The behavioral medicine It is defined as the multidisciplinary area committed to the development and integration of knowledge and technologies of the biomedical and behavioral sciences relevant to health and disease.
This article aims to make a brief tour of its main postulates and characteristics.
- 1 Behavioral Medicine: a new approach to health
- 2 Objectives and intervention strategies of behavioral medicine
- 3 Conclusions about Behavioral Medicine
Behavioral Medicine: a new approach to health
Indeed, behavioral medicine represents a paradigm shift in regards to health. It is developed from the following factors:
1. The change in disease patterns
Moving from infectious diseases until recently (malaria, smallpox, etc.) to functional diseases Also, to disorders associated with type of life (stress, diet, tobacco, sedentary lifestyle, rupture of traditional ways of life, negative working conditions, insecurity, etc.) and degenerative diseases (dementia, arthritis).
2. Framing the challenges
Most of the challenges of current medicine have to do with the diagnosis and treatment of chronic diseases They are very influenced by the lifestyle of the person.
3. Interest in prevention
The interest that the themes of disease prevention (public health, behavioral health, health education) given the exorbitant increase in the costs of medical services, which make maintenance difficult. Orientation to prevent rather than cure.
4. Awareness of behavioral factors
Both clinical and epidemiological evidence gives vital importance to behavioral factors in health and disease. For example, stress, emotional factors, personality, etc.
It is curious that several observations and studies have reported the rarity with which diseases such as cancer, high blood pressure, myocardial infarctions, allergies, asthma, etc. they occur in primitive villages without contact with the western world.
Chronic diseases (cardiovascular disorders, cancer) and the so-called psychosomatic or psychophysiological disorders (asthma, ulcers, headaches, etc.), and some mental diseases (anxiety, depression, anorexia), which are associated with loss of quality of life, labor problems and increased health costs, are very determined by the lifestyle, hence the concept of "lifestyle diseases."
5. Redefinition of the concept of "Health"
The change in the concept of health from passive conservative positions (health as absence of disease) to a more active approach, health as something to develop, as improvement of the quality of life. Medical therapeutics alone are not very effective in problems such as the prevention of myocardial infarctions, obesity, AIDS, promoting physical exercise, etc. To address these types of problems, behavioral medicine emerged.
Objectives and intervention strategies of behavioral medicine
- Direct intervention in a wide range of health disorders Traditionally addressed only from medicine: cardiovascular disorders, cancer, chronic pain, insomnia, headaches, sexual disorders, myopia, obesity, asthma, AIDS, sphincter control, epilepsy, neuromuscular disorders, etc.
- Improvements in the intervention of health professionals: more programming, better patient-professional communication, etc.
- Treatment Adhesion. This is a big health problem. Patients do not strictly follow the doctor's instructions, causing treatment to fail even if it is effective.
- Disease prevention by modifying lifestyles
- Design of new intervention strategies and programs multidisciplinary intervention
Adherence to treatment: curious facts
Something striking is that the degree of adherence to treatment by itself, regardless of whether it is a placebo or an active substance, significantly affects health.
- The poor adhesion (defined as taking less than 75-80% of the prescribed pills), whether it is a real medication or a placebo, it is associated with a much higher risk (about 2.5 times more) of death.
- Conversely, strong adhesion, even to a placebo, is associated with lower mortality.
How can these corroborated data be explained in several studies?
- Mechanism similar to the placebo effect, such as beliefs and expectations about the benefits of therapy.
- Certain characteristics of the subjects that adhere to the treatment also predispose to take advantage of non-specific treatment components. For example, optimism about healing, which can make you adhere more.
- Adherence can be a marker of a general orientation towards healthy behaviors. It also makes these people follow a lifestyle with lower risk behaviors.
- Subjects with the highest adherence participate more in pleasant social activities, having more social support.
Conclusions about Behavioral Medicine
The philosophy of behavioral medicine is that the dualism and separation between physical and mental health is spurious. Therefore all clinical disorders are influenced in its etiology, maintenance and treatment by emotional and behavioral factors.
In order to alter the pathological physiological activity underlying the problem, behavioral medicine tries to modify behavior, cognition, emotion or physiology through psychological intervention techniques:
- Relaxation and mindfulness
- Systematic desensitization
- Classic and instrumental conditioning
- Stress control techniques
- Cognitive restructuring
- Physical training
- Self-regulation methods
Another central aspect in behavioral medicine is the interventions focused on behavior modification (change in life habits).
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