Аннотация
Введение. В статье рассматриваются особенности типов отношения к болезни у женщин с разной продолжительностью течения соматизированных расстройств. Полученные результаты могут быть полезны для достижения успешного лечебного взаимодействия между специалистами вторичной медицинской сети и пациентами с данным диагнозом. Изменение дисгармоничного отношения к болезни является одним из факторов, способствующих выздоровлению больного.
Методы. Исследование проведено на женщинах, страдающих соматизированными расстройствами до года, а также от года до пяти лет. Использована методика «Тип отношения к болезни» Л.И. Вассермана с соавт. для определения типов отношения к болезни у женщин с разной продолжительностью течения заболевания.
Результаты. Описаны статистически значимые различия в типах отношения к заболеванию у пациенток, страдающих соматизированными расстройствами более года, и женщин с длительностью болезни до года. Установлено, что у женщин с длительностью соматизированных расстройств более года преобладает сенситивный тип отношения к болезни, характеризующийся повышенным беспокойством по отношению к своему заболеванию, что свидетельствует о нарушении социальной адаптации. У женщин с длительностью заболевания до года преобладают типы отношения к болезни с интрапсихической направленностью, сопровождающиеся уходом в болезнь.
Обсуждение результатов. Данные проведенного исследования свидетельствуют о наличии дисгармоничного отношения к болезни у женщин при разной длительности соматизированных расстройств. Выявленные особенности отношения к болезни позволяют обосновать проведение психокоррекционных мероприятий.
Библиографические ссылки
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Aleksandrovskii, Yu. A. (2006). Some key issues of modern border psychiatry. Psikhiatriya i psikhofarmakoterapiya (Psychiatry and Psychopharmacotherapy), 8(2), 4–13. (in Russ.).
Barsky, A. J., Orav, E. J., & Bates, D. W. (2005). Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch. Gen. Psychiatry, 62(8), 903–910. doi: http://dx.doi.org/10.1001/archpsyc.62.8.903
Bobrova, M. A. (2012). Emotional, cognitive, and personality disorders in somatization disorders: Typology, therapy, and prognosis (Doctoral dissertation). Moscow. (in Russ.).
Bryabrina, T. V. (2009). Characteristics of attitudes towards health and disease in young people suffering from somatoform autonomic dysfunction. Vestnik Yuzhno-Ural'skogo gosudarstvennogo universiteta. Seriya: Psikhologiya = Bulletin of the South Ural State University. Series: Psychology, 18(151), 80–85. (in Russ.).
Chizhova, A. I. (2012). Clinical and psychological aspects of the pathogenesis of somatization neurotic disorders. Vestnik Yuzhno-Ural'skogo gosudarstvennogo universiteta = Bulletin of the South Ural State University, 6, 138–144. (in Russ.).
Elfimova, E. V., & Elfimov, M. A. (2009). Personality and disease: ‘The internal picture of the disease’, quality of life, and adherence to treatment. Zamestitel' glavnogo vracha = Deputy Chief Physician, 11, 18–25. (in Russ.).
Filimonov, A. P. (2011). Attitudes towards the disease in patients with somatization disorders registered in psychiatric and somatic healthcare institutions. Sibirskii vestnik psikhiatrii i narkologii = Siberian Herald of Psychiatry and Addiction Psychiatry, 5(68), 28–30. (in Russ.).
First, M. B., & Fisher, C. E. (2012). Body-integrity identity disorder: The persistent desire to acquire a physical disability. Psychopathology, 45(1), 3–14. doi: http://dx.doi.org/10.1159/000330503
Glazyrina, T. M., Solodkov, A. S., Kulygin, S. V., Yusupov, V. V., & Yatmanov, A. N. (2016). Contribution of the internal picture of the disease and the disease type to the level of neuropsychic adaptation of patients. Uchenye zapiski universiteta imeni P. F. Lesgafta, 6 (136), 218–221. (in Russ.).
Gureje, O., & Reed, G. M. (2016). Bodily distress disorder in ICD-11: problems and prospects. World Psychiatry, 15(3), 291–292. doi: http://dx.doi.org/10.1002/wps.20353
Karvasarskii, B. D. (1990). Neurosis: A manual for physicians (2nd ed.). Moscow: Meditsina. (in Russ.).
