RT Journal Article
SR Electronic
T1 Evolution and significance of the psychosomatic model in gastroenterology
JF General Psychiatry
JO Gen Psych
FD BMJ Publishing Group Ltd
SP e100856
DO 10.1136/gpsych-2022-100856
VO 35
IS 5
A1 Qiaoli Zhang
A1 Lixin Ding
A1 Jianxin Cao
YR 2022
UL http://gpsych.bmj.com/content/35/5/e100856.abstract
AB The biomedical model, which limits itself to finding the attributions of organic disease, is challenged by gastrointestinal (GI) symptoms. Simultaneously, physicians' attribution of GI symptoms to underlying psychological issues is not readily accepted by patients and can negatively affect the clinical rapport between doctor and patient. In reality, psychosocial aspects are involved in many functional disorders and organic diseases, not just in mental disorders. Time is overdue for gastroenterologists to recognise the inadequacy and limitations of conventional gastroenterology and consider the role of psychological, social and biological variables throughout the entire clinical course of the illness, as is shown in George Engel’s model. This review discusses the following: (1) the current challenges of using the conventional clinical model for both functional and organic GI illness, (2) the inadequacy and limitations of explaining GI symptoms simply as psychological disorders, (3) the exploration of the symptom-centred, stepped reattribution clinical model, (4) the clarification of psychosomatic medical concepts for use in gastroenterology, and (5) the significance of a systematic and interdisciplinary framework for a comprehensive psychosomatic model in gastroenterology.