the connection between psychological and physical · pdf filepsychological, social, aspects of...

The Connection Between The Connection Between

Psychological and Physical Psychological and Physical

HealthHealth

Kathleen BulbrookKathleen Bulbrook

BNursBNurs BPsych(HonsBPsych(Hons))

MClinPsychMClinPsych CandidateCandidate

The ConnectionThe Connection

Psychological studies show that your mind Psychological studies show that your mind

and your body are strongly linked. As your and your body are strongly linked. As your

mental health declines, your physical mental health declines, your physical

health can wear down, and if your physical health can wear down, and if your physical

health declines, it can make you feel health declines, it can make you feel

mentally "down." mentally "down."

(American Psychological Association, 2005).(American Psychological Association, 2005).

What we will look at todayWhat we will look at today

�� Definitions of health. Definitions of health.

�� How physical interventions can impact on How physical interventions can impact on

our psychological health.our psychological health.

�� How psychiatric interventions can impact How psychiatric interventions can impact

on our physical health.on our physical health.

Overview continuedOverview continued

�� What is the link between psychological What is the link between psychological

and physical health.and physical health.

�� How can clinical psychologists help with How can clinical psychologists help with

our psychological and physical health.our psychological and physical health.

How is health defined?How is health defined?

As a complete state of physical, mental and As a complete state of physical, mental and

social wellsocial well--being, not merely the absence of being, not merely the absence of

disease and infirmity. WHO, 1948.disease and infirmity. WHO, 1948.

Indigenous Health ViewsIndigenous Health Views

�� Australian Aboriginal people generally Australian Aboriginal people generally

define health as define health as “…“…Health does not just Health does not just

mean the physical wellmean the physical well--being of the being of the

individual but refers to the social, individual but refers to the social,

emotional, spiritual and cultural wellemotional, spiritual and cultural well--being being

of the whole community. This is a whole of of the whole community. This is a whole of

life view and includes the cyclical concept life view and includes the cyclical concept

of lifeof life--deathdeath--life (NHMRC, 1996).life (NHMRC, 1996).

How is health defined?How is health defined?

�� BircherBircher (2005) defines health as (2005) defines health as ““a a

dynamic state of welldynamic state of well--being characterized being characterized

by a physical and mental potential, which by a physical and mental potential, which

satisfies the demands of life satisfies the demands of life

commensurate with age, culture, and commensurate with age, culture, and

personal responsibilitypersonal responsibility””..

Health is MultifactorialHealth is Multifactorial

�� Health is not simply free from disease, it is Health is not simply free from disease, it is

much more!much more!

�� Health incorporates the mental, emotional, Health incorporates the mental, emotional,

spiritual, physical, sexual, psychological, spiritual, physical, sexual, psychological,

social, aspects of our being.social, aspects of our being.

Physical InterventionsPhysical Interventions

�� What are physical interventions?What are physical interventions?

�� When we are looking at physical interventions, often When we are looking at physical interventions, often these are of the medical nature. these are of the medical nature.

�� An intervention in a medical context would be referred An intervention in a medical context would be referred to the act of intervening, interfering or interceding with to the act of intervening, interfering or interceding with the intent of modifying the outcome.the intent of modifying the outcome.

�� In medicine, an intervention is usually undertaken to In medicine, an intervention is usually undertaken to help treat or cure a condition (help treat or cure a condition (MorbsyMorbsy, 2010)., 2010).

InterventionsInterventions

�� There are two common medical/physical There are two common medical/physical

interventions that are used in todayinterventions that are used in today’’s society to s society to

improve our physical health.improve our physical health.

�� Medications and SurgeryMedications and Surgery

�� Physical Interventions can be undertaken by a Physical Interventions can be undertaken by a

medical doctor, this could be a GP, a specialist medical doctor, this could be a GP, a specialist

surgeon or a generalist surgeon. surgeon or a generalist surgeon.

�� The other type of doctors that would prescribe The other type of doctors that would prescribe

medications is one who has specialised in a medications is one who has specialised in a

particular area, particular area, egeg a Urologist.a Urologist.

MedicationsMedications

�� Medications can and often do have side Medications can and often do have side effects which can directly and indirectly effects which can directly and indirectly impact on our psychological health.impact on our psychological health.

