What is a somatic network. What is somatic pathology. Work in the department

Somatic diseases are one of the varieties of psychological disorders, when mental pathology leads to a physiological disease. If you have been diagnosed with "vegetative-vascular dystonia" or any other cause of neurosis, you cannot do without the help of a specialist. Psychosomatic diseases are often found in people who mistakenly are patients of therapists, surgeons, cardiologists. Most often, signs of deviations are inherent in young women, the elderly, people prone to alcohol addiction. Let us consider in more detail what somatic diseases are and how they are treated.

Somatic diseases - what is it?

Somatic disorders or diseases have long been widely known, there are even tables of somatic disorders. These are physical illnesses caused by psychological trauma or disorder. It is quite difficult to distinguish a somatic disease from other diseases, because it happens that a person complains of certain pains and symptoms, although tests and examinations do not confirm this. Often these disorders manifest as problems with appetite, sleep disturbances, problems with sexual function.

Why do such diseases occur?

1. Mind and body are parts of a single system - the failure of one leads to the failure of the other.
2. The accumulation of "entropy" - psychological trauma and mistakes.
3. Strong emotional experiences within oneself.
4. Physiological problems and diseases as prerequisites for the emergence of psychological problems.
5. Strong belief in the presence of the disease.

Considering the cause of the disease, it is important to understand that the psyche and physiology are connected, in fact, they are inseparable. It is necessary to monitor very clearly when a person is sick, and when there is no problem and it is simply imposed. Somatic disorders can only be found and identified by a specialist, and only he can solve them.

Somatic diseases

Let's turn to the reference book of medical diseases ICD-10.

F50.0 Anorexia nervosa

Often, a psychological trauma or problem manifests itself as a denial of nutrition, a decrease in appetite, weight loss. Such a situation is often accompanied by dissatisfaction with one's appearance, low self-esteem, and a slowdown in physiological processes.

F50.2 Bulimia nervosa

With such a violation, uncontrolled eating of large amounts of food occurs. Such attacks are accompanied by a decrease in self-esteem and an attack of guilt.

F51 Sleep disorders of non-organic etiology

F51 Sexual dysfunction

The basis of the diagnosis is the internal subjective feeling experienced by the patient (guilt, anxiety, dissatisfaction, depression). Variants of the disorder can be different: reduced desire, weak arousal, physiological disorders, pain during intercourse, and others.

F45.2 Obsessive (obsessive) hypochondria

It manifests itself as constant doubt and anxiety, constant analysis of current processes. The patient may complain of pain, feeling unwell, abnormalities in his body, which are not actually confirmed. If they are, they are not so serious as to fall under the description of a difficult situation. In other words, a person does not just invent a disease for himself, but believes in its existence, due to which his condition only worsens.

The patient can visit the clinic for years, and the doctors will not be able to find anything. Additionally, in addition, the patient may fall into drug dependence, which is very difficult to eradicate.

When you understand how somatic diseases are expressed, what they are, doubts may have gone that it is actually impossible to treat such problems on your own, only an experienced psychologist-psychotherapist can solve such problems, because it is he who knows what somatic diseases are and how to treat them correctly. can be eliminated.

Treatment of somatic diseases

Treatment of such problems is possible in the following areas:

1. Identification of the root cause of the appearance of a somatic disorder by time frame, if the exacerbation of the disease coincides with the time of experiencing psychological disorders, severe stress, depression.
2. Determination of possible hereditary manifestations in case of similar problems in other family members.
3. Studying the results of analyzes, if available.
4. Work with methods of psychotherapeutic influence to eliminate the consequences of psychological trauma, neuroses and other problems that cause psychosomatic disorders.
5. The work is carried out according to the Pareto method. This means that solving 20% ​​of the main problems will give 80% of the desired result, which will significantly speed up the treatment time and provide significant savings.

