ISSN: 2639-2038
Authors: Turabian JL*
Frequently causal models are established which, although they can show many factors, their connections are all linear. But what sense can have for a general practitioner the inexpressive formula that tells him separately the cause and the conditions, even if the conditions (for example the social ones) can be of immeasurably greater importance than "the cause"? Biopsychosocial causality emphasizes the importance of the transforming mutual influence of the different inter-acting "causal" factors, and points out the irrelevance of considering a "determining condition". Disease (bacterial, parasitic, cancer, vascular, autoimmune, etc.) is an ecosystem and many of its components are interactions in a community: emergency, growth, dissemination, regression, and resistance. Cause and effect constantly change place; from the psychosocial to the biological, and vice versa. The epidemiological cause-effect relationship is a process of displacement or transaction from an incomplete material to a more complete one; from a manifest material to another latent one. In epidemiology, when we try to estimate the effect of a possible cause, it is not taken into account that the confusion depends on how the variables interact in the individuals. There are no noncommunicable diseases and communicable diseases, there are no organic and functional diseases, there are no biological, psychological and social diseases separated from each other. In this model the doctor-patient relationship is a part of the skein or "tangle" of causes and effects. Biopsychosocial causes give rise to scenarios that behave like the arguments of "television series films": the characters, which are interconnected directly or tangentially with each other, get into the next mess or muddle before leaving the latter, this means that there are several storylines at the same time (two or three at least), where several causal stories are interwoven, and also all of them have moments of knots, or entanglements , or skeins, or mess, noise, jumble, confusion, disorder, which partly overlap for each character, and where there is no final outcome. And what does the general practitioner need to know in this knot, or tangle of causes of health and disease? He must find "the system that defines the problem", the set of relevant variables affected by the problem.
Keywords: Causation; Biopsychosocial; Complexity; General Practice; Framework; Physician-Patient Relations; Stress Responses; Psychosocial Risk; Chronic Diseases
