Iranian Psychiatrists Attitudes to Psychosomatic Medicine: A Qualitative Content Analysis
AbstractObjective:Psychosomatic attitudes may be rooted and grounded in the particular culture of the scientific community in each country. We conducted a qualitative research to understand the exclusive psychosomatic attitudes and psychosomatic medicine status of Iranian Psychiatrists.Method:This research was conducted using a qualitative content analysis based on Graneheim and Lundmanand method. All psychiatrists of Avicenna hospital, which is a teaching hospital of Mashhad University of Medical Sciences, were the target population of this study. Among them, 9 psychiatrists were selected by a non-random purposeful sampling method, and semi-structured interviews were used tocollect data.Results:Results indicated that most psychiatrists do not have a proper understanding of the term“psychosomatic medicine”, but they acknowledged the importance of an integrative approach in medicine.Biopsychosocial model, as a unified and integrated concept, can encompass all emerged categories and refers to the overall pattern in psychiatrists' attitude.Conclusion:Despite acknowledging the importance of a comprehensive approach to medicine and profound theoretical knowledge of psychiatrists, the practical application of biological, psychological, and social dimensions has not been considered equally. Thus, the scientific practical stand of this comprehensive approach requires more serious consideration by the medical community.
Elkins G, Fisher W, Johnson A. Mind–body therapies in integrative oncology. Curr Treat Options Oncol. 2010; 11: 128-140
Dobos G, Altner N, Lange S, Musial F, Langhorst J, Michalsen A, Paul A. Mind-body medicine as a part of German integrative medicine. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2006; 49: 723-728
Sheinman N. Mind-Body Medicine and Mind-Body Healing. heart. 2004; 34(35):36-7.
Puri NV, Azzam P, Gopalan P. Introducing a Psychosomatic Medicine Interest Group for Psychiatry Residents. Psychosomatics 2015; 56: 268-273.
Gordon JS. Mind-body medicine and cancer. Hematol Oncol Clin North Am 2008; 22: 683-708.
Astin JA, Shapiro SL, Eisenberg DM, Forys KL. Mind-body medicine: state of the science, implications for practice. J Am Board Fam Pract 2003; 16: 131-147.
Del Rosso A, Maddali-Bongi S. Mind body therapies in rehabilitation of patients with rheumatic diseases. Complement Ther Clin Pract 2016; 22: 80-86.
Younge JO, Gotink RA, Baena CP, Roos-Hesselink JW, Hunink MM. Mind–body practices for patients with cardiac disease: a systematic review and meta-analysis. Eur J Prev Cardiol 2015; 22: 1385-1398.
Theadom A, Cropley M, Smith HE, Feigin VL, McPherson K. Mind and body therapy for fibromyalgia. Cochrane Database Syst Rev 2015; CD001980.
Pojoga C, Stănculete MF. Biopsychosocial Approach of Gastrointestinal Disorders. Clujul Med 2014; 87: 95-97.
Dogar IA. Biopsychosocial model. Annals of Punjab Medical College 2007; 1: 11-3.
Borrell-Carrió F, Suchman AL, Epstein RM. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann FAM Med 2004; 2: 576-582.
Sulmasy DP. A biopsychosocial-spiritual model for the care of patients at the end of life. Gerontologist 2002; 42: 24-33.
Lumley MA, Cohen JL, Borszcz GS, Cano A, Radcliffe AM, Porter LS, Schubiner H, Keefe FJ. Pain and emotion: a biopsychosocial review of recent research. J Clin Psychol 2011; 67: 942-968.
Fava GA, Belaise C, Sonino N. Psychosomatic medicine is a comprehensive field, not a synonym for consultation liaison psychiatry. Curr Psychiatry Rep 2010; 12: 215-221.
Scheidt CE. Psychosomatic Medicine in Germany. International Journal of Body, Mind and Culture 2017; 4: 78-86.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004; 24:105-112.
Lincoln YS, Guba EG. Naturalistic Inquiry. Newbury Park, CA: Sage Publications; 1985.
