I am sick with worry or in Malay, ‘saya risau tak tertanggung‘. That is what parents of student studying in Egypt felt in the midst of Egyptian revolution middle of February this year. That is a mere expression of intense anxiety. Anxiety is a disease which can affect body-mind health.

Body-mind relationship can take place in five ways. 1) Concomitant effect. It means that there are known relationship between body and mind but they are not causally related. 2) somatopsychic. It means the physical illness could lead to psychological problems 3) psychosomatic i.e psychological conflict would lead to physical problems 4) stress related i.e stress caused illnesss and finally, all the above (holistic) i.e. all the above mentioned processes could give rise to problems.

It is not uncommon to see kids referred to you for stomach ache and the next day all you know, they refuse to go to school. Body-mind health should be thoroughly worked out. Failing to associate with it, then psychiatric work-out should taken place.

We had worked out a complex case of a kid who refused to walk and eat to the extent of using Ryle’s tube for feeding. Extensive work-out with school and family finally served her well.

Anyone can think of how ulcer could be related to somatopsychic causation?