Psychosomatic psychiatry: A Spanish proposal for a new dimension

Abstract

Psychosomatic Medicine has undergone important evolutionary changes throughout its history, from its flowering in the 20th century up to the present. Two important reasons have determined this evolution. The first one has to do with the movement out of the focus in illnesses such as the bholy seven,Q illnesses with histological lesions once believed to have a psychogenic origin [1]. The knowledge about biological, ethiopathogenic mechanisms involved and effective treatment in these illnesses has improved considerably; on the contrary, psychogenic theories have been criticized on the basis of insufficient evidence. The second reason is the increasing demand for psychiatry to care for mental disorders in medical patients. Psychiatric disturbances are common in medical patients. On the other hand, the sharp increase in all aspects of medical practice, including prevention, diagnosis, and treatment, has generalized health care. Diagnostic and therapeutic techniques have dramatically improved life expectancy, and present-day prospects for recovery from illness would have been considered to be fantastic only a few years ago. However, extreme situations arise as a result of the new developments and the ethical problems they give rise to, which constantly threaten the psychological balance of the individual. The probability of needing psychiatric help when suffering somatic illnesses has increased significantly. A conservative estimate by the European Consultation-Liaison Workgroup for General Hospital Psychiatric and Psychosomatics [2] considers that approximately 10% of the patients admitted to a general hospital require consultation with a psychiatrist.