�� Direct psychological effects can includeDirect psychological effects can include�� DepressionDepression

�� AnxietyAnxiety

�� IrritabilityIrritability

�� Decreased concentration, attention, and Decreased concentration, attention, and memorymemory

Direct psychological effects from Direct psychological effects from

medicationsmedications

�� HallucinationsHallucinations

�� Delusional thinkingDelusional thinking

�� ManiaMania

�� HypomaniaHypomania

�� ObsessionalObsessional preoccupationspreoccupations

�� Sleep disturbances (insomnias, nightmares, Sleep disturbances (insomnias, nightmares, unrestful sleep).unrestful sleep).

�� PsychosisPsychosis

�� ParanoidParanoid

Indirect psychological effectsIndirect psychological effects

�� Indirect side effects from medications that can Indirect side effects from medications that can

impact on our psychological health (not impact on our psychological health (not

exhaustive)exhaustive)

�� AcneAcne

�� Wt gain/ obesityWt gain/ obesity

�� Blurred visionBlurred vision

�� glaucomaglaucoma

�� FatigueFatigue

�� Hair loss (alopecia)Hair loss (alopecia)

�� Increased hair growth (Increased hair growth (hirsutismhirsutism))

Indirect effects from Indirect effects from

medicationsmedications�� GynecomastiaGynecomastia

�� PainPain

�� DiabetesDiabetes

�� Delay in wound healingDelay in wound healing

�� Daily nauseaDaily nausea

�� OsteoporsisOsteoporsis

�� Increased risk for infectionsIncreased risk for infections

�� InfertilityInfertility

SurgerySurgery

�� Surgery is used to help treat a large Surgery is used to help treat a large variety of physical conditions including variety of physical conditions including cancer, in the hope of curing, preventing cancer, in the hope of curing, preventing or delaying a decline in our health or or delaying a decline in our health or untimely death (untimely death (MorsbyMorsby, 2010)., 2010).

�� However, side effects after the surgery However, side effects after the surgery can impact on our overall quality of life and can impact on our overall quality of life and our psychological health.our psychological health.

Effects from surgeryEffects from surgery

�� Amputation of a limbAmputation of a limb

�� Complete removal or part removal of an organ Complete removal or part removal of an organ

((egeg bowel, stomach, breast, testis or eye).bowel, stomach, breast, testis or eye).

�� Stoma Stoma

�� Chronic painChronic pain

�� Loss of function of a limb/sLoss of function of a limb/s

�� Loss of bladder controlLoss of bladder control

Psychological effectsPsychological effects

As it can be seen there are many effects As it can be seen there are many effects

both direct and indirect from medication both direct and indirect from medication

and surgery which have the potential to and surgery which have the potential to

impact on our psychological health.impact on our psychological health.

Medication Side EffectsMedication Side Effects

�� There are thousands of medications There are thousands of medications prescribed or bought over the counter today prescribed or bought over the counter today which have the potential to effect our health in which have the potential to effect our health in a negative way. a negative way.

�� Rather than go through the different drug Rather than go through the different drug groups for this part of the talk I am going to groups for this part of the talk I am going to focus on focus on prednisoloneprednisolone. .

�� I will use this drug as an example to explain I will use this drug as an example to explain the linkage between how physical the linkage between how physical interventions can impact on our psychological interventions can impact on our psychological health.health.

Linking physical to Linking physical to

psychologicalpsychological�� The direct effects of a medication such as The direct effects of a medication such as

prednisoloneprednisolone can cause us to feel depressed, can cause us to feel depressed, anxious or alter our memory (Pharmaceutical anxious or alter our memory (Pharmaceutical Society of Australia, 2010). Society of Australia, 2010).

�� The indirect effects from this same drug can The indirect effects from this same drug can cause obesity, diabetes and acne, these side cause obesity, diabetes and acne, these side effects can also result in us feeling depressed effects can also result in us feeling depressed and/or anxious (Pharmaceutical Society of and/or anxious (Pharmaceutical Society of Australia, 2010).Australia, 2010).

