2023/07/10

心身医学 - Wikipedia Psychosomatic medicine

心身医学 - Wikipedia


심신의학

출처 : 무료 백과 사전 "Wikipedia (Wikipedia)"

심신의학 (심신학, 영어 : psychosomatic medicine ) 또는 심요 내과학 은 환자 의 신체면뿐만 아니라 심리·사회면을 포함하여 인간 을 통합적으로 진찰하려고 하는 전인적 의료를 목표로 하는 의학 의 한 분야이다. 심신의학을 실천하고 있는 진료과가 심요내과 (신료 없는가)이다.

개요 [ 편집 ]

심신의학은 원래 독일 에서 탄생한 의학이다. 그 후 미국 에 걸쳐 정신과 의사를 중심으로 발전해 갔다. 외국에서는 정신의학 의 한 분야라고 하는 인식이며, 대부분의 나라에서는 정신 증상이 있는 시점에서 정신과 의 진찰이 된다. 1940년대 부터 1960년대 까지는 프로이트파 의 정신분석 이나 역동정신의학 등을 배운 사람이 취급하는 것으로 생각되고 있었지만, 최근의 조류는 행동의학으로 시프트하고 있다[1 ] . 현재의 독일에서는 리에존 정신의학 으로서, 전의학생 에게 심신의학의 교육이 의무화되어 있고, 국가 시험에도 필수적인 문제가 출제되고 있다 [2] .

한편, 일본의 심신의학은 질병의 발병이나 진행에 심리적 요인이 크게 관련되는 기질성 질환을 중심으로 취급하는 분야로서 주로 내과학으로부터 발전해 갔다. 초기에는 "정신 신체 의학"이라고 불렸다 [3] .

심신의학의 주요 대상은 심신병 이다. 내과질환을 주된 대상으로 하는 경우는 「심요내과학」이라고 부르기도 한다. 심리면을 포함한 신체 질환의 치료에 해당하는 것이 심신 의학의 전문의이지만, 최근의 의료 기술의 진보에 의해, 신체과의 전문의와의 제휴 없이는 치료를 진행할 수 없는 경우도 많고, 그 경우, 컨설테이션・리에종 정신의학과의 명확한 구별은 할 수 없다 [1] .

심신증의 진단에는 「명백한 신체질환이다」 「부하가 되는 환경변화에 의해 신체증상이 악화된다」의 2개의 조건이 불가결하고, 그 밖에는 「사회 적응은 비교적 양호하다」 「 신체 치료를 해도 증상이 개선되지 않거나 재연을 반복한다” 등의 특징이 있는 경우가 많다 [1] .

심요내과 [ 편집 ]

심요내과는 주로 심신증 이나 스트레스 에서 오는 신체 증상을 다룬다. 최초로 심요내과가 탄생한 것은 규슈대학병원 에서 현재 심요내과 강좌·진료과를 가진 의과대학 은 규슈대학 , 도쿄대학 , 동방대학 , 간사이 의과 대학 , 가고시마 대학의 5개 대학뿐이다. [2] . 그 외에 진료과를 가지는 의과대학으로서는 긴키대학 , 일본대학 , 도호쿠 대학 , 도쿄의과 치과대학(치학부) 등이 있다 [4] .

심요내과와 정신과 [ 편집 ]

「심요내과」라는 명칭은 일본에만 존재한다(독일에서는 「심신의학과」라는 명칭의 진료과가 된다 [2] ). 여기서 「심요」란 「심리요법」의 생략이며, 「심을 치료한다」라고 하는 의미는 아니다(「물요내과」가 「물리요법」의 생략인 것과 동일 ) . 그러나 실제로는, 심신의학을 전문으로 하는 심요내과는, 정신과 와 다소의 경쟁 분야가 되고 있다 [1] .

현재는 일반적으로 정신과와 심요내과의 구별은 모호하고, 심신의학의 전문의나 심요내과의가, 신체 증상을 가지는 신경증성 장애나 경증 우울증 등의 진찰에 해당하는 것은 드물지 않게 되었지만 , 전문성에 관해서는 논의의 대상이 되고 있고 [1] , 심요내과의가 최신의 정신의학을 습득하고 있는지는 개인차가 있다고 한다 [5] .

