Psychosomatic Approach to Clinical Practice

There have been major transformations in health-care needs in the past decades. Chronic disease is now the principal cause of disability, and the use of health services for patients with chronic diseases consumes almost 80 % of health expenditures. The exponential spending on preventive medication justified by the potential long-term benefits to a small segment of the population is now being challenged, whereas the benefits of modifying lifestyle by population-based measures are increasingly demonstrated and are in keeping with the biopsychosocial model. Medically unexplained symptoms occur in up to 30–40 % of medical patients and increase medical utilization and costs. The traditional medical specialties, based mostly on organ systems (e.g., cardiology, gastroenterology), appear to be more and more inadequate in dealing with symptoms and problems which cut across organ system subdivisions. The need for a holistic approach is underscored by the implementation of interdisciplinary services. The need to include consideration of functioning in daily life, productivity, performance of social roles, intellectual capacity, emotional stability, and well-being, has emerged as a crucial part of clinical investigation and patient care. These aspects have become particularly important in chronic diseases, where cure cannot take place and also extend over family caregivers of chronically ill patients and health providers.