A psychosocial disorder is a mental illness caused or influenced by life experiences, as well as maladjusted cognitive and behavioral processes.
The term psychosocial refers to the psychological and social factors that influence mental health. Social influences such as peer pressure, parental support, cultural and religious background, socioeconomic status, and interpersonal relationships all help to shape personality and influence psychological makeup. Individuals with psychosocial disorders frequently have difficulty functioning in social situations and may have problems effectively communicating with others.
In the American Psychiatric Association it distinguishes 16 different subtypes (or categories) of mental illness. Although psychosocial variables arguably have some degree of influence on all subtypes of mental illness, the major categories of mental disorders thought to involve significant psychosocial factors include:
- Substance-related disorders. Disorders related to alcohol and drug use, abuse, dependence, and withdrawal.
- Schizophrenia and other psychotic disorders. These include the schizoid disorders (schizophrenia, schizophreniform, and schizoaffective disorder), delusional disorder, and psychotic disorders.
- Mood disorders. Affective disorders such as depression (major, dysthymic) and bipolar disorders.
- Anxiety disorders. Disorders in which a certain situation or place triggers excessive fear and/or anxiety symptoms (i.e., dizziness, racing heart), such as panic disorder, agoraphobia, social phobia, obsessive-compulsive disorder, post-traumatic stress disorder, and generalized anxiety disorders.
- Somatoform disorders. Somatoform disorders involve clinically significant physical symptoms that cannot be explained by a medical condition (e.g., somatization disorder, conversion disorder, pain disorder, hypochondriasis, and body dysmorphic disorder).
- Factitious disorders. Disorders in which an individual creates and complains of symptoms of a non-existent illness in order to assume the role of a patient (or sick role).
- Sexual and gender identity disorders. Disorders of sexual desire, arousal, and performance. It should be noted that the categorization of gender identity disorder as a mental illness has been a point of some contention among mental health professionals.
- Eating disorders. Anorexia and bulimia nervosa.
- Adjustment disorders. Adjustment disorders involve an excessive emotional or behavioral reaction to a stressful event.
- Personality disorders. Maladjustments of personality, including paranoid, schizoid, schizotypal, anti-social, borderline, histrionic, narcissistic, avoidant, dependent, and obsessive-compulsive personality disorder (not to be confused with the anxiety disorder OCD).
- Disorders usually first diagnosed in infancy childhood, or adolescence. Some learning and developmental disorders (i.e., ADHD) may be partially psychosocial in nature.
Causes and symptoms
It is important to note that the causes of mental illness are diverse and not completely understood. The majority of psychological disorders are thought to be caused by a complex combination of biological, genetic (hereditary), familial, and social factors or biopsychosocial influences. In addition, the role that each of these play can differ from person to person, so that a disorder such as depression that is caused by genetic factors in one person may be caused by a traumatic life event in another.
The symptoms of psychosocial disorders vary depending on the diagnosis in question. In addition to disorder-specific symptoms, individuals with psychosocial dysfunction usually have difficulty functioning normally in social situations and may have trouble forming and maintaining close interpersonal relationships.
Patients with symptoms of psychosocial disorders or other mental illness should undergo a thorough physical examination and patient history to rule out an organic cause for the illness (such as a neurological disorder). If no organic cause is suspected, a psychologist or other mental healthcare professional will meet with the patient to conduct an interview and take a detailed social and medical history. If the patient is a minor, interviews with a parent or guardian may also be part of the diagnostic process. The physician may also administer one or more psychological tests (also called clinical inventories, scales, or assessments).
Counseling is typically a front-line treatment for psychosocial disorders. A number of counseling or talk therapy approaches exist, including psychotherapy, cognitive therapy, behavioral therapy, and group therapy. Therapy or counseling may be administered by social workers, nurses, licensed counselors and therapists, psychologists, or psychiatrists.
Psychoactive medication may also be prescribed for symptom relief in patients with mental disorders considered psychosocial in nature. For disorders such as major depression or bipolar disorder, which may have psychosocial aspects but also have known organic causes, drug therapy is a primary treatment approach. In cases such as personality disorder that are thought to not have biological roots, psychoactive medications are usually considered a secondary, or companion treatment to psychotherapy.
Many individuals are successful in treating psychosocial disorders through regular attendance in self-help groups or 12-step programs such as Alcoholics Anonymous. This approach, which allows individuals to seek advice and counsel from others in similar circumstances, can be extremely effective.
In some cases, treating mental illness requires hospitalization of the patient. This hospitalization, also known as inpatient treatment, is usually employed in situations where a controlled therapeutic environment is critical for the patient's recovery (e.g., rehabilitation treatment for alcoholism or other drug addictions), or when there is a risk that the patient may harm himself (suicide) or others. It may also be necessary when the patient's physical health has deteriorated to a point where life-sustaining treatment is necessary, such as with severe malnutrition associated with anorexia nervosa.
Therapeutic approaches such as art therapy that encourage self-discovery and empowerment may be useful in treating psychosocial disorders. Art therapy, the use of the creative process to express and understand emotion, encompasses a broad range of humanistic disciplines, including visual arts, dance, drama, music, film, writing, literature, and other artistic genres. This use of the creative process is believed to provide the patient/artist with a means to gain insight to emotions and thoughts they might otherwise have difficulty expressing. After the artwork is created, the patient/artist continues the therapeutic journey by interpreting its meaning under the guidance of a trained therapist.
Affective disorder — An emotional disorder involving abnormal highs and/or lows in mood.
Bipolar disorder — An affective mental illness that causes radical emotional changes and mood swings, from manic highs to depressive lows. The majority of bipolar individuals experience alternating episodes of mania and depression.
Bulimia — An eating disorder characterized by binge eating and inappropriate compensatory behavior such as vomiting, misusing laxatives, or excessive exercise.
Cognitive processes — Thought processes (i.e., reasoning, perception, judgment, memory).
Learning disorders — Academic difficulties experienced by children and adults of average to above-average intelligence that involve reading, writing, and/or mathematics, and which significantly interfere with academic achievement or daily living.
Schizophrenia — A debilitating mental illness characterized by delusions, hallucinations, disorganized speech and behavior, and flattened affect (i.e., a lack of emotions) that seriously hampers normal functioning.
According to the National Institute of Mental Health, more than 90% of Americans who commit suicide have a diagnosable mental disorder, so swift and appropriate treatment is important. Because of the diversity of types of mental disorders influenced by psychosocial factors, and the complexity of diagnosis and treatment, the prognosis for psychosocial disorders is highly variable. In some cases, they can be effectively managed with therapy and/or medication. In others, mental illness can cause long-term disability.
Patient education (i.e., therapy or self-help groups) can encourage patients to take an active part in their treatment program and to recognize symptoms of a relapse of their condition. In addition, educating friends and family members on the nature of the psychosocial disorder can assist them in knowing how and when to provide support to the patient.
Epperly, Ted D., and Kevin E. Moore. "Health Issues in Men: Part II. Common Psychosocial Disorders." American Family Physician 62 (July 2000): 117-24.
National Institute of Mental Health. 6001 Executive Boulevard, Rm. 8184, MSC 9663, Bethesda, MD 20892-9663. (301) 443-4513.
Satcher, David. Mental Health: A Report of the Surgeon General. Washington, DC: Government Printing Office, 1999.