Psychological factors affecting other medical conditions: Clinical features, assessment, and diagnosis
- James L Levenson, MD
James L Levenson, MD
- Professor of Psychiatry, Medicine, and Surgery
- Virginia Commonwealth University School of Medicine
Psychological factors affecting other medical conditions (PFAOMC) is a disorder that is diagnosed when a general medical condition is adversely affected by psychological or behavioral factors; the factors may precipitate or exacerbate the medical condition, interfere with treatment, or contribute to morbidity and mortality . In addition, the factors are not part of another mental disorder (eg, unipolar major depression).
Virtually all medical illnesses are potentially affected by psychological and behavioral factors (as well as social and environmental factors, such as employment status, poverty, relationships, and neighborhood). Variation in how patients respond to medical illnesses and hospitalization appears to be due at least in part to psychological factors . Hippocrates wrote that “It is more important to know what sort of person has a disease than what sort of disease a person has” .
PFAOMC emphasizes one causal direction in the interactions between mind and body, that is, the effects of psychological factors on general medical conditions. In most patients with medical conditions, there are also effects in the other direction (ie, medical illnesses affect psychological function).
This topic reviews the epidemiology, pathogenesis, clinical features, assessment, diagnosis, and differential diagnosis of PFAOMC. Management of PFAOMC is discussed separately. (See "Psychological factors affecting other medical conditions: Management".)
The prevalence of psychological factors affecting other medical conditions (PFAOMC) is not clear because the disorder describes many possible interactions between a wide range of psychological traits, states, and behaviors, and the full range of general medical diseases. The prevalence may be large:
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- CLINICAL FEATURES
- Type of psychological factors
- - Regression
- - Anxiety
- - Depression
- - Denial
- - Anger
- - Other
- Course of illness
- When to suspect the disorder
- Initial evaluation
- Diagnostic criteria
- DIFFERENTIAL DIAGNOSIS
- Adjustment disorder
- Conversion disorder
- Illness anxiety disorder
- Mental disorder due to another medical condition
- Somatic symptom disorder