# Understanding the Mind-Body Connection: Why Complex Illnesses Are Too Often Dismissed as "All in Your Head"

Complex illnesses that involve both the body and the brain are frequently misdiagnosed, with patients all too often told their symptoms are "all in their head." This review article explains the crucial differences between psychosomatic conditions (mental states causing physical symptoms), somatopsychic conditions (physical illness causing psychiatric symptoms), and multisystem diseases that affect the whole body at once. Using two detailed patient case histories and a careful analysis of medical terminology, the authors show how diagnostic shortcuts, outdated terms, and flawed guidelines lead to dangerous delays in treatment. They call for better education at the intersection of medicine and psychiatry and urge physicians to trust their clinical judgment rather than rigidly following population-based guidelines.

# Understanding the Mind-Body Connection: Why Complex Illnesses Are Too Often Dismissed as "All in Your Head"

## Table of Contents

- Key Points
- Why This Research Matters
- Gaps and Problems in Today's Healthcare System
- The Serious Consequences of Diagnostic Errors
- When Medical Guidelines Lead Doctors Astray
- How This Review Was Conducted
- Patient Story A: An 18-Year-Old Athlete
- Patient Story B: A Teenager in England
- Key Medical Terms Explained
- What This Means for Patients
- What This Review Could Not Address
- Recommendations for Patients and Doctors
- Frequently Asked Questions
- Source Information

## Key Points

- Psychosomatic means mind affects body; somatopsychic means body affects mind; multisystem illnesses affect both simultaneously.
- A psychiatric diagnosis cannot be based only on negative test results; absence of evidence is not evidence of absence.
- Women are far more often given incorrect psychosomatic diagnoses, reflecting gender bias and lack of research on female biology.
- In a survey of over 12,000 participants, the average Lyme disease patient saw five different physicians before correct diagnosis.
- Patients with invisible illnesses like ME/CFS, fibromyalgia, and Lyme disease face increased risks of suicidal ideation and suicide.

## Why This Research Matters

For centuries, medicine has struggled with a fundamental puzzle: where exactly does the line fall between mental illness and physical illness? This review tackles that question head-on. The authors, a psychiatrist and a pharmacologist/physiologist, argue that many complex diseases are misunderstood because doctors lack adequate training in both general medicine and psychiatry.

Historically, there has been a strong bias in medicine: when a disease is poorly understood, doctors tend to label it as "psychiatric" until science eventually discovers a physical explanation. This pattern has repeated itself time and again with illnesses like multiple sclerosis, lupus, and epilepsy, which were once dismissed as psychological conditions. The same thing is happening today with conditions such as Lyme disease, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and fibromyalgia.

The article identifies three categories of illness that doctors frequently confuse:

-
**Psychosomatic disorders** — psychological factors that cause or worsen physical symptoms
-
**Somatopsychic disorders** — physical illness that produces psychiatric symptoms (such as an infection triggering depression or anxiety)
-
**Multisystem illnesses** — diseases that affect multiple body systems simultaneously, including the nervous system and brain

The consequences of getting this wrong are not merely academic. Misdiagnosis can mean years of suffering, permanent disability, and even death.

## Gaps and Problems in Today's Healthcare System

The authors describe a healthcare environment that is increasingly hostile to the thorough evaluation complex patients need. Modern medicine has fragmented into narrow specialties, creating what they call a "silo mentality" — one specialist sees the heart, another sees the joints, another sees the mood, but no one sees the whole picture.

Time pressure makes this worse. In one revealing study cited by the authors, **67% of clinical encounters in which doctors elicited patient concerns showed the doctor interrupting the patient after a median of only 11 seconds**. That is barely enough time to hear one or two sentences, let alone understand a complex multisystem illness.

There is also a knowledge gap problem. The authors point out that the average internal medicine physician — including many who write guidelines that other doctors follow — may have only one month of psychiatry training (often a rotation through a state hospital during medical school) and little continuing education in psychiatry since. Similarly, many psychiatrists do not stay current in general medicine, and many other mental health professionals have very limited training in general medicine at all. The result is that the mind–body interface falls through the cracks between two specialties.

Another troubling issue is who writes medical guidelines. Many authors of guidelines from the United States Centers for Disease Control and Prevention (CDC) are epidemiologists, microbiologists, and researchers — not practicing clinicians who have long-term responsibility for treating patients. For example, the 1994 Second National Conference on Serological Diagnosis of Lyme Disease in Dearborn, Michigan, produced the criteria used to diagnose Lyme disease. Most attendees were not physicians, and the few physicians present were academicians rather than community doctors with direct clinical experience.

