Classified as a "conversion disorder" by the DSM-IV, a psychogenic disease is a disease in which mental stressors cause physical symptoms of different diseases. The manifestation of physical symptoms without biologically identifiable causes results from disruptions of processes in the brain from psychological stress. During a psychogenic disease, neuroimaging has shown that neural circuits affecting functions such as emotion, executive functioning, perception, movement, and volition are inhibited. These disruptions become strong enough to prevent the brain from voluntarily allowing certain actions (e.g. moving a limb). When the brain is unable to signal to the body to perform an action voluntarily, physical symptoms of a disease are presented even though there is no biological identifiable cause.
Examples of diseases that are believed by many to be psychogenic include
psychogenic seizures
Psychogenic non-epileptic seizures (PNES) are events resembling an epileptic seizure, but without the characteristic electrical discharges associated with epilepsy. PNES fall under the category of disorders known as functional neurological disor ...
,
psychogenic polydipsia,
psychogenic tremor, and
psychogenic pain
Psychogenic pain is physical pain that is caused, increased, or prolonged by mental, emotional, or behavioral factors.
Headache, back pain, or stomach pain are some of the most common types of psychogenic pain. Commonly it accompanies or is indu ...
.
The term ''psychogenic disease'' is often used in a similar way to ''
psychosomatic
A somatic symptom disorder, formerly known as a somatoform disorder,(2013) asthma
Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...
can be exacerbated by
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
).
Diagnosis
With the advent of medical screening technologies, such as electroencephalography (EEG) monitoring, psychogenic diseases are becoming much more common as medical professionals have increasingly precise tools to monitor patients.
When a patient does not display typical markers of a disorder that could show up from medical exams, physicians typically diagnose a patient's symptoms as being psychogenic. Research into understanding psychogenic disorders has led to the development of both electronic diagnostic tests for ruling out the usual biological markers of a disorder and new clinical observation procedures. An example of something a physician would look for when testing for psychogenic symptoms is if the symptom changes with suggestion (e.g. a patient is told to use a tuning fork to aid symptoms in a movement disorder).
Despite the understanding of psychogenic symptoms, there are some problems with the assumption that all medically unexplained illness must have a psychological cause. It remains possible that
genetic, biochemical,
electrophysiological
Electrophysiology (from Greek , ''ēlektron'', "amber" etymology of "electron"">Electron#Etymology">etymology of "electron" , ''physis'', "nature, origin"; and , ''-logia'') is the branch of physiology that studies the electrical properties of bi ...
, or other abnormalities may be present which we do not have the technology or background to identify.
Some patients may also have their symptoms diagnosed as psychogenic even with a lack of evidence to suggest there are psychological causes. Misdiagnoses of psychogenic disease may be simply accidental, but they can also come from bias. For example, a doctor with a bias towards men may tell women that their symptoms are psychogenic, despite them being actual symptoms for a physical disease. This would then be contrasted with a man experiencing the same symptoms being treated differently, with the physical disease being detected.
See also
*
Functional symptom
A functional symptom is a medicine, medical symptom with no known physical cause. In other words, there is no structural or pathologically defined disease to explain the symptom. The use of the term 'functional symptom' does not assume Psychogen ...
*
Habit cough A habit cough is a chronic cough that has no underlying organic cause or medical diagnosis, and does not respond to conventional medical treatment. This is sometimes called tic cough, somatic cough syndrome and previously psychogenic cough, but with ...
*
Mass psychogenic illness
Mass psychogenic illness (MPI), also called mass sociogenic illness, mass psychogenic disorder, epidemic hysteria, or mass hysteria, involves the spread of illness symptoms through a population where there is no infectious agent responsible for c ...
*
Psychogenic amnesia
Psychogenic amnesia or dissociative amnesia is a memory disorder characterized by sudden retrograde episodic memory loss, said to occur for a period of time ranging from hours to years to decades. More recently, "dissociative amnesia" has been d ...
*
Psychological trauma
Psychological trauma, mental trauma or psychotrauma is an emotional response to a distressing event or series of events, such as accidents, rape, or natural disasters. Reactions such as psychological shock and psychological denial are typical. ...
*
Psychoneuroimmunology
Psychoneuroimmunology (PNI), also referred to as psychoendoneuroimmunology (PENI) or psychoneuroendocrinoimmunology (PNEI), is the study of the interaction between psychological processes and the nervous and immune systems of the human body. It is ...
References
{{Reflist, refs=
[Benbadis, S. R. (2005). The problem of psychogenic symptoms: is the psychiatric community in denial?. Epilepsy & Behavior, 6(1), 9-14.]
[Stonnington, C. M., Barry, J. J., & Fisher, R. S. (2006). Conversion disorder. American Journal of Psychiatry, 163(9), 1510-1517.]
[Biddle, C., Fallavollita, J. A., Homish, G. G., & Orom, H. (2019). Gender bias in clinical decision making emerges when patients with coronary heart disease symptoms also have psychological symptoms. Heart & Lung, 48(4), 331-338]
[Functional (Psychogenic) Movement Disorders. (2019). Baylor College of Medicine. https://www.bcm.edu/healthcare/specialties/neurology/parkinsons-disease-and-movement-disorders/psychogenic-movement-disorders#:~:text=There%20is%20no%20blood%20test%20or%20any%20other]
Further reading
* Lim, Erle C. H.; Seet, Raymond C. S. (2007). "What Is the Place for Placebo in the Management of Psychogenic Disease?". Journal of the Royal Society of Medicine. 100 (2): 60–61. doi:10.1258/jrsm.100.2.60. PMC 1790983. PMID 17277261.
* Sykes, Richard (2010). "Medically Unexplained Symptoms and the Siren 'Psychogenic Inference'". Philosophy, Psychiatry, & Psychology. 17 (4): 289–299. doi:10.1353/ppp.2010.0034. ISSN 1086-3303
*
Jannini, E. A., McCabe, M. P., Salonia, A., Montorsi, F., & Sachs, B. D. (2010). Controversies in sexual medicine: Organic vs. psychogenic? The Manichean diagnosis in sexual medicine. The journal of sexual medicine, 7(5), 1726–1733.
* Colligan, M. J. (1981). Mass psychogenic illness: Some clarification and perspectives. Journal of Occupational Medicine, 23(9), 635–638.
* Bransfield, R. C., & Friedman, K. J. (2019, December). Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty. In Healthcare (Vol. 7, No. 4, p. 114). Multidisciplinary Digital Publishing Institute.
Behavioural sciences
Types of mental disorders
Mind–body interventions