Medical psychology deals with the phenomenon of disease and health. It asks about the origin of disease. Psychological therapy is used to manage illness and interacts with other medical specialties.
What is medical psychology?
Medical psychology deals with the phenomenon of illness and health. It inquires into the origins of illness and is an application-oriented subdiscipline of clinical psychology. Medical psychology is an independent and application-oriented sub-discipline of clinical psychology that operates within human medicine. The discipline is represented in teaching and research as well as in patient care structurally and in terms of content 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 according to the Approbation Ordinance for Physicians (ÄAppoO). The “German Society for Medical Psychology” (DGMP), founded in 1979, is the scientific professional society for all physicians working in this specialty.
Treatments and therapies
The focus is on the doctor-patient relationship. Other important topics include doctor-patient communication, disease management, quality of life, prevention, health promotion, rehabilitation, developmental psychology, behavioral research, social psychology, medical intervention, psychosocial care research, and psychobiological relationships. In order to find the right therapeutic approach, medical psychology first defines the term disease, which refers to the presence of symptoms that lead to a deviation of the psychological balance. Deviation from a norm (control variable) is also defined as a disease, which can lead to external or internal damage. Deviations from an organ function, a control variable, an organ structure or a psychological balance are difficult to diagnose. Medical psychology asks about health in the second step. A person is healthy when he is in psychological 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 insight of this field is that health always means the absence of disease. Medical psychology is closely related to medical sociology. The ideal norm is the desired set point, while the therapeutic norm sees the fitness for daily living and the need for treatment for conditions that are not normal. According to the statistical norm, normal is what is average. The patient experiences his disease subjectively as a limitation (continuum) of his ability to act and his well-being. Perception arises from posture (interoception) and body movement (proprioception), from internal organs (visceroception), and from a pain state (nociception). Symptoms are influenced by emotional, cognitive, and motivational variables. Quality of life depends on how highly the individual values them. In fact, a disease state may be present. However, there is also the possibility of a subjective theory of disease that the sufferer develops from the symptoms. He or she implicitly (preconsciously) constructs a theory about the clinical picture, the causes (lay etiology, causal attribution), the course of the disease, the consequences and methods of treatment. Medical psychology takes up the subjective theory of illness because it affects the patient’s behavior and experience. It ranges widely from hypochondria to indolence (insensitivity to pain). Symptoms and complaints are defined by the actor-observer approach. Medical psychology designs cause attribution more effectively by putting oneself in the other person’s shoes. The higher a person estimates his or her self-efficacy expectation, the more likely it is that behavioral problems will show up if it turns out that he or she cannot cope with a certain situation using his or her 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.
Diagnosis and examination methods
Diagnosis and assessment of findings are not easy, because the discrepancy between the patient’s subjective perception of illness and an actual medically determined illness can be far apart (dichotomy). On the way to diagnosis, the psychologist must compare the available data with the norms in order to determine whether a real illness is present or whether the patient is only imagining it based on his subjective feelings. Since at this moment his psychological, physical and social sensation is out of balance, there is already a disease in the psychological sense, which must be treated. Data collection is simple, as the physician asks the patient about his or her present medical history (anamnesis), subjects him or her to a physiological examination, observes his or her behavior, and consults modern technical aids such as imaging diagnostics. He then groups identified symptoms into syndromes that lead to a final finding. Multiaxial classification systems enable operational and categorical diagnostics based on criteria. Findings are coded according to a classification key that facilitates documentation. The 3-axial ICD (International Classification of Diseases, Accidents, and Deaths) covers 3,500 diseases in 21 categories and lists social functional limitations and abnormal psychosocial situations. A practical and descriptive (atheoretical, descriptive) approach is used, 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 global assessment of functioning level. The conclusion from these classifications is that the objective findings by the psychologist and the subjective findings of the patient may diverge. According to this classification, there are healthy sick people who subjectively feel healthy, but objectively are sick according to a confirmed finding. The second group are sick healthy people, who have the subjective feeling to feel sick, but in fact is healthy, because the physiological and psychological examination could not find a confirmed finding. In therapy, the life situation, behavioral expectations and the social environment play a major role. Psychiatric illnesses are still subject to discrimination. People with mental illnesses are often not taken seriously by their environment and are classified as shirkers and lazybones when they are absent from work. Their illness is interpreted as a weakness of character and a lack of discipline. This attitude has a lasting effect on therapy and the patient’s self-esteem.
