1. Illness versus Disease
Lawrence Pike

2. Illness and Disease Introduction
Topics discussed include:
The Clinical Iceberg
The Differences between Disease and Illness
Doctors and Patients Agenda
Illness Behaviour
The Sick Role
Assessing Illness

3. Illness and Disease
Irritable Bowel Syndrome and Dyspepsia, have been associated with stress and anxiety in medical textbooks. In fact, control studies show that this is not the case. However the more anxious sufferers consult their doctor.
It is important to consider how this misunderstanding has come about.

4. The Clinical Iceberg
90% of people declare themselves to have been ill in the last 2 weeks
1 in 37 of symptom episodes will be declared to Primary Care. This is the Clinical Iceberg

5. Disease What is Disease?
The biological process that doctors use to explain and understand illness

6. Illness and Disease
The process of diagnosing disease is central to medical education. This becomes the doctor’s agenda
However in at least 25% of GP consultations, no disease specific diagnosis is available
We must understand then what the illness means to the patient – the patient’s agenda

7. Illness What is Illness?
Definitions vary and patients and doctors will disagree!
The patients experience of a physical or psychological disturbance

8. Illness Behaviour
Symptoms of Illness may be differently perceived, evaluated and acted upon by different kinds of people.
This is sometimes called “Illness Behaviour”

9. Illness Behaviour Culture Presentation Health beliefs Sex Social Class
Access to health care
Learned behaviour
Triggers (home, work, TV, family and friends)

10. The Sick Role Obligations Privileges Must seek professional help
Make an effort towards recovery
Privileges
Exempt normal social obligations
Not responsible for incapacity

11. Assessing the Illness Patient Centred Approach
Understanding the illness in the patient’s terms
Responding to patient’s cues
Exploring Ideas, Concerns, Expectations and Affect on daily living
Guard against making assumptions