Finally, there is the problem of applying group research to individual patients. Research studies produce statistics for groups, but every patient is unique. The authors argue that rigid adherence to population-based treatment guidelines — especially for patients who do not fit the typical picture — falls below the standard of care. They stress that doctors should rely more on their own clinical judgment and tailor treatment plans to the individual in front of them.

## The Serious Consequences of Diagnostic Errors

The human cost of misdiagnosis is enormous. Patients with complex illnesses often describe seeing doctor after doctor before anyone figures out what is really wrong. A survey of over **12,000 participants** found that the average patient with Lyme disease was seen by **five different physicians** before receiving a proper diagnosis.

The financial burden is equally severe. When reimbursement policies limit the time doctors can spend with patients, physicians often respond by ordering excessive testing. These patients may not fit neatly into diagnostic and treatment algorithms, leading to multiple tests and consultations of limited cost-effectiveness. Diagnostic delays also increase costs from disability, lost productivity, and caretaker burden. Many insurance companies place barriers on what they will cover, and a significant number of medical bankruptcies occur among both insured and uninsured individuals.

Some physicians view these patients as "difficult, frustrating, and demanding." Others become highly stressed when dealing with such challenging cases. But the greatest stress falls on the patients themselves, who report feeling dissatisfied, disbelieved, and dismissed by clinicians.

**Gender bias is a significant factor.** The authors note that women are far more often given an incorrect psychosomatic diagnosis, reflecting both gender bias and a lack of research on how the female body responds to biological illness. A book highlighted in the article explores women's experiences of being dismissed by medical providers, including a woman discharged from an emergency department mid-heart attack with a prescription for anti-anxiety medication, women with autoimmune diseases labeled "chronic complainers" for years, and women with endometriosis told they were just overreacting to "normal menstrual cramps."

The media has documented many tragic cases of misdiagnosis. One case that drew international attention was that of Julia, a young woman in a wheelchair from Lyme disease who was blessed by the Pope during his visit to Philadelphia. Two psychiatrists independently cleared Julia of any psychological cause for her symptoms — yet the attending pediatrician refused to accept either report. To rule out malingering (faking illness), she had the physical therapist deliberately drop Julia onto the concrete floor.

Another case involved a woman in the United Kingdom who was told her symptoms were "all in her head" and diagnosed with somatization disorder, resulting in a **20-year treatment delay**.

The medical literature contains equally alarming examples. One case describes a **57-year-old woman** who presented with pain in multiple sites on her upper body. After a partial examination came back negative, she was diagnosed with somatic symptom disorder. She lived with that incorrect diagnosis for **six months** before being correctly diagnosed with **multiple myeloma**, a cancer of plasma cells.

In gastroenterology, patients whose symptoms had unclear causes were most commonly treated with antipsychotics — a practice the authors describe as improper treatment born of diagnostic laziness.

One particularly illuminating study from the Dutch General Practice Registry found that patients diagnosed with somatoform disorders had a **higher infection load** compared to matched controls before their diagnosis. The results actually demonstrated a somatopsychic process — physical infection leading to psychiatric symptoms. Yet the authors of that study concluded the opposite, framing the infection as "causing somatoform disorders" in a way that reinforced the outdated mind-over-body bias.

Patients with so-called "invisible illnesses" — conditions that produce no outwardly visible signs — suffer enormously. People with ME/CFS, fibromyalgia, Lyme disease, and postural orthostatic tachycardia syndrome (POTS) are frequently misdiagnosed. They describe feeling unheard, told their symptoms are imaginary or self-inflicted. As a result, they often develop feelings of abandonment from physicians and the healthcare system. Alarmingly, these patients face **increased risks of suicidal ideation, suicide attempts, and suicide** compared with the general population.

## When Medical Guidelines Lead Doctors Astray

Guidelines are meant to help doctors, but they can also cause enormous harm when they are based on flawed research or biased reasoning. The authors stress that all guidelines come with disclaimers that individualized judgment is necessary, and they identify two major limitations of randomized controlled trials: (1) once a certain level of knowledge is established, it becomes unethical to continue placebo-controlled studies, and (2) any given research result may not apply to the unique individual patient.

**The PACE Trial and ME/CFS.** One of the most striking examples involves the PACE trial — a study that recommended graded exercise therapy and cognitive behavioral therapy for ME/CFS. Many healthcare organizations adopted these treatment recommendations. The underlying message was that patients should ignore their symptoms, challenge their beliefs about having a physiological illness, and become more active — possibly even fully recovering if only they tried hard enough.

