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The topics discussed in this issue of Focus are central in mental and physical well-being. The most practical and direct way for psychiatrists to conceptualize illness involving sleep, eating, or sexual behavior is to systematically assess symptoms and syndromes using the most recent edition of the DSM as a reference. Treatment would then be focused on eliminating or at the very least ameliorating them to whatever degree possible.
We agree that this is an excellent component of a diagnostic and treatment approach, but only a component. To understand the treatment of the diverse impairments that may arise in all three areas, it is necessary to be aware of the way that biological, psychological, and social factors interact with each other. Doing so requires use of a biopsychosocial developmental model of health and disease in addition to a medical model of illness (1). Treatment of illnesses that impair sleep, eating, or sexual behavior often involves changing the way that particular biological, social, and psychological factors interact with each other. Never to be underestimated as part of any treatment plan and particularly important in the treatment of the types of patients discussed in this special section of the journal is the establishment of a sound therapeutic relationship.

REFERENCE

1.
Engel G: The need for a new medical model: a challenge for biomedicine. Science 1977; 196: 129

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Published online: 1 October 2009
Published in print: Fall 2009

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Richard C. Friedman, M.D.
Jennifer I. Downey, M.D.

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