Report on new psychoneuroendocrinology service in outpatient treatment

Oct 20 2009

The value of interdisciplinary expertise has not been implemented in clinical practice. Based on a longstanding teamwork between endocrinologist and psychiatrist, the Authors designed a new outpatient clinic, called Psychoneuroendocrinology (PNE) Service, that applies current principles of psychosomatic medicine, such as the assessment of interacting biological and psychosocial factors in the course of disease.

They report, in the current issue of Psychotherapy and Psychosomatics, on the first one-hundred referrals and the type of management they received. A PNE visit did include: complete history; a psychological questionnaire filled-up by the patient; physical examination; appraisal of the present situation and patient education; discussion of treatment choices and prescriptions. Overall, the types of problems of major impact were: endocrine/metabolic, or any other medical issue, in psychiatric patients; endocrine/metabolic effects of psychotropic drugs; psychological distress associated with active endocrine disease; residual symptoms in spite of adequate treatment in endocrine disease; functional medical disorders or medically unexplained symptoms.

Several difficult patients could be appropriately managed by virtue of a holistic view. An interest of the Public Health System in this interdisciplinary type of clinic would derive from epidemiologic data documenting a high prevalence of mental disturbances in the medical outpatient population as well as from an increasing need for combined medical psychiatric longitudinal care. This approach, which is likely to improve final outcomes, must involve experienced clinicians with broad spectrum training in psychoneuroendocrinology/psychosomatic medicine.