrick J. Laustman, noted that depression is more common among diabetics than in the general population. Studies have shown that depressed diabetics are more likely than nondepressed diabetics to experience complications such as cardiovascular and ophthalmological complications.

Laustman speculates that depressed diabetic patients are less likely to adhere to lifestyle patterns, such as those that include proper diet and exercise that help reduce diabetic complications. Laustman and his colleagues found that blood sugar levels were significantly decreased in those patients receiving psychotherapy when compared to a control group of patients who received standard care without counseling.

For those who suffer from problems like diabetes, high blood pressure and seizure disorders, adherence to a prescribed treatment is essential. Factors such as depression, stress, and anxiety often interfere with the patient’s ability to comply with medical treatment.

Another study in the Journal Arthritis and Rheumatism suggested that arthritis patients who suffer from anxiety, fatigue and/or depression are more likely than others to experience high levels of arthritis-related pain. Dr. Judith Fisield and associates studied 203 middle-age patients with rheumatoid arthritis and found that those with a history of depressive signs reported higher scores on instruments measuring pain than those with no history or current complaints of anxiety or depression.

Many mental health professionals have reported patients tend to be more “inner directed” and focused on their problems. Less depressed individuals are more apt to be able to “shift” their thoughts to external events and divert their attention away from their experience of pain. According to some mental health professionals, depression tends to magnify the experience of pain, often leaving the patient with the feeling that they have no control over their discomfort.

Following are some of the pain management techniques used by psychologists and other mental health professionals.

• Relaxation training exercises can help reduce muscle tension, divert attention from pain and assist the pain sufferer with feeling more in control of pain.
• Patients can be taught to “reprioritize” and reduce pain by cognitive behavioral psychotherapy techniques.
• Hypnosis can be useful in assisting the patient with pain management control.

Recognizing the relationship between emotions and medical problems is becoming more important in medical education and treatment.

Copyright c 1998 Harold H. LeCrone, Jr., Ph.D.