Linking physical to Linking physical to

psychologicalpsychological�� Looking at both the direct and indirect effects Looking at both the direct and indirect effects

from this drug it is not a stretch to understand from this drug it is not a stretch to understand

why people across the life span, who take this why people across the life span, who take this

drug for conditions such as arthritis, drug for conditions such as arthritis, ulcerative ulcerative

coliticolitis, Crohn's disease, s, Crohn's disease, systemic lupussystemic lupus, severe , severe

asthma and severe asthma and severe psoriasispsoriasis, there are many , there are many

other conditions not listed here which could other conditions not listed here which could

potentially develop psychological concerns potentially develop psychological concerns

either directly (depression) or indirectly either directly (depression) or indirectly

(diabetes).(diabetes).

Explaining the LinkExplaining the Link

The linkage between surgical procedures The linkage between surgical procedures

and psychological effects can be and psychological effects can be

explained with an example of inflammatory explained with an example of inflammatory

bowel disease.bowel disease.


�� Inflammatory Bowel Disease (Inflammatory Bowel Disease (IBDIBD)) covers covers

a group of disorders in which the intestines a group of disorders in which the intestines

become inflamed (red and swollen), become inflamed (red and swollen),

probablyprobably as a result ofas a result of an immune reaction an immune reaction

of the bodyof the body against its own intestinal tissue against its own intestinal tissue

((MorsbyMorsby, 2010). , 2010).

�� Two are major types of IBD, Two are major types of IBD, ulcerative ulcerative

colitiscolitis and and Crohn's diseaseCrohn's disease..


�� Both ulcerative colitis andBoth ulcerative colitis and Crohn's disease Crohn's disease usuallyusually run arun a waxing and waning course in the waxing and waning course in the intensity and severity of condition. intensity and severity of condition.

�� When there is severe inflammation, the disease When there is severe inflammation, the disease is considered to be in an active stage, andis considered to be in an active stage, and the the person experiencesperson experiences a flarea flare--up ofup of their condition.their condition.

�� When the degree of inflammation is less (or When the degree of inflammation is less (or absent), the person usually is without symptoms, absent), the person usually is without symptoms, and the condition is considered to be in and the condition is considered to be in remissionremission ((MorsbyMorsby, 2010)., 2010).


�� Failure to suspend and/or control the Failure to suspend and/or control the

symptoms of inflammatory bowel disease symptoms of inflammatory bowel disease

with medications such as with medications such as prednisoloneprednisolone

often results in surgery to reduce the often results in surgery to reduce the

symptoms and can result in the formation symptoms and can result in the formation

of a stoma.of a stoma.

Psychological Effects From Psychological Effects From

SurgerySurgery

�� A stoma is an opening on the outside of A stoma is an opening on the outside of the body for the waste to pass through.the body for the waste to pass through.

�� Studies have shown people who have had Studies have shown people who have had to undergo surgery for the formation of a to undergo surgery for the formation of a stoma with inflammatory bowel disease stoma with inflammatory bowel disease are at risk of having on going problems are at risk of having on going problems with depression and anxiety (with depression and anxiety (MikockaMikocka--WalusWalus et al, 2006).et al, 2006).

Psychological Effects ContinuedPsychological Effects Continued

�� Many psychological effects can result from Many psychological effects can result from

having a formed stoma (other surgery also).having a formed stoma (other surgery also).

�� People may alienate themselves from social People may alienate themselves from social

activityactivity

�� They may go through stages of griefThey may go through stages of grief

�� They may feel emotionally downThey may feel emotionally down

�� They may have altered feelings about their body They may have altered feelings about their body

imageimage

Psychological Effects ContinuedPsychological Effects Continued

�� Restrictions within their current lifestyle Restrictions within their current lifestyle

and previous activities (including sports). and previous activities (including sports).

�� Change in perception of their own Change in perception of their own

attractivenessattractiveness

�� There may be feelings of degradation, There may be feelings of degradation,

isolation and mutilation (Woodward, 2002).isolation and mutilation (Woodward, 2002).

Concluding Physical to Concluding Physical to

PsychologicalPsychological

�� As we can see from the examples of physical As we can see from the examples of physical

interventions, of interventions, of prednisoloneprednisolone (medications) and (medications) and

surgery (formation of a stoma) can either directly surgery (formation of a stoma) can either directly

or indirectly effect our psychological health.or indirectly effect our psychological health.

�� From the examples provided, (medication and From the examples provided, (medication and

surgery) it becomes apparent why we can go on surgery) it becomes apparent why we can go on

to develop conditions like depression, and to develop conditions like depression, and

anxiety.anxiety.

