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More than 30 years ago, psychiatrist George Engel (1977) coined a word to describe a developing paradigm for patient care, the “biopsychosocial model.” The model encouraged formulating treatments that considered the mind and body of a patient as two intertwining systems influenced by yet a third system—society.

Twenty years before this paradigm, Erik Erikson (1963) created a model that describes psychological maturation across the life span. Combining these two models yields a dimensional perspective helpful for the evaluation, diagnosis, and treatment of any patient (Table 13-1).

Table 13-1. Biopsychosocial Development

Not only do women use more health care services in general than men in the United States, but more women approach their physicians with psychiatric complaints, and more women have comorbid illness than men (Andrade, 2003; Burt, 2005; Kessler, 1994). Coupled with the “almost universal recognition” that primary care is where most patients with psychiatric illness are first seen, obstetricians and gynecologists will often be the first to evaluate a woman in psychiatric distress (Goldberg, 2003). A clinical interview such as one presented in Table 13-2 can guide assessment and includes all three domains from the biopsychosocial model.

Table 13-2. Psychiatric Assessment of Women: Clinically Significant Considerations

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