[Value of the concept of attachment in somatic medicine]

Since the nineteen nineties, the theory of attachment, initially developed in paedopsychiatry, has increasingly been applied to somatic medicine. The main fields explored have been the links between the individual's attachment style, response to stress and attitude towards health: seeking help from professionals, using health care systems and compliance to treatment. A so-called 'secure" attachment corresponds to an inner resource related to more constructive response to stressful events; an"insecure" attachment (including three categories: preoccupied,detached and fearful) can be considered a risk factor leading to less efficient adaptation to stress or "coping" with it. Attachment styles appear to influence attitudes towards health. Adults with secure attachment have positive expectations with regard to the help that care workers will provide and to the trust they can have in them. Detached-type insecure patients tend to minimize their signs of distress and do not necessarily seek help. Preoccupied-type insecure adults tend to maximize distress signals and excessively appeal to the medical corps. Fearful-type insecure patients only seek help in situations of great distress and rarely have faith in the health professionals.