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Book and Media Reviews
April 25, 2007

Psychosomatic Medicine

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Fishbein Fellow.

JAMA. 2007;297(16):1827-1833. doi:10.1001/jama.297.16.1827

Psychosomatic medicine was recently granted a psychiatric subspecialty status by the American Board of Psychiatry and Neurology. Its first board examination was subsequently completed in 2005. Although it is unlikely that many nonpsychiatrist physicians have heard of this subspecialty, older physicians may remember that at one time psychosomatic medicine promised to explain the etiology and pathogenesis of such poorly understood illnesses as peptic ulcer disease and rheumatoid arthritis. Broadly speaking, psychosomatic medicine studies the 2-way interaction of mind and body in human function and illness. Whereas psychosomatic research attempts to discern how mental processes can produce somatic changes, clinical psychosomatic medicine (often called consultation-liaison psychiatry) focuses on the management of patients with comorbid medical and psychiatric illnesses. Many would consider psychosomatic illnesses to be those conditions without a seemingly straightforward medical basis, such as conversion disorders, chronic fatigue syndrome, irritable bowel syndrome, and fibromyalgia. Along with these types of disorders, psychosomatic medicine focuses on understanding the psychiatric adverse effects of medications (eg, steroid-induced mania), the effects of mental stress on the body (eg, alterations in blood pressure arising from public speaking; the association of depression with cardiovascular mortality), and essentially how physical illnesses affect mental states (eg, depression in patients with myocardial infarction; delirium due to hypoxemia).