일본에 있어서는 1996년 에 「심요내과」가 후생성 에 표방과로서 인정되어 이후, 정신과를 포함한 많은 의료기관에서 「심요내과」의 표방을 내걸게 되어, 심신증의 치료가 받기 쉽고 되었다. 환자측에 정신과통원에 대한 편견이 있는 경우 정신과가 아니라 심요내과의 진찰을 희망하는 경우도 많다. 그러나, 그러한 환자에서도 실제로 심요내과에서 진찰해야 할 심신증인 것은 적다고 한다 [6] .

덧붙여 심요내과의가 개업하고 있는 경우 「심요내과・내과」, 정신과의가 개업 하고 있는 경우는 「심요내과・정신과・신경과」등이라고 표방하고 있는 경우가 많다. 종합병원 등에 정신과가 없고 심요 내과만이 존재하고 있는 경우 등에서는 정신과 의사가 진찰을 하고 있는 경우도 있다 .

후생노동성의 2008년 통계에 의하면, 국내의 심요내과의사(내과의를 제외한다)의 수는 883명으로, 정신과의의 수는 13,534명이다[7 ] .

동방대학 의학부 부속 오모리병원 심요내과에서는 “심요내과는 순수한 심신증만을 보지 말아야 한다 . 요출전 ] .

심장 내과에서 다루는 질병 [ 편집 ]

정신 심리 상태와 신체의 상호 작용 [ 편집 ]

심리 상태가 신체 상태에 영향을 미친다는 실증적인 연구가 진행되고 있다. 일본에서는 1995년 전후에 웃음 과 스트레스 가 NK세포 의 활성도를 비롯한 면역상태에 영향을 미친다는 발표가 이루어졌다. 암의 경우에는 말기 암 환자에게 상담 치료를 실시한 경우와 실시하지 않은 경우에서 평균 생존기간과 생활의 질(QOL)에 큰 차이가 생긴 것이 1978 년 미국 컬 · 사이먼턴 에 의해 보고되었다.

암 심리 치료 [ 편집 ]

암 의 경우에, 환자의 정신면의 상담 등을 실시하여 치유의 촉진을 도모하는 요법이 있다. 1970년대 미국 칼 사이먼턴 에 의해 시작된 사이먼턴 요법이 있다 . 정신 종양학 , 정신 신경 면역학 에 기초. 일본에는 1999년 에 도입되어 인정 치료사 에 의한 치료가 진행되고 있다.

일본에서는 모리타 요법 에 근거한 생명요법 의 실천이 1980년대 부터 계속되고 있다.

각주 [ 편집 ]

[ 각주 사용법 ]
  1. ↑ a b c d e 노무라 소이치로·히구치 테츠히코·오자키 기오 “표준 정신 의학 제4판” 의학 서원, 2009년, p.13, pp.164-165, p.221
  2. ↑ a b c 간사이 의과대학 심요내과학 강좌 「심요내과란? 심신증이란?」
  3. ↑ 큐슈대학병원 심요내과의 소개
  4. ↑ 일본심신의학회 연선
  5. ^ 사이토 에이지 「마음의 병―정신병・우울증・심신증・스트레스…」서동사, 2000년
  6. ^ a b 카시와세 히로타카 『심요내과와 정신과』 2011년 1월
  7. ↑ 후생노동성 「의사・치과 의사・약제사 조사의 개황」2008년

관련 문헌 [ 편집 ]

  • 마스다 아키노 (Musuka Mizuru) 외 "건강 성인 남성의 NK 세포 활성과 심리 및 행동 특성, 스트레스 대처 행동, 만성 피로의 관계에 관한"심신 의학, 35 (5) 383-390, 1995.
  • "Getting Well Again"　O. Carl Simonton, MD, Stephanie Mathews-Simonton, James L. Creighton, 1981.

