It is a widely accepted view today that psychosocial factors can cause psychiatrie disorders. However, this view has as yet no firm foundation of verifiable facts. This paper outlines some research strategies which can provide data in favour of or against this theory:
1 systematic analysis of life events preceding psychiatrie disorders, covering both what I have called stable events and interactional events;
2 vulnerability research on three levels (biological, psychological and sociological), aimed at factors which could explain the increased vulnerability of some individuals to the detrimental effects of life events;
3 pathogenesis research, aimed at analysing how psychosocial stress disrupts cerebral systems, and which of these disruptions is responsible for disturbed behavior;
4 research into the efficacy of combined biological (mainly pharmacotherapeutic) and psycho(socio)therapeutic methods.
Some results obtained in these areas of research are discussed.
The central idea of this study is that psychosocial and biological factors do not operate independently but in close interaction. This seems a cliché, but is not, as clearly indicated by the scantiness of relevant research so far carried out. This gap is to be filled if psychiatry is to maintain and reinforce its status as a medical discipline.