psychosomatic medicine

Stemming from Lipowski's original definition^[1] and subsequent developments,^[9,10] psychosomatic medicine may be defined as a comprehensive, interdisciplinary framework for:

• assessment of psychosocial factors affecting individual vulnerability and course and outcome of any type of disease;
• holistic consideration of patient care in clinical practice;
• integration of psychological therapies in the prevention, treatment and rehabilitation of medical disease (psychological medicine).

Psychosomatic medicine has recently become in the U.S. a subspecialty recognised by the American Board of Medical Specialties.^[11] This may lead to identifying psychosomatic medicine with consultation-liaison psychiatry,^[11] a subspecialty of psychiatry concerned with diagnosis, treatment and prevention of psychiatric morbidity in the medical patient in the form of psychiatric consultations, liaison and teaching for non-psychiatric health workers, especially in the general hospital.^[12] Consultation liaison psychiatry is clearly within the field of psychiatry; its setting is the medical or surgical clinic or ward, and its focus is the comorbid state of patients with medical disorders.^[13] Psychosomatic medicine is, by definition,^[1,9,10] multidisciplinary. It is not confined to psychiatry, but may concern any other field of medicine. Not surprisingly, in countries such as Germany and Japan, psychosomatic activities have achieved an independent status and are often closely related to internal medicine.^[14]

Up to the seventies, psychosomatic medicine was the only site of research at the interface between medicine and the behavioural sciences. In those years, however, behavioural medicine developed^[15] as an interdisciplinary field that integrates behavioural and biomedical knowledge relevant to health and disease. It provided a room for an increasing number of psychologists dealing with basic laboratory research on the neural and humoral systems controlled by the brain, on visceral learning and on other aspects of behaviour, which lead to practical implications of medical significance.^[16] Its focus on unhealthful behaviour and risk factors (such as smoking and alcohol abuse) led to the development of the related discipline of health psychology.^[17]

Interestingly, the general psychosomatic approach has resulted in a number of sub-disciplines within their own areas of application: psycho oncology, psychonephrology, psychoneuroendocrinology, psychoimmunology, psychodermatololgy and others. Such sub-disciplines have developed clinical services, scientific societies and medical journals.

http://www.medscape.com/viewarticle/726444_2