Some symptoms of depressionSome symptoms of depression

�� Stop going outStop going out

�� Significant weight gain or lossSignificant weight gain or loss

�� Tired all the timeTired all the time

�� Loss of interest in pleasurable activitiesLoss of interest in pleasurable activities

�� Withdraw from close friends and familyWithdraw from close friends and family

DepressionDepression

�� Sleep problemsSleep problems


�� Feelings of worthlessnessFeelings of worthlessness

�� Diminished ability to concentrateDiminished ability to concentrate

�� Prevalence low moodPrevalence low mood

�� May have suicidal thoughtsMay have suicidal thoughts

Symptoms of AnxietySymptoms of Anxiety

�� This list is not exhaustive and anxiety This list is not exhaustive and anxiety

looks different for each person.looks different for each person.

�� SweatingSweating

�� FlushingFlushing

�� Increased heart rateIncreased heart rate

�� Muscle tensionMuscle tension

�� Churning stomachChurning stomach

�� Trouble falling asleep or staying asleepTrouble falling asleep or staying asleep

AnxietyAnxiety

�� Easily tiredEasily tired


�� NightmaresNightmares

�� Constant worrying thoughtsConstant worrying thoughts

Psychiatric Interventions that Psychiatric Interventions that

impact on physical healthimpact on physical health

�� A Psychiatric intervention is when a A Psychiatric intervention is when a

person is given either a drug for a person is given either a drug for a

particular mental health condition or series particular mental health condition or series

of ECT treatments. of ECT treatments.

�� Psychiatric interventions are undertaken Psychiatric interventions are undertaken

by a psychiatrist (by a psychiatrist (BregginBreggin, 2008)., 2008).

Psychiatric InterventionsPsychiatric Interventions

�� These psychiatric interventions are These psychiatric interventions are

prescribed to treat symptoms of prescribed to treat symptoms of

psychiatric conditions.psychiatric conditions.

�� There are a variety of conditions in which There are a variety of conditions in which

some one may be prescribed a psychiatric some one may be prescribed a psychiatric

drug.drug.

Mental Health ConditionsMental Health Conditions

�� Here is a list of some conditions that some one Here is a list of some conditions that some one may be prescribed a psychiatric drug.may be prescribed a psychiatric drug.

�� DepressionDepression

�� AnxietyAnxiety

�� Obsessive Compulsive DisorderObsessive Compulsive Disorder

�� PTSDPTSD

�� Bipolar Affective DisorderBipolar Affective Disorder

�� SchizophreniaSchizophrenia

�� Personality DisordersPersonality Disorders

�� Sleep disordersSleep disorders

�� Substance DependenceSubstance Dependence

Duration of treatmentDuration of treatment

•• Some people may be asked to take a drug for a Some people may be asked to take a drug for a few months while others are expected to remain few months while others are expected to remain on psychiatric medications for the rest of lives.on psychiatric medications for the rest of lives.

•• There are many psychiatric drugs around today.There are many psychiatric drugs around today.

•• AntiAnti--depressants:depressants:--•• EffexorEffexor•• ZoloftZoloft•• LuvoxLuvox•• ProzacProzac•• AmitryptylineAmitryptyline

Psychiatric DrugsPsychiatric Drugs

•• AnxiolyoticsAnxiolyotics (Drugs for anxiety)(Drugs for anxiety)

�� DiazepamDiazepam

�� AlprazolamAlprazolam

�� ClonazepamClonazepam

�� PropanololPropanolol

Psychiatric DrugsPsychiatric Drugs

�� Mood StabilizerMood Stabilizer

�� LithiumLithium

�� TegretolTegretol

�� GabapentinGabapentin

�� EpilimEpilim

�� StimulantsStimulants

�� RitalinRitalin

Psychiatric Drugs ContinuedPsychiatric Drugs Continued

�� AntiAnti--psychoticspsychotics

�� ClozarilClozaril

�� RisperidoneRisperidone

�� SeroquelSeroquel

�� ZyprexaZyprexa

�� HaloperidolHaloperidol

Linking Psychiatric to the Linking Psychiatric to the

physicalphysical

�� Psychiatric medication is prescribed for a Psychiatric medication is prescribed for a

variety of psychiatric conditions and there variety of psychiatric conditions and there

are physical sides from these drugs. are physical sides from these drugs.

