The writer discusses the relationship between physical illness and psychiatric disorders. He points out the relativity of the “psychosomatic” and “somatopsychic” concepts and the dynamic interaction between biological, psychological and social factors in initiating, predisposing to and influencing the course and outcome of all organic diseases. Psychiatric disorders causally related to physical illness include organic brain syndromes, reactive psychoses, neuroses and personality disorders, and deviant illness behavior. Some of the pathogenic mechanisms are discussed and the clinical importance of this area of psychosomatic medicine is stressed.
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References
1.
LipowskiZJ: Physical illness, the patient and his environment: Psychosocial foundations of medicine, in American Handbook of Psychiatry, 2nd Ed., Vol. 4, Ch. 1. Edited by ArietiS. New York, Basic Books (in press)
2.
LipowskiZJ: Psychophysiological cardiovascular disorders, in Comprehensive Textbook of Psychiatry, 2nd Ed. Edited by FreedmanAMKaplanHISadockBJ. Baltimore, Williams and Wilkins (in press)
3.
EliotRS, (ed): Stress and the Heart. Mount Kisco, N.Y., Futura Publishing Co., 1974
4.
FriedmanMRosenmanRH: Type A Behavior and Your Heart. New York, Knopf, 1974
5.
WeissJH: The current state of the concept of a psychosomatic disorder. Int J Psychiat Med (in press)
6.
LipowskiZJ: Review of consultation psychiatry and psychosomatic medicine: III. Theoretical issues. Psychosom Med30:395–422, 1968
7.
LipowskiZJ: Organic brain syndromes: An overview and classification, in Psychiatric Aspects of Neurologic Disorders. Edited by BensonDFBlumerD.New York, Grune & Stratton (in press)
8.
ChapmanLFWolffHG: Disease of the neopallium and impairment of the highest integrative functions. Med Clin N Amer, May 1958, pp 677–89
9.
LipowskiZJ: Delirium, clouding of consciousness and confusion. J Nerv Ment Dis145:227–55, 1967
10.
WellsCE, (ed): Dementia. Philadelphia, F. A. Davis, 1971
11.
VictorM: The amnesic syndrome and its anatomical basis. Canad Med Ass J100:1115–25, 1969
12.
NautaWJH: The problem of the frontal lobe: A reinterpretation. J Psychiat Res8:167–187, 1971
13.
TuckerGJ: Psychosomatic studies of psychiatric disorders: Schizophrenia. Int J Psychiat Med (in press)
14.
DavisonKBagleyCR: Schizophrenia-like psychoses associated with organic disorders of the central nervous system: A review of the literature, in Current Problems in Neuropsychiatry. Edited by HerringtonRN. Ashford, Kent, Headley Bros., 1969
Walther-BüelH: Die Psychiatrie der Hirngeschwülste. Wien, Springer-Verlag, 1951
17.
AchteKAHillbomEAalbergV: Post-traumatic Psychoses following War Brain Injuries. Helsinki, Kirjapaino Yrjö Levikoski, 1967
18.
StoneMH: Drug-related schizophrenic syndromes. Int J Psychiat11:391–441, 1973
19.
GouldJ: Viral disease and psychiatric ill-health. Brit J Clin Pract11:1–5, 1957
20.
GoodwinFKBunneyWE: Depressions following reserpine: A reevaluation. Sem Psychiat3:435–48, 1971
21.
ShulmanR: The present status of vitamin B12 and folic acid deficiency in psychiatric illness. Canad Psychiat Ass J17:205–16, 1972
22.
GiffordSGundersonJG: Cushing's disease as a psychosomatic disorder: A selective review of the clinical and experimental literature and a report of ten cases. Persp Biol Med13:169–221, 1970
23.
WarburtonJW: Depressive symptoms in Parkinson patients referred for thalamotomy. J Neurol Neurosurg Psychiat30:368–70, 1967
24.
HauriPChernikDHawkinsDMendelsJ: Sleep of depressed patients in remission. Arch Gen Psychiat31:386–91, 1974
25.
SnyderSH: Amphetamine psychosis: A “model” schizophrenia mediated by catecholamines. Amer J Psychiat130:61–67, 1973
26.
SwansonDWBohnertPJSmithJA: The Paranoid. Boston, Little, Brown, 1970
27.
LipowskiZJ: Psychiatric illness and somatic disease. Comprehens Psychiat (in press)
28.
LipowskiZJ: Psychosocial aspects of disease. Ann Int Med71:1197–206, 1969
29.
VerwoerdtA: Psychopathological responses to the stress of physical illness, in Psychosocial Aspects of Physical Illness, Advances in Psychosomatic Medicine, Vol. 8. Edited by LipowskiZJ. Basel, Karger, 1972
30.
LipowskiZJ: Review of consultation psychiatry and psychosomatic medicine: II. Clinical aspects. Psychosom Med29:201–24, 1967
31.
