Advertisement

Review of Consultation Psychiatry and Psychosomatic Medicine

III. Theoretical Issues
  • Z. J. Lipowski

Abstract

In the first two parts of this review75,76 an attempt was made to define the scope and functions of psychiatric consultative activity in the nonpsychiatric divisions of general hospitals. Part I dealt primarily with the various aspects of psychiatric consultations in this type of setting. Part II included a critical survey of the studies of psychiatric morbidity among medical and surgical patients as well as an overview of psychological problems encountered by -the consultants. One of the main purposes of Parts I and II was to emphasize (1) the wealth and diversity of the clinical material accessible to psychiatric study and (2) the expanding scope of the consultants’ work. Both of these factors have an important bearing on the development of psychosomatic medicine. The latter has now entered a new phase, characterized both by increased clinical application of its principles as well as by a siginificant broadening of its theoretical perspectives. The preceding phase was marked by the predominant interest in the groups of so-called psychosomatic disorders; a great deal of research, theorizing, and therapeutic endeavor was devoted to them. There have been gains in factual knowledge and a considerable yield of explanatory hypotheses which; however, largely failed to achieve satisfactory validation. The efficacy of psychotherapeutic intervention based on the theoretical assumptions about the role of psychological etiological factors has been unimpressive.19 The overall result has been a spreading sense of disenchantment with the whole concept of psychosomatic medicine. But is it really thewhole concept that has reached an impasse or just one particular methodological approach? This writer believes that it is the latter, and will try to support his view in this section of the review.

