Review of Consultation Psychiatry and Psychosomatic Medicine

III. Theoretical Issues
  • Z. J. Lipowski


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.


Ulcerative Colitis Body Image Anorexia Nervosa Psychological Stress Theoretical Concept 
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Copyright information

© The American Psychosomatic Society, Inc. 1968

Authors and Affiliations

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

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