Kvasenko, A. V. (1980). A patient’s psychology. Leningrad: Meditsina. (in Russ.).
Lenze, E. J., Miller, A. R., & Munir, Z. B. et al. (1999). Psychiatric symptoms endorsed by somatization disorder patients in a psychiatric clinic. Annals of Clinical Psychiatry, 11(2), 73–79. doi: http://dx.doi.org/10.1023/A:1022342431514
Martin, A., & Rief, W. (2011). Relevance of cognitive and behavioral factors in medically unexplained syndromes and somatoform disorders. Psychiatric Clinics of North America, 34(3), 565–578. doi: http://dx.doi.org/10.1016/j.psc.2011.05.007
Mendelevich, V. D. & Solov’eva, S. L. (2002). Neurosology and psychosomatic medicine. Moscow: MEDpress-inform. (in Russ.).
Merskey, H. (2004). Somatization, hysteria, or incompletely explained symptoms? The Canadian Journal of Psychiatry, 49(10), 649–651. doi: http://dx.doi.org/10.1177/070674370404901001
Mikhailova, I. I., Yastrebov, V. S., & Enikolopov, S. N. (2002). Clinical, psychological, and social factors affecting the stigmatization of patients with mental illness of different nosological groups. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S. S. Korsakov Journal of Neurology and Psychiatry, 7, 58–65. (in Russ.).
Naumova, E. L., Kupriyanova, E. I., & Beloborodova, E. I. (2014). Adaptive coping strategies in patients with irritable bowel syndrome. Sibirskii vestnik psikhiatrii i narkologii (Siberian Herald of Psychiatry and Addiction Psychiatry), 2(83), 62–64. (in Russ.).
Pogosov, A. V., & Bogushevskaya, Yu. V. (2017). Clinical, personal, psychological, social, and demographic factors impeding seeking specialized help by patients with somatization disorders. Sibirskii vestnik psikhiatrii i narkologii = Siberian Herald of Psychiatry and Addiction Psychiatry, 4(97), 22–30. doi: http://dx.doi.org/10.26617/1810-3111-2017-4 (97)-22-30 (in Russ.).
Pogosov, A. V., & Bogushevskaya, Yu. V. (2019). The problem of somatization disorders: Clinic, nonspecialized seeking for medical care, and psycho-education. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva = V. M. Bekhterev Review of Psychiatry and Medical Psychology, 3, 64–72. doi: http://dx.doi.org/10.31363/2313-7053-2019-3-64-72 (in Russ.).
Pogosov, A. V., Laskov, V. B., & Bogushevskaya, Yu. V. (2018). Reasons for unreasonable medical help-seeking among patients with somatization disorders. Nevrologiya, Neiropsikhiatriya, Psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics, 10, 40–45. doi: http://dx.doi.org/10.14412/2074-2711-2018-4-40-45 (in Russ.).
Pohontsch, N. J., Zimmermann, T., Jonas, C., Lehmann, M., Löwe, B., & Scherer, M. (2018). Coding of medically unexplained symptoms and somatoform disorders by general practitioners – an exploratory focus group study. BMS Family Practice, 19, 129. doi: http://dx.doi.org/10.1186/s12875-018-0812-8
Pribytkov, A. A., & Erichev, A. N. (2017). Somatization disorders. Part 2: A technique for cognitive-behavioral psychotherapy. Obozrenie psikhiatrii i meditsinskoi psikhologii = The Bekhterev Review of Psychiatry and Medical Psychology, 2, 10–16. (in Russ.).
Pribytkov, A. A., Yurkova, I. O., & Bazhenova, Yu. B. (2016). Personality structure and psychological defense mechanisms in patients with somatization disorders. Sotsial'naya i klinicheskaya psikhiatriya = Social and Clinical Psychiatry, 26(2), 31–35. (in Russ.).
Rasskazova, E. I. (2013). The influence of impaired cognitive and emotional regulation on the occurrence of somatic symptoms. Voprosy psikhologii, 6, 87a–97. (in Russ.).