Keywords

Ulcerative Colitis Body Image Anorexia Nervosa Psychological Stress Theoretical Concept 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Alexander F:Psychosomatic Medicine. New York, Norton, 1950.Google Scholar
  2. 2.
    Alexander F: The development of psychosomatic medicine.Psychosomatic Med24: 13, 1962.Google Scholar
  3. 3.
    Alexander FG, Selesnick, ST:The History of Psychiatry. New York, Harper, 1966, p 389.Google Scholar
  4. 4.
    Ax AF: Goals and methods of psychophysiology.Psychophysiology1: 8, 1964.PubMedCrossRefGoogle Scholar
  5. 5.
    Bain ST, Spaulding WB: The importance of coding presenting symptoms.Canad Med Assoc J97: 953, 1967.PubMedGoogle Scholar
  6. 6.
    Balint M:The Doctor, His Patient and the Illness. London, Pitman, 1957.Google Scholar
  7. 7.
    Balint M, Balint E:Psychotherapeutic Techniques in Medicine. London, Tavistock, 1961.Google Scholar
  8. 8.
    Bandler B: Some conceptual tendencies in the psychosomatic movement.Am J Psychiatry115: 36, 1958.PubMedGoogle Scholar
  9. 9.
    Berblinger KW: The functional symptom in psychiatric perspective.Psychosomatics7: 205, 1966.PubMedGoogle Scholar
  10. 10.
    Birren JE (ed):Handbook of Aging and the Individual, Chicago, University of Chicago Press, 1959.Google Scholar
  11. 11.
    Brady JV: Psychophysiology of emotional behavior in Experimental Foundations of Clinical Psychology, Bachrach AJ (ed). New York, Basic, 1962.Google Scholar
  12. 12.
    Brecht, B: The life of Galileo, in Plays, vol 1. London, Methuen, 1960.Google Scholar
  13. 13.
    Brodbeck M: Models, meaning and theories, in Gross L (ed).Symposium on Sociological Theory, New York, Harper, 1959.Google Scholar
  14. 14.
    Brown F: A clinical psychologist’s perspective on research in psychosomatic medicine.Psychosom Med20: 174, 1958.PubMedGoogle Scholar
  15. 15.
    Bruch H: Anorexia nervosa and its differential diagnosis.J Nerv Ment Dis141: 555, 1966.Google Scholar
  16. 16.
    Bruch H:The Importance of Overweight. New York, Norton, 1957.Google Scholar
  17. 17.
    Buck C, Hobbs GE: The problem of specificity in psychosomatic illness.J Psychosom Res3: 227, 1959.PubMedCrossRefGoogle Scholar
  18. 18.
    Bykov KM, Gantt HW:The Cerebral Cortex and the Internal Organs. New York, Chemical Pub., 1957.Google Scholar
  19. 19.
    Chalke FCR: Effect of psychotherapy for psychosomatic disorders.Psychosomatics6: 125, 1965.PubMedGoogle Scholar
  20. 20.
    Cleghorn RA: Message and method.Psychosom Med28: 272, 1966.PubMedGoogle Scholar
  21. 21.
    Cooper B: The epidemiological approach to psychosomatic medicine.J Psychosom Res8: 9, 1964.CrossRefGoogle Scholar
  22. 22.
    Crandell DL, Dohrenwend BP.: Some relations among psychiatric symptoms, organic illness, and social class.Am J Psychiatry123: 1527, 1967.PubMedGoogle Scholar
  23. 23.
    Deutsch F, (ed):Training in Psychosomatic Medicine, New York, Hafner, 1964.Google Scholar
  24. 24.
    Editorial: The specificity hypotheses of psychosomatic medicine.Am J Med24: 323, 1958.Google Scholar
  25. 25.
    Engel GL: A unified concept of health and disease,Perspect Biol Med3: 459, 1960.PubMedGoogle Scholar
  26. 26.
    Engel GL: Psychological factors and ulcerative colitis.Br Med J4: 56, 1967.CrossRefGoogle Scholar
  27. 27.
    Engel GL: Selection of clinical material in psychosomatic medicine.Psychosom Med16: 368, 1954.PubMedGoogle Scholar
  28. 28.
    Engel GL: Studies of ulcerative colitis: V. Psychological aspects and their implications for treatment.Am J Dig Dis3: 315, 1958.PubMedCrossRefGoogle Scholar
  29. 29.
    Engel GL: The concept of psychosomatic disorder.J Psychosom Res11: 3, 1967.PubMedCrossRefGoogle Scholar
  30. 30.
