A short review of four key physiopathological mechanisms for psychosomatic medicine

Abstract

The notion that “psychological factors” and the psychosocial environment influence the body function and the health maintenance or disease onset has been maintained over the years, and from different approaches to science, medicine, and psychology. Psychosomatic Medicine traditionally deals with this issue, but the “psychosomatic” name is now being criticized because of some implicit ambiguity, probably derived from the identification with the different theoretical frameworks and/or specific research methods that have been used in its evolution. This has given rise to misunderstandings about its definition, objectives, and a delay in the search for pathways of mediatizing these effects. Since then, there has been an increasing interest in the research of mechanisms, or mediatizing pathways through which the mind, the brain, and the environment could produce an impact on the somatic functioning. This brief review focuses on early stress, epigenetics and polymorphisms, such as the mechanism of penetration of the psychosocial environment; alostasis and alostatic load such as the accumulated wear and tear produced by the continuous adaptation to a variable psicosocial context; activation of the neuroimmune pathways as the physiological basis of somatizations; and interoception as a the pathway that the  body introduces into the brain, mind and consciousness.