Clinical Application of Psychiatric Assessment and Treatment in Psychosomatic Diseases

Book excerpt: Psychosomatic diseases are a group of diseases closely related to psychosocial factors but mainly manifested by somatic symptoms, involving respiratory, digestive, endocrine, and other systems. As a result, the lack of consensus on its diagnosis has plagued clinical treatment in internal medicine, surgery, and psychiatry for decades. In recent years, research on the pathogenesis of psychosomatic diseases has made significant progress. For example, Franz Alexander believes that unresolved subconscious conflicts are the main cause of psychosomatic disorders. The subconscious psychological conflict is caused by the changes in the functional activities of the autonomic nervous system, acting on the corresponding special organs and patients with susceptible qualities. Similarly, mental and psychological factors affect gastrointestinal sensory and motor functions through the autonomic nervous system, brain-gut axis, and neuroendocrine system. Meanwhile, gastrointestinal symptoms also affect emotions and behaviors through the brain-gut axis. In addition, the Cannon-Bard theory of emotional physiology and Pavlovian theory of higher neural activity types from quantitative research methods to study the relationship between conscious psychological factors, such as emotions, and measurable physiological and biochemical changes. In clinical work, the treatment of psychosomatic diseases has gradually shifted from emphasizing physical treatment to comprehensive treatment principles, that is, taking into account the psychological and behavioral aspects of the physical treatment of the primary disease. The main purpose of physical treatment of the primary disease is to control or relieve symptoms. To consolidate the treatment of psychosomatic diseases and reduce the recurrence of psychosomatic diseases, combining physical therapy with necessary psychotherapy would potentially obtain a more comprehensive curative effect.