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Inicio European Journal of Psychiatry The multi-disciplinary arena of psychosomatic medicine – Time for a transition...
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Vol. 34. Issue 2.
Pages 63-73 (April - June 2020)
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Vol. 34. Issue 2.
Pages 63-73 (April - June 2020)
Review article
DOI: 10.1016/j.ejpsy.2020.02.003
The multi-disciplinary arena of psychosomatic medicine – Time for a transitional network approach
C. Leuea,b,c,
Corresponding author

Corresponding author.
, M.A. van Schijndeld,e, D. Keszthelyif,g, G. van Koeveringec,h, R.W. Pondsa,b, R.G. Katholi,j,k, B.P. Ruttena,b
a Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
b School for Mental Health and Neuroscience (MeHNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
c Pelvic Care Centre, Maastricht University Medical Center, Maastricht, The Netherlands
d Department of Psychiatry, Rijnstate Hospital, Arnhem, The Netherlands
e Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
f Division of Gastroenterology-Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands
g School for Nutrition and Translational Research In Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
h Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
i Cartesian Solutions Inc., Burnsville, MN, United States
j Department of Internal Medicine, University of Minnesota, Minneapolis, United States
k Department of Psychiatry, University of Minnesota, Minneapolis, United States
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Background and objectives

Diverse disciplines, ranging from medical psychology to general hospital psychiatry and somatic specialties, are involved in efforts to understand psychosomatic conditions and to advocate multi-disciplinary management. Depending on the kind of problem, its acuity, severity and complexity, patients present at different settings. We aim to give examples of existing integrated care approaches at diverse health care settings and to depict obstacles to and benefits of that care. Furthermore, perspectives to overcome shortcomings concerning the organization of integrated care are outlined.


Narrative review.


This review describes obstacles to integrated psychosomatic care and delineates integrated medical and behavioural health services, ranging from the inpatient medical hospital setting to primary care. Benefits, shortcomings and aspirations of integrated care are drawn, suggesting that a transitional network approach might bridge the gap between medical disciplines and settings, within the medical hospital and back to primary care.


Various medical and behavioural health service models deliver integrated care. Research mainly focused on collaborative care in primary care. There are uncertainties about the effectiveness of primary care-based interventions targeting somatic complexity and severity in multi-conditional patients. Uncertainties remain, for instance, in cancer or cardiovascular disease with comorbid psychiatric disorders. Furthermore, current evidence does not support the use of primary caregivers in cases of functional somatic symptoms. Given that care transition is a vulnerable moment in health care, a transitional network approach using staff-guided case managers could bridge the gap between medical hospital disciplines and primary care, possibly having impact of societal relevance.

Integrated care
Collaborative care
Chronic disease
Psychosomatic medicine


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