Psychosomatic medicine is an interdisciplinary field of medicine that focuses on the interaction of biological, psychological, social and behavioral factors in the genesis of a disorder. A key element of the psychosomatic view is the effect of stress on the homeostatic dysregulation and the consequent emergence of symptomatology. The fields of intervention in psychosomatic medicine include health behavior modifications, a general psychosomatic approach, psychotherapy and pharmacotherapy. Assessment strategies include the Diagnostic Criteria for Psychosomatic Research. Psychotherapeutic strategies, such as cognitive-behavioral therapy, wellbeing therapy, mindfulness-based stress reduction as well as other therapeutic interventions, such as biofeedback, have several indications with regards to psychosomatic illnesses. According to various literature reports, most of these interventions have a positive effect on brain neuroplasticity and the reduction of allostatic load, often through epigenetic mechanisms. Psychotherapy has also been shown to bring on structural and functional changes to the brain through learning mechanisms and long-term potentiation (LPT). Epigenetic mechanisms may be potential targets of psychotherapeutic interventions. Psychopharmacology is also a frequently used intervention in the psychosomatic field. However, we should be aware of the fact that psychopharmacological interventions may produce adverse effects that may in turn exacerbate physical illness, and also somatic pharmacological interventions may cause psychiatric side effects. The beneficial roles of the social support network and eudaemonic well-being are also highlighted. Moreover, the recent emergence of epigenetic drugs has shown promising results in preclinical studies of idiopathic mental disorders. The goal of the biopsychosocial approach is to promote a humanitarian, holistic care and improve the health of the individual. The cornerstone of the implementation of this holistic approach is the presence of an interdisciplinary team that should collaborate with the patient in order to provide thorough information on diagnosis, therapy and prognosis of psychosomatic illness.

KEYWORDS: psychosomatic medicine, biopsychosocial model, brain neuroplasticity, holistic approach

Angeliki Theodorakopoulou, Ioannis Tollos, Georgios N. Christodoulou


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