Iatrogenic diseases: causes, classification

We live in a time when various diseases can occur not only against the background of malfunctions in the body, but are also the result of direct or indirect effects of medical workers. Turning to the doctors, we sometimes do not suspect that in addition to the existing sores, we can still make problems. How is this possible and what are iatrogenic diseases, we will try to figure it out.

Iatrogenic concept

Everyone knows that the main commandment of any doctor is "Do no harm!" Most doctors try to do it, but even the most devoted to their profession have mistakes, and what can we say about those who simply take their own place and do their own thing.

The concept of iatrogenic diseases includes those conditions and diseases that were triggered by medical intervention or influence. These can be both physical problems and psychological ones.

In medicine, there are two definitions of this concept:

1. The role of iatrogenic is various side diseases that are associated with:

• Incorrect treatment.
• Diagnostic research.
• Incorrect behavior of medical personnel.

2. Iatrogenic diseases include diseases that are manifested as complications of the underlying disease, they were caused by incorrect or erroneous actions of the doctor and nurses.

What is interesting is that all diseases and injuries that can occur not only in patients, but also in the course of medical care, belong to iatrogenic.

Speaking of iatrogenism, one immediately recalls the saying that a person can be killed in a word, so doctors should, on a subconscious level, feel which patient can tell the whole truth about his illness, and in which situation it is better to discuss this with relatives.

But, unfortunately, not all doctors in our medicine are good psychologists and think about the consequences of said words or actions. Despite the fact that many argue that there is no problem as such - a medical error, iatrogenic diseases say the opposite.

In some impressionable patients, even the simple carelessness of the doctor, his indifferent look and inhospiteness already cause mental anxiety.

In modern society, it is especially often necessary to deal with the callousness and shamelessness of our doctors.

Iatrogenic species

Until today, one generally accepted approach to the classification of iatrogenicity has not appeared, therefore, several options are used:

1. On the etiology of the disease.
2. According to the ICD.
3. According to Kalitievsky.
4. According to Rykov.

If we consider the classification according to the nature of the occurrence of the disease, then there are several classes of iatrogeny:

1. Iatrogenicity associated with disease prevention.
2. Diagnostic related.
3. Provoked by drugs.
4. Iatrogenic effects caused by radiation diagnosis or therapy.
5. Using medical equipment and instruments.
6. Complications after a blood transfusion.
7. Fatal as a result of the wrong dose of anesthesia.
8. Iatrogenic as a result of surgical operations.

According to the International Classifier of Diseases (ICD) , iatrogenic diseases are subdivided in their own way. Classification may be as follows:

1. Iatrogenic arising after surgery or as a result of a surgical disease.
2. Iatrogenic reactions provoked by medical treatment.
3. Diseases resulting from improper diagnosis.
4. Death from anesthesia.

Classification according to Kalitievsky is different in that each class of the disease is further subdivided.

1. Iatrogenic associated with treatment.

• Medicated iatrogenic.
• Surgical
• Physical.

2. Iatrogenic caused by diagnostic measures.

• Diseases that are caused by the risk of using a method or diagnostic tools.
• Diseases resulting from improper diagnosis.

3. Iatrogenic associated with preventive measures.

• For example, the risk of side effects of the method (vaccination).
• Diseases caused by erroneous prophylaxis.

4. Informational iatrogeny is most often associated with self-medication, that is, the patient does not administer therapy with the drugs prescribed by the doctor.

5. Pseudo-diseases, that is, those iatrogenics that arose as a result of an incorrect diagnosis.

Rykov's classification is based on the application of economic sanctions in the event of iatrogenic occurrence. There are several groups:

• Iatrogenic arising at the initial stage of treatment.
• Diseases provoked by an unexpected reaction of the body to drugs and other methods of therapy.
• Iatrogenism caused by erroneous diagnosis and treatment.
• Iatrogenic, which in the pathogenesis of the disease are superimposed on the underlying disease or concomitant.
• Problems arising from self-medication. In this case, there can be no question of any sanctions against a medical institution.

Here is such a many-sided classification, which just shows that the problem of iatrogenic diseases does not wane, but, on the contrary, is becoming more acute every year.

Iatrogenic features

If we analyze iatrogenic pathology, then we can distinguish the following features:

1. Biomedical. This means that the development of iatrogenic always depends on the individual characteristics of the patient, his stress resistance, susceptibility, tolerance to drugs. The doctor’s errors, which are not specially made, but are caused by his insufficient qualifications, also belong to the same features.
2. Medical and social features. Iatrogenic development can be caused by diagnostic errors associated with outdated equipment.
3. Legal features. They relate to compensation to a person for harm caused to his health as a result of medical intervention.