First MB. DSM-5 handbook of differential diagnosis. Arlington, Va: American Psychiatric Pub; 2013.
Davidsen AS, Guassora AD, Reventlow S. Understanding the body–mind in primary care. Med Health Care Philos. 2016; 19: 581-594.
Davidsen AS. How does the general practitioner understand the patient? A qualitative study about psychological interventions in general practice. Psychol Psychother. 2009; 82: 199-217.
Davidsen AS, Fosgerau CF. General practitioners’ and psychiatrists’ responses to emotional disclosures in patients with depression. Patient education and counseling. 2014; 95: 61-68.
Turk DC. A diathesis-stress model of chronic pain and disability following traumatic injury. Pain Res Manag. 2002; 7: 9-19.
Martin AL, Halket E, Asmundson GJ, Flora DB, Katz J. Posttraumatic stress symptoms and the diathesis-stress model of chronic pain and disability in patients undergoing major surgery. Clin J Pain. 2010; 26: 518-527.
Osvath P, Vörös V, Fekete S. Life events and psychopathology in a group of suicide attempters. Psychopathology. 2004; 37: 36-40.
Zvolensky MJ, Kotov R, Antipova AV, Schmidt NB. Diathesis stress model for panic-related distress: a test in a Russian epidemiological sample. Behav Res Ther. 2005; 43: 521-532.
Goin MK. Practical psychotherapy: Split treatment: The psychotherapy role of the prescribing psychiatrist. Psychiatric Services 200; 52: 605-609.
Gabbard GO. Psychotherapy in psychiatry. International review of Psychiatry. 2007 Jan; 19: 5-12.
Hall AM, Ferreira PH, Maher CG, Latimer J, Ferreira ML. The influence of the therapist-patient relationship on treatment outcome in physical rehabilitation: a systematic review. Phys Ther. 2010; 90: 1099-1110.
García-Pérez LE, Álvarez M, Dilla T, Gil-Guillén V, Orozco-Beltrán D. Adherence to therapies in patients with type 2 diabetes. Diabetes Therapy. 2013; 4: 175-194.
Hojat M. A Definition and Key Features of Empathy in Patient Care. In Empathy in Health Professions Education and Patient Care. Springer: 2016.
Jani BD, Blane DN, Mercer SW. The role of empathy in therapy and the physician-patient relationship. Forschende Komplementärmedizin/Research in Complementary Medicine. 2012; 19: 252-257.
Berry K, Gregg L, Lobban F, Barrowclough C. Therapeutic alliance in psychological therapy for people with recent onset psychosis who use cannabis. Compr Psychiatry. 2016; 67: 73-80.
Ivezić S, Ljubimir V, Urlić I. Therapist-patient relationship in treatment of chronic schizophrenic patients. Medicinski arhiv. 2000; 55 Suppl 1: 39-46.
Derksen F, Bensing J, Lagro-Janssen A. Effectiveness of empathy in general practice: a systematic review. Br J Gen Pract 2013; 63: e76-84.
Ruchlewska A, Kamperman AM, van der Gaag M, Wierdsma AI, Mulder NC. Working Alliance in Patients with Severe Mental Illness Who Need a Crisis Intervention Plan. Community Ment Health J. 2016; 52: 102–108.
Lee H, Yoon JY, Kim I, Jeong YH. The effects of personal resources and coping strategies on depression and anxiety in patients with chronic obstructive pulmonary disease. Heart & Lung: Heart Lung. 2013; 42: 473-479.
Galderisi S, Rossi A, Rocca P, Bertolino A, Mucci A, Bucci P, et al. The influence of illness‐related variables, personal resources and context‐related factors on real‐life functioning of people with schizophrenia. World Psychiatry. 2014; 13: 275-287.
Fava GA. Sonino N. Psychosomatic medicine. Ltd Int J Clin Pract 2010; 64: 1155–1161.
Benning TB. Limitations of the biopsychosocial model in psychiatry. Adv Med Educ Pract. 2015; 6: 347–352.