“The good physician treats the disease; the great physician treats the patient who has the disease.” – William Osler
Imagine two patients presenting with the same complaint of low mood. One has a strong family history of depression and hypothyroidism. The other recently lost a parent, is socially isolated, and is struggling academically. Although both meet the diagnostic criteria for depression, their stories—and therefore their treatment—are different.
This is where the biopsychosocial (BPS) model becomes the cornerstone of psychiatric practice.
Introduced by psychiatrist George L. Engel in 1977, the biopsychosocial model transformed the way clinicians understand illness. Instead of viewing psychiatric disorders solely as biological diseases, it proposes that mental health results from the dynamic interaction of biological, psychological, and social factors.
The biological component includes genetics, neurochemical changes, medical illnesses, hormones, and substance use. The psychological component encompasses personality, coping styles, emotions, thought patterns, and past experiences. The social component includes family relationships, education, occupation, culture, financial stress, and social support. Together, these factors influence not only the onset of illness but also its course and recovery.
For medical students, this model serves as a reminder that a diagnosis is only the beginning. Two patients with the same disorder may require very different management because the factors contributing to their illness differ. For example, while medication may reduce depressive symptoms, addressing unresolved grief, academic stress, or family conflict is often equally important for recovery.
The biopsychosocial model also forms the foundation of psychiatric case formulation. Rather than simply assigning a diagnosis, psychiatrists explore what predisposed the patient to illness, what triggered it, what continues to maintain it, and what protective factors may support recovery. This holistic understanding helps develop individualised treatment plans that combine medication, psychotherapy, and social interventions.
As future doctors, remembering one simple question can transform patient care: Instead of asking only, “What disease does this patient have?”, also ask “What factors have shaped this patient’s illness?” That shift in perspective lies at the heart of compassionate, patient-centred psychiatry.
Dr. Athik Kumar
PG Resident
Department of Psychiatry
Dr. SN Medical College, Jodhpur
