articles Biopsychosocial model
The biopsychosocial model of medicine, is a
way of looking at the mind and body of a patient as two important
systems that are interlinked. The biopsychosocial model is also
a technical term for the popular concept of the mind-body connection.
This is in contrast to the traditional biomedical model of medicine.
The model was proposed by psychiatrist George
Engel in a 1977 article in Science.
The biopsychosocial model treats the biological,
psychological and social issues as systems of the body, similar
to the traditional medical systems such as the respiratory and
The biopsychosocial model draws a distinction
between the actual pathological processes that cause disease,
and the patient's perception of their health and the effects
on it, called the illness.
Illness and disease do not necessarily run
together. A patient may be reasonably well (no sickness), but
if they feel unwell that's an illness. Similarly, patients with
something physically wrong with them are diseased, but they
may feel completely all right, they are not ill.
The biopsychosocial model presumes that it
is important to handle the two together as they are both important.
Proponents say that much money is wasted on healthy patients
because the doctor is not treating the illness. From this perspective,
a patient has not recovered from a disease until they feel better
and their illness is over.
The biopsychosocial model gives great importance
to the illness; therefore much more information needs to be
gathered during a consultation. As well as the biological signs
and symptoms, a doctor must find out about the patient's psychological
state, their feelings and beliefs about the illness, and social
factors such as their relationship with families and the larger
For this reason, the interview process should
encourage the patient to give as much information about not
only the physical symptoms, but how the illness affects the
patient. This is a patient-centred approach, and generally involves
open-ended questions designed for the patient to do much of
the talking. The patient is also better involved in the treatment,
and it includes steps to get over any illness as well as the
As well as an separate existence of disease
and illness, the biopsychosocial model states that the workings
of the body can affect the mind, and the workings of the mind
can affect the body.
This does not necessarily mean that there is
a direct effect between mind and body, but that other intermediate
factors can form a bridge from thought to biological fact.
Psychosocial factors can cause a biological
effect by predisposing the patient to risk factors. An example
is that depression by itself may not cause liver problems, but
a depressed person may be more likely to have alcohol problems,
thus liver damage. It is this increased risk-taking that leads
to an increase likelihood of disease.
There are also theories that the state of mind
directly affects the immune system, although most carefully-planned
studies do not show this to be the case.
Of course, it is apparent to most people that
a pathological disease can have an effect on a person's mind.
It is not surprising that some people who have been diagnosed
with cancer develop depression.