| الوصف: |
The objectives of the study is to study the clinical features of mental disorders in various somatic diseases. To achieve the goal, tasks were defined, such as a comparative analysis of the clinical and dynamic course of somatic pathology in patients of the general somatic sphere, as well as optimization of methods for diagnosing psychosomatic disorders. Materials and methods. To study the disorders of this circle, 280 patients were studied on the basis of a regional multidisciplinary clinic, with a diagnosis of gastroenterological and cardiological pathologies. Clinical and pathopsychological methods were used to confirm the mental status of the patient. The Giessen Somatic Complaints Questionnaire was also used. The questionnaire consists of 57 descriptions of ailments, the degree of intensity is assessed on a 5-point scale: 0 - no, 1 - slightly, 2 - somewhat, 3 - significant, 4 - severe. In addition to the complaints themselves, it is also revealed that, from the point of view of the patient, their conditionality is more likely to be physical or rather mental (psychological) factors. The structure of the questionnaire included 4 main scales and 1 additional scale. Each of the 4 main scales includes 6 points, the 5th additional scale is a total indicator and includes all 24 points included in the 4 main scales. The research results. In all the studied patients, in addition to various psychopathological signs, the state of the psycho-vegetative circle was revealed. The psycho-vegetative syndrome is a non-specific mediator and an intermediate link in the clinical presentation of symptoms, its transformation from subaffective to psychosomatic or extended affective. The nature of psychopathological symptoms was different, depending on the nosological affiliation of organ pathology. So, for coronary heart disease (30%, 83 patients) anxiety-phobic disorders were characteristic, in patients with hypertension, a depressed state with elements of anxiety prevailed (22%, 63 patients), for duodenal ulcer (28%, 77 patients ) — dysphoric manifestations, for nonspecific ulcerative colitis (20%, 57 patients) — hysterioform symptoms. The course of the components of psychosomatic disorders had a regular development. Conclusion. The diagnosis of psychosomatic disorders should be multi-axial. At the same time, it should be separately stated: psychopathological syndromes and the nature of organ pathology. An assessment of the nature and severity of the psychosocial stress factor, the level of the patient's social adaptation will provide additional important information for describing the mental status of the somatic patient. The use of an integrative approach as a basic one in the study of psychosomatic pathology is a promising and progressive way to understand this pathology and develop effective methods for its treatment |
