Note to users. If you're seeing this message, it means that your browser cannot find this page's style/presentation instructions -- or possibly that you are using a browser that does not support current Web standards. Find out more about why this message is appearing, and what you can do to make your experience of our site the best it can be.


Science 8 April 1977:
Vol. 196. no. 4286, pp. 129 - 136
DOI: 10.1126/science.847460

Articles

Science, Vol 196, Issue 4286, 129-136
Copyright © 1977 by American Association for the Advancement of Science


articles

The need for a new medical model: a challenge for biomedicine

GL Engel

The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES:
Biopsychosociospiritual Medicine and Other Political Schemes.
J. P. Bishop (2009)
Christ Bioeth
   Abstract »    Full Text »    PDF »
Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST-RA database.
T Sokka, H Kautiainen, T Pincus, S Toloza, G da Rocha Castelar Pinheiro, J Lazovskis, M L Hetland, T Peets, K Immonen, J F Maillefert, et al. (2009)
Ann Rheum Dis 68, 1666-1672
   Abstract »    Full Text »    PDF »
Therapeutic Factors in Group Counseling: Implications for Audiologic Rehabilitation.
S. A. Erdman (2009)
Aural Rehabilitation and Its Instrumentation 16, 15-28
   Abstract »    Full Text »    PDF »
The Case of the Proliferating Paradigms.
J. Coulehan (2009)
Qual Health Res 19, 1379-1382
   PDF »
Illness explanations among patients with medically unexplained symptoms: different idioms for different contexts.
M. B. Risor (2009)
Health (London) 13, 505-521
   Abstract »    PDF »
Living with Ankylosing Spondylitis: The Patient's Perspective.
K. E. Hamilton-West and L. Quine (2009)
J Health Psychol 14, 820-830
   Abstract »    PDF »
Understanding and Addressing Psychological and Social Problems: the Mediating Psychological Processes Model.
P. Kinderman (2009)
International Journal of Social Psychiatry 55, 464-470
   Abstract »    PDF »
A Science of Connectedness.
K. C. Stange (2009)
Ann. Fam. Med 7, 387-395
   Full Text »    PDF »
School Functioning in Adolescents With Chronic Pain: The Role of Depressive Symptoms in School Impairment.
D. E. Logan, L. E. Simons, and K. J. Kaczynski (2009)
J. Pediatr. Psychol. 34, 882-892
   Abstract »    Full Text »    PDF »
Foucauldian Diagnostics: Space, Time, and the Metaphysics of Medicine.
J. P. Bishop (2009)
J Med Philos 34, 328-349
   Abstract »    Full Text »    PDF »
Quantitative Clinical Rheumatology: Why Is a Test for Anti-CCP Antibodies Included in Most Routine Care for Rheumatoid Arthritis While a HAQ/MDHAQ Remains Largely a Research Tool?.
T. PINCUS, Y. YAZICI, and M. J. BERGMAN (2009)
J Rheumatol 36, 1563-1564
   Full Text »    PDF »
Testing Gender as a Moderator of Associations Between Psychosocial Variables and Functional Disability in Children and Adolescents with Chronic Pain.
K. J. Kaczynski, R. L. Claar, and D. E. Logan (2009)
J. Pediatr. Psychol. 34, 738-748
   Abstract »    Full Text »    PDF »
The rise and fall of the biopsychosocial model.
S. N. Ghaemi (2009)
The British Journal of Psychiatry 195, 3-4
   Abstract »    Full Text »    PDF »
The Political Economy Of U.S. Primary Care.
L. G. Sandy, T. Bodenheimer, L. G. Pawlson, and B. Starfield (2009)
Health Aff. 28, 1136-1145
   Abstract »    Full Text »    PDF »
New developments in the diagnosis of fibromyalgia syndrome: Say goodbye to tender points?.
W. S. WILKE (2009)
Cleveland Clinic Journal of Medicine 76, 345-352
   Abstract »    Full Text »    PDF »
The Generalist Approach.
K. C. Stange (2009)
Ann. Fam. Med 7, 198-203
