After 4.5 hours of instruction, two dozen mental health clinicians (MHCs) with varied training and experience were able to find the diagnosis in a half-dozen simulated stress illness patients. So I also talked to them about reaching out to medical clinicians to teach them how to explain the following concepts to their patients: (more…)
Posts Tagged ‘Stress History’
Stress Illness and The Health Care System (4)
Wednesday, April 28th, 2010Stress Illness and The Health Care System (3)
Monday, April 26th, 2010After four and a half hours of instruction in how to do a Stress Check-Up (which is an Illness Chronology plus a Stress History), my next question was whether my audience of two dozen mental health professionals could use it to diagnose a “real patient.” So I tested them.
Stress Illness and The Health Care System (2)
Saturday, April 24th, 2010I am slowly figuring out how we might move the existing health care system toward better care of stress illness patients. I learned a lot more yesterday when, for seven hours, I shared ideas with two dozen mental health clinicians who came from a wide range of training backgrounds and professional positions.
Stress Illness and The Health Care System (1)
Thursday, April 22nd, 2010Physical illness caused by psychosocial stress is a clinical dilemma that was known to Hippocrates nearly 2500 years ago. We still don’t have a good solution. Medical clinicians aren’t trained to ask about people’s lives and connect what they find with symptoms. Mental health clinicians don’t see too many patients whose main concern is pain or other body symptoms. But I’m optimistic that in the 21st century will see growing use of good solutions.
The Rosie Factor
Monday, April 19th, 2010Rosie O’Donnell has been a stand-up comic, television actress, film actress, adoptive mother and daytime television talk-show host as well as a singer, author, gay rights activist, magazine editor and philanthropist, giving millions of dollars to a children’s foundation and other charities. Since last November she has hosted a radio show on Sirius/XM where, this morning, I had the chance to inform her listeners about stress illness.
Closing the Blind Spot
Thursday, April 8th, 2010Kauai is a wonderful place to talk about stress, primarily because it is difficult to have any while you are there. Last week I went to the Garden Isle to present my lecture on stress illness to clinicians of a variety of specialties from the Pierce County (Washington State including Tacoma & Mt Rainer) Medical Society. They asked a number of thoughtful questions. They were clearly interested in diagnosing stress illness but felt the need for greater support from mental health clinicians (MHCs) than was available in their community. This referred to the limited number of MHCs and also to MHCs experience evaluating patients with unexplained physical symptoms.
Blood Test for Stress Illness?
Wednesday, March 31st, 2010Bethesda, Maryland. April 1. The Center for Irreproducible Results at the National Institution of Health today announced a stunning breakthrough that is certain to benefit hundreds of millions of patients. Dr. Freddie P. Ignobel reports that she has found a blood test that can reliably confirm when physical symptoms are caused by life stresses and not by a disease of an organ or a metabolic problem.
Stress and Blurred Vision
Thursday, March 25th, 2010For years I would teach medical residents about stress illness by telling the true story of a 16 year old girl who came to clinic with intermittent blurred vision (the full story is in my book). I would ask them to pretend she was in the room and to try to diagnose the cause. They would ask questions about her symptoms and “order” tests and I would give them the results. Very few even got close to the answer though a few, to their credit, were able to look beyond physiology alone and figure out that her vision blurred when she was crying. The crying was from severe depression brought on by regular physical abuse by her father.
Letter to New Medical Students (4)
Thursday, January 28th, 2010In your Clinical Medicine class you will be able to talk to real patients starting next week. They will know you are first year students and will not expect you to be physicians. You will learn that you can take a good medical history from a patient even if you have no clue what to do with the information. This experience highlights the importance of the human qualities you bring to the bedside because you won’t have any medical qualifications at that time.
Smith and Dwamena (2)
Friday, January 22nd, 2010Continuing our review of the Smith and Dwamena paper (1), they describe a spectrum of severity for patients with medically unexplained symptoms (MUS). The few patients who fully meet criteria for Somatoform Disorder (2) are severely ill. The rest range from mild to not quite as severe as those with Somatoform Disorder. The group with mild MUS is the largest. Their symptoms tend to be of short duration, resolve on their own, usually don’t require much medical care and aren’t associated with significant mental health issues. They can be managed with a Stress History (see earlier posts with this tag), observation over time and a minimum of diagnostic tests.