    Engel GL, Schmale AH Jr: Psychoanalytic theory of somatic disorder: Conversion, specificity, and the disease onset situation.J Am Psychoanal Assoc15: 344, 1967.PubMedCrossRefGoogle Scholar
  31. 31.
    Fawcett JA, Bunney W.E. Jr: Pituitary adrenal function and depression.Arch Gen Psychiatry16: 517, 1967.PubMedGoogle Scholar
  32. 32.
    Feingold BF, Singer MT, Freeman EH, Deskins A: Psychological variables in allergic disease: A critical appraisal of methodology.J Allerg38: 143, 1966.PubMedCrossRefGoogle Scholar
  33. 33.
    Ferreira AJ: Emotional factors in prenatal environment.J Nerv Ment Dis141: 108, 1965.PubMedCrossRefGoogle Scholar
  34. 34.
    Fisher S: A further appraisal of the body boundary concept.J Consult Psychol27: 62, 1963.PubMedCrossRefGoogle Scholar
  35. 35.
    Fisher S, Cleveland SE:Body Image and Personality. New York, Van Nostrand, 1958.Google Scholar
  36. 36.
    Fisher S., Cleveland SE: The role of body image in psychosomatic symptom choice.Psych Monogr69: 1, 1955.Google Scholar
  37. 37.
    Friedman SB, Glasgow LA: Psychologic factors and resistance to infectious disease.Pediatr Clin North Am13: 315, 1966.Google Scholar
  38. 38.
    Galdston I: Psychosomatic medicine.Arch Neurol (Chicago)74: 441, 1955.Google Scholar
  39. 39.
    Garner HH: Somatopsychic concepts.Psychosomatics7: 329, 1966.PubMedGoogle Scholar
  40. 40.
    Gellhorn E: The tuning of the nervous system: Physiological foundations and implications for behavior.Perspect Biol Med10: 559, 1967.PubMedGoogle Scholar
  41. 41.
    Gerö G: The idea of psychogenesis in modern psychiatry and in psychoanalysis.Psychoanal Rev30: 187, 1943.Google Scholar
  42. 42.
    Gibson JG: Emotions and the thyroid gland: A critical appraisal.J Psychosom Res6: 93, 1962.PubMedCrossRefGoogle Scholar
  43. 43.
    Gitelson M.A critique of current concepts in psychosomatic medicine.Bull Menninger Clin23: 165, 1959.PubMedGoogle Scholar
  44. 44.
    Goldberg EM:Family Influences and Psychosomatic Illness. London, Tavistock, 1958.Google Scholar
  45. 45.
    Graham DT: Health, disease, and the mind-body problem: Linguistic parallelism.Psychosom Med29: 52, 1967.PubMedGoogle Scholar
  46. 46.
    Graham DT, Stevenson I: Disease as response to life stress: 1. The nature of the evidence, in Lief HI, Lief VF, Lief NR (eds).:The Psychological Basis of Medical Practice, New York, Harper, 1963.Google Scholar
  47. 47.
    Granville-Grossman KL, Turner P: The effect of propranolol on anxiety.Lancet1: 788, 1966.PubMedCrossRefGoogle Scholar
  48. 48.
    Greenberg NH: Studies in psychosomatic differentiation during infancy.Arch Gen Psychiatry (Chicago)7: 389, 1962.Google Scholar
  49. 49.
    Grinker, RR:Psychosomatic Research. Norton, New York, 1953.Google Scholar
  50. 50.
    Grinker, RR: The physiology of emotions, in Simon A (ed):The Physiology of Emotions, Springfield, III, Charles Thomas, 1961.Google Scholar
  51. 51.
    Grinker RR Sr: “Open-system” psychiatry.Am J Psychoanal26:115, 1966.PubMedCrossRefGoogle Scholar
  52. 52.
    Grinker, RR Sr: The psychosomatic aspects of anxiety, inAnxiety and Behavior, Spielberger, CD (ed): New York, Academic Press, 1966.Google Scholar
  53. 53.
    Halliday JL:Psychosocial Medicine. New York, Norton, 1948.Google Scholar
  54. 54.
    Hamburg DA, Adams JE: A perspective on coping behavior.Arch Gen Psychiatry (Chicago)17: 277, 1967.Google Scholar
  55. 55.
    Heusner PA: Phantom genitalia.Trans Amer Neurol Assoc75: 128, 1950.Google Scholar
  56. 56.
    Hinkle LE Jr. Ecological observations of the relation of physical illness, mental illness, and the social environment.Psychosom Med23: 289, 1961.Google Scholar
  57. 57.
    Hinkle LE Jr; Human ecology, “psychosomatic medicine” and the medical curriculum.Adv Psychosom Med4: 23, 1964.Google Scholar
  58. 58.
