Psychology for medicine and healthcare – Article summary

Psychological factors are important in many aspects of physical and mental health. There are six definitions of health:

1. Not having symptoms of illness.
2. Having physical or social reserves.
3. Having healthy lifestyles.
4. Being physically fit or vital.
5. Psychological well-being.
6. Being able to function.

The definition that is used determines who is seen as ill or healthy. Health is very individual. For individuals, health and illness are subjective states of wellbeing. A definition of health can be physical (1), subjective (2), behavioural (3), functional (4), psychosocial (5), social (6) and cultural (7).

Health can be defined as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. However, this may be too broad or only refer to an utopian state of health barely anyone has. The definition of health has implications for treatments provided by health services. In the Western world, it is seen that individuals are responsible for their health by adopting healthy or unhealthy lifestyles.

Health can be seen as a continuum. Medical treatment focuses on the illness side of the continuum whereas health promotion techniques operate on the wellness side of the continuum.

Psychological research tests common sense views empirically and goes beyond common sense. Besides that, people don’t always act according to common sense, making psychology more than common sense.

To treat people effectively, it is necessary to diagnose the problem accurately (1) and treat the problem appropriately (2). Accurate diagnoses are more likely if it is understood how people’s experience shape perception, reporting of symptoms and help-seeking behaviour. Understanding psychological and social processes help us diagnose and treat people more effectively. There is a strong link between physical health and psychological health.

The biomedical approach is based on a separation of body and mind and is unhelpful. Embodied cognition states that many aspects of cognition are influenced by our bodily state. The motor system, the perceptual system and physical interactions with others and the environment influences cognition.

There are different approaches to medicine and healthcare:

1. Biomedical approach
   This approach is based on a dualistic view of the body. It assumes that all disease can be explained in terms of physiological processes. This means that the treatment acts on the disease and not on the person. Psychological and social processes are seen as separate and incidental.
2. Biopsychosocial approach
   This approach incorporates biological, psychological and social factors. External factors include the sociocultural environment (1), pathogenic stimuli (2) and any treatment that the individual receives which can act on pathogenic stimuli or the person (3). Internal factors include personal history (1), psychosocial processes (2) and physiological and biochemical mechanisms (3). In this approach, illness is seen to be caused by many factors at different levels.        

People in lower classes are at more risk of illness and death from a variety of causes, mostly due to differences in lifestyles. Next to lifestyle, individual factors such as personality, health behaviours and beliefs also affect health.

The placebo effect refers to recovery due to the idea that one has been treated and therefore should recover. A lot of people (i.e. 10-15%) have a history of multiple unexplained physical symptoms and a third of all the symptoms in primary care do not have an identifiable organic cause.

The biopsychosocial approach should lead to more comprehensive research that examines the multiple levels, systems and factors involved in health. It allows for a more complete understanding of the many factors that can contribute to health or illness in clinical practice.

Barriers to applying the biopsychosocial model include the fact that it is not possible to address all factors that influence illness (1) and linear causality is needed for treatment planning and the model uses circular causality (2).

Epigenetics focuses on how environmental factors regulate the activity and expression of genes. Intergenerational transmission of vulnerability refers to physiological changes that can be passed on to children and are the result of environmental factors.

Socioeconomic status (1), general socio-political context (2) and levels of gender equity (3) affect health outcomes and health-related behaviours. Ethnicity influences health behaviours and health outcomes as people from minorities tend to have poorer health. Sex and gender as well as sexual identity also influence health outcomes and health-related behaviours.

Intersectionality refers to the idea that health is shaped by a range of demographic variables which may intersect with other variables.