It should be borne in mind that complications or diseases that arose as a result of a refusal to provide assistance are not considered iatrogenic.

Iatrogenic Causes

Iatrogenic diseases can be triggered by the following factors:

1. Careless or deliberate influence on the patient with words or non-verbal means of expression, for example, facial expressions, gestures.
2. Hastily informing the patient about the diagnosis and its prognosis. Worst of all, when it turns out that this information was erroneous.
3. Pronounced inattentive attitude of medical personnel or inaction in general.
4. Failure to comply with the rules for storing medical records.

Recently, new concepts have appeared:

• "Sestrogenia" - mental disorders in the patient, provoked by careless statements or actions of a nurse.
• “Egogeny” - the patient’s influence on himself through self-hypnosis.
• “Egrotogeny” is when patients directly or indirectly influence one another’s condition.

As practice shows, patients who are most prone to iatrogenic are suspicious, who exhibit emotional instability, they are easily suggestible and highly dependent on the opinions of others.

Symptoms of iatrogenic

Iatrogenic diseases do not have strictly and clearly defined certain signs. This is due to the variety of reasons that cause them.

If this is a psychological iatrogeny , then it can manifest itself as a complete refusal of treatment by this doctor or by these methods. In some cases, the patient, on the contrary, begins to be treated intensively, walks constantly from one doctor to another, and does not bypass healers, psychics and fortune-tellers.

If iatrogenic is manifested by infectious diseases, then they have their typical symptoms, but are most often more difficult to treat.

It is also worth remembering that there are cases when medical workers are not at all to blame for the occurrence of iatrogeny (if we recall the self-hypnosis, the influence of patients on each other).

There are a lot of factors that can provoke the development of iatrogenic, therefore there are many manifestations. Most often, the causes are subjective, therefore, the course of the disease depends on the state of the psyche and on the whole organism.

Oddly enough, the medical staff themselves may suffer from such a pathology - everyone knows the "burnout syndrome."

Diagnosis of iatrogenic

For some iatrogenic patients it is not difficult to make a correct diagnosis, for example, if a patient, taking a course of treatment in a hospital for gastritis, suddenly picks up an infectious disease, it becomes more or less clear that this happened as a result of the presence of this infection in the hospital walls.

If the patient makes a complaint to the doctor about an incorrect attitude, improper treatment, as a result of which he received the disease, then in order to sue, it will still have to be proved. Maybe the patient already had these diseases, but did not suspect them.

Iatrogenic Treatment

Iatrogenic diseases are most often treated with psychotherapy if it is associated with mental problems. To eliminate this condition, tranquilizers, antidepressants and other psychotropic drugs are prescribed.

If, as a result of medical intervention, improper diagnosis and therapy, the patient receives another disease, then treatment is reduced to eliminating the symptoms of the disease.

When prescribing treatment for iatrogenic diseases, the doctor must necessarily take into account the psychological characteristics of the patient's body, its social environment. In some difficult situations, you may need the help of a psychiatrist or psychotherapist.

Iatrogenic treatment prognosis

In most cases, treatment of iatrogenic diseases ends favorably. Depending on the type of disease, the duration of therapy may take from several weeks to several months.

The sooner an iatrogenic disease is recognized, the more effective the therapy. There are prerequisites for an increase in the number of mental illnesses among older patients and children. In this regard, each medical worker should more carefully monitor all his words, gestures that relate to the patient. Carefully selected methods and methods of treatment, drug therapy.

There are several unspoken rules for medical staff:

1. Think to whom to speak.
2. Think over how to talk.
3. Think what you will say.

If at least these rules are respected, then it will already be possible to talk about a decrease in the number of iatrogenic.

Iatrogenic Prevention

Given the versatile nature of iatrogenic, we can talk about a variety of ways to prevent them.

1. To prevent drug iatrogenism, the doctor should know well the effect of the drug on the body, the possibility of complications. To carry out an individual dosage selection in each case.
2. Prevention of physical iatrogeny should consist in the wise use of diagnostic methods and indications for surgical intervention.
3. During surgery, only proven techniques should be used that allow the patient's organs and tissues to be treated as carefully as possible.

The general preventive measure is the observance by medical workers of medical ethics and the manifestation of compassion for their patients. If doctors become a little psychologists and treat not a disease, but a person, then the prevention of iatrogenic diseases is not required.