KerrTASchapiraKRothM: The relationship between premature death and affective disorders. Brit J Psychiat115:1277–82, 1969
32.
FrasILitinEMPearsonJS: Comparison of psychiatric symptoms in carcinoma of the pancreas with those in some other intra-abdominal neoplasma. Amer J Psychiat123:1553–562, 1967
33.
HutchinsonECLeonardBJMaudsleyCYatesPO: Neurological complications of the reticuloses. Brain81:75–92, 1958
34.
LewinKK: Role of depression in the production of illness in pernicious anemia. Psychosom Med21:23–27, 1959
35.
StraussH: Intracranial neoplasms masked as depression and diagnosed with the aid of electroencephalography. J Nerv Ment Dis122:185–89, 1955
36.
LipowskiZJ: Psychopathology as a science: Its scope and tasks. Comprehens Psychiat7:175–82, 1966
37.
MarksILaderM: Anxiety states (anxiety neurosis): A review. J Nerv Ment Dis156:3–18, 1973
38.
SchwabJJMarderLClemmonsRSMcGinnisNH: Anxiety, severity of illness and other medical variables. J Psychosom Res10:297–303, 1966
39.
CayELVetterNPhilipAEDugardP: Psychological status during recovery from an acute heart attack. J Psychosom Res16:425–35, 1972
40.
SternMJ: Psychosocial adaptation following an acute myocardial infarction. Paper presented at the Annual Meeting of the American Psychosomatic Society, Philadelphia, March 29–31, 1974
41.
RoddaBEMillerCMBruhnJG: Prediction of anxiety and depression patterns among coronary patients using a Markov process analysis. Behav Sci16:482–89, 1971
42.
JanisIL: Psychological Stress. New York, Wiley, 1959
43.
JohnsonJELeventhalHDabbsJM: Contribution of emotional and instrumental response processes in adaptation to surgery. J Person Soc Psychol20:55–64, 1971
44.
MorseRMLitinEM: Postoperative delirium: A study of etiologic factors. Amer J Psychiat126:388–95, 1969
45.
KennedyJABakstH: The influence of emotions on the outcome of cardiac surgery: A predictive study. Bull NY Acad Med42:811–49, 1966
46.
WolferJADavisJA: Assessment of surgical patients' preoperative emotional condition and postoperative welfare. Nurs Res19:402–14, 1970
47.
McKegneyPF: The incidence and characteristics of patients with conversion reactions: 1. A general hospital consultation service sample. Amer J Psychiat124:542–45, 1967
48.
LipowskiZJKiriakosRZ: Borderlands between neurology and psychiatry: Observations in a neurological hospital. Int J Psychiat Med3:131–47, 1972
49.
WhitlockFA: The aetiology of hysteria. Acta Psychiat Scand43:144–62, 1967
50.
WeinsteinEALyerlyOG: Conversion hysteria following brain injury. Arch Neurol15:545–48, 1966
51.
OrchardWH: Anxiety in patients with coronary disease. Aust NZ J Psychiat3:316–20, 1969
52.
KennedyANevilleJ: Sudden loss of memory. Brit Med J2:428–33, 1957
53.
OrbachCEBieberI: Depressive and paranoid reactions. Arch Neurol Psychiat78:301–11, 1957
54.
CareyWB: Psychologic sequelae of early infancy health crises. Clin Pediat8:459–63, 1969
55.
GreenMSolnitA: Reactions to the threatened loss of a child: A vulnerable child syndrome. Pediatrics34:58–66, 1964
56.
SigalJJChagoyaLVilleneuveCMeyerovitchJ: Later psychosocial sequelae of early childhood illness (severe croup). Amer J Psychiat130:786–89, 1973
57.
MaddisonDRaphaelB: Social and psychological consequences of chronic disease in childhood. Med J Aust2:1265–270, 1971
58.
BackusFIDudleyDL: Observations of psychosocial factors and their relationship to organic disease. Int J Psychiat Med (in press)
59.
DorpatTLAndersonWFRipleyHS: The relationship of physical illness to suicide, in Suicidal Behaviors. Edited by ResnikHLP. Boston, Little, Brown, 1968
60.
TuckmanJYoungmanWFKreizmanG: Suicide and physical illness. J Gen Psychol75:291–95, 1966
61.
TuckmanJLavellM: Study of suicide in Philadelphia. Pub Hlth Rep73:547–53, 1958
62.
FarberowNLShneidmanESLeonardCV: Suicide among general medical and surgical hospital patients with malignant neoplasms. Med Bull MB-9, Vet. Adm., Washington, D.C., Feb. 25, 1963
63.
PlumbMMHollandJParkSK: Depressive symptoms in patients with advanced cancer: A controlled assessment. Paper presented at the Annual Meeting of the American Psychosomatic Society, Philadelphia, March 29–31, 1974
64.
FarberowNLMcKelligottJWCohenSDarbonneA: Suicide among patients with cardiorespiratory illnesses. JAMA195:422–28, 1966
