Volume 6 Issue 10 October, 2016
Consultation Liaison Psychiatry Focus: Otorhinolaryngology
Symptom is a deviation from normal functioning which is noticed by a patient and is often perceived as herald of a disease. A symptom is subjective, observed by the patient and cannot be measured objectively. On the other hand, sign is directly observable and is amenable to measurement by others. A combination of symptoms and signs help in making a diagnosis.
Otolaryngology is a field where patient commonly presents with physical symptom of pain or soreness for the various commonly associated acute infections or malignancies in head and neck. We usually tend to associate the severity of pain with a more sinister or advanced stage of the disease. But it has often been found that the severity of symptom is not solely dependent on the severity of the disease but is also dependent on the persona of the patient. The same stage/severity of a disease may produce different manifestations on different patient.
Mind plays a very important role in manifestation and handling of a disease condition. This is where understanding a persons’ mind plays a very important role especially in comprehensive treatment of malignancies. In the event of a diagnosis of a malignancy, a patient often needs constant psychiatric evaluation. Right from the moment of diagnosis till formulation of treatment plan and even during the course of treatment the patient often needs psychological support and at times psychiatric treatment.
The acceptance of malignancy is a huge mental shock for the patient who often feels bewildered and lost. Both the patient and the family are needs of understanding and support. Breaking the bad news, understanding and acceptance of diagnosis as well as expectations from treatment are the areas the primary clinician needs to work on for better patient satisfaction.
The expertise of a psychiatrist provides a lot of help in difficult situations. The treatment given for head and neck malignancies often leads to difficulties in swallowing, speaking and disfigurement of the face which is unbearable at times. The care and support provided by a psychiatrist the difficult periods in diagnosis and treatment often become smooth and bearable for the patients. Patients have ease of understanding the disease and has better acceptance of the diagnosis which helps in treatment adherence as well as tolerance. Many a times this means early returns to daily routine. Thus there is a need to set up facilities of counselling of patients diagnosed with malignant and terminally ill diseases.
Dr. Saurav Sarkar, Assistant Professor, Department of Otorhinolaryngology, AIIMS Bhubaneswar
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