Chronic physical illness: a psychophysiological approach for chronic physical illness

Yale J Biol Med. 2013 Mar;86(1):15-28. Epub 2013 Mar 12.

Abstract

Growing evidence demonstrates that psychological risk variables can contribute to physical disease. In an effort to thoroughly investigate potential etiological origins and optimal interventions, this broad review is divided into five sections: the stress response, chronic diseases, mind-body theoretical models, psychophysiological interventions, and integrated health care solutions. The stress response and its correlation to chronic disorders such as cardiovascular, gastrointestinal, autoimmune, metabolic syndrome, and chronic pain are comprehensively explored. Current mind-body theoretical models, including peripheral nerve pathway, neurophysiological, and integrative theories, are reviewed to elucidate the biological mechanisms behind psychophysiological interventions. Specific interventions included are psychotherapy, mindfulness meditation, yoga, and psychopharmacology. Finally, the author advocates for an integrated care approach as a means by which to blur the sharp distinction between physical and psychological health. Integrated care approaches can utilize psychiatric nurse practitioners for behavioral assessment, intervention, research, advocacy, consultation, and education to optimize health outcomes.

Keywords: Type D personality; acceptance and commitment therapy; anger; autoimmune disease; cardiovascular disease; chronic pain; cognitive behavioral therapy; cynicism; depression; dialectical behavioral therapy; gastrointestinal disease; hypothalamic-pituitary axis; integrative medicine; metabolic syndrome; mindfulness meditation; optimism; positive psychotherapy; psychiatric mental health nurse practitioner; psychodynamic psychiatry; stress; sympathetic nervous system; vitality; yoga.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Chronic Disease / psychology*
  • Humans
  • Models, Theoretical
  • Psychophysics*
  • Psychophysiology
  • Stress, Psychological