   Full Text »    PDF »
Toward a Restorative Medicine--The Science of Care.
J. C. Harris (2009)
JAMA 301, 1710-1712
   Full Text »    PDF »
Situational, Psychosocial, and Physical Health--Related Correlates of HIV/AIDS Risk Behaviors in Homeless Men.
J. A. Stein, A. M. Nyamathi, and J. I. Zane (2009)
American Journal of Men's Health 3, 25-35
   Abstract »    PDF »
The Problem of Fragmentation and the Need for Integrative Solutions.
K. C. Stange (2009)
Ann. Fam. Med 7, 100-103
   Full Text »    PDF »
Chinese Health Beliefs of Older Chinese in Canada.
D. W. L. Lai and S. Surood (2009)
J Aging Health 21, 38-62
   Abstract »    PDF »
Tracking the Variability of Authority and Power in the Physician-Patient Relationship.
L. B. McCullough (2009)
J Med Philos 34, 1-5
   Full Text »    PDF »
Is patient-centredness in European hospitals related to existing quality improvement strategies? Analysis of a cross-sectional survey (MARQuIS study).
O Groene, M J M H Lombarts, N Klazinga, J Alonso, A Thompson, and R Sunol (2009)
Qual. Saf. Health Care 18, i44-i50
   Abstract »    Full Text »    PDF »
The Rebirth of Neuroscience in Psychosomatic Medicine, Part I: Historical Context, Methods, and Relevant Basic Science.
R. D. Lane, S. R. Waldstein, M. A. Chesney, J. R. Jennings, W. R. Lovallo, P. J. Kozel, R. M. Rose, D. A. Drossman, N. Schneiderman, J. F. Thayer, et al. (2009)
Psychosom Med 71, 117-134
   Abstract »    Full Text »    PDF »
The Rebirth of Neuroscience in Psychosomatic Medicine, Part II: Clinical Applications and Implications for Research.
R. D. Lane, S. R. Waldstein, H. D. Critchley, S. W. G. Derbyshire, D. A. Drossman, T. D. Wager, N. Schneiderman, M. A. Chesney, J. R. Jennings, W. R. Lovallo, et al. (2009)
Psychosom Med 71, 135-151
   Abstract »    Full Text »    PDF »
Collaborative Treatment for the Psychosomatic Couple.
J. Thoburn, G. Hoffman-Robinson, L. J. Shelly, and G. Sayre (2009)
The Family Journal 17, 6-13
   Abstract »    PDF »
Biopolitics, Terri Schiavo, and the Sovereign Subject of Death.
J. P. Bishop (2008)
J Med Philos
   Abstract »    Full Text »    PDF »
Globalization, Conflict and Mental Health.
J. Piachaud (2008)
Global Social Policy 8, 315-334
   Abstract »    PDF »
Exposure to Disability and Hearing Loss Narratives in Undergraduate Audiology Curriculum.
A. L. Berg, M. Canellas, S. Salbod, and R. Velayo (2008)
Am J Audiol 17, 123-128
   Abstract »    Full Text »    PDF »
Determinants of symptoms in functional dyspepsia: gastric sensorimotor function, psychosocial factors or somatisation?.
L Van Oudenhove, J Vandenberghe, B Geeraerts, R Vos, P Persoons, B Fischler, K Demyttenaere, and J Tack (2008)
Gut 57, 1666-1673
   Abstract »    Full Text »    PDF »
Predicting relapse in Crohn's disease: a biopsychosocial model.
A Bitton, P L Dobkin, M D Edwardes, M J Sewitch, J B Meddings, S Rawal, A Cohen, S Vermeire, L Dufresne, D Franchimont, et al. (2008)
Gut 57, 1386-1392
   Abstract »    Full Text »    PDF »
The Medical Home: Growing Evidence to Support a New Approach to Primary Care.
T. C. Rosenthal (2008)
J Am Board Fam Med 21, 427-440
   Abstract »    Full Text »    PDF »
Impact of Spiritual Symptoms and Their Interactions on Health Services and Life Satisfaction.
D. A. Katerndahl (2008)
Ann. Fam. Med 6, 412-420
   Abstract »    Full Text »    PDF »
Eastern and Western Spiritual Beliefs and Violent Trauma: A U.S. National Community Survey.
L.-C. Lee, K. M. Connor, and J. R. T. Davidson (2008)
Traumatology 14, 68-76
   Abstract »    PDF »
