Stress and Illness

  • Kyung Bong Koh


The mechanisms linking stress to illness were reviewed. Cognitive appraisal of stressors, coping with stress, emotional responses, physiological changes related to the hypothalamic-pituitary-adrenal (HPA) axis, sympathetic-adrenal-medullary (SAM) axis, endogenous opium, and immune system can be involved in the development of illnesses. Stress and coping model with emphases on individuals’ cognition toward stressors and coping consists of six steps: life event perception, psychological defense, psychophysiological response, response management (coping skill utilization), illness behavior, and illness evaluation steps. To explore the role of the brain in the relationship between stress and illnesses, the functions of each of the reticular activating system (RAS), limbic system, hypothalamus, autonomic nervous system (ANS), and pituitary, and their interactions were reviewed. In addition, the relationship between stress and memes was discussed. More details on the relationship between stress and immune system were already described in the chapter “Stress, Emotion, and Immunity.”


Stress Illness Cognitive appraisal Coping Hypothalamic-pituitary-adrenal (HPA) axis Sympathetic-adrenal-medullary (SAM) axis Immune system Cognition Memes 


  1. 1.
    Koh KB. The prevalence of psychosomatic disorders and stress perception in medical inpatients. J Korean Neuropsychiatr Assoc. 1988;27:525–34.Google Scholar
  2. 2.
    Koh KB. Stress perception of patients with psychosomatic disorders. J Korean Neuropsychiatr Assoc. 1988;27:514–23.Google Scholar
  3. 3.
    Koh KB. Stress and psychosomatic medicine. Ilchokak: Seoul; 2011.Google Scholar
  4. 4.
    American Psychiatric Association (APA). Statistical and diagnostic manual of mental disorders. 5th ed. Washington, DC: Am Psychiatric Publishing; 2013.CrossRefGoogle Scholar
  5. 5.
    Holmes TH, Rahe RH. The social readjustment rating scale. J Psychosom Res. 1967;11:213.CrossRefGoogle Scholar
  6. 6.
    Rahe RH. Stress and psychiatry. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. 6th ed. Baltimore: Williams & Wilkins; 1995.Google Scholar
  7. 7.
    Hong K, Chung D. Social readjustment rating scale: methodological study. J Korean Neuropsychiatr Assoc. 1982;21:123–36.Google Scholar
  8. 8.
    Reiser MF. Psychophysiology of stress and its sequelae. In: Reiser MF, editor. Mind, brain, body: toward a convergence of psychoanalysis and neurobiology. New York: Basic Books; 1984.Google Scholar
  9. 9.
    Oken D. Current theoretical concepts in psychosomatic medicine. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry, vol. 2. 5th ed. Baltimore: Williams & Wilkins; 1989.Google Scholar
  10. 10.
    Fawzy FI. Behavior and immunity. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. Baltimore: Williams & Wilkins; 1995.Google Scholar
  11. 11.
    Greenberg JS. Coping with stress: a practical guide. Dubuque: Wm C Publishers; 1990.Google Scholar
  12. 12.
    Rice PL. Stress and health: principles and practice for coping and wellness. Pacific Grove: Brooks/Cole Publishing Co; 1987. p. 17–33. p37–60.Google Scholar
  13. 13.
    Grossman S. Essentials of physiological psychology. New York: Wiley; 1973.Google Scholar
  14. 14.
    Melzack R, Wall P. Pain mechanisms: a new theory. Science. 1965;50:971–9.CrossRefGoogle Scholar
  15. 15.
    Standring S. Gray’s anatomy. The anatomical basis of clinical practice. 41st ed. Amsterdam: Elsevier Health Sciences; 2015. p. 358.Google Scholar
  16. 16.
    Marieb E. Anatomy & physiology. Glenview: Pearson Education; 2014.Google Scholar
  17. 17.
    Locke SE. Stress, adaptation, and immunity: studies in humans. Gen Hosp Psychiatry. 1982;4:49–58.CrossRefGoogle Scholar
  18. 18.
    Chrousos GP. The concept of stress and stress system disorders. JAMA. 1992;267:1244–52.CrossRefGoogle Scholar
  19. 19.
    Weiss JM, Sundar S. Effects of stress on cellular immune responses in animals. In: Tasman A, Riba MB, editors. Am psychiatr press review of psychiatry, vol. 11. Washington, DC: Am Psychiatr Press; 1992.Google Scholar
  20. 20.
    Duric V, Clayton S, Leong ML, et al. Comorbidity factors and brain mechanisms linking chronic stress and systemic illness. Neural Plast. Scholar
  21. 21.
    Leigh H. Genes, memes, culture, and psychosomatic medicine: an integrative model. In: Koh KB, editor. Somatization and psychosomatic symptoms. New York: Springer; 2013.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Kyung Bong Koh
    • 1
  1. 1.Department of PsychiatryYonsei University College of MedicineSeoulKorea

Personalised recommendations