Many patients failed to respond, and the treatment advice caused immense harm. The research supporting exercise as a treatment for chronic fatigue syndrome was subsequently **rejected by Cochrane**, an independent network of researchers, on the grounds that the work does not meet their "quality standards." Meanwhile, **more than 80% of patients with ME/CFS remain undiagnosed**, and **65% spend more than a year seeking the correct diagnosis**. Many patients report feeling belittled, dismissed, and ignored by healthcare professionals who followed these guidelines.

**The IDSA Lyme Disease Guidelines.** The Infectious Diseases Society of America (IDSA) guidelines for Lyme disease have drawn multiple criticisms since the day they were published, including accusations of being highly biased and lacking objectivity. These guidelines gave excessive credibility to flawed testing, failed to recognize the psychiatric symptoms caused by Lyme and other tick-borne diseases, and discounted many late-stage symptoms as "the aches and pains of daily living," "subjective and non-specific," and "medically unexplained symptoms."

The Institute of Medicine's report on trustworthy guidelines actually uses the IDSA Lyme guidelines as a case study in untrustworthiness, citing conflicts of interest, lack of transparency, and bias in guideline development. The report includes this powerful quote: *"Unfortunately, patients cannot put their chronic illness on hold until the medical scientists come to a consensus on whether the evidence suggesting infectious causation is or is not close enough to 'definitive.' Making wise decisions in an uncertain environment requires balanced reasoning, critical thinking, compassion, and common sense ... Some players in the Lyme controversy seem to pride themselves in their acceptance of a conclusion only when the evidence overwhelmingly supports it."*

**The "Medically Unexplained Symptoms" Guideline for Children.** A guideline called *Medically Unexplained Symptoms (MUS) in Children and Young People* was endorsed by the Royal College of Psychiatrists and the Paediatric Mental Health Association. The authors argue this guideline appears to benefit third parties and physicians more than patients. It attempts to revive the concept of MUS, even though it has been considered invalid since the 2013 publication of the DSM-5. The guideline encouraged doctors to consider a diagnosis of MUS if:

1. The patient has undergone an unusual level of investigations or seen many hospital specialists relative to their diagnosis
1. The doctor experiences a high level of anxiety when seeing the patient and family, or feels pressured into referring for investigations
1. The doctor feels irritated with the patient or their family for not "getting better"
1. There is a family history of MUS
1. There is significant absence from school as a result of symptoms that appear "out of proportion" to physical investigations
1. The doctor perceives a parent who appears overly invested in their child's illness and loss of function

Notice how these criteria are based on the *doctor's feelings* and *the patient's behavior* rather than on any objective medical evidence. The authors call this a clear bias toward dismissing patients rather than investigating their symptoms.

## How This Review Was Conducted

This is a review article, not a new clinical trial. The authors used two anonymized patient case presentations from their own practice to illustrate the diagnostic challenges. Written consent for publication was obtained from both patients, and their identities were concealed.

To establish a framework for accurate diagnosis, the authors searched for relevant brain–body diagnostic terms using PubMed, Google Scholar, and the first author's personal archives from decades of consultation-liaison psychiatry work. Terms were then defined and discussed, drawing on formal diagnostic references including the American Psychiatric Association's DSM-5 and the World Health Organization's International Classification of Diseases (ICD). Each DSM-5 term is accompanied by its official diagnostic code and corresponding ICD code.

## Patient Story A: An 18-Year-Old Athlete

Patient A was an 18-year-old white female who had previously been healthy and skilled at Taekwondo. Her illness began with a classic bull's-eye rash (erythema migrans), followed by Bell's palsy (facial paralysis). Over the next four years, she became increasingly debilitated and eventually required a wheelchair.

Before receiving proper care, she was given multiple incorrect diagnoses, including "wanting attention," **fibromyalgia**, **chronic fatigue**, **hypoglycemia**, and **pseudoseizures** (seizures believed to be psychological).