It does not matter what problem you are facing - sleep disorder, bulimia, problems in the sexual sphere - the psychologist-psychotherapist will delicately approach the solution of the problem, help to eradicate the manifestations of the disease. If you are little aware of the concept of somatic disease, what it is, or you are trying to recover from a certain disease, although examinations show that everything is fine with your health, then this is the first reason to visit a specialist. So you take the first step from the problem - to the desired health.

In the modern world, the development of many diseases occurs, according to psychologists and scientists, due to psychological trauma, experiences, various negative beliefs and thoughts. Quite often there are situations when there are no physiological prerequisites for the onset of the disease, but the disease progresses. In this case, they begin to talk about somatic disorders. So what is it?

Somatic diseases are bodily diseases, as opposed to mental pathologies. This group includes pathologies that are caused by disruptions in the functioning of internal systems and organs or external influences that do not relate to the mental activity of a person.

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Somatic manifestations lead to the appearance of symptoms of many diseases, the nature of which is influenced by the predisposition of the individual.

Common somatic pathologies include the following diseases:

• Ulcer of the stomach and duodenum. The main cause of this disease is increased nervousness. Overexertion causes an increase in acidity and, as a result, the appearance of an ulcer.
• Neurodermatitis(skin disease) - appears due to depression, the disease is accompanied by skin imperfections, nervousness, severe itching.
• Bronchial asthma- can be caused by strong feelings. Affecting the heart, stress causes an attack of suffocation.
• Ulcerative colitis- Nervous disorders and stress are common causes of the disease.
• Rheumatoid arthritis- most often appears due to mental disorders, nervous strain, resulting in symptoms of joint disease.
• Essential (chronic) hypertension- appears due to overload of nervous activity.

Less commonly, somatic diseases contribute to the development of:

• Diabetes.
• Ischemic myocardial disease.
• Somatoform behavioral disorders.

Causes

The basis of somatic personality disorders is the body's reaction to stressful situations that provoke disturbances in the functioning of internal organs.

The reason for the development of such conditions is emotional stress caused by:

• conflicts;
• increased nervousness;
• anger;
• discontent;
• anxiety;
• fear.

Symptoms

It is quite difficult to recognize somatization, often in such a condition the patient complains of pain in the body, but as a result of the examination, there are no causes for the onset of symptoms. The most common symptoms of somatic diseases are:

Appetite disorder

Such disorders can look like a complete lack of appetite, or an increased feeling of hunger. Often they are caused by depression, stress. Most neuroses are accompanied by loss of appetite. Some diseases manifest themselves in a complex in one person. For example, bulimia and anorexia.

If the patient suffers from anorexia nervosa, then he may refuse to eat, sometimes feel disgust for it, while the body's need for food will remain. Bulimia is characterized by uncontrolled consumption of large amounts of food and can be a cause of obesity. In some cases, pathology entails weight loss. This happens when a person, feeling hostility towards himself due to neurosis, begins to drink laxatives and induce vomiting.

Sleep disturbance

One of the most common symptoms of a mental disorder is insomnia. Basically, it appears due to internal experiences. In this case, the patient cannot fall asleep, trying to make the right decision and find a way out of a difficult situation. In the morning, a person wakes up irritable and tired. Insomnia is often observed in neuroses.

Neurasthenia is characterized by the sensitivity of sleep: a person is asleep, but even a small sound wakes him up, after which he cannot fall asleep.

Pain syndrome

With somatic disorders, the patient complains of pain in the organ that is most vulnerable to him.

Depression is often accompanied by unpleasant, stabbing sensations in the heart, which may be accompanied by anxiety and fears.

A headache that is psychogenic in origin may occur due to tension in the muscles of the neck. Hysteria or self-hypnosis also lead to headaches.

Some stressful situations provoke the occurrence of severe pain in the back of the head, the patient feels pain radiating to the shoulders. Such conditions often haunt anxious and suspicious people.

Disorders of sexual function

There are several libido disorders. These include: excessively increased or decreased sexual desire, pain during intercourse, lack of orgasm.

