Introduction
Psychosomatic medicine studies the interaction between psychological factors and physical illness. It does not claim that illness is 'all in the mind'. It asks how emotions, personality, stress and social conditions influence the onset, course and outcome of organic disease, and how the body's stress systems link these to tissue changes. This topic covers the historical theories, the modern biopsychosocial model, the main mechanisms, and the clinical categories of psychosomatic disorders.
Historical theories
Alexander's specificity hypothesis (1950) proposed that particular emotional conflicts were linked to particular diseases, such as essential hypertension, peptic ulcer, bronchial asthma and rheumatoid arthritis. Research did not confirm specific emotion-disease pairs, so the hypothesis is now of historical interest. Its value lies in drawing attention to the role of emotion and to the search for mechanisms.
Later work moved from specific conflicts to general factors: stress, personality traits and social circumstances, which increase the risk of disease in a less specific way.