Definition and Overview

A psychosomatic medicine specialist consultation is an appointment with a psychiatrist who specializes on diagnosing and treating mental problems that affect people who are medically ill. Psychosomatic medicine is one of the more challenging aspects of psychiatry and is recognized as an important part of treatment for patients suffering from chronic diseases.

A psychosomatic medicine consultation may occur between the specialist and the patient or between the specialist and the general physician in charge of the patient’s case. The consultation is the first step to ensuring that patients do not suffer from serious psychological complications caused by their health problems.

Who Should Undergo and Expected Results

A psychosomatic medicine specialist consultation is beneficial for patients suffering from psychiatric problems that may develop due to the emotional and psychological impact of a chronic illness. Dealing with a chronic illness can be challenging in many aspects, causing many patients to experience more than just physical effects but also mental problems, which are heightened as their illness disrupt their lives. This results in additional challenges to the proper management of their illness and may even contribute to the worsening of their condition.

Chronic conditions that may cause psychiatric symptoms include, but are not limited to, the following:

  • Heart disease
  • Stroke
  • Cancer
  • Diabetes
  • Obesity
  • Arthritis
  • Alzheimer’s disease
  • Asthma
  • Cystic fibrosis
  • Chronic obstructive pulmonary disease
  • Osteoporosis

These diseases may cause psychiatric problems such as depression and anxiety disorders. These may cause symptoms such as:

  • Helplessness
  • Feelings of hopelessness
  • Loss of appetite
  • Drastic weight changes
  • Sleep disorders
  • Anger
  • Irritability
  • Loss of energy
  • Reckless behavior
  • Lack of interest in previously enjoyable activities
  • Tiredness
  • Inability to concentrate
  • Aggressiveness
  • Talking about committing suicide

Some individuals also have a tendency to develop a mental illness that stressful life situations such as a chronic illness can easily trigger the said predisposition. These individuals include those who have a genetic predisposition due to a family history of mental illness, those who experienced substance or drug abuse, those who are taking certain types of medications, and those who have weak social support.

A consultation with a psychosomatic medicine specialist is expected to help incorporate a psychiatric treatment plan in the long-term management of the patient’s condition to help manage his psychiatric symptoms.

How the Procedure is Done?

A psychosomatic medicine specialist consultation takes place at the specialist’s office or clinic and usually takes 45 minutes to an hour. If the appointment is between the specialist and the general physician attending to the patient’s case, it is considered as a liaison consultation.

The consultation begins with an interview with the patient or his attending physician. Some specialists also ask the patient to fill up a questionnaire that covers some background information regarding the patient’s condition. The specialist will also ask about any psychiatric symptoms the patient may be experiencing.

In summary, the consultation involves:

  • An evaluation of the patient’s medical history
  • A review of the patient’s family history of mental illness
  • An assessment of the patient’s history of substance abuse
  • An evaluation of the patient’s symptoms
  • An evaluation of previous treatments and medications the patient has received
  • A diagnosis of the specific psychiatric problem that affects the patient

If the specialist requires more information to make a diagnosis, he may request for a more comprehensive psychological examination as well as some lab tests.

At the end of the consultation, the specialist will formulate a treatment plan and prescribe medications if needed. Treatment for psychosomatic problems include:

  • Antidepressants
  • Anti-anxiety medications
  • Mood stabilizers
  • Antipsychotic drugs
  • Psychotherapy
  • Brain stimulation

Patients may also be confined to a hospital or a rehabilitation center for treatment, or to his own home for residential treatment. In some cases, the patient is also advised to join a support group.

From this point on, the specialist will become part of the patient’s primary care team alongside other specialists.

Possible Risks and Complications

Incorporating psychosomatic care in the treatment plan of a patient suffering from a chronic illness can help prevent serious psychological and emotional complications that may arise due to their compromised mental state. These complications include:

  • Problematic relationships
  • Substance addiction
  • Legal problems
  • Self-harm such as suicide
  • Tendency to harm others

On the other hand, if a comorbid patient is showing signs of psychiatric disease but the psychosomatic aspect is left untreated, it can hinder proper treatment and accelerate the deterioration of the patient’s condition.

  • American Psychiatric Association
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