[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Behavioral science](https://durgical.com/en/behavioral-science/) › [Stress, coping and grief](https://durgical.com/en/behavioral-science/areas/stress/) › Psychological factors in physical illness

# Psychological factors in physical illness

- Concept

Mind and body interact: stress, mood and behavior can bring on or worsen physical illness, and illness affects mood in return.

Updated Nov 5, 2026

## Key points

- Depression after a myocardial infarction is common and is associated with higher cardiac mortality.
- Hostility and anger, rather than the whole type A pattern, are the parts linked to coronary disease.
- Chronic stress weakens immune responses: more colds after viral exposure, weaker vaccine responses, slower wound healing.
- Acute emotional stress can trigger takotsubo cardiomyopathy.
- Classic conditions worsened by stress: hypertension, IBS, asthma, tension headache, psoriasis and eczema.

## What it is

Psychological factors can affect physical illness through three routes: biological (stress hormones, autonomic and immune changes), behavioral (smoking, diet, sleep, adherence) and through how symptoms are noticed and reported. The link runs both ways: chronic illness raises the risk of depression and anxiety. The old idea that specific personalities cause specific diseases has been largely abandoned.

## Key facts

- DSM-5 lists ‘psychological factors affecting other medical conditions’ for a diagnosed medical illness worsened by psychological or behavioral factors.
- Type A behavior (competitive, impatient, hostile) was an early heart-disease hypothesis; later studies did not confirm it as a whole.
- Caregivers of relatives with dementia show measurable immune changes, a classic example of chronic stress.
- Psychological treatment can improve symptoms in IBS, chronic pain and tension headache.

## Examples of the mind–body link

| Condition | Psychological factor | Likely route |
| --- | --- | --- |
| Coronary disease | Depression, hostility, social isolation | Sympathetic activation, inflammation, worse adherence |
| [Takotsubo cardiomyopathy](https://durgical.com/en/conditions/takotsubo-cardiomyopathy/) | Sudden emotional or physical stress | Likely a catecholamine surge that stuns the myocardium |
| [Irritable bowel syndrome](https://durgical.com/en/conditions/irritable-bowel-syndrome/) | Anxiety, stress, past adversity | Gut–brain axis and visceral hypersensitivity |
| [Fibromyalgia](https://durgical.com/en/conditions/fibromyalgia/) | Stress, poor sleep, catastrophizing | Central sensitization to pain |
| [Tension-type headache](https://durgical.com/en/conditions/tension-type-headache/) | Stress, poor sleep | Muscle tension and lower pain threshold |

## Clinical notes

- Screening for depression in patients with heart disease is recommended because depression worsens prognosis.
- Explaining a stress link without implying ‘it is all in your head’ protects the relationship and adherence.

## Memory aid

Three roads from mind to body: Hormones, Habits and How symptoms are heard.

## Test yourself

Think of the answer, then tap the question to see it.

## Which component of the type A pattern is most strongly linked to coronary disease?

Hostility and anger.

## What are three routes by which psychological factors affect physical illness?

Biological (hormones, autonomic and immune changes), behavioral (habits, adherence) and perception and reporting of symptoms.

## Which cardiomyopathy is classically triggered by acute emotional stress?

Takotsubo (stress) cardiomyopathy.

## Why does depression matter after a myocardial infarction?

It is common and is associated with higher cardiac mortality and worse adherence.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/behavioral-science/psychological-factors-in-physical-illness/)

## Elsewhere in DurgiPedia

- [The endocrine stress response](https://durgical.com/en/physiology/the-endocrine-stress-response/)
- [The HPA axis and its circadian rhythm](https://durgical.com/en/physiology/the-hpa-axis-and-its-circadian-rhythm/)

## Connections

## Related 5

- [Stress: the general adaptation syndrome and allostatic load](https://durgical.com/en/behavioral-science/stress-the-general-adaptation-syndrome-and-allostatic-load/)
- [Life events and social support](https://durgical.com/en/behavioral-science/life-events-and-social-support/)
- [The reaction to illness: sick role, illness behavior and hospitalization](https://durgical.com/en/behavioral-science/the-reaction-to-illness-sick-role-illness-behavior-and-hospitalization/)
- [The psychology of pain: gate control and the biopsychosocial model](https://durgical.com/en/behavioral-science/the-psychology-of-pain-gate-control-and-the-biopsychosocial-model/)
- [Coping and resilience](https://durgical.com/en/behavioral-science/coping-and-resilience/)

## Related conditions 6

- [Takotsubo (stress) cardiomyopathy](https://durgical.com/en/conditions/takotsubo-cardiomyopathy/)
- [Irritable bowel syndrome](https://durgical.com/en/conditions/irritable-bowel-syndrome/)
- [Somatic symptom and illness anxiety disorders](https://durgical.com/en/conditions/somatic-symptom-and-illness-anxiety-disorders/)
- [Fibromyalgia](https://durgical.com/en/conditions/fibromyalgia/)
- [Tension-type headache](https://durgical.com/en/conditions/tension-type-headache/)
- [Major depressive disorder](https://durgical.com/en/conditions/major-depressive-disorder/)

[← All of behavioral science](https://durgical.com/en/behavioral-science/)

Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.

Sources: [Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry](https://pmc.ncbi.nlm.nih.gov/articles/PMC1361287/) (Psychological Bulletin, via PubMed Central (US National Library of Medicine), 2004); [Psychological factors and coronary heart disease](https://pmc.ncbi.nlm.nih.gov/articles/PMC3653260/) (ARYA Atherosclerosis, via PubMed Central (US National Library of Medicine), 2013).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/behavioral-science/psychological-factors-in-physical-illness/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/behavioral-science/psychological-factors-in-physical-illness/