Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies

The intersection of psychiatry and medicine presents unique diagnostic and ethical challenges, particularly for conditions involving significant brain-body interactions, such as psychosomatic, somatopsychic, and complex systemic disorders. This article explores the historical and contemporary issues...

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Main Authors: Francesco Monaco, Annarita Vignapiano, Martina D’Angelo, Fabiola Raffone, Valeria Di Stefano, Antonella Boccia, Anna Longobardi, Benedetta Di Gruttola, Michele Fornaro, Giulio Corrivetti, Iolanda Martino, Luca Steardo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1576179/full
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author Francesco Monaco
Francesco Monaco
Annarita Vignapiano
Annarita Vignapiano
Martina D’Angelo
Fabiola Raffone
Valeria Di Stefano
Antonella Boccia
Anna Longobardi
Benedetta Di Gruttola
Michele Fornaro
Giulio Corrivetti
Giulio Corrivetti
Iolanda Martino
Luca Steardo
Luca Steardo
Luca Steardo
author_facet Francesco Monaco
Francesco Monaco
Annarita Vignapiano
Annarita Vignapiano
Martina D’Angelo
Fabiola Raffone
Valeria Di Stefano
Antonella Boccia
Anna Longobardi
Benedetta Di Gruttola
Michele Fornaro
Giulio Corrivetti
Giulio Corrivetti
Iolanda Martino
Luca Steardo
Luca Steardo
Luca Steardo
author_sort Francesco Monaco
collection DOAJ
description The intersection of psychiatry and medicine presents unique diagnostic and ethical challenges, particularly for conditions involving significant brain-body interactions, such as psychosomatic, somatopsychic, and complex systemic disorders. This article explores the historical and contemporary issues in diagnosing such conditions, emphasizing the fragmentation of medical and psychiatric knowledge, biases in clinical guidelines, and the mismanagement of complex illnesses. Diagnostic errors often arise from insufficient integration between general medicine and psychiatry, compounded by the reliance on population-based guidelines that neglect individual patient needs. Misclassification of conditions like myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Lyme disease, and fibromyalgia as psychosomatic or psychogenic has led to stigmatization and delayed care. While these conditions are referenced as emblematic examples of misclassified and poorly understood disorders, the five clinical cases discussed in this article do not directly illustrate these diseases. Instead, they exemplify shared diagnostic and ethical dilemmas at the medicine–psychiatry interface, including uncertainty, fragmentation, and the risk of epistemic injustice. The article critically examines terms like medically unexplained symptoms and functional disorders, highlighting their limitations and potential for misuse. Case examples underscore the consequences of diagnostic inaccuracies and the urgent need for improved approaches. Ethical considerations are also explored, emphasizing respecting patient experiences, promoting individualized care, and acknowledging the inherent uncertainties in medical diagnosis. Advances in technologies such as brain imaging and molecular diagnostics offer hope for bridging the gap between psychiatry and medicine, enabling more accurate assessments and better patient outcomes. The article concludes by advocating comprehensive training at the medicine-psychiatry interface and a patient-centered approach that integrates clinical observation, research insights, and a nuanced understanding of mind-body dynamics.