Her actual symptoms were extensive and included:

- Cognitive impairments affecting attention, memory, processing speed, concentration, and executive functioning
- Tactile hypersensitivity (extreme sensitivity to touch)
- Sun sensitivity
- Orthostatic hypotension (blood pressure drops when standing)
- Weight loss and fatigue
- Non-restorative sleep (waking up exhausted)
- Pelvic pain and difficulty urinating
- Headaches and peripheral neuropathy (nerve damage)
- Muscle atrophy (wasting) and cervical radiculopathy (pinched nerves in the neck)
- Hair loss, costochondritis (chest wall inflammation), and subluxation of multiple joints (partial dislocations)
- Generalized pain throughout the body

After more thorough assessments, the eventual diagnosis was **late-stage Lyme borreliosis** with multisystem symptoms, **porphyria** (a group of disorders affecting the body's ability to produce heme, a component of red blood cells), and **Ehlers-Danlos/ALPIM syndrome** — the acronym standing for anxiety, laxity (joint looseness), pain, immune problems, and mood disorders. Her seizure episodes were actually **complex partial seizures** caused by increased intracranial pressure from cranio-cervical instability (instability where the skull meets the spine) — not pseudoseizures as previously diagnosed.

Once properly treated, Patient A made a remarkable recovery. She is now physically active, married, and leading a productive life. Her story demonstrates how a teenager's real, complex neurological and multisystem disease was dismissed as attention-seeking behavior — with years of unnecessary suffering as the result.

## Patient Story B: A Teenager in England

Patient B grew up in England. At age 12, she was diagnosed with reactive arthritis causing leg pain. She then developed an excruciating headache accompanied by complete loss of balance and involuntary jerking movements. Her mother rushed her to the hospital, where she was admitted overnight. Over the following days, her symptoms rapidly worsened.

The first doctor to assess her wrote in her chart: **"Hysteria, possible conversion disorder."** Following that impression, no relevant investigations were performed. Patient B was left to deteriorate untreated. She eventually developed constant seizures and needed a wheelchair.

Her mother repeatedly told medical staff that Lyme disease was highly suspected — the family lived in a region known to be epidemic for the disease, and other relatives had already been diagnosed with it. She begged the doctors to help her daughter. These appeals were ignored.

In desperation, the mother took Patient B to a private clinic, where a consultant thoroughly examined her and diagnosed **encephalitis and possible encephalomyelitis** (inflammation of the brain, brainstem, and/or spinal cord), probably due to Lyme disease. She was immediately started on intravenous antibiotics at the clinic for four days. **Within 36 hours, the seizures stopped**, and her headache slowly improved. Her blood tests subsequently came back positive for Lyme disease.

The hospital admitted its error and gave an unreserved apology. Following the consultant's instructions, Patient B received a further **three months of daily intravenous antibiotic treatment** at a National Health Service hospital. After about two months, she was able to walk again.

Tragically, when the antibiotics were stopped, the seizures and other symptoms returned. The family raised funds to take Patient B to the United States for treatment by a physician experienced with such cases. Her treatment stabilized her condition and brought great improvement to some symptoms. However, because of the treatment delay, she still had persistent health issues, including severe headaches, joint pains, extreme fatigue, cognitive dysfunction, and other symptoms.

The authors emphasize that in both cases, the complexity of a multisystem illness was not understood or adequately pursued by the treating physicians. Psychiatric diagnoses were given by default — "wanting attention," "pseudoseizures," "hysteria," and "possible conversion disorder" — even though there was no adequate psychiatric assessment and no valid psychological basis to support such diagnoses. The first author has seen and published descriptions of many other tragic cases in his practice.

## Key Medical Terms Explained

The Greek philosopher Socrates wrote, *"The beginning of wisdom is the definition of terms."* The authors apply this principle to the confusion surrounding mind–body diagnoses. Here are the key terms they define and clarify:

**Mental health and mental illness.** Interestingly, the DSM-5 and the ICD — the two major diagnostic manuals — do not define "mental health" at all. The authors argue that you cannot define "mental illness" unless you first define "mental health." They draw on the U.S. Surgeon General's Mental Health Report and the first author's experience to suggest a framework: mental health involves well-being, functioning, and resilience, while mental illness involves clinically significant disturbances in thinking, emotion, or behavior.

**Psychosomatic disorders** are conditions in which psychological factors play a significant role in causing or worsening physical symptoms. The term literally means "mind (psyche) affecting body (soma)." A classic example is stress-induced stomach ulcers or panic attacks causing chest pain.

**Somatopsychic disorders** are the reverse: physical illness causing psychological symptoms. For instance, an infection, autoimmune condition, or hormonal imbalance can trigger depression, anxiety, psychosis, or cognitive impairment. The Dutch study showing higher infection loads preceding somatoform diagnoses is an example of a somatopsychic process being mislabeled as psychosomatic.

