Ania Gurynowicz
Psychosomatic medicine may be defined as a comprehensive,
interdisciplinary framework for: assessment of
psychological factors affecting individual vulnerability
as well as course and outcome of illness; biopsychosocial
consideration of patient care in clinical practice; specialist
interventions to integrate psychological therapies in
the prevention, treatment and rehabilitation of medical
disease. The aim of this review is to provide an updated
definition of psychosomatic medicine, to outline its
boundaries with related disciplines and to illustrate its
main contributions to clinical and preventive medicine.
Current advances in the field have practical implications
for medical research and practice, with particular reference
to the role of lifestyle, the challenge of medically
unexplained symptoms, the psychosocial needs entailed
by chronic illness, the appraisal of therapy beyond pharmaceutical
reductionism, the function of the patient actively
contributing to his/her health. Today, the field of
psychosomatic medicine is scientifically rigorous, more
diversified and therapeutically relevant than ever before.
Developments have occurred in all aspects of psychosomatic
medicine. Among factors affecting individual
vulnerability to all types of disease, the following have
been highlighted by recent research: recent and early life
events, chronic stress and allostatic load, personality, psychological
well-being, health attitudes and behavior. As to
the interaction between psychological and biological factors
in the course and outcome of disease, the presence
of psychiatric (DSM-IV) as well as subclinical (Diagnostic
Criteria for Psychosomatic Research) symptoms, illness
behavior and the impact on quality of life all need to be
assessed