The Test Anxiety Inventory for Children and Adolescents (TAICA): Examination of the Psychometric Properties of a New Multidimensional Measure of Test Anxiety Among Elementary and Secondary School Students.
P. A. Lowe, S. W. Lee, K. M. Witteborg, K. W. Prichard, M. E. Luhr, C. M. Cullinan, B. A. Mildren, J. M. Raad, R. A. Cornelius, and M. Janik (2008)
Journal of Psychoeducational Assessment 26, 215-230
   Abstract »    PDF »
Chronic Pain in Adolescence: Parental Responses, Adolescent Coping, and their Impact on Adolescent's Pain Behaviors.
L. E. Simons, R. L. Claar, and D. L. Logan (2008)
J. Pediatr. Psychol. 33, 894-904
   Abstract »    Full Text »    PDF »
Gender and Health: The Effects of Constrained Choices and Social Policies.
L. B. McCullough (2008)
JAMA 300, 968
   Full Text »    PDF »
Because one shoe doesn't fit all: A repertoire of doctor-patient relationships.
M.-T. Lussier and C. Richard (2008)
Can Fam Physician 54, 1089-1092
   Full Text »    PDF »
En l'absence de panacee universelle: Repertoire des relations medecin-patient.
M.-T. Lussier and C. Richard (2008)
Can Fam Physician 54, 1096-1099
   Full Text »    PDF »
Individual determinants of primary healthcare utilisation in Gaza Strip, Palestine.
T Abu-Mourad, A Alegakis, S Shashaa, A Koutis, C Lionis, and A Philalithis (2008)
J Epidemiol Community Health 62, 701-707
   Abstract »    Full Text »    PDF »
Caregivers' Experiences With Major Depression Concealed by Physical Illness in Patients Recruited From Central Ugandan Primary Health Care Centers.
W. W. Muhwezi, E. S. Okello, S. Neema, and S. Musisi (2008)
Qual Health Res 18, 1096-1114
   Abstract »    PDF »
An Integrative Approach to Cultural Competence in the Psychiatric Curriculum.
K. Fung, L. Andermann, A. Zaretsky, and H.-T. Lo (2008)
Acad Psychiatry 32, 272-282
   Abstract »    Full Text »    PDF »
The Development of an Instrument for Measuring Healing.
J. P. Meza and G. F. Fahoome (2008)
Ann. Fam. Med 6, 355-360
   Abstract »    Full Text »    PDF »
Recovery and the medical model.
D. Mountain and P. J. Shah (2008)
Adv. Psychiatr. Treat. 14, 241-244
   Abstract »    Full Text »    PDF »
Explanatory Models for Psychiatric Illness.
K. S. Kendler (2008)
Am J Psychiatry 165, 695-702
   Abstract »    Full Text »    PDF »
The Psychological Impact of Severe Hand Injury.
M. GROB, N. A. PAPADOPULOS, A. ZIMMERMANN, E. BIEMER, and L. KOVACS (2008)
J Hand Surg Eur Vol. 33, 358-362
   Abstract »    Full Text »    PDF »
The development and validation of the Office Work Screen.
G. Gilworth, G. Smyth, J. Smith, and A. Tennant (2008)
Occup. Med. 58, 289-294
   Abstract »    Full Text »    PDF »
Reintegrating Family Therapy Training in Psychiatric Residency Programs: Making the Case.
D. Rait and I. Glick (2008)
Acad Psychiatry 32, 76-80
   Abstract »    Full Text »    PDF »
Gender Differences in Sleep, Fatigue, and Daytime Activity in a Pediatric Oncology Sample Receiving Dexamethasone.
S. D. Sanford, J. O. Okuma, J. Pan, D. K. Srivastava, N. West, L. Farr, and P. S. Hinds (2008)
J. Pediatr. Psychol. 33, 298-306
   Abstract »    Full Text »    PDF »
Psychological and Clinical Factors Implicated in Decision Making About a Trial of Low-Dose Tamoxifen in Hormone Replacement Therapy Users.
G. Rondanina, M. Puntoni, G. Severi, C. Varricchio, A. Zunino, I. Feroce, B. Bonanni, and A. Decensi (2008)
J. Clin. Oncol. 26, 1537-1543
   Abstract »    Full Text »    PDF »
Les problemes psychosociaux -- un defi en promotion de la sante.
G. Steffgen and S. Recchia (2008)
Global Health Promotion 15, 60-63
   PDF »
Daily Assessment of Pain in Adults with Sickle Cell Disease.
