Psychosomatic Psychiatry in Spain: Historical Notes and the State of the Art

Abstract

This chapter reviews the important historical background of what we call in Spain Psychosomatic Psychiatry (PP), or Psychosomatic and Liaison Psychiatry (PLP). Both medical humanism and empirical, or evidence based science are crucial philosophical ingredients in present day developments. Different theories born in other countries are also apparent, and include the so called “anthropological” medicine, or the “cortico-visceral” medical models. In the approach to medical patients, the Johns Hopkins “perspectives” are prominent. Among the current dominant trends, the influence of the American, consultation-liaison (C-L) model has been crucial. However, the implant of psychiatric services in all general hospitals of the National Health Service (NHS) was decisive to make available the C-L activities. The chapter also reviews some early research movements in the field, the foundation of a specialized journal and the role of national associations. The chapter highlights the notable development of the discipline, since a recent national enquiry shows that close to 60% of NHS hospitals in Spain have a PLP Unit; the advances in education, the crucial one being the mandatory rotation in PLPU’s in the official, national training program in Psychiatry; and the vigorous teaching of psychiatry directed to general physicians in medical schools. Important research initiatives include the organization of National Networks, which have recruited research groups publishing systematically in international, high impact journals. Specific areas of PLP interest in this country are related to Primary Care, Medical Ethics, Psycho-Oncology and Medical Sexology, all of them with qualified representatives. The discipline aims at an eventual, official sub-specialization in Psychiatry. In this background, it has been argued that the future will depend fundamentally on the vision and compromise of the psychiatric Services and Departments; on the commitment and leadership of the psychiatrists; and, certainly, on the advances in research and innovation.