    Hinsie LE, Campbell RJ:Psychiatric Dictionary, ed 3. New York, Oxford, 1960.Google Scholar
  59. 59.
    Hoffman J: Facial phantom phenomenon.J Nerv Ment Dis122: 143, 1954.Google Scholar
  60. 60.
    Hollender MH:The Psychology of Medical Practice. Philadelphia, Saunders, 1958.Google Scholar
  61. 61.
    Jarvis JH: Post-mastectomy breast phantoms.J Nerv Ment Dis144: 266, 1967.CrossRefGoogle Scholar
  62. 62.
    Kaplan HI, Kaplan HS: an historical survey of psychosomatic medicine.J Nerv Ment Dis124: 546, 1956.PubMedCrossRefGoogle Scholar
  63. 63.
    Kaplan HI, Kaplan HS: A psychosomatic concept.Am J Psychother11: 16, 1957.PubMedGoogle Scholar
  64. 64.
    Kaplan HI, Kaplan HS: Current theoretical concepts in psychosomatic medicine.Am J Psychiatry115: 1091, 1959.PubMedGoogle Scholar
  65. 65.
    Kaufman RM: Introduction, in Early recognition and management of psychiatric disorders in general practice.J Mount Sinai Hosp NY25:137, 1958.Google Scholar
  66. 66.
    Kaufman RM, Heiman, M (eds):Evolution of Psychosomatic Concepts. Anorexia Nervosa: A Paradigm. New York, International Universities Press, 1964.Google Scholar
  67. 67.
    Kessel N., Munro A: Epidemiological studies in psychosomatic medicine.J Psychosom Res8: 67, 1964.CrossRefGoogle Scholar
  68. 68.
    Kral VA: Psychiatric observations under severe chronic stress.Am J Psychiatry108: 185, 1951.PubMedGoogle Scholar
  69. 69.
    Kubie LS: The problem of specificity in the psychosomatic process, in Deutsch F (ed):The Psychosomatic Concept in Psychoanalysis, New York, International Universities Press, 1953.Google Scholar
  70. 70.
    Langer SK:Mind: An Essay on Human Feeling. Baltimore, Johns Hopkins Press, 1967, vol 1.Google Scholar
  71. 71.
    Lazarus RS:Psychological Stress and the Coping Process. New York, McGrawHill, 1966.Google Scholar
  72. 72.
    Lewin KK: Psychosomatic research: Problems in methodology.Ann Intern Med50: 122, 1959.PubMedGoogle Scholar
  73. 73.
    Lewis A:Inquiries in Psychiatry. London, Routledge, 1967.Google Scholar
  74. 74.
    Lipowski ZJ: Delirium, clouding of consciousness and confusion.J Nerv Ment Dis145: 227, 1967.PubMedCrossRefGoogle Scholar
  75. 75.
    Lipowski ZJ: Review of consultation psychiatry and psychosomatic medicine. I. General principles.Psychosom Med29: 153, 1967.PubMedGoogle Scholar
  76. 76.
    Lipowski ZJ: Review of consultation psychiatry and psychosomatic medicine. II. Clinical aspects.Psychosom Med29: 201, 1967.PubMedGoogle Scholar
  77. 77.
    Lipton EL, Steinschneider A, Richmond JB: The autonomic nervous system in early life.N Engl J Med273: 147, 1965.PubMedCrossRefGoogle Scholar
  78. 78.
    Lukianowicz N: “Body image” disturbances in psychiatric disorders.Br J Psychiatry113:31, 1967.PubMedCrossRefGoogle Scholar
  79. 79.
    Maclay I: The “functional” medical outpatient.Br J Psychiatry111: 34, 1965.PubMedCrossRefGoogle Scholar
  80. 80.
    MacLean PD: Psychosomatics, in Field J (ed):Handbook of Physiology. Washington, DC, American Physiology Society, 1960, section 1, vol 3.Google Scholar
  81. 81.
    McCleary AR, Moore RY:Subcortical Mechanisms of Behavior. New York, Basic, 1965.Google Scholar
  82. 82.
    McDermott JF Jr., Finch, SM: Ulcerative colitis in children: Reassessment of a dilemma.J Am Acad Child Psychiatry6: 512, 1967.PubMedCrossRefGoogle Scholar
  83. 83.
    Meissner WW: Family dynamics and psychosomatic processes.Fam Process5: 142, 1966.CrossRefGoogle Scholar
  84. 84.
    Mendel WM: Psychiatric consultation education—1966.Am J Psychiatry123: 150, 1966.PubMedGoogle Scholar
  85. 85.
    Mendelson M, Hitsch S, Webber MA. A critical examination of some recent theoretical models in psychosomatic medicine.Psychosom Med18: 363, 1956.PubMedGoogle Scholar
  86. 86.