�� For the purpose of todayFor the purpose of today’’s talk we will use s talk we will use

the drug Risperidone as an example of the drug Risperidone as an example of

how this medication can and usually does how this medication can and usually does

impact on physical health.impact on physical health.

Psychiatric medications impact Psychiatric medications impact

on physical healthon physical health

�� Risperidone is a medication that is given Risperidone is a medication that is given

for psychotic symptoms. for psychotic symptoms.

�� It is however, sometimes given as a mood It is however, sometimes given as a mood

stabilizer, for behavioural disturbances in stabilizer, for behavioural disturbances in

the elderly, and treatment in autism.the elderly, and treatment in autism.

Linking Psychiatric interventions to Linking Psychiatric interventions to

physical health side effectsphysical health side effects

�� Side Effects from RisperidoneSide Effects from Risperidone

�� InsomniaInsomnia

�� Weight gainWeight gain

�� IncontinenceIncontinence

�� PolydipsiaPolydipsia (water intoxication)(water intoxication)

�� Rhinitis Rhinitis

�� Chronic brain impairmentChronic brain impairment

�� Tardive dyskinesiaTardive dyskinesia

ECT and physical side effectsECT and physical side effects

�� ECT is prescribed often in series of ECT is prescribed often in series of

treatments most commonly for individuals treatments most commonly for individuals

with more severe forms of depression.with more severe forms of depression.

�� This treatment which involves being under This treatment which involves being under

a general anaesthesia, and electrodes a general anaesthesia, and electrodes

placed onto the temporal lobes with an placed onto the temporal lobes with an

electric current passing through the body.electric current passing through the body.

Linking Psychiatric Interventions to Linking Psychiatric Interventions to

Physical Side EffectsPhysical Side Effects

�� Evidence has shown that ECT treatments Evidence has shown that ECT treatments cause damage to the brain resulting in cause damage to the brain resulting in memory damage, or chronic brain memory damage, or chronic brain impairment (CBI). impairment (CBI).

�� Other symptoms of CBI include:Other symptoms of CBI include:--

�� Short term memory impairmentShort term memory impairment

�� Impaired new learningImpaired new learning

�� Difficulty concentrationDifficulty concentration

�� InattentionInattention

ECT and Chronic Brain ImpairmentECT and Chronic Brain Impairment

�� Loss of energy and vitalityLoss of energy and vitality

�� Loss in the ability to have empathyLoss in the ability to have empathy

�� Increased impatienceIncreased impatience

�� Increased irritabilityIncreased irritability

�� Increased angerIncreased anger

�� The deterioration is gradual over months or The deterioration is gradual over months or

years so that the person appears to declining years so that the person appears to declining

from stress or the mental health condition from stress or the mental health condition

((BregginBreggin, 2008)., 2008).

The Link Between Psychological The Link Between Psychological

and Physical Healthand Physical Health

�� Health incorporates the mental, emotional, Health incorporates the mental, emotional,

spiritual, physical, biological, sexual, spiritual, physical, biological, sexual,

psychological, social, aspects of our being.psychological, social, aspects of our being.

�� When one of these aspects is out of balance When one of these aspects is out of balance

than we can feel the effects from this. It is from than we can feel the effects from this. It is from

this change in balance that we need to learn to this change in balance that we need to learn to

shift to real life changes and to reshift to real life changes and to re--balance the balance the

harmony with our health.harmony with our health.


ConnectionConnection

�� Whether it is the side effects from a Whether it is the side effects from a

medication for a physical or psychiatric medication for a physical or psychiatric

condition these can impact on our condition these can impact on our

psychological health either directly or psychological health either directly or

indirectly.indirectly.

�� So may a surgical or ECT procedure So may a surgical or ECT procedure

create psychological distress and pain.create psychological distress and pain.


ConnectionConnection

�� In todayIn today’’s society there is an attempt to separate s society there is an attempt to separate

the psychological from the physical.the psychological from the physical.

�� So, what can we do if we are unhappy with our So, what can we do if we are unhappy with our

psychological health as a result of physical or psychological health as a result of physical or

psychiatric interventions? psychiatric interventions?

�� If we are feeling sad, angry, altered, anxious, If we are feeling sad, angry, altered, anxious,

dissatisfied, stressed, or mutilated? dissatisfied, stressed, or mutilated?

