A reappraisal of some psychosomatic concepts

The paper presents a critical reappraisal of some psychosomatic concepts which have become entrenched in the literature. The limitations of concepts of specificity relating to stimuli, emotional changes and various psychosocial stresses are discussed. The available evidence indicates the importance of the patient's personality, but does not support the claims of specific personality types for each disorder. Concepts of aetiology are discussed. The importance of heterogeneity rather than homogeneity is stressed. Relationships between psychiatric and psychosomatic disorders are considered. The significance of somatopsychic as well as psychosomatic sequences of events are emphasised. Finally, the importance of multifactorial causation in psychosomatic disorders is underlined.