Psychosocial determinants of health and illness: integrating mind, body, and spirit.

Presented in this paper is a review of some of the evidence linking psychosocial factors to a variety of health outcomes. Drawing upon the work of the philosopher Ken Wilber, we begin with a consideration of some of the historic roots of the mind-body split. As will be seen, Wilber argues that in the premodern era, "mind" and "body" were essentially fused (ie, thought of as not separate); with the dawn in the West of the Enlightenment and the emergence and subsequent dominance of the empiric-scientific mode of inquiry, the mind and body became separate; and in the postmodern world, the task now is one of reintegrating mind and body, an undertaking with obvious implications for the field of medicine. With the goal of helping in this mind-body reintegration, we first summarize the epidemiological findings examining the relation between various psychosocial factors (personality, mood states, and cognitive factors) and physical health. We then review some of the physiological and mechanistic data that link mental-emotional factors (eg, psychosocial stress) with physical function and health. Finally, we discuss the therapeutic implications of these findings.