An Integrated Bio-psycho-social Approach to Psychiatric Disorders

  • Seon-Cheol Park
  • Yong-Ku KimEmail author
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1192)


The biopsychosocial approach is a model of eclecticism, which consists of multidisciplinary academic fields, reacting against the “neuroscientification” of psychiatry. The biopsychosocial approach was proposed by George Engel following Adolf Meyer’s psychobiological and Roy R. Ginker’s eclectic approach to psychiatry. Although the use of the biopsychosocial approach is increasing, it has several limitations: First, specific practices cannot be guided by the biopsychosocial approach because it is considered to be “boundless psychiatry.” Second, unlike an initial intention, the symptomatic use of psychotropic medications may be justified by the biopsychosocial approach. Third, the economic forces to enhance biological psychiatry cannot be hindered by the biopsychosocial approach. Hence, to overcome the limitations of the current biopsychosocial approach, potential new paradigms including evolutionary psychiatry, pragmatism, integrationism, and pluralism have been proposed. Above all, Eric Kandel presented the link between neuroscience and psychiatry from the perspective of integrationism. In accordance with integrationism and/or pluralism, based on the paradigm shift of the theoretical construct from chemical imbalance to dysfunctional circuit, next-generation treatments for mental disorders have been proposed by Thomas Insel. Thus, a more integrated biopsychosocial approach to managing psychiatric disorders including schizophrenia and panic disorder may be proposed.


Biopsychosocial approach Eclecticism Integrationism Pluralism Schizophrenia Panic disorder 


