Q J Med 2003; 96: 617-621
© 2003 Association of Physicians
Editorial |
The emotional dimension and the biological paradigm of illness: time for a change
| The first 150 words of the full text of this article appear below. |
Physicians love numbers and pictures of their patients. They make clinical problems more tangible, and decisions less complex and uncertain. Consider an elderly man with haemoglobin 9 g/dl and mean corpuscular volume 70 fl, a woman who has had a myocardial infarction, and has an ejection fraction of 25%, or a jaundiced patient whose common bile duct is dilated to 13 mm on abdominal ultrasound. Immediately the differential of iron deficiency anaemia, the many therapeutic approaches to ischaemic dilated cardiomyopathy, or the causes of painless common bile duct obstruction, come to mind. However, data that cannot be easily quantified, imaged or brought under the microscope are all too often neglected. Yet psychological factors contribute significantly to the pathogenesis of medical illnesses, affect their course and may be a target for effective intervention.
Does the patient suffer from depression, anxiety or stress? Is the patient hopeful, optimistic? Is the patient alone,
Hadassah Medical School Jerusalem e-mail: amimd@clalit.org.il
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