Many patients with physical symptoms actually have undiag- nosed psychiatric illness: A recent US study of 334 patients who attended an accident and emergency department with acute chest pain found that 17.5 per cent had panic disorder and a further 23 per cent had clinical depression. If these psychological symptoms are not picked up, these patients will seek medical help again and again for physical symptoms, requiring expensive tests. Numerous studies show that simple screening procedures which identify psychological symptoms can reduce unnecessary medical testing, decrease health costs by one-third and result in appropriate treatment for the patient.

Psychological stress and ill health: Stress is a causative or an exacerbating factor in many illnesses including arthritis, hypertension, cardiac arrhythmia, insomnia, pre-menstrual syndrome, infertility and the nausea and vomiting associated with chemotherapy

Cancer and the mind: Women who undergo group therapy as part of treatment for breast cancer live longer than those who receive no such treatment.

Trauma and the immune system: A US study found that research subjects who simply wrote about traumatic events in their lives showed a boost in their immune-system activity compared to control subjects

Heart attacks and stress: The Mayo Clinic in the US found that cardiac patients undergoing psychological distress had poorer medical outcomes and increased health care costs. Distressed patients were nearly 2.4 times more likely to be rehospitalised.

Students and stress: Students under stress show a decline in the activity of the cells that fight off tumours and viral infections. Some 400 healthy university students were injected with a cold virus - those who reported more stress in their lives were more likely to develop colds. Carers and stress: People caring for a spouse with Alzheimer's disease show decreases in immune activity.

Arthritis and attitude: Education and counselling can improve the health of arthritis patients, causing a 20 per cent reduction in pain and a 43 per cent reduction in doctor visits at four-year follow-up.

Chronic pain relief: several studies show that chronic pain centres which integrate psychological and medical treatment strategies are a cost-effective way to treat patients with chronic back pain.