관련 항목 [ 편집 ]

외부 링크 [ 편집 ]



===


出典: フリー百科事典『ウィキペディア（Wikipedia）』

心身医学（しんしんいがく、英語: psychosomatic medicine）または心療内科学は、患者の身体面だけではなく心理・社会面を含めて、人間を統合的に診ていこうとする全人的医療を目指す医学の一分野である。心身医学を実践している診療科が心療内科（しんりょうないか）である。

概要[編集]

心身医学は元来ドイツで誕生した医学である。その後アメリカ合衆国にわたり、精神科医を中心に発展していった。諸外国では精神医学の一分野という認識であり、大半の国では精神症状がある時点で精神科の受診となる。1940年代から1960年代までは、フロイト派の精神分析や力動精神医学などを学んだ者が扱うものと考えられていたが、近年の潮流は行動医学へとシフトしている[1]。現在のドイツではリエゾン精神医学として、全医学生に心身医学の教育が義務づけられており、国家試験にも必須の問題が出題されている[2]。

一方、日本の心身医学は、病気の発症や進行に心理的要因が大きく関わる器質性疾患を中心に扱う分野として主に内科学から発展していった。初期の頃は「精神身体医学」と称されていた[3]。

心身医学の主な対象は心身症である。内科疾患を主な対象とする場合は「心療内科学」と呼ぶこともある。心理面を含めた身体疾患の治療にあたるのが心身医学の専門医であるが、近年の医療技術の進歩によって、身体科の専門医との連携なしでは治療を進め得ないことも多く、その場合、コンサルテーション・リエゾン精神医学との明確な区別はできない[1]。

心身症の診断には「明らかな身体疾患である」「負荷となる環境変化により身体症状が増悪する」の2つの条件が不可欠であり、他には「社会適応は比較的良好である」「身体治療をしても症状が改善しない、あるいは再燃を繰り返す」などの特徴があることが多い[1]。

心療内科[編集]

心療内科は主に心身症やストレスからくる身体症状を扱う。最初に心療内科が誕生したのは、九州大学病院で、現在心療内科の講座・診療科を持つ医科大学は、九州大学、東京大学、東邦大学、関西医科大学、鹿児島大学の5大学のみである[2]。他に診療科を持つ医科大学としては近畿大学、日本大学、東北大学、東京医科歯科大学（歯学部）などがある[4]。

心療内科と精神科[編集]

「心療内科」という名称は日本にしか存在しない（ドイツでは「心身医学科」という名称の診療科になる[2]）。ここで「心療」とは「心理療法」の省略であり、「心を治療する」という意味ではない（「物療内科」が「物理療法」の省略であるのと同様）。しかし実際は、心身医学を専門とする心療内科は、精神科と多少の競合分野となっている[1]。

現在では一般的に精神科と心療内科の区別は曖昧であり、心身医学の専門医や心療内科医が、身体症状を有する神経症性障害や軽症うつ病などの診察にあたることは珍しくなくなったが、専門性に関しては議論の対象となっており[1]、心療内科医が最新の精神医学を修得しているかは個人差があるといわれる[5]。

日本においては1996年に「心療内科」が厚生省に標榜科として認められて以降、精神科を含む多くの医療機関で「心療内科」の標榜が掲げられるようになり、心身症の治療が受けやすくなった。患者側に精神科通院に対する偏見がある場合、精神科ではなく心療内科の受診を希望することも多い。しかし、そのような患者でも実際に心療内科で診るべき心身症であることは少ないという[6]。

なお心療内科医が開業している場合「心療内科・内科」、精神科医が開業している場合は「心療内科・精神科・神経科」などと標榜している場合が多い。総合病院などに精神科がなく心療内科のみが存在しているケースなどでは、精神科医が診察を行っていることもある[6]。

厚生労働省の2008年統計によると、国内の心療内科医（内科医を除く）の数は883人で、精神科医の数は13,534人である[7]。

東邦大学医学部附属大森病院心療内科では、「心療内科は純粋な心身症だけを見るべきではない。本来の心身症の患者は、心療内科受診者の15%にすぎない」とコメントしている[要出典]。

心療内科で扱う病気[編集]

精神心理状態と身体の相互作用[編集]

心理状態が身体の状態に影響を与えるという実証的な研究が進んでいる。日本では1995年前後に、笑いやストレスがNK細胞の活性度をはじめとする免疫状態に影響を与えるという発表が行われた。癌の場合には、末期がんの患者にカウンセリング治療を行った場合と行わなかった場合とで、平均生存期間や生活の質 (QOL) に大きな違いが生じたことが1978年に米国のカール・サイモントンによって報告された。

癌の心理療法[編集]