Psychological factors lead to such disorders, among them - prolonged abstinence, low self-esteem, lack of a permanent partner, fear, unconscious disgust.

Assessment of risk factors

Most often, somatic diseases develop in adolescence and rarely in those over 30. In most cases, disorders occur in women, and the risk of their occurrence is higher for those who have a family history of a similar pathology, drug or drug addiction, and antisocial personality disorders.

In addition, suspicious people and those who are engaged in mental work or are constantly in a state of stress are prone to somatic diseases.

How to treat

Treatment of somatic diseases is carried out both on an outpatient basis and in a hospital. Staying in stationary conditions is indicated at the stage of acute manifestation of psychomatosis, after which a recovery period begins. Great importance is given to work with the patient, which will facilitate the neuropsychiatric factors in the development of the disease.

Of the drugs, preference is given to those that are needed to treat the disease that has appeared. In parallel with taking medications, psychotherapeutic therapy is performed in order to influence the mechanism of the development of the disease and its provoking factors. To calm down, antidepressants or tranquilizers are prescribed.

The use of folk remedies is considered as an addition to the main methods of treatment. Most often, the doctor prescribes plant extracts and herbs that will help in the treatment of a certain disease that has arisen (for example, cabbage juice for stomach ulcers, calendula decoction for hypertension).

In children

The most common physical disorder that can create difficulties for a child's emotional, mental, and physical development is neuropathy. This is a severe violation of congenital etiology, that is, that appeared during fetal development or during childbirth.

Causes of neuropathy can be:

• Prolonged toxicosis in the mother.
• Pathological development of pregnancy, which leads to the threat of miscarriage.
• Stress of the expectant mother during the period of expectation of the child.

Signs of childhood neuropathy are:

• Emotional instability- a tendency to anxiety, emotional disorders, irritable weakness, rapid onset of affects.
• Sleep disturbance in the form of night terrors, difficulty falling asleep, refusal to sleep during the day.
• Vegetative dystonia(a disorder of the nervous system that regulates the functioning of internal organs). It is expressed in a variety of disorders in the work of internal organs: dizziness, difficulty breathing, gastrointestinal disorders, nausea, etc. At school and preschool age in children with difficulties in adapting to a children's institution, somatic reactions are often observed in the form of pressure fluctuations, headaches, vomiting, etc.
• Metabolic disorders, a tendency to allergic reactions with various manifestations, increased sensitivity to infections. Scientists suggest that allergies in boys and reduced appetite are associated with internal tension and emotional dissatisfaction of the mother with family life during the period of bearing a child.
• Minimal brain weakness. It manifests itself in the increased sensitivity of the child to external influences: bright light, noise, stuffiness, travel by transport, weather changes.
• General somatic disorder, decrease in the body's immune forces. The child often suffers from acute respiratory viral infections, acute respiratory infections, gastrointestinal diseases, diseases of the respiratory system, etc. In this case, the disease can begin with a strong emotional experience associated, for example, with separation from loved ones, difficulties in adapting to a preschool institution. In the development of such a condition, a significant role is played by the general condition of the mother during pregnancy, especially poor emotional well-being, sleep disturbance, severe overwork.
• Psychomotor disorders(stuttering, tics, involuntary urination during night and daytime sleep). Such disorders most often disappear with age and have only a seasonal dependence, aggravating in autumn and spring.

The first signs of neuropathy are diagnosed already in the first year of a child's life, they appear:

• frequent regurgitation;
• restless sleep;
• temperature fluctuations;
• rolling when crying.

Neuropathy is only a basic pathogenic factor, against which a decrease in the overall activity of the child, including mental activity, may appear. As a result, psychophysical maturation slows down, which negatively affects mental development, adaptation to social realities, personality changes (a child can become completely dependent on others, lose interest in life, and so on).

With the timely organization of health-improving, restorative measures, including a favorable psychological atmosphere, over time, the signs of neuropathy decrease and disappear. In case of unfavorable circumstances, pathology becomes the basis for the development of chronic somatic diseases, psycho-organic syndrome.

