Psychosomatic medicine: Emerging trends and perspectives

Developments have occurred in all aspects of psychosomatic medicine. Among factors affecting individual vulnerability to all types of disease, the fol lowing have been highlighted by recent research: recent and early life even ts, chronic stress and allostatic load, personality, psychological well-bei ng, health attitudes and behavior. As to the interaction between psychologi cal and biological factors in the course and outcome of disease, the presen ce of psychiatric (DSM-IV) as well as subclinical (Diagnostic Criteria for Psychosomatic Research) symptoms, illness behavior and the impact on qualit y of life all need to be assessed. The prevention, treatment and rehabilita tion of physical illness include the consideration for psychosomatic preven tion, the treatment of psychiatric morbidity and abnormal illness behavior and the use of psychotropic drugs in the medically ill. In the past 60 year s, psychosomatic medicine has addressed some fundamental questions, contrib uting to the growth of other related disciplines, such as psychoneuroendocr inology, psychoimmunology, consultation-liaison psychiatry, behavioral medi cine, health psychology and quality of life research. Psychosomatic medicin e may also provide a comprehensive frame of reference for several current i ssues of clinical medicine (the phenomenon of somatization, the increasing occurrence of mysterious symptoms, the demand for well-being and quality of life), including its new dialogue with mind-body and alternative medicine. Copyright (C) 2000 S. Karger AG, Basel.