W. R. Smith, L. T. Penberthy, V. E. Bovbjerg, D. K. McClish, J. D. Roberts, B. Dahman, I. P. Aisiku, J. L. Levenson, and S. D. Roseff (2008)
Ann Intern Med 148, 94-101
   Abstract »    Full Text »    PDF »
Psychosocial Adaptations to Dual Sensory Loss in Middle and Late Adulthood.
M. Brennan and S. J. Bally (2007)
Trends in Amplification 11, 281-300
   Abstract »    PDF »
Religion, Spirituality, and Medicine.
B. Eichelman (2007)
Am J Psychiatry 164, 1774-1775
   Full Text »    PDF »
Religion, Spirituality, and Medicine: Psychiatrists' and Other Physicians' Differing Observations, Interpretations, and Clinical Approaches.
F. A. Curlin, R. E. Lawrence, S. Odell, M. H. Chin, J. D. Lantos, H. G. Koenig, and K. G. Meador (2007)
Am J Psychiatry 164, 1825-1831
   Abstract »    Full Text »    PDF »
Calculating health and social change: an essay on Jerry Morris and Late-modernist epidemiology.
D. Porter (2007)
Int. J. Epidemiol. 36, 1180-1184
   Full Text »    PDF »
Psychosocial Aspects of Chronic Disease: ESRD as a Paradigmatic Illness.
D. Cukor, S. D. Cohen, R. A. Peterson, and P. L. Kimmel (2007)
J. Am. Soc. Nephrol. 18, 3042-3055
   Abstract »    Full Text »    PDF »
The medical model is dead long live the medical model.
P. SHAH and D. MOUNTAIN (2007)
The British Journal of Psychiatry 191, 375-377
   Abstract »    Full Text »    PDF »
Psychosomatic Medicine: The Scientific Foundation of the Biopsychosocial Model.
D. H. Novack, O. Cameron, E. Epel, R. Ader, S. R. Waldstein, S. Levenstein, M. H. Antoni, and A. R. Wainer (2007)
Acad Psychiatry 31, 388-401
   Abstract »    Full Text »    PDF »
Efficacy of St. John's Wort for Treating Mild to Moderate Depression.
T. Gahlsdorf, R. Krause, and M. W. Beal (2007)
Complementary Health Practice Review 12, 184-195
   Abstract »    PDF »
An Interactive Model of Pain and Myocardial Ischemia.
S. E. Hofkamp, C. A. Henrikson, and S. T. Wegener (2007)
Psychosom Med 69, 632-639
   Abstract »    Full Text »    PDF »
Acute Emotional Stress and Cardiac Arrhythmias.
R. C. Ziegelstein (2007)
JAMA 298, 324-329
   Abstract »    Full Text »    PDF »
The Biopsychosocial Formulation Manual: A Guide for Mental Health Professionals.
S. Guzofski and J. Geller (2007)
Psychiatr Serv 58, 1014-1015
   Full Text »    PDF »
Problematic Integration of Uncertainty and Desire in Pregnancy.
M. Sassi Matthias and A. S. Babrow (2007)
Qual Health Res 17, 786-798
   Abstract »    PDF »
lIlness as argumentation: a prolegomenon to the rhetorical study of contestable complaints.
J. Z. Segal (2007)
Health (London) 11, 227-244
   Abstract »    PDF »
The Relevance of Neuroscience to Forensic Psychiatry.
J. A. Silva (2007)
J Am Acad Psychiatry Law 35, 6-9
   Full Text »    PDF »
Perceptions of Elderly Self-Neglect: A Look at Culture and Cohort.
S. M. S. Filippo, W. Reiboldt, B. White, and J. Hails (2007)
Family and Consumer Sciences Research Journal 35, 215-231
   Abstract »    PDF »
Further evidence supporting a psychological component to irritable bowel syndrome * Authors's reply.
M Castle, G W Libby, L. Van Oudenhove, and J. Tack (2007)
Gut 56, 437-438
   Full Text »    PDF »
Prevalence and Correlates of Early Onset Asthma and Wheezing in a Healthy Birth Cohort of 2- to 3-Year Olds.
J. B. Berz, A. S. Carter, R. L. Wagmiller, S. M. Horwitz, K. K. Murdock, and M. Briggs-Gowan (2007)
J. Pediatr. Psychol. 32, 154-166
   Abstract »    Full Text »    PDF »
Meaning and Action in Employed Mothers' Health Work.
K. E. Kushner (2007)
Journal of Family Nursing 13, 33-55
   Abstract »    PDF »
Work disability in early rheumatoid arthritis: higher rates but better clinical status in Finland compared with the US.
