Emotion, Social Relationships, and Physical Health: Concepts, Methods, and Evidence for an Integrative Perspective.

Emotional characteristics and processes are robust predictors of the development and course of major medical illnesses and premature mortality, as are a variety of indicators of the presence and quality of personal relationships. Despite clear evidence of close interconnection between these two domains of risk and protection, affective characteristics and relationships have largely been studied separately as influences on health. After a recent conference on integrative perspectives on emotions, relationships and health co-sponsored by the American Psychosomatic Society and the Society for Affective Science, the present review builds on prior calls for integration, related theory, and current research to outline what is known about the interconnection of these domains as it specifically relates to their overlapping influences on health. Areas of interest include the following: their interconnected roles over the course of development, which may inform current efforts to understand the influence of early life events on adult health; the parallel positive and negative factors in both domains that could have distinct influences on health; the role of emotion regulation in relationship contexts; and measurement, design, and analysis approaches to capture the dyadic and dynamic aspects of these interconnected influences on health. We conclude with a discussion of an emerging research agenda that includes the following: common biological foundations of affective and relationship processes, the cultural embeddedness of affective and relationship processes, the potential contribution of affective-relational processes to health disparities, and implications for intervention research.

Corrective biology: psychosomatics in and as neuropsychoanalysis.

This article analyses how and with what consequences body-mind relations (the sphere of the psychosomatic) are being modelled in the 21st century through considering the interdiscipline of neuropsychoanalysis. The promise of the term psychosomatic lies in its efforts to rework standard, bifurcated models of mind and body: somatic acts are simultaneously psychic acts. But neuropsychoanalysis, as it brings the neurosciences and psychoanalysis together to model an embodied 'MindBrain', ends up evacuating another potent characteristic found in much of the psychosomatic tradition-its refusal to adjudicate, a priori, what counts as the adaptive or well-regulated subject. The psychosomatic problem in psychoanalysis profoundly disturbs everyday models of functionality, adaptation and agency, by positing the psyche as an 'other' of the physiological within the physiological. By contrast, neuropsychoanalysis ends up parsing too easily the healthy from the pathological body, such that it is only the latter that is subject to forces that work against self-preservation and self-regulation. In so doing, neuropsychoanalysis recasts the radical problematic that the psychosomatic installed for psychoanalysis in the direction of a corrective biology. This corrective biology is given form in two ways: (1) through translating the Freudian drive-that unruly and foundational concept which addresses the difficult articulation of soma and psyche-into a series of Basic Emotion Systems modelled by the affective neuroscientist Jaak Panksepp and (2) through resituating and quarantining the troubling, non-adaptive aspects of the Freudian psyche within the domain of addiction. That easy separation between the healthy and the pathological is all too often found in current descriptions of healthcare and patient encounters. The article refuses it and calls for the revivification of other ways of thinking about how human subjects-psychosomatic organisms-find ways to live, and to die.

[Psychosomatic research in 2018: Lost illusions, renewed hopes]. / La recherche psychosomatique en 2018 : illusions perdues, espoirs renouvelés.

A critical analysis of the basic hypotheses of psychosomatic research and the sometimes hasty assertions drawn from the previous works makes it possible to better discern the data confirmed by the most recent works or the most rigorous meta-analyses and to highlight the emerging tracks. If the hypothesis of behavioral patterns specifically related to the risk of certain pathologies seems abandoned, the predictive value of depression in the cardiovascular field, more than in that of oncology, becomes clearer. Negative affect and impaired emotional awareness emerge as two complementary factors of somatic vulnerability. Several vulnerability factors seem all the more effective as they affect individuals of lower socio-economic status. Social exclusion feeling and its links with the inflammatory response appear to be a possible common denominator, both for depression and for many somatic conditions. A series of studies on the cerebral regulation of emotions and stress, as well as on bidirectional brain-bowel relations and on the mediating role of the gut microbiota, complements the available epidemiological data. The same is true for certain advances in behavioral neuro-economics, which inform the decision-making processes of patients facing preventive health choices. Lastly, it appears that a significant part of the excess mortality associated with the existence of severe mental disorders is not due to factors inherent to the patients themselves, but to disparities in the quality of the care provided to them.

Past, Present, and Future of Psychosomatic Movements in an Ever-Changing World: Presidential Address.

