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A significant proportion of the patients referred to health services are people who have some psychosocial problems. Many of these patients can not explain their problem obviously and prefer to express them as nonspecific somatic and bodily symptoms; although there are no definite clinical and laboratory findings about any specific medical disease. This phenomenon named "somatization". Recurrent visits of these cases in outpatient clinics or hospitals and the vicious cycle of unnecessary investigations that reinforce "sick role" and somatic complaints, cause many problems for the patients, as well as the physicians and health services. 

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This review tried to describe the historical development of consultation-liaison (CL) psychiatry and psychosomatic medicine in the world and Iran. It also aimed to present a classification of different models of patient care and service delivery in CL psychiatry. It finally provided some explanation about the status of psychosomatic medicine and CL psychiatry in Germany as a different model in comparison with other parts of the world.

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Aim and Background: There is a relation between patients&#039; levels of physical functioning and their acceptance of chronic pain. However, this relation has not been examined amongst Iranian chronic pain patients. The purpose of this paper was to evaluate the relation between acceptance of chronic pain and physical disability. Methods and Materials: In a descriptive-correlational study, convenience sampling was used to select 245 chronic pain patients from pain clinics in Tehran, Iran during spring and summer of 2010. The participants completed the Chronic Pain Acceptance Questionnaire (CPAQ) and a demographic questionnaire. They also provided information about physical disability, pain intensity, and daily dysfunction. Data was analyzed using Pearson&#039;s correlation and multiple hierarchical regression models. Findings: There were significant relations between acceptance of pain and pain intensity and disability (P < 0.001). According to the regression model, acceptance of pain could predict a significant proportion of variance of disability scales (i.e. physical disability and daily dysfunction) (P < 0.0001). Therefore, it was a better predictor of disability compared to over pain intensity, gender, education, and pain duration. Conclusions: Chronic pain acceptance is an important factor in reducing the perceived disability in chronic pain patients. Therefore, acceptance-based treatment methods are helpful to decrease pain-related disability.

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  Aim and Background:  The purpose of this study was comparison of forgiveness and its components together with mental health in normal and ongoing divorce couples in Isfahan. Materials and Methods:The population is consisted of couples who lived in Isfahan city in 1387 (2009). 100 normal couples were selected randomly from 4 parks  in four regions of city and 100 at-divorce couples were selected randomly from couples who referred to divorce centers in Isfahan. Forgiveness and its components was measured by forgiveness scale (FFS) and mental health was measured by General Health Questionnaire (GHQ). Finding: The results of a factor analysis of variance (MANOVA), showed that forgiveness and its components (Recognition, Reparation, Restitution, Resolution) significantly higher than in normal couples. The couple&#039;s divorce. The findings related to mental health and its subscales (somatic symptoms, anxiety and insomnia, social dysfunction, major depression) were obtained Conclusions: The results of this study confirm that, in cases referred for mental health and the relief of divorce can be very important.    

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Abstract Aim and Background: the aim of this study was to evaluate effectiveness of schema therapy in reducing symptoms and adjusting early maladaptive schemas in patients with bipolar disorder. The purpose was to identify patient’s maladaptive schemas and attempt to modify or change them. Methods and Materials: Subjects included 30 patients, 10 men and 20 women that were chosen by convenience sampling from visitors of Nour Medical Center, two mental health clinics in Isfahan and Baran ‘e’ Mehr counselling center in Shahin Shahr. They were diagnosed with bipolar disorder (type I or II) by a psychiatrist using DSM-IV-TR and receiving medical treatment, were randomly put in two groups. Test group received medical treatment with schema therapy and the control group received only medical treatment. Young mania rating scale (YMRS), bipolar depression rating scale (BDRS) and Young schema questionnaire (YSQ3) were used before and after treatment. Data were analyzed by multivariate analysis of variance and covariance using SPSS 18.0. Findings: Controlling the covariate variable, differences between two groups after the intervention were significant for all three variables of symptoms of mania and depression and early maladaptive schemas (P<0.01). Conclusions: schema therapy as an adjuvant psychological treatment with medication can be effective in reducing symptoms and adjusting the early maladaptive schemas in patients with bipolar disorder, therefore providing regular protocols for schema therapy and adding it to medical treatment is suggested.  

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Aim and Background: A large number of studies show that alexithymia may be a risk factor for many physical and mental illnesses. This study was conducted to evaluate the predictive value of different dimensions of alexithymia for assessing vulnerability to psychosomatic diseases. Methods and Materials: This case-control survey was conducted on 146 individuals. The subjects were selected through census method from among patients referred to the Psychosomatic Clinic of Isfahan University of Medical Sciences, Iran. The participants completed the Toronto Alexithymia Scale. The obtained data were analyzed using logistic regression in SPSS software. Findings: The results showed that for every one unit increase in total score of alexithymia, the chance of psychosomatic disease incidence increased by 5% (P < 0.008). On the other hand, for every one unit increase in the subscale of difficulty in identifying feelings, the chance of psychosomatic disease incidence increases by 11%. Conclusions: This study demonstrated that alexithymia, and especially the subscale of difficulty in identifying feelings can significantly increase the risk of psychosomatic diseases. Therefore, alexithymia can be introduced as a predictive tool for psychosomatic diseases.

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Aim and Background: Interference of psychological and physical factors in the digestive system has always been of grave importance. The aim of this study was to compare neurotic symptoms among patients with gastrointestinal disease, their healthy relatives, and a control group. Methods and Materials: This causal-comparative study was conducted through a descriptive design. The study participants were selected through convenience sampling and divided into patients (n = 100), healthy relatives (n = 60), and control (n = 100) groups. The data collection tool was the Symptom Checklist-90-Revised (SCL-90-R). Data were analyzed in SPSS software. Findings: A significant difference was observed between the three groups in terms of psychosis (P = 0.04), obsessive-compulsive disorder (OCD) (P < 0.001), somatization (P < 0.001), and anxiety (P = 0.02). Moreover, there was a significant difference between patients and control groups in terms of Global Symptoms Index (GSI) (P = 0.02), psychosis (P = 0.01), OCD (P < 0.001), somatization (P < 0.001), and anxiety (P = 0.01). There was a significant difference between the healthy relatives and control groups in terms of OCD (P = 0.02) and anxiety (P = 0.04). Conclusions: There is a strong relationship between gastrointestinal symptoms and emotional problems. The results of the present study can be a basis for more in-depth studies on gastrointestinal disorders, and an important step toward the description, recognition, and treatment of gastrointestinal disorders. The performance of similar studies with a wider scope and greater depth is suggested.