In schizophrenia, despite the relatively frequent complaints of patients about their poor somatic condition, the psychopathological symptoms of acute psychosis: delusions and hallucinations, psychomotor agitation usually come to the fore in the clinical picture of the disease.

At the stage of remission formation, traditionally, attention is paid to the remnants of productive symptoms, signs of negative manifestations, and neurocognitive deficits. Somewhat more often they talk about somatic pathology within the framework of hypochondriacal symptoms, "", its residual form.

The somatic syndrome usually does not dominate even in the initial states. It is not observed where it is not possible to detect a noticeable movement of psychopathological symptoms. (Goldenberg S.I., Gofshtein M.K., 1940).

At the same time, among patients with schizophrenia, regardless of whether they take psychotropic drugs or not, more often than in the general population, there are symptoms of somatic diseases: cardiovascular disorders, obesity, type 2 diabetes mellitus and some oncological pathology.

Absolutely comorbid schizophrenia somatic diseases

1. Lipid metabolism disorders
2. Diseases of the cardiovascular system

Relatively comorbid schizophrenia, somatic and infectious diseases

1. Osteoporosis
2. Dental diseases
3. Inflammation of the lungs and chronic bronchitis
4. Hyperprolactinemia
5. Thyroid diseases
6. Diabetes
7. Metabolic syndrome (hyperlipedemia)
8. Polydipsia
9. Skin pigmentation
10. Tuberculosis
11. Hepatitis B
12. Hepatitis C
13. Acquired immunodeficiency syndrome (AIDS)

Somatic diseases rarely seen in schizophrenia

• Rheumatoid arthritis
• Bronchial asthma
• Peptic ulcer of the duodenum
• Prostate cancer

Mortality in schizophrenia is twice that of the general population. This fact is clearly noticeable at the age of 20 - 40 years. The average life expectancy of a patient with schizophrenia is 20% shorter than that of a person who does not suffer from this pathology.

Somato-neurological causes of death in patients with schizophrenia

1. Diseases of the endocrine system (diabetes mellitus)
2. Vascular diseases of the brain
3. Heart diseases
4. Seizures
5. Cancers (especially throat cancer)
6. Respiratory diseases (pneumonia)

Among the somatic causes of death, cardiovascular diseases and cancer are recorded in 60% of cases. Recall that according to some authors, suicides and accidents are often recorded among unnatural causes of death in schizophrenia.

Schizophrenia significantly reduces the quality of life and the ability to adapt patients with somatic pathology, complicates it and the outcome, increases the risk of mortality. Inadequate behavior of patients, anosognosia, refusal to take medications contribute to the appearance of somatic diseases (Smulevich A.B., 2007).

Within the framework of “psychotic abnormal behavior in illness” (Pilovs-ki L., 1994), in the presence of a comorbid pathology of schizophrenia with somatic pathology, one can speak of “hypergnosic and hypognosic nosogenic reactions” (Smulevich A.B., 2007). "Hypergnosic reactions" are divided into hypochondriacal ("coenostopathic", variants of overvalued hypochondria with a kind of "cult of the disease"), depressive and "paranoid" (nonsense "other" illness, sensitive, paranoia of invention). "Hypoanosognosic nosogenic reactions" include: pathological denial of the disease, "euphoria with pseudodementia", "paranoid reactions with delusions of the attributed disease".

In the presence of overvalued hypochondria in the clinical picture of the disease, heteronomous "bodily sensations" (Glatzel J.) are observed in the form of senestopathies and "bodily fantasies".

Depressive reactions, which occur in almost half of patients with schizophrenia, acquire an atypical character and transform into prolonged hypochondriacal depression.

In the delusion of a “different” disease, patients are convinced that they are not being treated for the disease that they actually suffer from; in the delusion of invention, patients develop strange methods of treatment on their own; doctors, being “in collusion with enemies”, attribute a non-existent disease in order to exclude them from active life and the struggle for justice. The most severe nosogenic reactions include hyponosognosia with features of pathological denial of the disease: patients refuse hospitalization even in the presence of a life-threatening situation, show signs of inadequate euphoria (Smulevich A.B., 2007).

