The role of psychosocial factors in the causation, course and outcome of physical disorders: a review.

Complex interactions occur between psychological and biological factors in health and disease. Stressful life events have been shown to be important in the initiation and exacerbation of both infectious and non-infectious diseases while personality factors may act to increase or reduce vulnerability to physical disorders. Some of the psychosocial complications of physical disorders include marital and financial difficulties, personality changes, affective disturbances, memory impairment and intellectual deterioration. Psychotic reactions may occur in some cases. These complications could worsen the overall outcome and increase family stress and burden. Psychosocial intervention techniques may be required in the management of psychosocial consequences of physical disorders and for some physical illnesses uncomplicated by psychological disorders (e.g. application of biofeedback and relaxation training in the management of hypertension). It is thus important to pay more attention to the behavioural, psychological and social aspects of medical care, particularly in developing countries where available resources are limited.