    Meyer E: The psychosomatic concept, use and abuse.J Chron Dis9: 298, 1959.PubMedCrossRefGoogle Scholar
  87. 87.
    Miller JG: Living systems: Basic concepts.Behav Sci10: 193, 1965.PubMedCrossRefGoogle Scholar
  88. 88.
    Miller MH, Greenfield NS: Body image: The value of a psychiatric construct in medical practice.AP-DT10: 447, 1959.Google Scholar
  89. 89.
    Mirsky AI: Physiologic, psychologic, and social determinants in the etiology of duodenal ulcer.Am J Dig Dis3: 285, 1958.PubMedCrossRefGoogle Scholar
  90. 90.
    Mirsky AI: Psycho-physiological basis of anxiety.Psychosomatics1: 1, 1960.Google Scholar
  91. 91.
    Mirsky AI: The psychosomatic approach to the etiology of clinical disorders.Psychosom Med19: 424, 1957.PubMedGoogle Scholar
  92. 92.
    Moos RH: Personality factors associated with rheumatoid arthritis: A review.J Chron Dis17: 41, 1964.PubMedCrossRefGoogle Scholar
  93. 93.
    Mordkoff AM, Parsons OA: The coronary personality: A critique.Psychosom Med29: 1, 1967.PubMedGoogle Scholar
  94. 94.
    Mutter AZ, Schleifer MJ: The role of psychological and social factors in the onset of somatic illness in children.Psychosom Med28: 333, 1966.PubMedGoogle Scholar
  95. 95.
    Neurophysiology and psychosomatic research.J Psychosom Res9: 5, 1965.CrossRefGoogle Scholar
  96. 96.
    Nichols DC, Tursky B: Body image, anxiety, and tolerance for experimental pain.Psychosom Med29: 103, 1967.PubMedGoogle Scholar
  97. 97.
    O’Connor JF, Daniels G., Karush A, Flood C, Stern, LO: Prognostic implications of psychiatric diagnosis in ulcerative colitis.Psychosom Med28: 375, 1966.PubMedGoogle Scholar
  98. 98.
    O’Connor JF, Stern LO: Symptom alternation.Arch Gen Psychiatry (Chicago)16: 432, 1967.Google Scholar
  99. 99.
    Oken D: The role of defense in psychological stress, in Roessler R, Greenfield NS (eds).Physiological Correlates of Psychological Disorder, Madison, University of Wisconsin Press, 1962.Google Scholar
  100. 100.
    Parens H, McConville BJ, Kaplan SM: The prediction of frequency of illness from the response to separation: A preliminary study and replication attempt.Psychosom Med28: 162, 1966.PubMedGoogle Scholar
  101. 101.
    Petrie A:Individuality in Pain and Suffering. Chicago, University of Chicago Press, 1967.Google Scholar
  102. 102.
    Psychosphysiological aspects of cancer.Ann NY Acad Sci125: 773, 1966.Google Scholar
  103. 103.
    Psychosomatic Disorders. WHO Techn. Rep. Ser., 275, 1964.Google Scholar
  104. 104.
    Purchard PR: Some psychiatric aspects of dermatology.Psychiat Quart41: 280, 1967.PubMedCrossRefGoogle Scholar
  105. 105.
    Rahe, RH, McKean JD, Arthur RJ: A longitudinal study of life-change and illness patterns.J Psychosom Res10: 355, 1967.PubMedCrossRefGoogle Scholar
  106. 106.
    Rahe RH, Meyer M, Smith M, Kjaer G, Holmes TH: Social stress and illness onset.J Psychosom Res8: 35, 1964.CrossRefGoogle Scholar
  107. 107.
    Reiser MF, Bakst H: Psychology of cardiovascular disorders, inAmerican Handbook of Psychiatry Arieti, S (ed). New York, Basic, 1959, vol 1.Google Scholar
  108. 108.
    Rosenbaum, M, Reiser, MF: Principles of management of psychosomatic disorders.Med Clin North Am42: 769, 1958.PubMedGoogle Scholar
  109. 109.
    Rubin RT, Mandell AJ: Adrenal cortical activity in pathological emotional states: A review.Am J Psychiatry123: 387, 1966.PubMedGoogle Scholar
  110. 110.
    Rubins JL: Psychodynamics and psychosomatic symptoms, inThe Collected Award Papers, New York, Gralnick Foundation, 1966.Google Scholar
  111. 111.
    Schilder, P:The Image and Appearance of the Human Body, New York, International Universities Press, 1950.Google Scholar
  112. 112.
    Schmale AH Jr, Engel GL: The giving up-given up complex illustrated on film.Arch Gen Psychiatry (Chicago)17: 135, 1967.Google Scholar
