Psychological Medicine: Integrating Psychological Knowledge Into Medical Assessment

Psychological research has much to offer to the medical assessment.

This post is inspired by the general concerns (and my own concerns) about the overuse and misuse of medication. So what alternatives are there? Psychological medicine is a term for the integration of psychological knowledge into the general medical assessment and treatment.

The idea of psychological medicine is to improve the medical care of patients by paying more attention to the psychological aspects of a medical condition.

Kurt Kroene (2002), a professor of medicine, empashizes that up to 30% of patients who go to their doctors for the relief of physical symptoms have co-existing psychological disorders such as depression and anxiety.

We tend to view the mind and body as two separated entities, but the validity of this dualism should be reconsidered. Sometimes physical symptoms are the consequence of mental conditions, but it is often the other way around as well so that physical symptoms increase the risk of mental disorders.

Physical symptoms account for most of the visits to doctors, but one-third of these symptoms cannot be explained medically. On the basis of this fact, the need to look at psychological aspects is prominent. Our understanding of a number of subjective health complaints are vague, and the respective contributions of psychological and physical factors are not known or clarified.

In fact, this is the case for all medically unexplained symptoms, and here is just mentioned a few of them: fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, and multiple chemical sensitivity.

Psychological medicine does not imply a paradigm that all medical disorders should be considered as psychological. In fact, the majority of patients prefer to have a medical problem rather than a psychological one.

Integrating psychological aspects into the medical assessment could be done in different ways, and here are some of them: Collaborative care, where the symptoms of a patient is seen by a doctor as well as a psychiatrist.

Stepped care is yet another alternative, in which patients are referred to a psychiatrist, when they do not respond to ordinary medical treatment. The integration of psychological aspects leads to obvious symptomatic improvements in the patients, but it also seems to improve quality of life, social and work functioning.

It is also associated with greater satisfaction by the patient as well as the doctor because the doctor does not get frustrated about the lack of improvements from medical treatment.

In order to facilitate an integration, the resources and time spent on each patient should be adapted so that the patients with common colds are treated quickly, and those with more demanding conditions (e.g. medically  unexplained symptoms) get more consultation than the usual 10-15 minutes so that a possible referral can take place.

Image: Truthout