Events

How do you feel? This simple question is asked by doctors, family and friends when you feel ill. But how do health complaints come about and what do they tell about actual bodily dysfunction? Health complaints are the result of a complex process integrating afferent (bottom-up) interoceptive information with (top-down) perceptual-cognitive and affective processes. Afferent information from peripheral physiology is an important source, but a variety of top-down processes can make correlations between complaints and physiological processes vary from almost perfect to zero. When the latter happens, medically unexplained symptoms arise, frustrating both the doctor and the patient and leading to excessive health care consumption. An important research question, then, is to determine when health complaints are related to pheripheral physiology and when and why they are not. In search for these critical conditions, we will review evidence from controlled laboratory work with experimental symptom inductions as well as from clinical studies. These studies show that health complaints and physiological dysfunction can be easily uncoupled and that affective sources of interoceptive input often overrule somatic sources to determine health complaints. The clinical implications for medical diagnosis and treatment of health complaints will be discussed.