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spelling doaj-art-c99cc8aa1ed3447e8208a3c37870a65b2025-08-20T02:24:30ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-04-011610.3389/fpsyt.2025.15761791576179Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studiesFrancesco Monaco0Francesco Monaco1Annarita Vignapiano2Annarita Vignapiano3Martina D’Angelo4Fabiola Raffone5Valeria Di Stefano6Antonella Boccia7Anna Longobardi8Benedetta Di Gruttola9Michele Fornaro10Giulio Corrivetti11Giulio Corrivetti12Iolanda Martino13Luca Steardo14Luca Steardo15Luca Steardo16Department of Mental Health, Azienda Sanitaria Locale (ASL) Salerno, Salerno, ItalyEuropean Biomedical Research Institute of Salerno (EBRIS), Salerno, ItalyDepartment of Mental Health, Azienda Sanitaria Locale (ASL) Salerno, Salerno, ItalyEuropean Biomedical Research Institute of Salerno (EBRIS), Salerno, ItalyPsychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, ItalyDepartment of Mental Health, Azienda Sanitaria Locale (ASL) Napoli 1 Centro, Napoli, ItalyPsychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, ItalyDepartment of Mental Health, Azienda Sanitaria Locale (ASL) Salerno, Salerno, ItalyDepartment of Mental Health, Azienda Sanitaria Locale (ASL) Salerno, Salerno, ItalyDepartment of Mental Health, Azienda Sanitaria Locale (ASL) Salerno, Salerno, ItalySection of Psychiatry, Department of Neuroscience, Reproductive Science, and Dentistry, Federico II University of Naples, Naples, ItalyDepartment of Mental Health, Azienda Sanitaria Locale (ASL) Salerno, Salerno, ItalyEuropean Biomedical Research Institute of Salerno (EBRIS), Salerno, ItalyDepartment of Medical Sciences, Institute of Neurology, University “Magna Graecia” of Catanzaro, Catanzaro, ItalyDepartment of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, ItalyDepartment of Clinical Psychology, University Giustino Fortunato, Benevento, ItalyPsychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, ItalyThe intersection of psychiatry and medicine presents unique diagnostic and ethical challenges, particularly for conditions involving significant brain-body interactions, such as psychosomatic, somatopsychic, and complex systemic disorders. This article explores the historical and contemporary issues in diagnosing such conditions, emphasizing the fragmentation of medical and psychiatric knowledge, biases in clinical guidelines, and the mismanagement of complex illnesses. Diagnostic errors often arise from insufficient integration between general medicine and psychiatry, compounded by the reliance on population-based guidelines that neglect individual patient needs. Misclassification of conditions like myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Lyme disease, and fibromyalgia as psychosomatic or psychogenic has led to stigmatization and delayed care. While these conditions are referenced as emblematic examples of misclassified and poorly understood disorders, the five clinical cases discussed in this article do not directly illustrate these diseases. Instead, they exemplify shared diagnostic and ethical dilemmas at the medicine–psychiatry interface, including uncertainty, fragmentation, and the risk of epistemic injustice. The article critically examines terms like medically unexplained symptoms and functional disorders, highlighting their limitations and potential for misuse. Case examples underscore the consequences of diagnostic inaccuracies and the urgent need for improved approaches. Ethical considerations are also explored, emphasizing respecting patient experiences, promoting individualized care, and acknowledging the inherent uncertainties in medical diagnosis. Advances in technologies such as brain imaging and molecular diagnostics offer hope for bridging the gap between psychiatry and medicine, enabling more accurate assessments and better patient outcomes. The article concludes by advocating comprehensive training at the medicine-psychiatry interface and a patient-centered approach that integrates clinical observation, research insights, and a nuanced understanding of mind-body dynamics.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1576179/fullpsychosomatic disorderssomatopsychic conditionscomplex systemic disordersdiagnostic challengesmedicine-psychiatry interfaceethical implications
spellingShingle Francesco Monaco
Francesco Monaco
Annarita Vignapiano
Annarita Vignapiano
Martina D’Angelo
Fabiola Raffone
Valeria Di Stefano
Antonella Boccia
Anna Longobardi
Benedetta Di Gruttola
Michele Fornaro
Giulio Corrivetti
Giulio Corrivetti
Iolanda Martino
Luca Steardo
Luca Steardo
Luca Steardo
Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies
Frontiers in Psychiatry
psychosomatic disorders
somatopsychic conditions
complex systemic disorders
diagnostic challenges
medicine-psychiatry interface
ethical implications
title Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies
title_full Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies
title_fullStr Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies
title_full_unstemmed Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies
title_short Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies
title_sort case report the intersection of psychiatry and medicine diagnostic and ethical insights from case studies
topic psychosomatic disorders
somatopsychic conditions
complex systemic disorders
diagnostic challenges
medicine-psychiatry interface
ethical implications
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1576179/full
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