What the Future Holds for Psychosomatic Medicine

Abstract

In the recent past, the questions that face a comprehensive psychosomatic medicine have been defined. These questions refer to the context in which disease begins, the timing of the onset of the disease, the role of previous social experience in predisposing to disease, and the choice of the particular disease. It is suggested that a study of bereavement may be paradigmatic in answering these four questions: Bereavement has been cited as a factor in a large variety of disease. However, bereavement may produce discriminated responses of grief; helplessness, hopelessness, and giving-up; and pathological mourning. Pathological mourning in turn may be associated with autoimmune disease. There is evidence that separation and bereavement produces changes in immune function but there is as yet no evidence that it produces distortions of the immune process. There are many factors that affect the timing of disease onset, including maturational ones. Many social experiences have been shown to alter behavior and bodily function and predispose to disease. The question of the choice of disease is determined not only by the effects of bereavement and early experiences, and age, but also by a multiplicity of predisposing ones some of which have been specified.

Cellular allostatic load is linked to increased energy expenditure and accelerated biological aging

“…This means that for a given amount of energy required to sustain basal cellular functions, Dex-treated fibroblasts maintained an even larger spare J ATP-OxPhos capacity than control cells – an effect that persisted across the lifespan (p < 0.0001, Fig. 3D ) and consistent with the anticipatory process of allostasis and allostatic load ( McEwen, 1998 ; McEwen and Stellar, 1993 ; Sterling and Eyer, 1988 ; Weiner and Mayer, 1990 ).…”

“…In response to environmental stressors, living organisms mount evolutionarily conserved responses that aim to increase resilience and promote survival, a phenomenon termed allostasis ( Sterling and Eyer, 1988 ; Weiner and Mayer, 1990 ). However, the chronic activation of these responses produces allostatic load ( McEwen and Stellar, 1993 ; McEwen, 1998 ).…”

The Role of Craniocerebral Trauma in the Dynamics of Combat-Related Post-Traumatic Stress Disorder

“…As demonstrated by studies reported by Vein, transformation of neuromental tension (stress) into somatic illness is mediated via the autonomic nervous system, a view which has been supported by Marilov's studies of psychosomatoses [13]. The physiological and neurophysiological mechanisms of this transformation have thus far received insuffi cient study and this aspect requires further development [20].…”