[Bases of psychosomatic medicine]

The theoretical and therapeutic concept of psychoneurosis is no longer the only pathogenetic framework for the theory of psychosomatic diseases. Some fundamental differences exist between psychosomatic diseases and psychoneurosis. The interdependencies between psychosomatic influencing factors and the corresponding somatopsychical (pathophysiological) correlates for different diseases are presented. It is shown that to a certain extent conditional chains are preformed in the somatic sphere which, once they have been initiated and maintained by psychosocial releasing factors, possess a peculiar somatisation tendency. In addition the multi-factorial level of analysis is pointed out by the example of modern CHD research (prospective epidemiology and multivariate statistics). In conclusion the relation of psychoneurosis to psychosomatic medicine is commented. Regarding this, the de- and resomatisation model according to Schur is specially taken into account.