Psychological and behavioral factors affecting medical conditions and DSM-IV. An overview.

As part of the process of reevaluating the category Psychological Factors Affecting Physical Condition (PFAPC) for possible revisions in DSM-IV, a coordinated review of the literature was conducted to document the extent of empirical evidence that exists for an association between psychological factors affecting the onset, exacerbation, course, and outcome of medical disorders. In this introduction and overview, the authors discuss the methodology and purpose of the reviews, as well as the reasons for considering revisions in the PFAPC category. Relevant historical concepts in psychosomatic medicine are briefly reviewed, and an argument is made that the general scope of the PFAPC category should be broadened in DSM-IV to include behaviorally related factors of major public health concern, as well as the effects of psychiatric comorbidity on medical outcome.