A Healthy Mind in a Healthy Body

Prof Dr Nor Zuraida Zainal

Consultant of Psychiatry, University Malaya Specialist Centre, Kuala Lumpur

Mind and body are two entities that are interrelated to each other 1 . A person cannot be
considered as healthy only with the absence of physical disease if the mind is not at peace.
On the other hand, the mind would be disturbed if any parts of the body become sick.
This concept of healthy well-being is not something new. The slogan was emphasized long
time ago by the World Health Organization. Numerous research studies on this issue have
been conducted, and the findings have been recommended to be implemented in clinical
practice.
Epidemiological research studies on the relationship between mental health variables and
physical disease are commonly conducted, be it cross-sectional, retrospective or prospective
studies. Each of the research methods has its own advantages and disadvantages. Longer
follow-up prospective studies may enlighten us with a better picture of the causal relationship
between any risk factors and the disease outcome. Conversely, retrospective studies may
expose to recall bias.
In recent years, molecular changes have been widely studied to look at the molecular and
cellular activities in the body 1 as a result of chronic stress that may lead to diseases such as
cardiovascular disease 2 , cancer 3 and brain structure changes. This may be mediated by stress
hormones such as cortisol, suppressed neurogenesis, decreased neuroplasticity, reduced
resilience or immunological changes. The effects of chronic stress on Hypothalamic-
Pituitary-Adrenal (HPA) axis function have been studied in both animal models and clinical
populations 4 . In the presence of stress, an impact on estrogen activity in mammary gland that
may initiate pro-tumorigenic changes may lead to breast cancer 3 .
There is more and more evidence to emphasize the importance of maintaining a healthy mind
as the fundamental of resilience to physical illnesses. Therefore, a clinician must not ignore
or neglect the psychological issues that may have contributed to the physical symptoms
manifested by his/her patients or to the physical disease suffered.

References

1. Renoir T, Hasebe K, Gray L. Mind and body: how the health of the body impacts on
   neuropsychiatry. Front Pharmacol. 2013 Dec 18;4:158. doi:
   10.3389/fphar.2013.00158
   
2. van Reedt Dortland AK, Vreeburg SA, Giltay EJ, Licht CM, Vogelzangs N, van Veen
   T, de Geus EJ, Penninx BW, Zitman FG. The impact of stress systems and lifestyle on
   dyslipidemia and obesity in anxiety and depression. Psychoneuroendocrinology.
   2013; 38(2):209-18.
   
3. Antonova L, Aronson K, Mueller C. Stress and breast cancer: from epidemiology to
   molecular biology. Breast Cancer Research 2011; 13: 208
   
4. Evans J, Sun Y, McGregor A, Connor B. Allopregnanolone regulates neurogenesis
   and depressive/anxiety-like behaviour in a social isolation rodent model of chronic
   stress. Neuropharmacology. 2012; 63(8):1315-1326