癌の場合に、患者の精神面のカウンセリングなどを行って治癒の促進を図る療法がある。同じような病状の患者に同じ治療を施しても、患者の心理状態によって治療結果が大きく変わるとして、1970年代に米国のカール・サイモントンによって始められたサイモントン療法がある。精神腫瘍学、精神神経免疫学に基づく。日本へは1999年に導入され、認定セラピストによる治療が行われている。

日本では、森田療法に基づく生きがい療法の実践が、1980年代から続けられている。

脚注[編集]

[脚注の使い方]
  1. ^ a b c d e 野村総一郎・樋口輝彦・尾崎紀夫『標準精神医学 第4版』医学書院、2009年、p.13、pp.164-165、p.221
  2. ^ a b c 関西医科大学 心療内科学講座「心療内科とは？心身症とは？」
  3. ^ 九州大学病院 心療内科の紹介
  4. ^ 日本心身医学会 沿線
  5. ^ 齋藤英二『心の病気―精神病・うつ病・心身症・ストレス…』西東社、2000年
  6. ^ a b 柏瀬宏隆 『心療内科と精神科』 2011年1月
  7. ^ 厚生労働省『医師・歯科医師・薬剤師調査の概況』2008年

関連文献[編集]

  • 増田彰則他「健常成人男性におけるNK細胞活性と心理・行動特性、ストレス対処行動、慢性疲労の関係について」心身医学、35 (5) 383-390, 1995.
  • "Getting Well Again"　O. Carl Simonton, MD, Stephanie Mathews-Simonton, James L. Creighton, 1981.（日本語訳「がんのセルフコントロール」）

関連項目[編集]

外部リンク[編集]

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Psychosomatic medicine

From Wikipedia, the free encyclopedia
For the medical journal, see Psychosomatic Medicine (journal).

Psychosomatic medicine is an interdisciplinary medical field exploring the relationships among social, psychological, behavioral factors on bodily processes and quality of life in humans and animals.[1]

The academic forebear of the modern field of behavioral medicine and a part of the practice of consultation-liaison psychiatry, psychosomatic medicine integrates interdisciplinary evaluation and management involving diverse specialties including psychiatry, psychology, neurology, psychoanalysis, internal medicine, pediatrics, surgery, allergy, dermatology, and psychoneuroimmunology. Clinical situations where mental processes act as a major factor affecting medical outcomes are areas where psychosomatic medicine has competence.[2]

Psychosomatic disorders[edit]

Main article: Somatic symptom disorder

Some physical diseases are believed to have a mental component derived from stresses and strains of everyday living. This has been suggested, for example, of lower back pain and high blood pressure, which some researchers have suggested may be related to stresses in everyday life.[3] The psychosomatic framework additionally sees mental and emotional states as capable of significantly influencing the course of any physical illness. Psychiatry traditionally distinguishes between psychosomatic disorders, disorders in which mental factors play a significant role in the development, expression, or resolution of a physical illness, and somatoform disorders, disorders in which mental factors are the sole cause of a physical illness.

It is difficult to establish for certain whether an illness has a psychosomatic component. A psychosomatic component is often inferred when there are some aspects of the patient's presentation that are unaccounted for by biological factors, or some cases where there is no biological explanation at all. For instance, Helicobacter pylori causes 80% of peptic ulcers. However, most people living with Helicobacter pylori do not develop ulcers, and 20% of patients with ulcers have no H. pylori infection. Therefore, in these cases, psychological factors could still play some role.[4] Similarly, in irritable bowel syndrome (IBS), there are abnormalities in the behavior of the gut. However, there are no actual structural changes in the gut, so stress and emotions might still play a role.[5]

The strongest perspective on psychosomatic disorders is that attempting to distinguish between purely physical and mixed psychosomatic disorders is obsolete as almost all physical illness have mental factors that determine their onset, presentation, maintenance, susceptibility to treatment, and resolution.[6][7] According to this view, even the course of serious illnesses, such as cancer, can potentially be influenced by a person's thoughts, feelings and general state of mental health.

Addressing such factors is the remit of the applied field of behavioral medicine. In modern society, psychosomatic aspects of illness are often attributed to stress[8] making the remediation of stress one important factor in the development, treatment, and prevention of psychosomatic illness.