OBJECTIVE: The American Psychosomatic Society was founded in 1942 and is celebrating its 75th anniversary in 2017. In recognizing the society's anniversary, this article provides a historical perspective on its history, the field of psychosomatic medicine in general, and anticipated future directions. METHODS: Essay and narrative review of the literature on the historic development of psychosomatic concepts and their impact on medicine over time. RESULTS: Mind-body associations have been described in the medical literature for more than 3500 years. Early concepts of mind-body dualism and attempts to overcome them are found in classical Greek medicine. Psychosomatic thinking can be observed ever since, but only in the 20th century, a "psychosomatic movement" emerged in Europe and North America, aiming at humanizing medicine by introducing a holistic understanding of man into what was considered a widely reductionistic practice of medicine. This movement led to the inauguration of the American Psychosomatic Society during World War II and of national and international societies of psychosomatic medicine and its subspecializations thereafter. CONCLUSIONS: Psychosomatic medicine has its roots in the beginnings of medicine. During the past 75 years, it has made substantial contributions to the science and practice of medicine. The field has also changed in response to developments in medicine, technology, and society and is facing new challenges and opportunities that may require further adaptation of its concepts and practice.

Contribuciones de la medicina psicosomática a la medicina clínica y preventiva / Contributions of psychosomatic medicine to clinical and preventive medicine

El trabajo ofrece una revisión actualizada de las principales contribuciones de la Medicina Psicosomática a la medicina clínica y preventiva. Su contenido se basa en los resultados de revisiones sistemáticas, metaanálisis y estudios controlados. La evidencia acumulada indica que la perspectiva psicosomática podría contribuir significativamente a mejorar los resultados de la atención sanitaria, mediante una práctica clínica holística, la evaluación de los factores psicosociales implicados en la vulnerabilidad individual y la integración de intervenciones psicológicas en medicina. Dicha evidencia constituye el terreno ideal para afrontar necesidades emergentes en sanidad, como la gestión de enfermedades crónicas y de síntomas inexplicables, el paciente como productor activo de salud, la prevención temprana y una valoración de resultados que supere el reduccionismo biomédico

This paper provides an updated review of the main contributions of Psychosomatic Medicine to clinical and preventive medicine. Metaanalyses, comprehensive reviews and controlled studies were selected. Current advances in the field indicate that health care can be improved by using a psychosomatic approach that takes into account psychosocial factors affecting individual vulnerability, the holistic consideration of patient care, and the integration of psychological interventions in medicine. Consolidated evidence in Psychosomatic Medicine provides the ideal background for dealing with new needs emerging in medical practice, including chronic illness management, somatic unexplained symptoms, the shift in the role of patients from health consumers to actively health producers, primary earlylife prevention, and the appraisal of health outcomes beyond the biomedical reductionism

La eficacia del tratamiento individual de los acúfenos subjetivos con terapia cognitiva-conductual / The efficacy of individual treatment of subjective tinnitus with cognitive behavioural therapy

Introducción: Los acúfenos subjetivos, a pesar del tiempo transcurrido desde que fueron descritos por primera vez, continúan sin tener un tratamiento con eficacia demostrada. El objetivo de este artículo es valorar la eficacia de la terapia cognitiva-conductual en el tratamiento de estos enfermos. Pacientes y métodos: Durante un periodo de tiempo de los años 2012-2013 se estudia a 310 enfermos que presentaban acúfenos subjetivos. De ellos, 267 fueron incluidos en un tratamiento basado en terapia cognitiva-conductual. El periodo de seguimiento fue de 18 meses y en 11 enfermos de 21 meses. Resultados: Considerando los enfermos que interrumpieron el tratamiento como fracasos, el porcentaje de curación fue de 95,7%. Conclusión: La terapia cognitiva-conductual debe estar siempre incluida en el tratamiento de los enfermos de acúfenos (AU)

Introduction: It has been a long time since subjective tinnitus cases were described for the first time but they still lack a treatment with proven effectiveness. The main goal of this study was to evaluate the effectiveness of cognitive behavioural therapy in these patients. Patients and method: Between 2012 and 2013, 310 patients that suffered from subjective tinnitus were studied. Of these, 267 were included in treatment based on cognitive behavioural therapy. The monitoring period lasted 18 months for most cases, while it lasted 21 months for 11 patients. Results: Considering patients that interrupted their treatment as failures, the percentage of recovery was 95.7%. Conclusion: Cognitive behavioural therapy should always be included in the treatment of people suffering from tinnitus (AU)