Psychosomatic Medicine
Psychosomatic medicine (PM) is a newly licensed subspecialty in the field of psychiatry; it is also known as consultation-liaison (C-L) psychiatry. C-L psychiatry provides knowledge, practice, and instruction in the relation between mental and physical illness. This field is associated with services like diagnosis, therapeutics and research of illnesses in this area. Hence it connects psychiatry and other medical specialties, so that physicians and psychiatrists can discuss how to best manage patients with psychosomatic illness.
The ancient Greeks and the French were well aware of psychosomatic disorders. Hippocrates was the first physician to affirm that mental factors have an impact on health and disease. The French philosopher Rene Descartes refreshed the psychological ethics of Hippocrates through his "body-mind dualism" theory, which promoted many scientific studies in relation to the body and mind.
Initially, physicians of C-L psychiatry were not aware of the psychosomatic features of medically ill patients. In the USA, C-L psychiatry started to evolve and underwent a series of developmental changes in the 20th century. In 2003, C-L psychiatry was given the comprehensive name psychosomatic medicine.
Objectives of Psychosomatic MedicineThe psychosomatic medicine service (PMS) provides a complete approach to the emotional, cognitive, and behavioral needs of a patient through its dual function—as a consultant and as a part of a primary care crew. Both the functions of C-L psychiatry pursue the following objectives:
Medical intelligence: C-L psychiatrists need to possess extensive knowledge about physical, social, and neurological disorders and their relation to abnormal illness. They should be capable of implementing this intelligence in patient care. Practitioners in this field should also be aware of the therapies used for psychosomatic patients.
Patient care: Specialists in this field improve the quality of psychiatric care for both in- and outpatients. A warm atmosphere, appropriate consultations, and evidence-based patient care promotes the physical and mental health of the patient.
Evaluation of mental factors: This enables complete assessment of the psychological and social factors responsible for an individual's mental illness through observation under psychiatric consultants. The symptoms of mental disorders are diagnosed and effectively treated by psychiatric therapies.
Individual therapy plans: In addition to being a skilled diagnostician, the C-L psychiatrist is required to develop effective treatment plans for individual patients, which are effective in the prevention, treatment, and recovery of physical disease.
Collaborative care: The consultant promotes education on mental health and psychosocial skills for patients, their families, and medical physicians, which results in effective exchange of information. This cooperative care enables them to take care of the root cause of the patient's disease.
Training: Specialists provide training to junior consultants and to the nonpsychiatric healthcare provider to help them identify aberrant reactions in patients caused by treatment, plus the psychological care required in such reactions.
Clinical function
In relation to the clinical function of psychosomatic medicine, there are two categories of psychiatrists:
Consultation psychiatrists: They are usually seen in outpatient departments and in chronic care facilities where they can impart advice to requesting physicians involved in treatment of patients. Referral psychiatrist: They assist the medical physician by providing comprehensive psychiatric care to patients who are hospitalized.
Educational function
Specialists in psychosomatic medicine provide education to nonpsychiatric physicians, medical students, and nursing staff about
- the psychological needs of patients based on their behavior
- immediate management of psychiatric conditions
- use of psychotropic drugs and recognizing drug reactions in patients
Research function
The field of psychosomatic medicine offers opportunity for research in the interface between medicine and psychiatry. Most research studies in this field over the last century has been conducted by consulting liaison psychiatrists, who are responsible for the rise of subspecialties like psycho-oncology, psycho-immunology, and psycho-obstetrics.
Administrative function
This function is generally authorized either by the government or the respective institution. It usually involves an assessment of the violent actions of patients while they are under forcible restraint, and nonvoluntary treatment. For example, the psychiatrist in this department will assess the patient's tendency to refuse medical procedures.
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