Reed, G. M., First, M. B., Kogan, C. S., Hyman, S. E., Gureje, O., Gaebel, W., … Saxena, S. (2019). Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry, 18(1), 3–19. doi: http://dx.doi.org/10.1002/wps.20611
Rupchev, G. E. (2001). The psychological structure of internal bodily experience during somatization: A case of somatization disorders (Doctoral dissertation). Moscow. (in Russ.).
Salkovskis, P. M., Warwick, H. M., Deale, A. C., et al. (2003). Cognitive‐behavioral treatment for severe and persistent health anxiety (hypochondriasis). Brief Treatment and Crisis Intervention, 3(3), 353. doi: http://dx.doi.org/10.1093/brief-treatment/mhg026
Sobennikov, V. S. (2014). Somatization and somatization disorders. Retrieved from https://psychiatr.ru/news/344?pag e=117 (in Russ.)
Tomenson, B., McBeth, J., Chew-Graham, C., MacFarlane, G., Davies, I., Jackson, J. … Creed, F. (2012). Somatization and health anxiety as predictors of health care use. Psychosomatic Medicine, 74(6), 656–664. doi: http://dx.doi.org/10.1097/PSY.0b013e31825cb140
Urvantsev, L. P. (2000). Alexithymia as a factor in psychosomatic diseases. In L. P. Urvantsev (Ed.), Psychology of somatization disorder patients. Yaroslavl: Yaroslavl State University. (in Russ.).
Ushakov, G. K. (1978). Borderline neuropsychiatric disorders. Moscow. (in Russ.).
Vasilenko, T. D., & Mangushev, F. Yu. (2018). Bodily experience and its role in the structure of social frustration in patients with somatization disorders. Psikhologiya. Istoriko-kriticheskie obzory i sovremennye issledovaniya = Psychology. Historical-critical Reviews and Current Researches, 7(2A), 38–45. (in Russ.).
Vasserman, L. I., Iovlev, B. V., Karpova, E. B., & Vuks, A. Ya. (2005). Psychological diagnosis of attitudes towards the disease: A manual for doctors. St. Petersburg: St. Petersburg Bekhterev Psychoneurological Research Institute. (in Russ.).
White, K. S., McDonnell, C. J., & Gervino, E. V. (2011). Alexithymia and anxiety sensitivity in patients with non-cardiac chest pain. Journal of Behavior Therapy and Experimental Psychiatry, 42(4), 432–439. doi: http://dx.doi.org/10.1016/j.jbtep.2011.04.001
Yundalova, T. A., & Nikolaevskaya, A. O. (2017). Characteristics of physicality in patients with neurotic spectrum disorders: A case of somatization disorders. In I. E. Esaulenko (Ed.), Organization of outpatient care in Russia: Issues and prospects for their solution. Proceedings of the inter-university student theoretical and practical conference based on the results of research work (pp. 380–382). Moscow: Pero. (in Russ.).
Aleksandrovskii, Yu. A. (2006). Some key issues of modern border psychiatry. Psikhiatriya i psikhofarmakoterapiya (Psychiatry and Psychopharmacotherapy), 8(2), 4–13. (in Russ.).
Barsky, A. J., Orav, E. J., & Bates, D. W. (2005). Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch. Gen. Psychiatry, 62(8), 903–910. doi: http://dx.doi.org/10.1001/archpsyc.62.8.903
Bobrova, M. A. (2012). Emotional, cognitive, and personality disorders in somatization disorders: Typology, therapy, and prognosis (Doctoral dissertation). Moscow. (in Russ.).
Bryabrina, T. V. (2009). Characteristics of attitudes towards health and disease in young people suffering from somatoform autonomic dysfunction. Vestnik Yuzhno-Ural'skogo gosudarstvennogo universiteta. Seriya: Psikhologiya = Bulletin of the South Ural State University. Series: Psychology, 18(151), 80–85. (in Russ.).
Chizhova, A. I. (2012). Clinical and psychological aspects of the pathogenesis of somatization neurotic disorders. Vestnik Yuzhno-Ural'skogo gosudarstvennogo universiteta = Bulletin of the South Ural State University, 6, 138–144. (in Russ.).
