Global Psychosomatic Medicine and Consultation-Liaison Psychiatry by Hoyle Leigh

Author:Hoyle Leigh
Language: eng
Format: epub
ISBN: 9783030125844
Publisher: Springer International Publishing

13.6.2 Epidemiological Research

Epidemiological research related to psychosomatics has produced abundant papers and good quality research, and this includes relevant Spanish contributions. In an article published in 1997, the potential input of epidemiology to psychosomatic medicine was emphasized (Lobo and Campos 1997) and a review of the state of the art was presented in the last meeting of the European Association of Psychosomatic Medicine (Lobo 2017). Following the outline put forward by a pioneer in epidemiological psychiatry (Shepherd 1978), contributions from the following perspectives have been reported in the international literature. In relation to what Shepherd called “the completion of the spectrum of disease”, early relevant contributions in primary care were reported, such as those related to somatization (García-Campayo et al. 1996); or the reasons for consulting the primary care physician (Vazquez-Barquero et al. 1992). General population studies have been completed, including those by the Cantabria group (Vazquez-Barquero et al. 1997). There was more recent documentation related to the “clustering phenomenon”, the coincidence of somatic and psychiatric morbidity in a sector of the general population, reported for the first time in a predominantly elderly population (Lobo-Escolar et al. 2008) and contributions in a subject of increasing interest, such as the multimorbidity (Olaya et al. 2017). In relation to the more ambitious task of “the establishment of outcome”, which requires longitudinal studies, some examples include the documentation of the increased mortality in elderly depressed patients (Saz and Dewey 2001).

Of particular epidemiological and public heath interest is “the actuarial assessment of morbid risk”, where a relevant contribution deserving an editorial comment in the American Journal of Psychiatry documented that depression in the adult and elderly individuals increases by 65% the risk of type II diabetes mellitus, the ‘population attributable fraction’ being 7% (Campayo et al. 2011). M. Shepherd also underlined the potential of psychiatric epidemiology to contribute to “the evaluation of the efficacy of treatment”, and some relevant studies document in this country the potential of this methodology in the study design (Justicia et al. 2017), including the design of randomized treatment studies (Ortiz Collado et al. 2014). Finally, the British expert also underlined the potential of epidemiological studies for “the conceptual construction of diagnosis and classification”, where some relevant studies have similarly been conducted by Spanish psychiatrists (García-Campayo et al. 1996). In addition to this, other Spanish groups contributing with epidemiological type of studies (Dueñas et al. 2016) have reported on the biological bases of psychopathologies such as pain (Borges et al. 2017), even in experimental, animal studies (Romero-Grimaldi et al. 2015).

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