Connotations of the term "psychosomatic illness"[edit]

The term psychosomatic disease was most likely first used by Paul D. MacLean in his 1949 seminal paper ‘Psychosomatic disease and the “visceral brain”; recent developments bearing on the Papez theory of emotions.’[9] In the field of psychosomatic medicine, the phrase "psychosomatic illness" is used more narrowly than it is within the general population. For example, in lay language, the term often encompasses illnesses with no physical basis at all, and even illnesses that are faked (malingering). In contrast, in contemporary psychosomatic medicine, the term is normally restricted to those illnesses that do have a clear physical basis, but where it is believed that psychological and mental factors also play a role. Some researchers within the field believe that this overly broad interpretation of the term may have caused the discipline to fall into disrepute clinically.[10] For this reason, among others, the field of behavioral medicine has taken over much of the remit of psychosomatic medicine in practice and there exist large areas of overlap in the scientific research.

Criticism[edit]

Studies have yielded mixed evidence regarding the impact of psychosomatic factors in illnesses. Early evidence suggested that patients with advanced-stage cancer may be able to survive longer if provided with psychotherapy to improve their social support and outlook.[11][12][13] However, a major review published in 2007, which evaluated the evidence for these benefits, concluded that no studies meeting the minimum quality standards required in this field have demonstrated such a benefit.[14] The review further argues that unsubstantiated claims that "positive outlook" or "fighting spirit" can help slow cancer may be harmful to the patients themselves if they come to believe that their poor progress results from "not having the right attitude".

In her book Authors of Our Own Misfortune, Angela Kennedy argues that psychogenic explanations for physical illnesses are rooted in faulty logic and moralistic belief systems which situate patients with medically unexplained symptoms as deviant, bad and malingering. The diagnosis of a psychogenic disorder often has detrimental consequences for these patients as they are stigmatised and denied adequate support because of the contested nature of their condition and the value judgements attached to it.[15]

On the other hand, psychosomatic medicine criticizes the current approach of medical doctors disregarding psychodynamic ideas in their daily practice. For example, it questions the broad acceptance of self-proclaimed diseases such as gluten-intolerance, chronic Lyme disease and Fibromyalgia as a gain of illness for patients to avoid the underlying intra-psychic conflicts eliciting the disease, while at the same time, challenging the reasons for this neglect in the doctors’ own avoidance of their emotional intra-psychic conflict.[16][unreliable source?]

Treatment[edit]

While in the U.S., psychosomatic medicine is considered a subspecialty of the fields of psychiatry and neurology, in Germany and other European countries it is considered a subspecialty of internal medicine. Thure von Uexküll and contemporary physicians following his thoughts regard the psychosomatic approach as a core attitude of medical doctors, thereby declaring it not as a subspecialty, but rather an integrated part of every specialty.[17] Medical treatments and psychotherapy are used to treat illnesses believed to have a psychosomatic component.[18]

History[edit]

In the medieval Islamic world the Persian psychologist-physicians Ahmed ibn Sahl al-Balkhi (d. 934) and Haly Abbas (d. 994) developed an early model of illness that emphasized the interaction of the mind and the body. He proposed that a patient's physiology and psychology can influence one another.[19]

Contrary to Hippocrates and Galen, Ahmed ibn Sahl al-Balkhi did not believe that mere regulation and modulation of the body tempers and medication would remedy mental disorders because words play a vital and necessary role in emotional regulation. To change such behaviors, he used techniques, such as belief altering, regular musing, rehearsals of experiences, and imagination.[20]

In the beginnings of the 20th century, there was a renewed interest in psychosomatic concepts. Psychoanalyst Franz Alexander had a deep interest in understanding the dynamic interrelation between mind and body.[21] Sigmund Freud pursued a deep interest in psychosomatic illnesses following his correspondence with Georg Groddeck who was, at the time, researching the possibility of treating physical disorders through psychological processes.[22] Hélène Michel-Wolfromm applied psychosomatic medicine to the field of gynecology and sexual problems experienced by women.[23]

