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Psychosomatic medicine is an interdisciplinary medical field studying psychosomatic illness, now more commonly referred to as psychophysiologic illness or disorder, whose symptoms are caused by mental processes of the sufferer rather than immediate physiological causes. These syndromes are classified as neurotic, stress-related and somatoform disorders by the World Health Organization in the International Statistical Classification of Diseases and Related Health Problems.
Psychosomatic medicine integrates interdisciplinary evaluation and management involving diverse specialties, including but not limited to psychiatry, psychology, neurology; surgery; gynecology; pain management; pediatrics; dermatology; and psychoneuroimmunology. Clinical situations where psychological processes act as a major factor affecting medical outcome and affecting medical compliance and/or surgical results are areas where Psychosomatic medicine has competence.[1] A major European textbook on psychosomatic medicine (over 1000 pp, six German editions) is the one edited by Thure von Uexküll.[2]
Sufferers of psychosomatic illness are experiencing pain, nausea, or other physically felt symptoms, but with no physical cause that can be diagnosed.
Physical complaints may have a defined psychological cause, including conversion disorder, somatization disorder, and tension myositis syndrome, while some physical conditions such as vitamin deficiency or brain injury can cause major psychological symptoms. When the cause of a condition is uncertain, the possibility that it is psychosomatic is sometimes considered. Some illnesses which were previously thought of as being purely psychosomatic, such as allergies, are now known to have an identifiable organic cause. For other illnesses, such as chronic fatigue syndrome, controversies remain. A complicating factor is that there is a psychological influence on the risk and development of many physical conditions, such as heart disease and peptic ulcers.
Until the seventeenth century, hysteria was regarded as of uterine origin (from the Greek “hustera” = uterus) in the Western world. The ancient Greeks believed that the uterus could detach itself and move about the body, and hysterical symptoms would emanate from the part of the body in which the wandering uterus lodged itself.[3]
In the medieval Islamic world, the Muslim psychologist-physicians, Ahmed ibn Sahl al-Balkhi (d. 934) and Haly Abbas (d. 994), developed an early understanding of psychosomatic disorders. They realized how a patient’s physiology and psychology can have an effect on one another, and found a correlation between patients who were physically and mentally healthy and those who were physically and mentally ill.[4] Avicenna (980-1037) recognized ‘physiological psychology’ in the treatment of illnesses involving emotions, and developed a system for associating changes in the pulse rate with inner feelings, which is seen as an anticipation of the word association test later developed by Carl Jung.[5]
In the 1840s and 1850s, hysteria was already the subject in medical textbooks and specialized studies as i. e. the “Traité Clinique et Therapeutique de L’Hysterie” published in 1859 by Pierre Briquet.[6][7] In the 1870s, hysteria was also studied by Jean-Martin Charcot.[8] Charcot wanted to demonstrate recurrent clinical characteristics in hysterical symptoms, similarly to neuropathological disorders. Through observation and the use of a camera Charcot was able to record some recurrent clinical features of hysteria and with the use of hypnosis he researched into hysterical neurosis and its associated neurological mechanisms.[9]
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