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Emotional Expression and Disease Outcome

David Spiegel, MD

JAMA. 1999;281:1328-1329.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We have been closet Cartesians in modern medicine, treating the mind as though it were reactive to but otherwise disconnected from disease in the body. Although medical science has productively focused on the pathophysiology of disease, such as tumor biology, coronary artery disease, and immunology, it has done so at the expense of studying the body's psychophysiological reactions to these disease processes. These reactions are mediated by brain and body mechanisms, including the endocrine, neuroimmune, and autonomic nervous systems. While a large portion of the variance in any disease outcome is accounted for by the specific local pathophysiology of that disease, some variability must also be explained by host resistance factors, which include the manner of response to the stress of the illness. For example, in a series of classic experiments in animals, Riley^1-2 showed that crowding accelerated the rate of tumor growth and mortality. In a . . . [Full Text of this Article]

Author Affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif.

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