Psychological Factors Affecting Medical Conditions: Introduction | Psychological Factors in Cancer | Psychological Factors and Endocrine Disease | Psychological Factors and Cardiac Disorders | Lifestyle Risk Factors | Psychological Factors and Pulmonary Diseases | Psychological Factors and Rheumatological Disease | Psychological Factors and Gastrointestinal Disorders | Psychological Factors and Dermatological Disorders | Psychological Factors and End-Stage Renal Disease | Conclusion | Key Points | Suggested Readings | References
The fact that psychological factors and psychiatric
disorders may affect the clinical course of medical illness is incontrovertible
and is no longer the topic of serious debate. For example, psychiatric
disorders may negatively affect outcome, increasing adverse events,
length of stay in general hospital patients, and health care costs
(Daumit et al. 2006; Walker et al. 2003).
A striking example is the increased morbidity and mortality associated
with major depression in patients with coronary artery disease (Frasure-Smith et al. 1993). Although most of the consultation-liaison literature
has focused on interrelations between comorbid psychiatric and medical
disorders, a wealth of epidemiological research has identified behavioral
risk factors for the development of medical illness. Behavioral
factors such as cigarette smoking, obesity, alcohol and substance
dependence, and hazardous sexual practices are major causes of premature
death and medical morbidity both in the United States and worldwide.
A description of areas of investigation for classifying the psychological,
behavioral, and social factors that may affect physical health is
presented in Table 24–1.