What studies have foundWhat studies have found

�� 80 percent of Americans say that during the past 80 percent of Americans say that during the past few years they have become more aware of how few years they have become more aware of how their mental health and emotions can affect their their mental health and emotions can affect their physical health (APA 2005).physical health (APA 2005).

�� Research supports the idea that having a Research supports the idea that having a positive outlook can extend one's life positive outlook can extend one's life ("Emotional Longevity: What Really Determines ("Emotional Longevity: What Really Determines How Long You Live," Norman B. Anderson and How Long You Live," Norman B. Anderson and Elizabeth P. Anderson, 2003).Elizabeth P. Anderson, 2003).

Studies supporting the linkStudies supporting the link

�� TwoTwo--thirds of all office visits to G.P.thirds of all office visits to G.P.’’s, are s, are

due to stressdue to stress--related symptoms (American related symptoms (American

Academy of Family Physicians).Academy of Family Physicians).

�� Consumers report that talk therapy was Consumers report that talk therapy was

reportedly more effective than drug reportedly more effective than drug

therapy for depression and anxiety therapy for depression and anxiety

(Consumer Reports, October 2004).(Consumer Reports, October 2004).

What Clinical Psychologist May Do What Clinical Psychologist May Do

to Help?to Help?

�� To see a clinical psychologist, we can To see a clinical psychologist, we can either get a referral from our GP, either get a referral from our GP, specialist, or our community health specialist, or our community health agency. agency.

�� The clinical psychologist will first start with The clinical psychologist will first start with a through interview with yourself and if a through interview with yourself and if suitable with loved ones (some one that suitable with loved ones (some one that you trust).you trust).

What Clinical Psychologist May do What Clinical Psychologist May do

to Help?to Help?

�� A interview is done to begin to get to know A interview is done to begin to get to know you and to get a picture of what has been you and to get a picture of what has been happening for you.happening for you.

�� Following on from this information the Following on from this information the clinical psychologist may do some formal clinical psychologist may do some formal assessments to ascertain what you were assessments to ascertain what you were like before the treatment you were like before the treatment you were receiving.receiving.

What Clinical Psychologists May do What Clinical Psychologists May do

to Help?to Help?

�� Depending on the outcome from the interviews, Depending on the outcome from the interviews, assessments and referral information the clinical assessments and referral information the clinical psychologist will then work with you to help psychologist will then work with you to help begin to gain a better balance in your overall begin to gain a better balance in your overall health.health.

�� The treatment plan that is devised will be The treatment plan that is devised will be individualised to your specific goals and realistic individualised to your specific goals and realistic to every day life outcomes, taking into to every day life outcomes, taking into consideration your age, culture, physical, consideration your age, culture, physical, psychological and environmental factors.psychological and environmental factors.

Where might the Clinical Where might the Clinical

Psychologist Assist?Psychologist Assist?

�� Low moodLow mood

�� Anxious feelings and thoughtsAnxious feelings and thoughts

�� Distress with body imageDistress with body image

�� Management of stressManagement of stress

�� ReRe--focus on lifestyle practicesfocus on lifestyle practices

�� Sleep problemsSleep problems

�� Alcohol and smoking problemsAlcohol and smoking problems

�� Assistance with adjustmentAssistance with adjustment

�� Grief counsellingGrief counselling

The ConnectionThe Connection

�� Just as light brightens darkness, Just as light brightens darkness,

discovering inner fulfillment can eliminate discovering inner fulfillment can eliminate

any disorder or discomfort. This is truly the any disorder or discomfort. This is truly the

key to creating balance and harmony in key to creating balance and harmony in

everything you do. everything you do. Deepak ChopraDeepak Chopra


Psychological and Physical HealthPsychological and Physical Health

Online and local organisations that can help.Online and local organisations that can help.

www.cqu.edu.au/aboutwww.cqu.edu.au/about--us/serviceus/service--andand--

facilities/wellnessfacilities/wellness--centre/resourcescentre/resources

www.psychology.org.au/findapsychologist/www.psychology.org.au/findapsychologist/


Psychological and Physical HealthPsychological and Physical Health

For any feedback, questions or enquiries For any feedback, questions or enquiries

please contactplease contact me at me at

[email protected]@cqumail.com

OrOr

CQuni Wellness Centre at (07) 4923 2233CQuni Wellness Centre at (07) 4923 2233

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