Psychosomatic Illness

Some physical diseases are believed to have a mental component derived from the stresses and strains of everyday living. This is the case, for example, of lower back pain and high blood pressure, which appear to be partly related to stresses in everyday life.[1] Psychiatry has found it difficult until relatively recently to distinguish somatoform disorders, disorders in which mental factors are the sole cause of a physical illness, from psychosomatic disorders, disorders in which mental factors play a significant role in the development, expression, or resolution of a physical illness.

For instance, while peptic ulcer was once thought of as being purely caused by stress, later research revealed that Helicobacter pylori caused 80% of ulcers. However 4 out of 5 people colonised with Helicobacter pylori do not develop ulcers, and an expert panel convened by the Academy of Behavioral Medicine Research concluded that ulcers are not merely an infectious disease and that mental factors do play a significant role. One likelihood is that stress diverts energy away from the immune system, thereby stress promotes Helicobacter pylori infection in the body.[2]

It is still difficult to classify some disorders as purely physical, mixed psychosomatic, or purely somatoform. One example is Irritable Bowel Syndrome(IBS) that was considered formerly as having purely mental causes, while subsequent research showed significant differences in the behaviour of the gut in IBS patients. On the other hand, there are no actual structural changes in IBS patients and research shows that stress and emotions are still significant factors in causing IBS.[3]

However, while it is necessary to identify if an illness has a physical basis, it is recognized more and more that the effort to identify disorders as purely physical or mixed psychosomatic is increasingly obsolete as almost all physical illness have mental factors that determine their onset, presentation, maintenance, susceptibility to treatment, and resolution.[4][5]

Addressing such factors is the domain of the applied field of behavioral medicine. In modern society, psychosomatic aspects of illness are often attributed to stress[6] making the remediation of stress one important factor in the development, treatment, and prevention of psychosomatic illness.

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References

Sarno, John (2006). The Divided Mind. ReganBooks. ISBN 0-06-085178-3.
Jump up^ “GI Consult: Perforated Peptic Ulcer”. Retrieved 2007-08-26.
Jump up^ Melmed, Raphael N. (2001). Mind, Body and Medicine: An Integrative Text. Oxford University Press Inc, USA. pp. 191–192. ISBN 978-0-19-513164-2.
Jump up^ Skumin V A Borderline mental disorders in chronic diseases of the digestive system in children and adolescents. Zhurnal nevropatologii i psikhiatrii imeni SS Korsakova Moscow Russia 1952 (1991), Volume: 91, Issue: 8, Pages: 81-84 PubMed: 1661526
Jump up^ Skumin, VA (1982). Непсихотические нарушения психики у больных с приобретёнными пороками сердца до и после операции (обзор). [Nonpsychotic mental disorders in patients with acquired heart defects before and after surgery (review)]. Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova (in Russian) 82 (11): 130–5. PMID 6758444.
Jump up^ I. H. Treasaden, Basant K. Puri, P. J. Laking (2002). Textbook of Psychiatry. Churchill Livingstone. p. 7. ISBN 978-0-443-07016-7.

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