Many patients with schizophrenia suffering from comorbid somatic pathology often do not come into view at all. So, according to A.B. Smulevich (2007), only a third of such patients at least once turned to a psychiatrist and only 20% received specialized care in a neuropsychiatric dispensary. At the same time, speaking about these figures, one cannot exclude the overdiagnosis of schizophrenia, since other mental disorders are traditionally referred to as “sluggish” and “latent” schizophrenia in Russian psychiatry.

A fairly complete review of the current state of the problem of the relationship between somatic diseases and schizophrenia is presented in the monograph by S. Leucht et al. (2007).

Appearance

Patients with schizophrenia are most often untidy, reduced nutrition in case of a negative attitude to antipsychotic therapy and increased when taking them.

The skin tends to be pale, there is lethargy and relaxation of the muscles.

With persistent hallucinations that have existed for years, boils and traces of acne are often found on the skin of patients.

They wrote that the fifth finger of the hand of a patient with schizophrenia seemed to be bent inward, and the third toe was longer than the second. However, no significant correlations of these external structural features of the skull and limbs with the symptoms of schizophrenia were found.

There was also a decrease in facial expression of the upper part of the face, dissociation of the top and bottom of the face with productive symptoms, asymmetry of the right and left halves of the face - with negative ones.

Patients smile unusually, turning their faces away, and making the smile strained. All these are somatic disorders, manifested in the appearance of patients with schizophrenia.

Cardiovascular disorders

In schizophrenia, there are somatic disorders such as disorders of the cardiovascular system. They can manifest themselves in painful sensations in the region of the heart, a decrease or instability of blood pressure, some symptoms of a fall in cardiac activity, its insufficiency: increased heart rate, pallor of the skin, acrocyanosis, fainting.

Some researchers wrote that in patients with schizophrenia, the cardiovascular system was initially underdeveloped, the borders of the heart were somewhat reduced, and the heart sounds were deaf. M.D. Pyatov (1966) spoke of "congenital hypoplasia of the heart and great vessels".

In schizophrenia, the difference in blood pressure in the temporal arteries or the arteries of the bottom of the eye and forearm, as well as the dissociation of the response of these vessels to emotional and pharmacological stimuli, was noted. Changes in blood pressure were found: its asymmetry between the right and left sides, hypotension, less often hypertension, often dissociation of pressure in the vessels of the brain with the presence of partial cerebral hypertension, especially in catatonia.

Patients with schizophrenia are prone to tachycardia, which is probably the result of arousal or increased activity of the adrenergic system.

These observations partly agreed with data on the insufficiency or, more precisely, the perversion of the reaction of the adrenal system of patients to psychogenic and pharmacological stimuli.

In recent years, many psychiatrists have begun to talk about the relatively high risk of death in patients with schizophrenia due to cardiovascular pathology (Broun S. et al., 2000; Osby U. et al., 2000).

A number of antipsychotics negatively affect the activity of the heart, disrupting the conduction of the heart muscle, prolonging the QTc interval, causing ventricular arrhythmia and increasing blood clotting. The ability of some of them, for example, clozapine, to cause myocarditis is well known.

An important factor in the prevention of cardiovascular disease in schizophrenia, many psychiatrists consider between the patient and the attending physician.

Hypertonic disease

According to Canadian scientists, the proportion of people with hypertension in schizophrenia is 13.7%, in many respects similar data were obtained in an epidemiological study of patients in the general medical network, conducted by domestic researchers (Kozyrev V.N., 2002; Smulevich A.B. et al., 2005).

