Soma

The research theme Soma & Psyche has been formed in order to facilitate research on the interface between common mental disorders and physical illnesses. The objectives are to encourage, initiate, conduct and publish excellent research in the area of ‘soma and psyche’.

Soma and Psyche is part of the Research Program Mental Health: researchers participating in Mental Health contribute to Soma and Psyche. Selected researchers participating in other research programs and Institutes contribute to Soma & Psyche as well.

 

Rationale and focus

Mental disorders are highly prevalent in patients with physical illnesses. Mental disorders – anxiety and depression in particular – occur frequently in cardiovascular disease, cancer, arthritis, degenerative neuromuscular diseases, diabetes, gastrointestinal disorders, and other chronic diseases. Anxiety and depression occur frequently in chronic pain, chronic fatigue and other somatoform disorders as well. Finally, psychiatric patients frequently have coexisting physical illness: cardiovascular diseases, lung diseases and neurological disorders are common in psychiatric patients.

Thus, the area of research concerns:

  • mental disorders in physical illnesses
  • somatoform disorders
  • physical illness in psychiatric disorders.

Mental disorders may constitute an etiological factor in some physical illnesses. For example, depression is a risk factor for both cardiovascular disease and diabetes. In other physical illnesses, e.g. cancer, the etiological role of mental disorders has not been convincingly demonstrated.

Much more evidence is available for the prognostic impact of mental disorders in physical illness: mental disorders (e.g. depression) constitute a prognostic factor for mortality and morbidity (e.g. in diabetes), symptoms and activity limitations (e.g. in cancer, arthritis, and somatoform disorders) and quality of life (e.g. in neuromuscular and gastrointestinal disorders).

Treatment of mental disorders has been shown to improve symptoms, activity limitations and quality of life. Finally, although little evidence is available, physical illness may have impact on psychiatric disorders; physical illness in psychiatric patients certainly needs to be treated.

Thus, the area of research concerns:

  • mental disorders as an etiological factor in some physical illnesses
  • mental disorders as a prognostic factor in physical illness
  • physical illness as a factor in mental disorders
  • treatment of mental disorders in physical illness
  • treatment of physical illness in mental disorders.

 

Scientific approach

The research theme brings together researchers working in the clinical epidemiological tradition, public mental health and the biological tradition. The combination of the clinical epidemiological approach, public mental health and the biological approach will create new insights which would not be available if these approaches were kept separate.

Soma & Psyche runs both observational studies and intervention studies. Observational research is usually designed as a cross-sectional and/or prospective cohort study. Intervention studies are designed as controlled (randomized) trials.

 

Research lines

The theme Soma & Psyche has a well established tradition in the following medical fields:

  • cardiovascular disease
  • diabetes
  • oncology
  • degenerative neurological diseases
  • somatoform disorders.

The possibility of starting research in the fields of reumatology and gastrointestinal disorders are currently being explored.

In these fields research focuses on three research lines:

  • Pathophysiology at the soma-psyche interface
    This research line contributes to elucidating mechanisms of the interaction between psyche and soma in medical disorders. Studies focus on the hypothalamic-pituitary-adrenal axis, the autonomous nervous system, inflammation, and genetic factors.
  • Diagnosis, etiology and prognosis at the soma-psyche interface
    This research line contributes to (i) the assessment of mental disorders in physical illness and somatoform disorders; and (ii) to elucidating the role of both mental and somatic factors in the etiology and prognosis of physical illness and somatoform disorders.
  • Interventions at the soma-psyche interface
    This research line contributes to the development and evaluation of interventions. Studies focus on the stepped care approach, i.e. less intensive interventions are tried first, with more intensive and costly interventions reserved for those insufficiently helped by the initial intervention.

 

Infrastructure

At present, the following departments participate in and contribute to Soma & Psyche:

 

Our Staff

If you have any questions or like to have more information, you can e-mail Marijke Bremmer at ma.bremmer@vumc.nl