From the Lesson of George Engel to Current Knowledge: The Biopsychosocial Model 40 Years Later

Fava, Giovanni A.; Sonino, Nicoletta

doi:10.1159/000478808

Cited by 33 publications

(21 citation statements)

References 23 publications

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“…Whether an individual meets the criteria of euthymia or not, it is important to evaluate its components in clinical practice and to incorporate them in the psychiatric examination. There is, in fact, extensive evidence that positive affects and well‐being represent protective factors for health and increase resistance to stressful life situations.…”

Section: Euthymia As An Integrative Frameworkmentioning

confidence: 99%

The pursuit of euthymia

2020

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Psychiatrists often consider the positive characteristics displayed by a patient in their clinical judgment, yet current assessment and treatment strategies are shifted on the side of psychological dysfunction. Euthymia is a transdiagnostic construct referring to the presence of positive affects and psychological well‐being, i.e., balance and integration of psychic forces (flexibility), a unifying outlook on life which guides actions and feelings for shaping future accordingly (consistency), and resistance to stress (resilience and tolerance to anxiety or frustration). There is increasing evidence that the evaluation of euthymia and its components has major clinical implications. Specific instruments (clinical interviews and questionnaires) may be included in a clinimetric assessment strategy encompassing macro‐analysis and staging. The pursuit of euthymia cannot be conceived as a therapeutic intervention for specific mental disorders, but as a transdiagnostic strategy to be incorporated in an individualized therapeutic plan. A number of psychotherapeutic techniques aiming to enhance positive affects and psychological well‐being (such as well‐being therapy, mindfulness‐based cognitive therapy, and acceptance and commitment therapy) have been developed and validated in randomized controlled clinical trials. The findings indicate that flourishing and resilience can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continuing growth and development, the belief that life is purposeful and meaningful, satisfaction with one's relations with others, the capacity to manage effectively one's life, and a sense of self‐determination.

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Section: Euthymia As An Integrative Frameworkmentioning

confidence: 99%

The pursuit of euthymia

2020

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“…This follows the theory of the bio-psychosocial model for biomedicine crystallised by Engel four decades ago [4]. He formulated a personalised model for patient-care in which there would be mutual influence of the mind and body, in order to understand disease aetiology [5,6].…”

Section: Introductionmentioning

confidence: 99%

Understanding the complexity of glycaemic health: systematic bio-psychosocial modelling of fasting glucose in middle-age adults; a DynaHEALTH study

et al. 2018

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Background The prevention of the risk of type 2 diabetes (T2D) is complicated by multidimensional interplays between biological and psychosocial factors acting at the individual level. To address the challenge we took a systematic approach, to explore the bio-psychosocial predictors of blood glucose in mid-age. Methods Based on the 31-year and 46-year follow-ups (5,078 participants, 43% male) of Northern Finland Birth Cohort 1966, we used a systematic strategy to select bio-psychosocial variables at 31 years to enable a data-driven approach. As selection criteria, the variable must be (i) a component of the metabolic syndrome or an indicator of psychosocial health using WHO guidelines, (ii) easily obtainable in general health check-ups and (iii) associated with fasting blood glucose at 46 years (P < 0.10). Exploratory and confirmatory factor analysis were used to derive latent factors, and stepwise linear regression allowed exploration of relationships between factors and fasting glucose. Results Of all 26 variables originally considered, 19 met the selection criteria and were included in an exploratory factor analysis. Two variables were further excluded due to low loading (<0.3). We derived four latent factors, which we named as socioeconomic, metabolic, psychosocial and blood pressure status. The combination of metabolic and psychosocial factors, adjusted for sex, provided best prediction of fasting glucose at 46 years (explaining 10.7% of variation in glucose; P < 0.001). Regarding different bio-psychosocial pathways and relationships, the importance of psychosocial factors in addition to established metabolic risk factors was highlighted. Conclusions The present study supports evidence for the bio-psychosocial nature of adult glycemic health and exemplifies an evidence-based approach to model the bio-psychosocial relationships. The factorial model may help further research and public health practice in focusing also on psychosocial aspects in maintaining normoglycaemia in the prevention of cardiometabolic diseases.

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“…Los profesionales deben consiDiabetes mellitus tipo I -R. Henríquez-Tejo et al derar los aspectos sociales que rodean al niño y adolescente 41 , incluir el uso de instrumentos de detección que evalúen relación de autocontrol con funcionamiento cognitivo y problemas psicológicos 42 . La medicina debe velar por el cuidado de la persona entera, no solo de los aspectos físicos 43 . Este apoyo y tratamiento psicosocial no solo debe ser duradero, sino apropiado para la edad sobre todo en la transición de la infancia a la adolescencia y luego a la etapa de adulto joven, debido a que se da lugar a menos ansiedades y mejor comprensión de la enfermedad, lo que lleva a una mejor calidad de vida, no solo del paciente, sino que de toda su familia y círculo de apoyo 5 .…”

Section: Atención Psicosocialunclassified

Impacto psicosocial de la diabetes mellitus tipo 1 en niños, adolescentes y sus familias. Revisión de la literatura

Henríquez-Tejo¹,

Cartes‐Velásquez

2018

Rev. chil. pediatr.

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ResumenLa diabetes mellitus tipo 1 es la patología endocrina crónica más común en niños. El tratamiento incluye dieta, actividad física, medicación con insulina y un autocontrol adecuado. Este autocontrol puede ser dificultoso, provocando que niños, adolescentes y sus familias sufran diversas complicaciones psicosociales. Existe una relación inversa entre autocontrol y presencia de complicaciones psicosociales, siendo los principales problemas ansiedad y depresión, donde los adolescentes llegan a ser 2,3 veces más propensos a presentar problemas de salud mental. Las familias se ven afectadas inicialmente en el período de debut por un estado de shock, con sentimientos de angustia e ira. Los necesarios cambios de hábitos y estilos de vida pueden generar problemas psicosociales entre los que destacan trastornos ansiosos, depresivos y alimenticios. Posteriormente, el niño o adolescente y su grupo familiar pueden transitar a un nuevo equilibrio caracterizado por un buen autocontrol y adherencia al tratamiento o profundizar los trastornos individuales y grupales, trastornos que pueden reaparecer, especialmente en la adolescencia. El tratamiento integral de la diabetes mellitus tipo 1 requiere atender estos aspectos mediante equipos multidisciplinarios que incluyen profesionales médicos y del ámbito psicosocial. En esta revisión se analizan los principales aspectos relacionados al impacto psicosocial en niños y adolescentes con diabetes mellitus tipo 1 y sus familias. Keywords:Diabetes mellitus type 1; psychosocial impact; family AbstractType 1 diabetes mellitus is the most common chronic endocrine pathology among children. Treatment includes diet, physical activity, insulin medication, and proper self-control. This self-control may be difficult, resulting in children, adolescents and their families suffering diverse psychosocial complications. There is an inverse relationship between self-control and psychosocial complications, the main problems being anxiety and depression, where adolescents are 2.3 times more likely to have mental

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From the Lesson of George Engel to Current Knowledge: The Biopsychosocial Model 40 Years Later

Cited by 33 publications

References 23 publications

The pursuit of euthymia

The pursuit of euthymia

Understanding the complexity of glycaemic health: systematic bio-psychosocial modelling of fasting glucose in middle-age adults; a DynaHEALTH study

Impacto psicosocial de la diabetes mellitus tipo 1 en niños, adolescentes y sus familias. Revisión de la literatura

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