• Psychosomatic Medicine

Psychosomatic medicine is a branch of medicine that studies psychosomatic interactions. It focuses on the aetiology, pathology, diagnosis, treatment and prevention of psychosomatic diseases. Increasing effort is being made to improve the understanding of psychosomatic medicine in patients, their families, general hospitals and society.1 2 In addition, the development of psychosomatic medicine calls for wide collaboration with psychiatry, psychology, behavioural science, sociology, biology, neurochemistry and immunology.3 We initiated this special issue to encourage interdisciplinary studies in psychosomatic medicine.

This issue has generated a very informative collection of articles. We cover current psychosomatic development, cross-cultural issues, sexual studies, gastroenterology, cardiology, cancer, stress, anxiety, depression, schizophrenia and others. In the first article, Dr Lee,4 the president of the International College of Psychosomatic Medicine, comprehensively introduces the history of psychosomatic societies and their global presence. The author noted the rapid growth of psychosomatic communities in Asian countries, especially China. In addition, Dr Lee called for friendship and collegiality to foster a better future for our rapidly developing psychosomatic society.

Cultural diversity is highly represented in this issue. Khaustova et al 5 shared their experiences providing proactive psychiatry support for people suffering from chronic disease in the Ukrainian population. They highlighted that such support could reduce subclinical anxiety and somatisation symptoms and improve quality of life. Shah et al 6 introduced and compared the mental health laws and coronavirus disease 2019 (COVID-19) mental health policies in Pakistan and China. They concluded that mental health issues could be reduced by adequate mental health laws and appropriate implementation. Amone-P'Olak et al 7 explored the prevalence and risks of post-traumatic stress disorder among war-affected youth in Uganda. They detected background and post-war environmental risk factors among them and highlighted the disastrous effects of war on young people’s mental health. Liang et al 8 translated the Central Sensitisation Inventory into the Chinese language, and they proved excellent reliability and validity. The authors also recommended the usefulness of this tool in Chinese populations.

Specific groups with psychosomatic problems are represented in this issue. Joshi et al 9 focused on women with Dhat syndrome and studied its phenomenology, disability and sexual functioning in these patients. The authors concluded that women with non-pathological vaginal discharge are similar to men with Dhat syndrome, having a deficit understanding of pathology; they recommend comprehensive assessments and management to decrease the suffering of women with the disorder experience. Sun et al 10 studied the relationship between faecal microbiota and long-term Tibetan meditation in monks. The enriched microbiotas in monks were associated with a lower risk of anxiety, depression, cardiovascular disease and better immune function.

Wang et al 11 described the psychological relationships among cancer survivors. They noted that cancer survivors commonly experienced self-concept impairments, body image disturbance, sexual troubles and social relationship crises. The caregivers exhibited critical burdens and health condition issues. In addition, physicians in the related departments were experiencing challenges in patient–doctor communication and burnout. Zhang et al 12 focused on patients with gastrointestinal diseases. They discussed the necessity of generating a conventional clinical model for both functional and organic gastrointestinal illness. They reviewed the challenges, limitations and concept development. The authors emphasised the significance of a novel systematic psychosomatic model.

Depression is the most prevalent and disturbing mental disorder in modern society, and its interaction with the body is a major focus of psychiatry. Liu et al 13 studied the brain’s connectivity in major depressive episodes with mixed features. They stated that the abnormal connectivity within the default mode network’s subsystem might be a critical mechanism for the pathology of major depressive episodes with mixed features. In addition, Liu et al 14 explored interleukin 6, high-sensitivity C reactive protein and tumour necrosis factor-α in melancholic in atypical and anxious depression. They suggested these dynamic immunoinflammatory components could be used as potential biomarkers in depression. Simultaneously, a novel treatment study of depression was also presented in this issue. Wang et al 15 focused on ketamine and its rapid antidepressant effect. The authors noted that increased activity of AMPA receptors, enhanced BDNF production and release, BDNF-mTORC1 signal pathways, disinhibition, interaction with 5-HT and dopamine system and other mechanisms might be behind ketamine’s rapid antidepressant effect. The relationship between depression and other clinical situations was explored. Li et al 16 explored the relationship between depression and handgrip strength (HGS) and suggested that increased left HGS was associated with lower depression risk.

Anxiety and stress were other critical subjects addressed in this issue. Jin et al 17 summarised the neuro-humoral-immune regulatory network in psychiatric and psychosomatic disorders. The authors discussed potential mechanisms of stress-induced neuroinflammation, neuron damage and apoptosis. Cai et al 18 demonstrated the causal effects between blood pressure and anxiety, depressive symptoms, neuroticism and well-being. The authors also suggested that proper blood pressure management lowers the risk of mood disorders and cardiovascular diseases.

Finally, Chen et al 19 studied the effect of obesity on schizophrenia’s mortality risk and presented the results from a large cohort with body mass index records. They found that underweight status was associated with higher mortality in this disorder group; however, this was potentially affected by older ages.

We foresee that the articles included in this special issue will expand the knowledge of psychosomatic medicine and interdisciplinary research. Ongoing collaborative studies from psychosomatic societies will further reveal cross-cultural issues and under-represented populations throughout the world. Finally, additional research on biopsychosocial mechanisms would contribute to the clinical practice of psychosomatic disorders.

Wenhao Jiang, MD/PhD/PhD. He received a doctoral degree in Neurology from the Southeast University in Nanjing, China and a doctoral degree in psychology from Georgia State University in the USA. His main research interests include imaging genetic studies in schizophrenia, bipolar disorder, and ADHD. He participated in the data analysis and coordinating phase of the ENIGMA schizophrenia project. He also participated in the remission of ADHD adults study held by the Center for Translational Research in Neuroimaging and Data Science in China.