In the 1970s, Thure von Uexküll and his colleagues in Germany and elsewhere proposed a biosemiotic theory (the umwelt concept) that was widely influential as a theoretical framework for conceptualizing mind-body relations.[24] This model shows that life is a meaning or functional system. Farzad Goli further explains in Biosemiotic Medicine (2016),[25] how signs in the form of matter (e.g., atoms, molecules, cells), energy (e.g., electrical signals in nervous system), symbols (e.g., words, images, machine codes), and reflections (e.g., mindful moments, metacognition) can be interpreted and translated into each other.[26]

Henri Laborit, one of the founders of modern neuropsychopharmacology, carried out experiments in the 1970s that showed that illness quickly occurred when there was inhibition of action in rats. Rats in exactly the same stressful situations but whom were not inhibited in their behavior (those who could flee or fight—even if fighting is completely ineffective) had no negative health consequences.[27] He proposed that psychosomatic illnesses in humans largely have their source in the constraints that society puts on individuals in order to maintain hierarchical structures of dominance. The film My American Uncle, directed by Alain Resnais and influenced by Laborit, explores the relationship between self and society and the effects of the inhibition of action.

In February 2005, the Boston Syndromic Surveillance System detected an increase in young men seeking medical treatment for stroke. Most of them did not actually experience a stroke, but the largest number presented a day after Tedy Bruschi, a local sports figure, was hospitalized for a stroke. Presumably they began misinterpreting their own harmless symptoms, a group phenomenon now known as Tedy Bruschi syndrome.[28]

Robert Adler is credited with coining the term Psychoneuroimmunology (PNI) to categorize a new field of study also known as mind-body medicine. The principles of mind-body medicine suggest that our mind and the emotional thoughts we produce have an incredible impact on our physiology, either positive or negative.

PNI integrates the mental/psychological, nervous, and immune system, and these systems are further linked together by ligands, which are hormones, neurotransmitters and peptides. PNI studies how every single cell in our body is in constant communication—how they are literally having a conversation and are responsible for 98% of all data transferred between the body and the brain.[29]

Dr. Candace Pert, a professor and neuroscientist who discovered the opiate receptor, called this communication between our cells the ‘Molecules of Emotion' because they produce the feelings of bliss, hunger, anger, relaxation, or satiety. Dr. Pert maintains that our body is our subconscious mind, so what is going on in the subconscious mind is being played out by our body.[30]

See also[edit]

References[edit]

