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The Whole Picture: Integrating Mental and Physical Health

Our new MSc in Psychology and Neuroscience of Mind-Body Interface offered by the Institute of Psychiatry, Psychology, and Neuroscience at King’s College London aims to offer knowledge on the interaction between mind and body in psychiatric and physical conditions. This article has been written by Dr Giulia Lombardo and Professor Valeria Mondelli, co-leads of the Psychology module.


For a long time, people have been anchored to the mind-body dualism, a concept partly introduced in the 17th century by the philosopher Rene Descartes viewing the mind and the body as separate entities. This has unfortunately partly contributed to an “unbalanced” clinical approach, trying to resolve either physical or mental health issues without recognising the influence they have on each other. We are now entering a new era, where we are becoming increasingly aware that there is no real separation between the mind and the body, and that mental and physical health conditions are often interconnected.


This blog is part of a series of ITM pieces on our MSc in Psychology and Neuroscience of Mind-Body Interface at King's College London starting in October 2024. We already have three pieces: two by the MSc lead, Dr Alessandra Borsini, on how this knowledge can project the clinical and academic career of students, and on the many mechanisms connecting the brain, the mind, and the body, and a third one by the co-lead of the Neuroscience Module, Professor Carmine Pariante on the role of blood in the mind and body interface.


Here, we want to take a step back and give an overview of the importance of studying the co-occurrence of psychiatric and somatic symptoms (that is bodily symptoms) in physical health and psychiatric conditions respectively. 


This interdisciplinary and integrated approach views the individual as a whole, considering both mental and physical health. Such an approach is of primary importance, whether you study to become a researcher or a clinician. As part of the Psychology Module, we will also discuss some examples of how understanding the interaction between mind and body can aid in advancing clinical care and research framework, bringing insights into the development of new therapeutic approaches.


Understanding the shared biological mechanisms

To understand the relationship between mental and physical health, we need to understand the shared biological mechanisms, that is the changes in the body and the brain that are common between two or more conditions. This is one of the best approaches we can use to ultimately find new ways to improve patients’ well-being.


One clear example is obesity, a condition characterised by metabolic dysfunctions (such as type 2 diabetes) and is highly associated with depression. The co-occurrence of these two disorders is a major public health issue but the biology behind this comorbidity (that is, having two or more health-related disorders at the same time) is still unclear.


Therefore, it’s important to investigate the link between metabolic dysregulation and depressive symptoms. A shared biological mechanism between obesity and depression is the dysregulation of the immune system.


The immune system is the system that fights infections and other threats in our body, and of course, it is helpful and protects us in the short term. However, when its activation becomes chronic, the body is affected by this maladjustment. Interestingly, both obesity and depression can be associated with increased body inflammation, indicating an over-activation of this biological mechanism.


The immune system is quite complex and there is no straightforward answer as to where exactly the dysfunction comes from and how we could act to improve clinical symptoms. However, the study of immunometabolic abnormalities (problems in how the immune system and metabolism work together) will help in informing targeted treatments (which are treatments targeting specific mechanisms in the body) for individuals with obesity and depression. A united front in investigating the interaction between the two aspects in individuals with obesity and depression will help in ultimately managing the care of these patients and improving the overall quality of life.

 

Taking care of both physical and mental health

Generally, it is important to consider psychological wellbeing in individuals with medical conditions when providing traditional health care. A striking example of this integration can be seen in the case of cardiovascular diseases (CVDs). The interface between mind and body is extremely relevant to this diagnosis, as mental health can increase the risk of developing CVDs. Stress, anxiety, and depression can greatly impact the cardiovascular system (that is the heart and blood vessels), by triggering body responses such as increased heart rate and blood pressure, and the presence of inflammation.  In turn, this can contribute to the development and aggravation of heart conditions, highlighting the intricate connection between psychological factors and cardiovascular health. On the other hand, the chronicity of CVDs can induce mental health problems, creating a scenario that can make difficult both treatment and recovery.

 

A practical delivery of this clinical approach in the healthcare system is through a discipline called liaison psychiatry”. This is an essential branch of psychiatry that fills the gap between physical and mental health. The multidisciplinary team is usually made up of various professional figures such as psychologists, psychiatric nurses, social workers, and of course, the lead liaison psychiatrist. This approach offers an opportunity for joint physical and psychiatric care to patients with physical conditions.

 

This is important as improving mental wellbeing can also have some positive effects on the prognosis of patients with physical comorbidity. Indeed, the co-occurring of both psychiatric and physical symptoms could hide the primary medical or psychiatric problem of an individual, and thus the need for a holistic approach.

 

In conclusion, this approach recognises the intricate interplay between mental and physical health, which is crucial for advancing both clinical care and research. The interdisciplinary approach of the MSc in Psychology and Neuroscience of Mind-Body Interface aims to offer the knowledge to fill the gap between mind and body, emphasising the necessity of viewing individuals in a more integrated way rather than an assembly of separate fragments.

 



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