Grand Challenges in Psychosomatic Research

The link between emotion and disease has long fascinated mankind. Famous seventeen century British physician, Thomas Willis (1621–1675) saw diabetes as a consequence of sadness or long sorrow (Willis, 1971). Though better known for describing what eventually became known as the " Circle of Willis " , he provided a fairly comprehensive description of the role of nervous system in disease (Encyclopaedia Britannica, 2010). Willis may not have been the first to see the link, but his account stands out for its sophistication. In subsequent years and centuries , psychosomatic medicine has fallen in and out of favor many times. Depending on whom we ask, and what we focus on, we are currently witnessing exciting and challenging times for psychosomatic research. Despite decades of work, a key question in psychosomatic research remains: do psychiatric disorders cause or contribute to physical disease such as heart disease, diabetes and asthma? And given the treatments that we have, a second question is: does timely and optimum treatment of the psychiatric disorders prevent, arrest or roll back the progression of physical disease? As brain was shown to influence systemic physiology in health, as well as in disease, the impact of cognition and emotion, and not just psychiatric illness, on general physical health became an important line of investigation. Indeed, there is more to psychosomatic research than just psychosomatic medicine. With the new interest in positive psychology, the impact " positive emotional states " such as equanimity, level-headedness and congruence is also an important topic for investigation. Among the positive developments are many exciting findings from neuroimag-ing studies as well as the promise of genetic studies. Neuroimaging has put " brain " back at the center of the psychosomatic medicine (Lane et al., 2009). Consequently, models in " mind body " medicine are becoming more elegant and plausible, and include diverse variables such as, mental/psychological/ behavioral states and traits; brain; information transfer systems such as autonomic nervous system, endocrine, immune; and end organ functioning (Lane et al., 2009). Imaging studies suggest that brain has a role in a wide variety of systemic disorders such as irritable bowel syndrome, conversion disorder, asthma, fibromyalgia and pain disorder (Lane and Wager, 2009). The evidence of such a role is not surprising, but what is striking is the amount of overlap in the findings among these seemingly diverse conditions. Most of this overlap is apparent in the fronto-limbic structures, …