  1. ^ von Uexküll T, ed. (1997). Psychosomatic Medicine. München: Urban & Schwarzenberg.
  2. ^ Levenson JL (2006). Essentials of Psychosomatic Medicine. American Psychiatric Press Inc. ISBN 978-1-58562-246-7.
  3. ^ Sarno J (2006). The Divided Mind. ReganBooks. ISBN 978-0-06-085178-1.
  4. ^ Fink G (February 2011). "Stress controversies: post-traumatic stress disorder, hippocampal volume, gastroduodenal ulceration*". Journal of Neuroendocrinology. 23 (2): 107–117. doi:10.1111/j.1365-2826.2010.02089.x. PMID 20973838. S2CID 30231594.
  5. ^ Melmed RN (2001). Mind, Body and Medicine: An Integrative Text. Oxford University Press Inc, USA. pp. 191–192. ISBN 978-0-19-513164-2.
  6. ^ Skumin VA (24 January 1991). "[Borderline mental disorders in chronic diseases of the digestive system in children and adolescents]". Zhurnal Nevropatologii I Psikhiatrii Imeni S.S. Korsakova. 91 (8): 81–84. PMID 1661526. Archived from the original on 4 March 2016. Retrieved 2 March 2012.
  7. ^ Skumin VA (1982). "[Nonpsychotic mental disorders in patients with acquired heart defects before and after surgery (review)]" Непсихотические нарушения психики у больных с приобретёнными пороками сердца до и после операции (обзор) [Nonpsychotic mental disorders in patients with acquired heart defects before and after surgery (review)]. Zhurnal Nevropatologii I Psikhiatrii Imeni S.S. Korsakova (in Russian). 82 (11): 130–135. PMID 6758444.
  8. ^ Treasaden IH, Puri BK, Laking PJ (2002). Textbook of Psychiatry. Churchill Livingstone. p. 7. ISBN 978-0-443-07016-7.
  9. ^ Maclean PD (1949). "Psychosomatic disease and the visceral brain; recent developments bearing on the Papez theory of emotion". Psychosomatic Medicine. 11 (6): 338–53. doi:10.1097/00006842-194911000-00003. PMID 15410445. S2CID 12779897.
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  12. ^ Fawzy FI, Fawzy NW, Hyun CS, Elashoff R, Guthrie D, Fahey JL, Morton DL (September 1993). "Malignant melanoma. Effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later". Archives of General Psychiatry. 50 (9): 681–689. doi:10.1001/archpsyc.1993.01820210015002. PMID 8357293.
  13. ^ Spiegel D, Bloom JR, Kraemer HC, Gottheil E (October 1989). "Effect of psychosocial treatment on survival of patients with metastatic breast cancer". Lancet. 2 (8668): 888–891. doi:10.1016/s0140-6736(89)91551-1. PMID 2571815. S2CID 8445427.
  14. ^ Coyne JC, Stefanek M, Palmer SC (May 2007). "Psychotherapy and survival in cancer: the conflict between hope and evidence". Psychological Bulletin. 133 (3): 367–394. doi:10.1037/0033-2909.133.3.367. PMID 17469983.
  15. ^ Troke S (2017-07-03). "Authors of our own misfortune? The problems with psychogenic explanations for physical illnesses". Disability & Society. 32 (6): 931–933. doi:10.1080/09687599.2017.1321239. ISSN 0968-7599.
  16. ^ Rueckert KK (15 December 2017). "The Nameless Disease". in-training. Retrieved 5 February 2018.
  17. ^ von Uexküll T (2017). Psychosomatische Medizin. pp. 245–246. ISBN 978-3-437-21833-0.
  18. ^ Wise TN (March 2008). "Update on consultation-liaison psychiatry (psychosomatic medicine)". Current Opinion in Psychiatry. 21 (2): 196–200. doi:10.1097/YCO.0b013e3282f393ae. PMID 18332670. S2CID 40136135.
  19. ^ Nurdeen D, Mansor AT (2005). "Mental health in Islamic medical tradition". The International Medical Journal. 4 (2): 76–79.
  20. ^ Goli F, Zanjani HA (2020), Fritzsche K, McDaniel SH, Wirsching M (eds.), "Development of Psychosomatic Medicine in Iran", Psychosomatic Medicine, Cham: Springer International Publishing, pp. 315–322, doi:10.1007/978-3-030-27080-3_24, ISBN 978-3-030-27079-7, S2CID 214208574, retrieved 2023-01-31
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  22. ^ Erwin E (2002). The Freud Encyclopedia: Theory, Therapy and Culture. Routledge. pp. 245–246. ISBN 978-0-415-93677-4.
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  24. ^ Kull K, Hoffmeyer J (2005-12-31). "Thure von Uexküll 1908–2004". Sign Systems Studies. 33 (2): 487–494. doi:10.12697/SSS.2005.33.2.13. ISSN 1736-7409.
  25. ^ Partridge GW (March 2017). "Books: Biosemiotic Medicine: Healing in the World of Meaning (Studies in Neuroscience, Consciousness and Spirituality): A Paradigm Shift in Biology". The British Journal of General Practice. 67 (656): 130. doi:10.3399/bjgp17X689761. PMC 5325648. PMID 28232356.
  26. ^ Fritzsche K, Goli F, Dobos CM (2020). "What Is Psychosomatic Medicine?". In Fritzsche K, McDaniel SH, Wirsching M (eds.). Psychosomatic Medicine: An International Guide for the Primary Care Setting. Cham: Springer International Publishing. pp. 3–16. doi:10.1007/978-3-030-27080-3_1. ISBN 978-3-030-27080-3.
  27. ^ Kunz E (March 2014). "Henri Laborit and the inhibition of action". Dialogues in Clinical Neuroscience. 16 (1): 113–117. doi:10.31887/DCNS.2014.16.1/ekunz. PMC 3984888. PMID 24733976.
  28. ^ Jangi S (11 October 2017). "Why is it so hard to track the source of a food poisoning outbreak?". Boston Globe.
  29. ^ Hrsto V (2014-09-16). "When your biography becomes your biology". Vesna Hrsto. Retrieved 2020-01-24.
  30. ^ Pert P. "Explorer of the Brain, Bodymind & Beyond". Candace Pert, PhD. Retrieved 2020-01-24.

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