Editing Psychosomatic medicine (section)

==Psychosomatic disorders==
{{main|Somatic symptom disorder}}
Some physical diseases are believed to have a mental component derived from  [[Stress (biology)|stresses]] and strains of everyday living. Some researchers have suggested, for example, that [[lower back pain]] and [[high blood pressure]] may be related to [[Stress (biology)|stress]]es in everyday life.<ref>{{cite book| vauthors = Sarno J | title = The Divided Mind| publisher = ReganBooks| year = 2006| isbn = 978-0-06-085178-1| url-access = registration| url = https://archive.org/details/dividedmindep00sarn}}</ref> The psychosomatic framework additionally sees mental and emotional states as capable of significantly influencing the course of any physical illness. Psychiatry traditionally distinguishes between psychosomatic disorders, disorders in which mental factors play a significant role in the development, expression, or resolution of a physical illness, and [[Somatoform Disorders|somatoform disorders]], disorders in which mental factors are the sole cause of a physical illness.

It is difficult to establish for certain whether an illness has a psychosomatic component. A psychosomatic component is often inferred when there are some aspects of the patient's presentation that are unaccounted for by biological factors, or some cases where there is no biological explanation at all. For instance, ''[[Helicobacter pylori]]'' causes 80% of [[peptic ulcers]]. However, most people living with ''Helicobacter pylori'' do not develop ulcers, and 20% of patients with ulcers have no ''H. pylori'' infection. Therefore, in these cases, psychological factors could still play some role.<ref>{{cite journal | vauthors = Fink G | title = Stress controversies: post-traumatic stress disorder, hippocampal volume, gastroduodenal ulceration* | journal = Journal of Neuroendocrinology | volume = 23 | issue = 2 | pages = 107–117 | date = February 2011 | pmid = 20973838 | doi = 10.1111/j.1365-2826.2010.02089.x | s2cid = 30231594 }}</ref> Similarly, in [[irritable bowel syndrome]] (IBS), there are abnormalities in the behavior of the gut. However, there are no actual structural changes in the gut, so stress and emotions might still play a role.<ref>{{cite book | vauthors = Melmed RN | title = Mind, Body and Medicine: An Integrative Text| publisher = Oxford University Press Inc, USA| year = 2001| pages = 191–192 | isbn = 978-0-19-513164-2}}</ref>

The strongest perspective on psychosomatic disorders is that attempting to distinguish between purely physical and mixed psychosomatic disorders is obsolete as almost all physical illness have mental factors that determine their onset, presentation, maintenance, susceptibility to treatment, and resolution.<ref>{{cite journal | vauthors = Skumin VA | title = [Borderline mental disorders in chronic diseases of the digestive system in children and adolescents] | journal = Zhurnal Nevropatologii I Psikhiatrii Imeni S.S. Korsakova | volume = 91 | issue = 8 | pages = 81–84 | date = 24 January 1991 | pmid = 1661526 | url = http://www.mendeley.com/research/borderline-mental-disorders-chronic-diseases-digestive-system-children-adolescents/ | access-date = 2 March 2012 | url-status = dead | archive-url = https://web.archive.org/web/20160304054309/https://www.mendeley.com/research/borderline-mental-disorders-chronic-diseases-digestive-system-children-adolescents/ | archive-date = 4 March 2016 }}</ref><ref>{{cite journal | vauthors = Skumin VA | title = [Nonpsychotic mental disorders in patients with acquired heart defects before and after surgery (review)] | language = ru | journal = Zhurnal Nevropatologii I Psikhiatrii Imeni S.S. Korsakova | volume = 82 | issue = 11 | pages = 130–135 | year = 1982 | pmid = 6758444 | url = https://biblmdkz.ru/articles/nmd.html | trans-title = Nonpsychotic mental disorders in patients with acquired heart defects before and after surgery (review) | script-title = ru:Непсихотические нарушения психики у больных с приобретёнными пороками сердца до и после операции (обзор) }}</ref> According to this view, even the course of serious illnesses, such as cancer, can potentially be influenced by a person's thoughts, feelings and general state of mental health.

Addressing such factors is the remit of the applied field of [[behavioral medicine]]. In modern society, psychosomatic aspects of illness are often attributed to [[stress (medicine)|stress]]<ref>{{cite book | vauthors = Treasaden IH, Puri BK, Laking PJ | title = Textbook of Psychiatry| publisher = Churchill Livingstone| year = 2002| pages = 7| isbn = 978-0-443-07016-7}}</ref> making the remediation of stress one important factor in the development, treatment, and prevention of psychosomatic illness.