Related - [[BioPsychoSocial]] - [[20220107 My current understanding of treatment rationale and theories]]]] - [[What are the factors contributing or prevent illness]] - [[Chapter 5 Psychological Approaches to Mental Illness - Christopher Peterson]] - [[C20200327 Why do we formulate cases]] # Biopsychosocial Model The Biopsychosocial Model and Case Formulation (also known as the Biopsychosocial Formulation) in psychiatry is a way of understanding a patient as more than a diagnostic label. Hypotheses are generated about the origins and causes of a patient's symptoms. The most common and clinically practical way to formulate is through the biopsychosocial approach, first described in 1980 by George Engel.[1][2] Biopsychosocial formulation combines biological, psychological, and social factors to understand a patient, and uses this to guide both treatment and prognosis. Your formulation of a patient evolves and changes as you collect more information. Formulation is like cooking, and there is no 'right' or 'wrong' way to do it, but most get better over time with increasing clinical experience. The biopsychosocial model considers the “4 Ps” for each of the biological, psychological, and social factors: 1. **Predisposing factors** are areas of vulnerability that increase the risk for the presenting problem. Examples include genetic (i.e. -family history) predisposition for mental illness or prenatal exposure to alcohol. 2. **Precipitating factors** are typically thought of as stressors or other events (they could be positive or negative) that may be precipitants of the symptoms. Examples include conflicts about identity, relationship conflicts, or transitions. 3. **Perpetuating factors** are any conditions in the patient, family, community, or larger systems that exacerbate rather than solve the problem. Examples include unaddressed relationship conflicts, lack of education, financial stresses, and occupation stress (or lack of employment) 4. **Protective factors** include the patient’s own areas of competency, skill, talents, interest and supportive elements. Protective factors counteract the predisposing, precipitating, and perpetuating factors. [Biopsychosocial Model and Case Formulation - PsychDB](https://www.psychdb.com/teaching/biopsychosocial-case-formulation) ----