  1. 1.
    Yang BY, Hwang HS. The differentiation and integration of mind and body. Korean J Psychosom Med. 2000;8(1):110–21.Google Scholar
  2. 2.
    Schwartz GE. A systems analysis of psychology and behavior therapy. Implications for behavioral medicine. Psychother Psychosom. 1981;36(3–4):159–84.PubMedCrossRefGoogle Scholar
  3. 3.
    Bunge M. Emergence and the mind. Neuroscience. 1977;2(4):501–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Sperry RW. A modified concept of consciousness. Psychol Rev. 1969;76(6):532–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):126–36.CrossRefGoogle Scholar
  6. 6.
    Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry. 1980;137(5):535–44.CrossRefGoogle Scholar
  7. 7.
    Borrell-Carrio F, Suchman AL, Epstein RM. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med. 2004;2(6):576–82.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Ghaemi SN. Paradigms of psychiatry: eclecticism and its discontents. Curr Opin Psychiatry. 2006;19(6):619–24.PubMedCrossRefGoogle Scholar
  9. 9.
    Ghaemi SN. The rise and fall of the biopsychosocial model. Br J Psychiatry. 2009;195(1):3–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Ghaemi SN. The rise and fall of the biopsychosocial model: reconciling art & science in psychiatry. Baltimore: The Johns Hopkins University Press; 2010.Google Scholar
  11. 11.
    Meyer A. The commonsense psychiatry of Adolf Meyer. New York: McGraw Hill; 1948.Google Scholar
  12. 12.
    Ginker RR Sr. “Open-system” psychiatry. Am J Psychoanal. 1966;26(2):115–28.CrossRefGoogle Scholar
  13. 13.
    Ginker RR Sr. Training of a psychiatrist-psychoanalyst. J Am Acad Psychoanal. 1994;22(2):343–50.CrossRefGoogle Scholar
  14. 14.
    Kuhn T. The structure of scientific revolutions. Chicago: University of Chicago Press; 1962.Google Scholar
  15. 15.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington: American Psychiatric Association; 1980.Google Scholar
  16. 16.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 1st ed. Washington: American Psychiatric Association; 1952.Google Scholar
  17. 17.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 2nd ed. Washington: American Psychiatric Association; 1968.Google Scholar
  18. 18.
    McHugh RR, Slavney PR. The perspectives of psychiatry. Baltimore: Johns Hopkins University Press; 1983.Google Scholar
  19. 19.
    McLaren N. A critical review of the biopsychosocial model. Aust N Z Psychiatry. 1998;32(1):86–92.CrossRefGoogle Scholar
  20. 20.
    Ghaemi SN. Toward a hippocratic psychopharmacology. Can J Psychiatry. 2008;53(3):189–96.PubMedCrossRefGoogle Scholar
  21. 21.
    McGuire M, Troisi A. Darwinian psychiatry. New York: Oxford University Press; 1998.CrossRefGoogle Scholar
  22. 22.
    Crow TJ. Schizophrenia as failure of hemispheric dominance for language. Trends Neurosci. 1997;20(8):339–43.PubMedCrossRefGoogle Scholar
  23. 23.
    Pearlson GD, Folley BS. Schizophrenia, psychiatric genetics, and Darwinian psychiatry: an evolutionary framework. Schizophr Bull. 2008;34(4):722–33.PubMedCrossRefGoogle Scholar
  24. 24.
    Park YC, Lee MS, Si TM, Chiu HFK, Kanba S, Chong MY, Tripathi A, Udomratn P, Chee KY, Tanra AJ, Rabbani G, Javel A, Kathiarachchi S, Myint WA, Cuoung TV, Sim K, Yang SY, Sartorius N, Tan CH, Shinfuku N, Park S-C. Psychotropic drug-prescribing correlates of disorganized speech in Asians with schizophrenia: the REAP-AP study. Saudi Pharm J. 2019;27(2):246–53.PubMedCrossRefGoogle Scholar
  25. 25.
    Crow TJ. The ‘big bang’ theory of the origin of psychosis and the faculty of language. Schizophr Res. 2008;102(1–3):31–2.PubMedCrossRefGoogle Scholar
  26. 26.
    Crow TJ. The origins of psychosis and the evolution of language: cerebral asymmetry. In: Hugdahl K, Westerhausen R, editors. The two halves of the brain: information processing in the cerebral hemispheres. Massachusetts: The MIT Press; 2010. p. 621–61.CrossRefGoogle Scholar
  27. 27.
    Grigorenko EL, LaBuda MC, Carter AS. Similarity in general cognitive ability, creativity, and cognitive style in a sample of adolescent Russian twins. Acta Genet Med Gemellol. 1992;41(1):65–72.PubMedCrossRefGoogle Scholar
  28. 28.
    James W. A pluralistic universe. Lincoln, NB: University of Nebraska Press; 1909.Google Scholar
  29. 29.
    Perice C. Selected writings. New York: Dover Publications; 1958.Google Scholar
  30. 30.
    Brendel D. Healing psychiatry. Cambridge, MA: MIT Press; 2006.CrossRefGoogle Scholar
  31. 31.
    Kandel E. A new intellectual framework for psychiatry. Am J Psychiatry. 1998;155(4):457–69.PubMedCrossRefGoogle Scholar
  32. 32.
    Etkin A, Pittenger C, Polan HJ, Kandel ER. Toward a neurobiology of psychotherapy: basic science and clinical applications. J Neuropsychiatry Clin Neurosci. 2005;17(2):145–58.PubMedCrossRefGoogle Scholar
  33. 33.
    Kandel E. The new science of mind and the future of knowledge. Neuron. 2013;80(3):546–60.PubMedCrossRefGoogle Scholar
  34. 34.
    Whitehead CC. Toward a ‘new’ paradigm of therapeutic action: neuro-psychoanalysis and downward causation. J Am Acad Psychoanal Dyn Psychiatry. 2005;33(4):637–56.PubMedCrossRefGoogle Scholar
  35. 35.
    de Leon J. DSM-5 and the research domain criteria: 100 years after Jaspers’ general psychopathology. Am J Psychiatry. 2014;171(5):492–4.PubMedCrossRefGoogle Scholar
  36. 36.
    Yang BY, Moon HS. Karl Jaspers and general psychopathology. Korean J Psychopathol. 1992;1(1):12–21.Google Scholar
  37. 37.
    Yang BY, Hong SK. Psychopathology of delusion: the phenomenological approach of Karl Jaspers. Korean J Psychopathol. 1996;5(1):15–26.Google Scholar
  38. 38.
    Yang BY, Hur YS. Karl Jaspers and psychopathology. Korean J Psychopathol. 2002;11(2):3–11.Google Scholar
  39. 39.
    Ghaemi SN. Understanding mood disorders: Karl Jaspers’ biological existentialism. In: Stanghellini G, Fuchs T, editors. One century of Karl Jaspers’ general psychopathology. New York: Oxford University Press; 2013. p. 258–75.Google Scholar
  40. 40.
    Park S-C. Karl Jaspers’ general psychopathology (Allgemeine Psychopathologie) and its implication for the current psychiatry. Psychiatry Investig. 2019;16(2):99–108.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    de Leon J. Is psychiatry scientific? A letter to a 21st century psychiatry resident. Psychiatry Investig. 2013;10(3):205–17.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Insel TR. Next-generation treatments for mental disorders. Sci Transl Med. 2012;4(155):155psc19.PubMedCrossRefGoogle Scholar
  43. 43.
    Insel TR. Rethinking schizophrenia. Nature. 2010;468(7321):187–93.PubMedCrossRefGoogle Scholar
  44. 44.
    Kim YK, Choi J, Park S-C. A novel bio-psychosocial-behavioral treatment model in schizophrenia. Int J Mol Sci. 2017;18(4):E734.PubMedCrossRefGoogle Scholar
  45. 45.
    Nestler EJ, Hyman SE. Animal models of neuropsychiatric disorders. Nat Neurosci. 2010;13(10):1161–9.PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Park S-C, Kim Y-K. A novel bio-psychosocial-behavioral treatment model of panic disorder. Psychiatry Investig. 2019;16(1):4–15.PubMedCrossRefGoogle Scholar
  47. 47.
    Dresler T, Guhn A, Tupak SV, Ehlis AC, Herrman MJ, Fallgatter AJ, Deckert J, Domschke K. Revise the revised? New dimensions of the neuroanatomical hypothesis of panic disorder. J Neural Transm. 2013;120(1):3–29.PubMedCrossRefGoogle Scholar
  48. 48.
    Santos M, D’Amico D, Dierssen M. From neural to genetic substrates of panic disorder: insights from human and mouse studies. Eur J Pharmacol. 2015;759:127–41.PubMedCrossRefGoogle Scholar
  49. 49.
    Choi KY, Kim YK. Plasticity-augemented psychotherapy for refractory depressive and anxiety disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2016;70:134–47.PubMedCrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of PsychiatryInje University Haeundae Paik HospitalBusanRepublic of Korea
  2. 2.Department of Psychiatry, College of MedicineKorea University Ansan HospitalAnsanRepublic of Korea

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