Psychological Factors Affecting Other Medical Conditions

The DSM-V outlines specific criteria for a person’s symptoms to rise to the level of receiving a diagnosis of psychological factors affecting other medical conditions. These symptoms include:

• The person has a diagnosed medical condition or symptom that is not a mental health disorder.
• The medical condition or symptom is being negatively affected by psychological factors in at least one of the following ways:
  • Around the time the psychological factors emerged, the medical condition developed or was exacerbated, or the individual experienced a delayed recovery, indicating a clear link between the condition and the psychological factors.
  • The psychological factors prevent adequate treatment of the medical condition.
  • The psychological factors lead to additional health risks for the individual.
  • The psychological factors have impacted the development of the medical condition to the point where professional medical attention is required. 

The symptoms of psychological factors affecting other medical conditions can be defined as mild, moderate, severe, or extreme, with the following definitions: 

• Mild: Mild PFAOMC increases the risk of the medical condition worsening. An example would be an individual with high blood pressure not taking their medication.
• Moderate: Moderate PFAOMC actively makes medical conditions worse, such as overwhelming anxiety intensifying asthma attacks.
• Severe: Severe PFAOMC worsens the medical condition to the point where an emergency room visit or hospitalization is necessary. 
• Extreme: Extreme PFAOMC puts the patient’s life at risk. An example would be a patient ignoring the symptoms of a heart attack despite knowing they are occurring or ignoring a tumor and not seeking medical help. 

To be diagnosed with psychological factors affecting other medical conditions, a person can’t have another mental health condition that better explains the adverse medical results. For instance, a person with agoraphobia who refuses to leave their house even when they require medical care would not be eligible for a PFAOMC diagnosis. Somatic symptom disorder, adjustment disorder,³ and illness anxiety disorder⁴ are other differentials.

Psychological factors affecting other medical conditions are not caused by any specific experience or predisposition. Several risk factors may make it more likely that a person navigating the medical system may develop PFAOMC. 

The risk of PFAOMC increases for people with a history of maladaptive health behaviors. These behaviors can include smoking, unsafe sex, avoiding exercise and remaining mostly sedentary, substance use, poor nutrition, and not following a doctor’s recommendations or prescriptions. A history of mental health concerns, particularly depression, dysphoria, anxiety, and suicidal thoughts, can heighten the risk associated with an unhealthy lifestyle.

Other factors

Some psychological factors can be more prevalent in medical settings than others. Researchers have identified more concrete risk factors for the following situations.

Anxiety

Individuals are more likely to experience anxiety that is severe enough to negatively impact their prognosis if:

• They have lost someone close to them.
• The pain level associated with their medical condition is high.
• They have had previous unpleasant experiences in healthcare settings.
• They know other people who have become disabled or died as a result of their medical condition.
• Regression

Regression is a partial or complete return to immature and childlike patterns of behavior, including dependency on others and avoiding responsibilities. Individuals are more likely to experience regression that rises to the level of PFAOMC if they have a history of childhood trauma, particularly physical or emotional abuse or neglect.

Denial

Denial can be a dangerous psychological factor in a medical setting, as it may lead to not accepting care or following instructions. The risk of a client using denial as a coping mechanism increases for people who have a history of denying other life stressors (such as minimizing marital issues), people who have a difficult time being dependent on others, and people whose self-image is inconsistent with their diagnosis.

The goal of treatment for psychological factors affecting other medical conditions is often to reduce the negative impact the psychological or behavioral factors are having on the medical prognosis. In some cases, this process can involve attempting to eliminate the factor entirely if it is problematic behavior, such as poor medication adherence, or it can focus more on mitigating the factor’s effects, such as developing coping mechanisms for addressing anxiety. 

Medication

No medication has been approved by the US Food and Drug Administration (FDA) to treat psychological factors affecting medical conditions, in part because the factors can be varied. However, there are some situations where pharmacological intervention might be helpful.

Experiences of anxiety can have a direct physical effect on medical conditions like hypertension or asthma. Prescription anti-anxiety medication in these circumstances may be beneficial. Beta-blockers may lower blood pressure (many anxiety-exacerbated medical conditions are cardiovascular) and reduce anxiety symptoms simultaneously. 

For individuals with depressive or dysthymic symptoms, thoughts of hopelessness may cause them to struggle to meaningfully engage in therapy. In these situations, a prescription antidepressant may be appropriate. Medication may also be used to treat the underlying medical condition. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

Self-care

For some people with PFAOMC, the first step in self-care is developing an understanding and acknowledgment of their medical condition and the way their emotions and behaviors may be impacting their prognosis. This acceptance can be difficult, particularly for people who are using denial as a coping mechanism. In this situation, self-care can involve more education about one’s medical condition and any risks associated with not treating it properly.

For people seeking healthier coping strategies in addressing their emotions related to their medical condition, self-care can be an effective and beneficial step forward. Ensuring one regularly gets enough sleep, eats a nutritious diet, and participates in an exercise or physical activity routine can significantly improve overall well-being.

Coping with psychological factors affecting other medical conditions can seem overwhelming. While any medical condition can precipitate a PFAOMC diagnosis, some people with PFAOMC are also experiencing serious medical concerns like diabetes or cancer. Living with a major medical diagnosis can take up one’s time and energy, and speaking to an in-person therapist may seem like yet another task on an ever-growing to-do list.

In these situations, online therapy through a platform like BetterHelp may be helpful. With a legitimate online therapy provider, individuals can find a database with thousands of therapists with whom they can meet in the comfort and convenience of their homes. 

Because of the varied experiences and manifestations of PFAOMC, few resources exist specifically to support those with the condition. However, there are a multitude of groups available for conditions that are commonly associated with PFAOMC. These groups include the American Diabetes Association’s Diabetes Self-Management Education and Support Network, the National Cancer Institute’s database of support services, and the American Chronic Pain Association’s support group list.   

For those with thoughts of suicide, contact 988 Suicide & Crisis Lifeline at 988. Please also see our Get Help Now page for more immediate resources.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

While several psychological factors may negatively impact medical conditions, factors related to symptoms of depression and anxiety can be among the most damaging. Depressive and anxious thoughts and behaviors are associated with significantly higher mortality rates in several chronic diseases, including renal disease, coronary artery disease, and cancer.

One study examined the effectiveness of cognitive-behavioral therapy on cancer patients who were experiencing symptoms of depression and anxiety. Individuals who completed a course of CBT reported both reduced depression and anxiety symptoms and overall improved treatment outcomes.

Developing psychological factors affecting other medical conditions in childhood can heighten the risk of more chronic and severe PFAOMC later in life. To this end, researchers studied the impact of cognitive-behavioral therapy treatment on depressive symptoms in adolescents and young adults who had been diagnosed with cancer. The study found that an online-delivered course of CBT treatment was effective in reducing symptoms of depression in this vulnerable population. 

Below are several statistics on psychological factors affecting other medical conditions:

• According to the DSM-V, while the exact prevalence of PFAOMC is not clear, it is currently understood to be more common than other somatic symptom disorders.
• In a global analysis of risk factors for worsening cardiovascular disease, symptoms of anxiety and distress were found to have similar impacts on disease progression as smoking, drinking alcohol, eating poorly, and not exercising.
• One study examined medication non-adherence in people with a history of heart attacks and found that excessive worrying about future medical conditions was associated with a higher likelihood of not complying with prescribed medication regimes. 
• Group therapy for cancer patients experiencing depressive symptoms was found to not only reduce those symptoms but also reduce hostility, stress, and pain levels.