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Biopsychosocial model of disease: 40 years on. Which way is the pendulum swinging?
  1. Gwendolen Jull
  1. Correspondence to Professor Gwendolen Jull, Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia Campus, Brisbane, QLD 4072, Australia; g.jull{at}

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The biopsychosocial model came to prominence in 1977 when it was introduced by Engel1 who argued against the reductionist biomedical model of disease and for concomitant consideration of behavioural, psychological and social dimensions in understanding a person's medical condition. This conceptual model was initially proposed within the field of psychiatry, but it quickly expanded to other fields of medicine. In 1987, Waddell2 proposed a new conceptual model for the treatment of chronic low back pain, which encompassed the biopsychosocial framework and brought it into the sphere of musculoskeletal disorders.

Few would question the merits of the model as it is unreasonable to separate the person and their personal circumstances from their medical condition and to regard physical and psychosocial components as independent entities. The model has relevance for all musculoskeletal pain states, acute or chronic, but it has been most widely advocated in chronic pain disorders.3 It has wide perspectives and promotes consideration and evaluation of all potential biological, psychological and social determinants of a …

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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