An old, ubiquitous and not always properly addressed issue: stress.

Abstract

Introduction: Stress is a complex concept that has undergone significant changes and has physiopathological, psychopathological, and social impacts on general and everyday clinical practice. Objective: Through a literature review, describe the history, evolution, and physiological impact of stress and illustrate its clinical impact. Methodology: A literature search was conducted in PubMed using the terms: ‘Hans Selye, general adaptation syndrome, psychosocial stress, stress impact, stress AND neurobiology, karoshi, Takotsubo syndrome’. Development: Since stress was first mentioned, the concept of stress has undergone significant changes from a biological point of view. Currently, different types of stressful stimuli, types of stress, responses to stress, and short- and long-term effects can be identified. Stress can be subdivided based on its effect on the ability to adapt into eustress, distress, and substress. Physiologically, it can manifest as epigenetic, immune system, neurological, endocrine, cardiovascular, and gastrointestinal alterations. The impact of these alterations can be seen in clinical practice, increasing risk, modifying the course and decreasing the response to treatment of different pathologies, both in the psychiatric field and in other specialities. Conclusion: Stress is a complex concept that includes different types of stimuli, responses, and physiological effects that have an impact on clinical practice. Therefore, it is necessary for healthcare personnel to understand and identify them in order to comprehensively address each patient's context.