Psychosocial Aspects of Disease

An understanding of the psychosocial aspects of physical illness is one of the most important contributions that behavioral sciences can make to medicine. A conceptual framework for the clinical study of these aspects is presented. The determinants and the manifold components of psychological reactions to disease and disability are discussed. The determinants fall into four classes of variables: the personality of the patient and his life history, the state of the patient's current interpersonal relationships, characteristics of his non-human environment, and the nature and characteristics of the pathological process or injury. The resulting psychological reactions include three components: the intrapsychic, the behavioral, and the social. To understand how the patient experiences his illlness and copes with it one has to know what all aspects of his disease mean to him and what responses to his complaints he obtains from other persons, including health professionals. Psychosocial factors influence the course and outcome of every illness, and it is imperative that their evaluation should be a part of medical diagnosis and management.