Elfimova, E. V., & Elfimov, M. A. (2009). Personality and disease: ‘The internal picture of the disease’, quality of life, and adherence to treatment. Zamestitel' glavnogo vracha = Deputy Chief Physician, 11, 18–25. (in Russ.).
Filimonov, A. P. (2011). Attitudes towards the disease in patients with somatization disorders registered in psychiatric and somatic healthcare institutions. Sibirskii vestnik psikhiatrii i narkologii = Siberian Herald of Psychiatry and Addiction Psychiatry, 5(68), 28–30. (in Russ.).
First, M. B., & Fisher, C. E. (2012). Body-integrity identity disorder: The persistent desire to acquire a physical disability. Psychopathology, 45(1), 3–14. doi: http://dx.doi.org/10.1159/000330503
Glazyrina, T. M., Solodkov, A. S., Kulygin, S. V., Yusupov, V. V., & Yatmanov, A. N. (2016). Contribution of the internal picture of the disease and the disease type to the level of neuropsychic adaptation of patients. Uchenye zapiski universiteta imeni P. F. Lesgafta, 6 (136), 218–221. (in Russ.).
Gureje, O., & Reed, G. M. (2016). Bodily distress disorder in ICD-11: problems and prospects. World Psychiatry, 15(3), 291–292. doi: http://dx.doi.org/10.1002/wps.20353
Karvasarskii, B. D. (1990). Neurosis: A manual for physicians (2nd ed.). Moscow: Meditsina. (in Russ.).
Kvasenko, A. V. (1980). A patient’s psychology. Leningrad: Meditsina. (in Russ.).
Lenze, E. J., Miller, A. R., & Munir, Z. B. et al. (1999). Psychiatric symptoms endorsed by somatization disorder patients in a psychiatric clinic. Annals of Clinical Psychiatry, 11(2), 73–79. doi: http://dx.doi.org/10.1023/A:1022342431514
Martin, A., & Rief, W. (2011). Relevance of cognitive and behavioral factors in medically unexplained syndromes and somatoform disorders. Psychiatric Clinics of North America, 34(3), 565–578. doi: http://dx.doi.org/10.1016/j.psc.2011.05.007
Mendelevich, V. D. & Solov’eva, S. L. (2002). Neurosology and psychosomatic medicine. Moscow: MEDpress-inform. (in Russ.).
Merskey, H. (2004). Somatization, hysteria, or incompletely explained symptoms? The Canadian Journal of Psychiatry, 49(10), 649–651. doi: http://dx.doi.org/10.1177/070674370404901001
Mikhailova, I. I., Yastrebov, V. S., & Enikolopov, S. N. (2002). Clinical, psychological, and social factors affecting the stigmatization of patients with mental illness of different nosological groups. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S. S. Korsakov Journal of Neurology and Psychiatry, 7, 58–65. (in Russ.).
Naumova, E. L., Kupriyanova, E. I., & Beloborodova, E. I. (2014). Adaptive coping strategies in patients with irritable bowel syndrome. Sibirskii vestnik psikhiatrii i narkologii (Siberian Herald of Psychiatry and Addiction Psychiatry), 2(83), 62–64. (in Russ.).
Pogosov, A. V., & Bogushevskaya, Yu. V. (2017). Clinical, personal, psychological, social, and demographic factors impeding seeking specialized help by patients with somatization disorders. Sibirskii vestnik psikhiatrii i narkologii = Siberian Herald of Psychiatry and Addiction Psychiatry, 4(97), 22–30. doi: http://dx.doi.org/10.26617/1810-3111-2017-4 (97)-22-30 (in Russ.).
Pogosov, A. V., & Bogushevskaya, Yu. V. (2019). The problem of somatization disorders: Clinic, nonspecialized seeking for medical care, and psycho-education. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva = V. M. Bekhterev Review of Psychiatry and Medical Psychology, 3, 64–72. doi: http://dx.doi.org/10.31363/2313-7053-2019-3-64-72 (in Russ.).
Pogosov, A. V., Laskov, V. B., & Bogushevskaya, Yu. V. (2018). Reasons for unreasonable medical help-seeking among patients with somatization disorders. Nevrologiya, Neiropsikhiatriya, Psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics, 10, 40–45. doi: http://dx.doi.org/10.14412/2074-2711-2018-4-40-45 (in Russ.).