**Multisystem illnesses** affect multiple organ systems at once — including the brain. Lyme disease, ME/CFS, fibromyalgia, POTS, and autoimmune diseases often behave this way. Because they do not fit neatly into any one specialty, patients get shuttled between specialists who each see only a piece of the puzzle.

**Medical uncertainty** refers to the honest reality that some cases are genuinely difficult to diagnose. The authors stress that uncertainty should not be disguised as a psychiatric diagnosis. Not knowing what is wrong is not the same as knowing it is "all in the patient's head."

The authors are highly critical of several diagnostic terms they consider inaccurate or harmful:

-
**Medically unexplained symptoms (MUS)** — described as an outdated and/or inaccurate term. Just because current tests cannot explain a symptom does not mean the symptom is psychological. This term has been considered invalid since the 2013 DSM-5.
-
**Somatoform disorder** — a former DSM category that the authors consider outdated. It assumed psychological origins for physical symptoms without adequate evidence.
-
**Compensation neurosis** — an outdated term suggesting patients are faking or exaggerating illness for financial gain through disability or compensation claims.
-
**Bodily distress disorder** and **bodily distress syndrome** — scientifically unsupported and inaccurate labels, according to the authors.
-
**Somatic symptom disorder** — a DSM-5 category that can be and has been over-diagnosed. The authors cite the case of the woman with multiple myeloma who was mislabeled with this condition for six months.

The article also warns against over-diagnosing **conversion disorders** (neurological symptoms with no identifiable medical cause), **functional disorders**, **psychogenic illness**, **factitious disorder imposed upon another** (formerly Munchausen's syndrome by proxy), **psychogenic seizures**, **psychogenic pain**, **psychogenic fatigue**, and **delusional parasitosis** (the false belief of being infested with parasites). All of these can be misapplied when a genuine physical illness has not been adequately ruled out.

Equally problematic, the authors say, is the inaccurate use of terms like **"subjective," "non-specific,"** and **"vague"** to dismiss symptoms that are simply difficult to measure with standard laboratory tests.

The article makes a crucial point about diagnostic responsibility: **a psychiatric diagnosis cannot be given solely based upon the absence of physical, laboratory, or pathological findings.** In other words, "we couldn't find anything wrong" does not equal "the problem is in your head."

Finally, the authors highlight that many "all in your head" conditions may actually be related to the **microbiome** (the community of bacteria and other microorganisms living in and on the body) and the **immune system**. This emerging area of science shows how closely the gut, immune system, and brain are connected — reinforcing the need for doctors to consider biological causes before assuming psychological ones.

## What This Means for Patients

If you or a loved one has a complex, chronic illness that has been dismissed as psychological, this review validates your experience. The authors confirm that:

- Being told "it's all in your head" is a common and harmful pattern, not a rare exception
- Lyme disease, ME/CFS, fibromyalgia, POTS, and similar conditions are genuine physical illnesses that are frequently missed
- Women are especially likely to have their symptoms dismissed
- A psychiatric diagnosis based only on negative test results is scientifically and ethically unjustified
- Patients with these invisible illnesses have higher rates of suicidal thoughts and attempts — and deserve compassionate, thorough care

For patients, the message is that diagnostic delays are not their fault. The problem lies in fragmented healthcare systems, inadequate training, and flawed guidelines — not in the patient's character or mental state.

## What This Review Could Not Address

This is a review article based on two case presentations and a literature synthesis, not a randomized clinical trial. As such, it cannot prove how often misdiagnosis occurs or which specific diagnostic approach works best in every situation. The authors draw on decades of clinical experience and published literature, but their conclusions reflect expert opinion — albeit well-supported opinion — rather than controlled experimental data.

Additionally, the full text of this review covers many terms and distinctions, and some of the diagnostic categories discussed (such as the DSM-5 and ICD systems) continue to evolve. The ICD-11 was proposed at the time of writing, which may further change diagnostic language. The reader should keep in mind that medical knowledge in this area is advancing, and some of the guidelines criticized in this article have since been revised.

## Recommendations for Patients and Doctors

**For patients:**

1. Keep a detailed symptom diary that tracks when symptoms started, what makes them better or worse, and how they affect your daily functioning.
1. Do not accept a psychiatric diagnosis without a thorough physical evaluation. You are entitled to a complete assessment.
1. Bring a family member or advocate to appointments who can help you communicate your history and concerns.
1. Ask your doctor directly: "What physical conditions have you ruled out, and what tests were done to rule them out?"
1. If you feel dismissed, seek a second opinion — ideally from a physician who specializes in complex or multisystem illnesses.
1. If you experience thoughts of self-harm, contact a crisis line or emergency services immediately. Your suffering is real and help is available.

