The term "function/functional" in manual medicine and psychosomatics/internal medicine Similarities and differences

Background On the one hand, the term "functional" is used in internal medicine for disorders of the gastrointestinal tract, respiratory system, cardiovascular system, and urogenital tract. On the other hand, the term is also necessary in manual medicine for understanding the processes and disorders of the locomotor system. How do these two concepts differ and what do they have in common? Methods The first author is a liaison psychiatrist (CL psychiatrist) trained in manual medicine. The second author is an anesthetist who is also additionally qualified in manual medicine. This combination allowed us to deal simultaneously with these two concepts at the physical and the psychiatric level as well as from the general clinical and manual medical perspective. Conclusion An uncritical equation of these two clinical areas or a sole understanding of the term "functional" in the sense of internal medicine is not possible. The difference between these two notions regarding the term "functional" becomes even greater when this expression is equated to "somatoform", a term used in psychosomatic medicine. From a psychiatric point of view, an important reason-but not the only reason-for this is that the term "somatoform" is clearly connected to a psychological diagnosis (Chapter F of ISD-10). In contrast, the term "functional" means that the effect of any influential psychological factor on each individual patient, irrespective of its weight and influence, is to be discussed.