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Table 1 Bio psycho social origins of chronic diseases (e.g coronary heart disease, bronchial asthma, rheumatoid arthritis, inflammatory bowel disease, essential hypertension, atopic dermatitis, diabetes, cancer and others; modified after Orth-Gomér et al 1997)

From: Psychosocial interventions for patients with chronic disease

Origins of

Disease

Factor 1

Factor 2

Factor 3

Factor 4

Factor 5

Factor 6

Factor 7

Psychological mediators

depression

anxiety

hostility

denial

type A

type C

type D

Behavioral risk factors

smoking

sedentary life style

poor nutrition

alcohol consumption

suicidal behavior

no care for the own person

over active

Pathological mechanism

genetic

autonomic im-balance

psycho-immunological path-ways

psycho-endocrinological path-ways

inflammation

lipids/

glucose

coagulation

Severity of disease

       

somatic

bodily complaints

bodily limitations

pain

    

psychological

psychic symptoms

chronic depression

suicidal tenden-cies

chronic anxiety

too many doctor visits

too many drugs

social inhibition

sociological

low social functioning

social isolation

unable to work

low income

high treatment costs

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