  113. 113.
    Schmitt FO: Molecular biology among the neurosciences.Arch Neurol17: 561, 1967.PubMedGoogle Scholar
  114. 114.
    Schur M: Comments on the metapsychology of somatization, inThe Psychoanalytic Study of the Child. New York, International Universities Press, 1955, vol 10.Google Scholar
  115. 115.
    Shapiro AP: Psychophysiologic mechanisms in hypertensive vascular disease.Ann Intern Med53: 64, 1960.PubMedGoogle Scholar
  116. 116.
    Simmel ML: On phantom limbs.Arch Neurol Psychiatry75: 637, 1956.Google Scholar
  117. 117.
    Solomon GF, Moos RH: Emotions, immunity, and disease.Arch Gen Psychiatry(Chicago) 11: 657, 1964.Google Scholar
  118. 118.
    Sontag LW: Somatopsychics of personality and body funtion.Vita Hum6: 1, 1963.PubMedGoogle Scholar
  119. 119.
    Sperling M: Transference neurosis in patients with psychsomatic disorders.Psychoanal Quart36: 342, 1967.Google Scholar
  120. 120.
    Spielberger CD (ed).:Anxiety and Behavior. New York, Academic Press, 1966.Google Scholar
  121. 121.
    Sternbach RA:Prinicples of Psychophysiology. New York, Academic Press, 1966.Google Scholar
  122. 122.
    Stoeckle JD, Zola IK, Davidson GE: The quantity and significance of psychological distress in medical patients.J Chronic Dis17: 959, 1964.PubMedCrossRefGoogle Scholar
  123. 123.
    Szasz TS: Comments on “the definition of psychosomatic disorder.”Br J Philos Sci7: 231, 1956.CrossRefGoogle Scholar
  124. 124.
    Taylor BW, Litin EM, Litzow TJ: Psychiatric considerations in cosmetic surgery.Mayo Clin Proc41: 608, 1966.PubMedGoogle Scholar
  125. 125.
    Tchehov AP: A dreary story, inSelect Tales of Tchehov. London, Chatto & Windus, 1954.Google Scholar
  126. 126.
    Thurlow JH: General susceptibility to illness: A selective review.Can Med Assoc J97: 1397, 1967.PubMedGoogle Scholar
  127. 127.
    Von Bertalanffy L: A biologist looks at human nature.Sci Monthly82: 33, 1956.Google Scholar
  128. 128.
    Von Bertalanffy L: The mind-body problem: A new view.Psychosom Med26: 29, 1964.Google Scholar
  129. 129.
    Walker N: The definition of psychosomatic disorder.Br J Philos Sci6: 265, 1956.CrossRefGoogle Scholar
  130. 130.
    Wapner S, Werner H (eds):The Body Percept. New York, Random, 1965.Google Scholar
  131. 131.
    Weiner H: Training in psychosomatic research.Adv Psychosom Med5: 64, 1967.PubMedGoogle Scholar
  132. 132.
    Wenar C, Handion MW, Garner AM (eds).:Origins of Psychosomatic and Emotional Disturbances. A Study of Mother-Child Relationships. New York, Hoeber, 1962.Google Scholar
  133. 133.
    Whitehead AN, quoted in Woodger JH:Biological Principles, New York, Humanities, 1967, p 157.Google Scholar
  134. 134.
    Williams RL, Krasnoff AG: Body image and physiological patterns in patients with peptic ulcer and rheumatoid arthritis.Psychosom Med26: 701, 1964.PubMedGoogle Scholar
  135. 135.
    Wisdom JO: Whole-person medicine: Psychosomatic approach or psychosomatic disorder?Acta Psychother12: 241, 1964.Google Scholar
  136. 136.
    Wittkower ED, Lipowski ZJ: Recent developments in psychosomatic medicine.Psychosom Med28: 722, 1966.Google Scholar
  137. 137.
    Wittkower ED, Solyom L: Models of mind-body interaction.Int J Psychiatry4: 225, 1967.PubMedGoogle Scholar
  138. 138.
    Woodger JH:Biology and Language. London, Cambridge, 1952.Google Scholar
  139. 139.
    Woodger JH:Physics, Psychology and Medicine. London, Cambridge, 1956.Google Scholar
  140. 140.
    Zimmer H (ed): Computers in Psychophysiology. Springfield III, Charles C Thomas, 1966.Google Scholar

Copyright information

© The American Psychosomatic Society, Inc. 1968

Authors and Affiliations

  • Z. J. Lipowski
    • 1
  1. 1.Clarke Institute of PsychiatryTorontoCanada

Personalised recommendations