Leigh H, Reiser M F
Ann Intern Med. 1977 Aug;87(2):233-9. doi: 10.7326/0003-4819-87-2-233.
Three developmental lines are identifiable in psychosomatic medicine: (1) psychodynamic investigations, (2) psychophysiologic and psychosocial research, and (3) consultation-liaison psychiatry. Although psychodynamic understanding of medical patients remains important, "psychogenesis" is no longer the principal concern of psychosomatic medicine, which has shifted emphasis to a holistic understanding that includes the biologic, psychologic, and social systems of medical and psychiatric patients. Recent investigations along the second line indicate that all medical and psychiatric illnesses can be regarded as "psychosomatic," in that comprehensive understanding and care cannot be achieved without considering the three interrelated systems. Consultation-liaison psychiatry is the practice of this holistic approach in the general hospital. The essential role of the consultation-liaison psychiatrist as a bridge between the biologic and behavioral disciplines may become a major part of the role of the general psychiatrist in the future.
（1）精神动力学研究；（2）心理生理学和心理社会学研究；（3）会诊-联络精神病学。尽管对内科患者的精神动力学理解仍然很重要，但“心理发生”已不再是心身医学的主要关注点，心身医学已将重点转向整体理解，这种理解涵盖内科和精神科患者的生物、心理和社会系统。沿着第二条脉络进行的近期研究表明，所有内科和精神科疾病都可被视为“心身性的”，因为如果不考虑这三个相互关联的系统，就无法实现全面的理解和治疗。会诊-联络精神病学是这种整体方法在综合医院中的实践。会诊-联络精神科医生作为生物学科和行为学科之间桥梁的重要作用，可能会在未来成为普通精神科医生角色的主要组成部分。
