McEwen and Stellar1 have done a nice job reviewing the current status of "stress" as a cause of organic disease. But I believe that they have left off two important features of psychosocial stress. First, psychosocial stresses may not cause much of the organic disease that we see but they surely lead the patient to consult physicians. Second, the popular "stress theory of pathophysiology" allows patients to disclose to us areas they previously kept private.
I believe that patients will tolerate almost any organic problem until they suffer a relationship loss or an emotional upheaval. Then they come to consult the physician. I am unaware of any good studies on this phenomenon other than those on patients with functional bowel disorder. Patients with functional bowel disorder do not suffer more from emotional disorders than do others, except for the group of patients with functional bowel disorder who consult physicians.