Pohontsch, N. J., Zimmermann, T., Jonas, C., Lehmann, M., Löwe, B., & Scherer, M. (2018). Coding of medically unexplained symptoms and somatoform disorders by general practitioners – an exploratory focus group study. BMS Family Practice, 19, 129. doi: http://dx.doi.org/10.1186/s12875-018-0812-8
Pribytkov, A. A., & Erichev, A. N. (2017). Somatization disorders. Part 2: A technique for cognitive-behavioral psychotherapy. Obozrenie psikhiatrii i meditsinskoi psikhologii = The Bekhterev Review of Psychiatry and Medical Psychology, 2, 10–16. (in Russ.).
Pribytkov, A. A., Yurkova, I. O., & Bazhenova, Yu. B. (2016). Personality structure and psychological defense mechanisms in patients with somatization disorders. Sotsial'naya i klinicheskaya psikhiatriya = Social and Clinical Psychiatry, 26(2), 31–35. (in Russ.).
Rasskazova, E. I. (2013). The influence of impaired cognitive and emotional regulation on the occurrence of somatic symptoms. Voprosy psikhologii, 6, 87a–97. (in Russ.).
Reed, G. M., First, M. B., Kogan, C. S., Hyman, S. E., Gureje, O., Gaebel, W., … Saxena, S. (2019). Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry, 18(1), 3–19. doi: http://dx.doi.org/10.1002/wps.20611
Rupchev, G. E. (2001). The psychological structure of internal bodily experience during somatization: A case of somatization disorders (Doctoral dissertation). Moscow. (in Russ.).
Salkovskis, P. M., Warwick, H. M., Deale, A. C., et al. (2003). Cognitive‐behavioral treatment for severe and persistent health anxiety (hypochondriasis). Brief Treatment and Crisis Intervention, 3(3), 353. doi: http://dx.doi.org/10.1093/brief-treatment/mhg026
Sobennikov, V. S. (2014). Somatization and somatization disorders. Retrieved from https://psychiatr.ru/news/344?pag e=117 (in Russ.)
Tomenson, B., McBeth, J., Chew-Graham, C., MacFarlane, G., Davies, I., Jackson, J. … Creed, F. (2012). Somatization and health anxiety as predictors of health care use. Psychosomatic Medicine, 74(6), 656–664. doi: http://dx.doi.org/10.1097/PSY.0b013e31825cb140
Urvantsev, L. P. (2000). Alexithymia as a factor in psychosomatic diseases. In L. P. Urvantsev (Ed.), Psychology of somatization disorder patients. Yaroslavl: Yaroslavl State University. (in Russ.).
Ushakov, G. K. (1978). Borderline neuropsychiatric disorders. Moscow. (in Russ.).
Vasilenko, T. D., & Mangushev, F. Yu. (2018). Bodily experience and its role in the structure of social frustration in patients with somatization disorders. Psikhologiya. Istoriko-kriticheskie obzory i sovremennye issledovaniya = Psychology. Historical-critical Reviews and Current Researches, 7(2A), 38–45. (in Russ.).
Vasserman, L. I., Iovlev, B. V., Karpova, E. B., & Vuks, A. Ya. (2005). Psychological diagnosis of attitudes towards the disease: A manual for doctors. St. Petersburg: St. Petersburg Bekhterev Psychoneurological Research Institute. (in Russ.).
White, K. S., McDonnell, C. J., & Gervino, E. V. (2011). Alexithymia and anxiety sensitivity in patients with non-cardiac chest pain. Journal of Behavior Therapy and Experimental Psychiatry, 42(4), 432–439. doi: http://dx.doi.org/10.1016/j.jbtep.2011.04.001
Yundalova, T. A., & Nikolaevskaya, A. O. (2017). Characteristics of physicality in patients with neurotic spectrum disorders: A case of somatization disorders. In I. E. Esaulenko (Ed.), Organization of outpatient care in Russia: Issues and prospects for their solution. Proceedings of the inter-university student theoretical and practical conference based on the results of research work (pp. 380–382). Moscow: Pero. (in Russ.).