Medical psychology

The Medical psychology deals with the phenomenon of illness and health. She asks how the disease developed. Psychological therapy is used to cope with illness and interacts with other medical specialties.

What is Medical Psychology?

Medical psychology deals with the phenomenon of illness and health. It asks about how the disease develops and is an application-oriented sub-discipline of clinical psychology.

Medical psychology is an independent and application-oriented sub-discipline of clinical psychology that operates within human medicine. The specialist area is represented structurally and in terms of content in teaching and research as well as in patient care as an institute, department and personnel.

In addition to medical sociology, this sub-discipline is a compulsory subject in the first semester of medical studies in accordance with the Medical Licensing Regulations (ÄAppoO). The "German Society for Medical Psychology" (DGMP), founded in 1979, is the scientific specialist society for all medical professionals working in this field.

Treatments & therapies

The focus is on the doctor-patient relationship. Other important topics are communication between doctor and patient, coping with illness, quality of life, prevention, health promotion, rehabilitation, developmental psychology, behavioral research, social psychology, medical intervention, psychosocial health care research and the psychobiological context.

In order to find the right therapeutic approach, the first step in medical psychology is to define the term disease, which is used to describe the presence of symptoms that lead to a deviation in the psychological balance. The deviation from a norm (controlled variable) is also defined as a disease that can lead to external or internal damage. Deviations from an organ function, a controlled variable, an organ structure or a psychological balance are difficult to diagnose. In the second step, medical psychology asks about health. A person is healthy when he is in mental and physical balance.

Her social environment and living conditions allow her to realize her goals according to her own possibilities. There is a subjective and objective well-being. Medical psychology plays an important role in medical training and asks about the connections between physiological and psychological relationships in order to better understand the resulting clinical processes. The elementary finding of this subject is that health always means the absence of disease. Medical psychology is closely related to medical sociology. The ideal norm is the desired target value, while the therapeutic norm sees suitability for everyday use and the need for treatment in abnormal conditions.

According to the statistical norm, what is average is normal. The patient experiences his illness subjectively as a limitation (continuum) of his ability to act and his well-being. The perception arises from posture (interoception) and body movement (proprioception), from the internal organs (visceroception) and from a state of pain (nociception). Symptoms are influenced by emotional, cognitive, and motivational variables. The quality of life depends on how highly the individual rates it. Indeed, there may be a disease state. However, there is also the possibility of the subjective disease theory, which the person concerned develops from the symptoms.

He implicitly (preconsciously) creates a theory about the clinical picture, the causes (lay etiology, causal attribution), the course of the disease, the consequences and treatment methods. Medical psychology takes up the subjective disease theory because it influences the behavior and experience of the patient. The spectrum ranges from hypochondria to indolence (insensitivity to pain). Symptoms and complaints are determined by the actor-observer approach. Medical psychology makes the attribution of causes more effective by empathizing with the other person.

The higher a person rates their self-efficacy expectation, the more likely they are to show behavioral problems if it turns out that they cannot cope with a certain situation with their own resources. Women are more likely to suffer from somatization disorders and depression, while men often have personality disorders and respond to psychological stress with heart attacks.

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Diagnosis & examination methods

Diagnosis and assessment are not easy, because the discrepancy between the patient's subjective feeling of illness and an actually medically determined illness can vary widely (dichotomy). On the way to the diagnosis, the psychologist has to compare the available data with the norms in order to determine whether a real illness is present or whether the patient only imagines it based on his subjective feelings.

Since at this moment his psychological, physical and social feelings are out of balance, there is already an illness in the psychological sense that must be treated. The collection of data is simple because the doctor asks the patient about their medical history (anamnesis), subjects them to a physiological examination, observes their behavior and consults modern technical aids such as diagnostic imaging. He then summarizes the identified symptoms into syndromes that lead to a final finding. Multi-axial classification systems enable criteria-oriented, operational and categorical diagnostics.

The findings are coded according to a classification key that facilitates documentation. The 3-axis ICD (International Classification of Diseases, Accidents and Deaths) covers 3,500 diseases in 21 categories and lists social functional restrictions and abnormal psychosocial situations. A practical and descriptive (atheoretical, descriptive) approach is taken, with classification based on symptoms rather than etiology.

The 5-axis DSM-IV-TR classification annually lists the static and diagnostic psychological disorders, which are classified according to clinical findings, psychosocial problems, medical disease factors, personality disorders and the global assessment of the functional level. The conclusion from these classifications is that the objective findings by the psychologist and the subjective condition of the patient can diverge. According to this classification, there are healthy patients who subjectively perceive themselves to be healthy, but who are objectively ill according to a reliable finding. The second group are sick healthy people who have the subjective feeling that they feel sick, but are actually healthy because the physiological and psychological examination could not establish any reliable findings.

The life situation, behavioral expectations and the social environment play a major role in therapy. Psychiatric illnesses are still subject to discrimination. Mentally ill people are often not taken seriously by their environment and are classified as slackers and lazy people when they are absent from work. Their illness is interpreted as a character weakness and a lack of discipline. This attitude has a lasting effect on the therapy and the self-esteem of the patient.