**For doctors:**

1. Resist the pressure to give a psychiatric diagnosis by default when physical findings are absent. Remember: absence of evidence is not evidence of absence.
1. Use clinical judgment and humility when applying guidelines. Guidelines are tools, not rigid rules.
1. Learn to recognize the interface between medicine and psychiatry — the way physical illnesses present with psychiatric symptoms and vice versa.
1. Listen without interrupting. Patients with complex illnesses often have important stories to tell.
1. Be cautious with terms like "subjective," "non-specific," "vague," and "medically unexplained." These labels can cause profound harm.
1. Stay current in both general medicine and psychiatry, regardless of your specialty.

The authors conclude that better education concerning the interface between medicine and psychiatry — along with using clinical judgment, performing thorough assessments, exercising humility, and maintaining the roots of traditional medicine — will help to improve diagnostic accuracy and patient trust. For the millions of patients living with complex, chronic, invisible illnesses, that shift cannot come soon enough.

## Frequently Asked Questions

### What is the difference between psychosomatic, somatopsychic, and multisystem illnesses?

Psychosomatic means psychological factors cause or worsen physical symptoms. Somatopsychic means a physical illness causes psychiatric symptoms, like an infection triggering depression. Multisystem illnesses affect multiple body systems at once, including the brain. Examples include Lyme disease, ME/CFS, and fibromyalgia. Doctors often confuse these categories, leading to misdiagnosis.

### Why are complex illnesses like Lyme disease and ME/CFS so often dismissed as 'all in your head'?

The article explains that doctors lack adequate training in both medicine and psychiatry. Medicine is fragmented into narrow specialties, so no one sees the whole picture. Time pressure leads to interrupted patient visits. Also, many guidelines are written by researchers, not practicing clinicians. Historically, poorly understood diseases were labeled psychiatric until science found a physical cause.

### What should I do if my doctor tells me my symptoms are psychosomatic or 'medically unexplained'?

Keep a detailed symptom diary and bring an advocate to appointments. Ask directly what physical conditions have been ruled out and what tests were done. Do not accept a psychiatric diagnosis without a thorough physical evaluation. If you feel dismissed, seek a second opinion from a physician who specializes in complex or multisystem illnesses.

### Are women more likely to have their physical symptoms dismissed as psychological?

Yes, the article states that women are far more often given an incorrect psychosomatic diagnosis. This reflects gender bias and a lack of research on how the female body responds to biological illness. Examples include a woman discharged mid-heart attack with anti-anxiety medication and women with autoimmune diseases labeled 'chronic complainers' for years.

### Can a psychiatric diagnosis be made just because medical tests find nothing wrong?

No. The article emphasizes that a psychiatric diagnosis cannot be given solely based upon the absence of physical, laboratory, or pathological findings. 'We couldn't find anything wrong' does not equal 'the problem is in your head.' Doctors should consider biological causes, including infections and immune system issues, before assuming psychological ones.

### What are the consequences of misdiagnosing complex illnesses?

Misdiagnosis can cause years of suffering, permanent disability, and even death. Patients often see multiple doctors before getting a correct diagnosis. For example, an average Lyme disease patient saw five different physicians before diagnosis. Diagnostic delays also increase costs from disability, lost productivity, and caretaker burden, and patients face higher risks of suicidal thoughts and suicide.

### What does the article recommend for doctors to improve diagnosis of multisystem illnesses?

Doctors should resist giving psychiatric diagnoses by default when physical findings are absent. They should use clinical judgment when applying guidelines, recognize the mind-body interface, listen without interrupting, and be cautious with labels like 'subjective' or 'medically unexplained.' Better education at the intersection of medicine and psychiatry is also essential.

## Source Information

**Original article title:** Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty

**Authors:** Robert C. Bransfield, MD (Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA) and Kenneth J. Friedman, PhD (Pharmacology and Physiology, NJ Medical School, Newark, NJ, USA)

**Journal:** Healthcare, 2019, Volume 7, Issue 4, Article 114

**Publication date:** Received 15 July 2019; Accepted 1 October 2019; Published 8 October 2019

**DOI:** 10.3390/healthcare7040114

*This patient-friendly article is based on peer-reviewed research. It is intended for educational purposes and does not constitute medical advice. Always consult a qualified healthcare professional regarding diagnosis and treatment.*


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