In other studies, it was found that 34.1% of patients with schizophrenia have a diagnosis of hypertension (Dixon L. et al., 1999). However, earlier M.D. Pyatov (1966) in his study showed that the combination of schizophrenia with hypertension is rare and amounts to only 2.65%. A similar point of view is shared by H. Schwalb (1975) and T. Steinert et al. (1996), who believe that cases of vascular hypertension in schizophrenia are relatively rare. According to some authors, hypotension in schizophrenia is due to the effect of antipsychotics, many of which affect alpha and muscarinic receptors.

Probably, this spread of statistics reflects the same old question about the boundaries of schizophrenia and its diagnostic criteria. According to A.B. Smulevich et al. (2005), the difference in data regarding the prevalence of arterial hypertension is due to the contingent that falls into the field of view of researchers.

It should be borne in mind that such well-known risk factors for the occurrence of diseases of the cardiovascular system, such as smoking, diabetes, a sedentary lifestyle, impaired fat metabolism, are quite common in patients with schizophrenia, which undoubtedly contributes to the development of this pathology.

In patients with schizophrenia treated in psychiatric hospitals, arterial hypertension is more malignant, and on an outpatient basis, its course is easier.

We support the point of view of those authors who consider the combination of hypertension with schizophrenia to be a relatively rare occurrence. In our opinion, this is to some extent due to the psychosomatic nature of hypertension, which, for reasons that are not entirely clear, is not so typical of schizophrenia, neither in terms of hereditary predisposition, nor in terms of the pathogenesis of the disease. However, in this case, we again turn to the topic of the boundaries of schizophrenia and its differences from affective disorders.

If there is a combination of schizophrenia and hypertension, then the dynamics of the schizophrenic process, the course of hypertension and the expected outcome of the disease are often unpredictable.

According to some authors, the schizophrenic process here acquires a clearly more favorable course, with the mitigation of the main psychopathological symptoms, with the possibility of long-term remissions, especially in those cases where hypertension joins a long-standing process. A different picture is observed when schizophrenia and hypertension began almost simultaneously or when the latter preceded the former. Here, the course of schizophrenia acquires a noticeably accelerated course, and its symptoms become pronounced. (Bathshchikov V.M., Nevzorova T.A., 1962).

Atherosclerosis

When schizophrenia is combined with a cardiovascular disease such as atherosclerosis, mental illness predominates. Against the background of atherosclerosis, there is an introduction of age-related themes of delirium, a kind of poverty of the delusional system. Disorders of perception become less legible, their individual affiliation is lost, and the phenomena of mental automatism are simplified.

The influence of the vascular factor is reflected in an increase in excitability, irritability, and a tendency to affective outbursts. The low mood is accompanied by weakness, tearfulness, dull headaches, superficiality due to rapid exhaustion. The instability of emotions is combined with impulsiveness. The symptoms of the defect appear against an asthenic background, there is a surprising combination of inactivity with an inability to mobilize and fussy hyperactivity. Cynicism and emotional coldness are combined with the appearance of exaggerated courtesy and condescension (Valeeva A.M., 2000).

The most pronounced effect of vascular pathology is noticeable in periodically relapsing schizophrenia.

Signs of vascular disease are more pronounced during bouts of psychosis than in remission. Identified memory impairment, short-term episodes of delirium. With the addition of vascular pathology, schizophrenia attacks become protracted, and the quality of remissions deteriorates. When symptoms of vascular disorders can be interpreted in a delusional way. Patients claim that dizziness, headaches, pains in the heart arise as a result of exposure (Morozova VD, 2000).

Coronary artery disease

In accordance with the results of domestic researchers (Neznanov N.G. et al., 1995; Smulevich A.B. et al., 2005), a significant impact on the development of coronary heart disease, along with a number of traditional factors (hyperlipedemia, smoking and other risks ), have features of the course of schizophrenia and its clinical manifestations. However, according to R. Filik et al. (2006), although angina is more common in schizophrenia than in the general population, these differences are not statistically significant.