C P Chung, T Sokka, P G Arbogast, and T Pincus (2006)
Ann Rheum Dis 65, 1653-1657
   Abstract »    Full Text »    PDF »
Fatherhood as a Component of Men's Health..
C. F. Garfield, E. Clark-Kauffman, and M. M. Davis (2006)
JAMA 296, 2365-2368
   Full Text »    PDF »
Barriers to the Integration of Psychosocial Factors in Medicine: Results of a National Survey of Physicians.
J. A. Astin, K. Soeken, V. S. Sierpina, and B. R. Clarridge (2006)
J Am Board Fam Med 19, 557-565
   Abstract »    Full Text »    PDF »
Preventing incapacity in people with musculoskeletal disorders.
G. Waddell (2006)
Br. Med. Bull.
   Abstract »    Full Text »    PDF »
Family Medicine's Identity: Being Generalists in a Specialist Culture?.
H. F. Stein (2006)
Ann. Fam. Med 4, 455-459
   Abstract »    Full Text »    PDF »
Introduction to the Special Issue on Pain: From Pain to Pain-Associated Disability Syndrome.
L. K. Zeltzer, J. C. I. Tsao, B. Bursch, and C. D. Myers (2006)
J. Pediatr. Psychol. 31, 661-666
   Full Text »    PDF »
Definitions of Health Among Healthcare Providers.
K. Julliard, E. Klimenko, and M. S. Jacob (2006)
Nurs Sci Q 19, 265-271
   Abstract »    PDF »
Counseling Psychology in the Era of Genetic Testing: Considerations for Practice, Research, and Training.
K. P. Kaut (2006)
The Counseling Psychologist 34, 461-488
   Abstract »    PDF »
Stress, the Brain and Depression.
P. E. Veenhuis (2006)
Am J Psychiatry 163, 1301-1302
   Full Text »    PDF »
The Problem of the Psychopharmacologist.
N. Kontos, J. Querques, and O. Freudenreich (2006)
Acad Psychiatry 30, 218-226
   Abstract »    Full Text »    PDF »
Objective Cancer-Related Variables Are Not Associated With Depressive Symptoms in Women Treated for Early-Stage Breast Cancer.
W. A. Bardwell, L. Natarajan, J. E. Dimsdale, C. L. Rock, J. E. Mortimer, K. Hollenbach, and J. P. Pierce (2006)
J. Clin. Oncol. 24, 2420-2427
   Abstract »    Full Text »    PDF »
The Persistence of Mind-Brain Dualism in Psychiatric Reasoning About Clinical Scenarios.
M. J. Miresco and L. J. Kirmayer (2006)
Am J Psychiatry 163, 913-918
   Abstract »    Full Text »    PDF »
Toward a Common Language for Function, Disability, and Health.
A. M Jette (2006)
Physical Therapy 86, 726-734
   Abstract »    Full Text »    PDF »
"Joining the dots" for patients with systemic lupus erythematosus: personal perspectives of health care from a qualitative study.
E D Hale, G J Treharne, A C Lyons, Y Norton, S Mole, D L Mitton, K M J Douglas, N Erb, and G D Kitas (2006)
Ann Rheum Dis 65, 585-589
   Abstract »    Full Text »    PDF »
The Psychodynamic Formulation: Its Purpose, Structure, and Clinical Application.
S. Perry, A. M. Cooper, and R. Michels (2006)
Focus 4, 297
   Abstract »    Full Text »    PDF »
'Why Don't they Get It?' Talk of Medicine as Science. St Luke's Hospital, Panniqtuuq, Baffin Island.
F. J. Tester and P. McNicoll (2006)
Soc Hist Med 19, 87-106
   Abstract »    Full Text »    PDF »
Targeting Schizophrenia Research to Patient Outcomes.
W. T. CARPENTER Jr. (2006)
Am J Psychiatry 163, 353-355
   Full Text »    PDF »
Health Beliefs and Behaviour of Cervix Cancer Patients.
P. AwasthiI, R. C. Mishra, and U.P. Shahi (2006)
Psychology Developing Societies 18, 37-58
   Abstract »    PDF »
On Addressing Racial and Ethnic Health Disparities: The Potential Role of Patient Communication Skills Interventions.
D. J. Cegala and D. M. Post (2006)
American Behavioral Scientist 49, 853-867
   Abstract »    PDF »



To Advertise     Find Products


Science. ISSN 0036-8075 (print), 1095-9203 (online)