According to O.V. Ryzhkova (1999), in patients with schizophrenia, a relatively high mortality rate from coronary heart disease was noted, due to the unfavorable dynamics of this pathology. The latter is usually associated with hyperlipidemia, which occurs in 18-51% of cases in schizophrenia (Bellinier T. et al., 2001). In patients with schizophrenia, men with coronary heart disease, the risk of death increases by almost 4 times (Smulevich A.B., 2007).

People with schizophrenia have an increased risk of developing thrombosis, a thromboembolic lesion of the venous system, usually manifested in the form of deep vein thrombosis of the lower leg or pulmonary thrombosis. Thromboembolic disease of arterial vessels can lead to the development of stroke and heart attack.

endocrine disorders

In schizophrenia, changes in the endocrine system, starting from the first stages of the study of this mental disorder, have always been in the focus of attention.

At one time I.V. Lysakovsky (1925) found in schizophrenia microscopic changes in the tissues of the thyroid gland, adrenal glands, pituitary gland and gonads. According to V.S. Beletsky (1926), in 70% of cases with schizophrenia, depletion of the adrenal cortex in lipoids is detected, and at the same time, a decrease in their concentration in the brain tissues can be recorded.

V.P. Osipov (1931), V.P. Protopopov (1946) attributed schizophrenia to "pluriglandular psychoses", believing that patients with schizophrenia have a congenital inferiority of the endocrine system.

In 1932, R. Gjessing put forward a hypothesis, according to which in patients with schizophrenia there is a relationship between the violation of basic metabolism and nitrogen balance and the state of the functional activity of the thyroid gland. Somewhat later, M. Reiss et al. (1958) came to the conclusion that in patients with schizophrenia, the sensitivity of organs to the effects of thyroid hormones is significantly reduced. At the same time, the brain tissue of patients with schizophrenia showed reduced sensitivity to thyroid-stimulating hormones of the pituitary gland.

M. Bleuler (1954) did a lot for the endocrinology of schizophrenia. His monograph "Endocrinological Psychiatry" at one time gained wide popularity among psychiatrists. The author conducted a parallel study of endocrine disorders in psychosis and other mental disorders. M. Bleuler paid special attention to the dynamics of endocrine disorders in schizophrenia, the dependence of their severity on premorbid personality traits, the state of the affective sphere of patients and the nature of drives.

In the second half of the twentieth century, most researchers of schizophrenia were inclined to deny the importance of hormonal disorders in the genesis of this mental disorder. An important argument for this was the numerous statistical data showing that severe endocrine diseases are not necessarily accompanied by severe mental disorders.

According to I.A. Polishchuk (1963), endocrine disorders in inpatients with schizophrenia in the 60s were detected only in 1.1% of cases, in outpatient practice they were found in 50% of patients suffering from this disease (Skanavi E.E., 1964).

A.I. Belkin (1960) put forward a hypothesis about the pronounced effect of thyroid dysfunction on the clinical picture and the course of schizophrenia. The author believed that if its manifestation is accompanied by symptoms of thyrotoxicosis, then the course of the disease will be more favorable. In hypothyroidism, the clinical picture of schizophrenia was distinguished by the severity of psychopathological symptoms and noticeable personality disorders.

A.G. Androsov (1970) singled out three types of syndromes in schizophrenia: hypogenitalism, diencephalic-endocrine and pluriglandular disorders. At the same time, emphasizing that in the last two cases, the course of schizophrenia becomes more malignant. Against the background of hypogenitalism, schizophrenia also proceeded more unfavorably and was characterized by severe disorders of the autonomic nervous system.

A large number of researchers of endocrine disorders occurring in schizophrenia believed that an important role in their genesis is played by a violation of the functional activity of the diencephalic structures of the brain (Grashchenkov N.I., 1957; Orlovskaya D.D., 1966; Belkin A.I., 1973, and etc.).

Numerous studies have shown that most of the parameters of the activity of various endocrine organs in schizophrenia are important to evaluate in dynamics, and also useload tests, allowing to identify the insufficiency of the functional activity of a particular department of the hormonal system. Moreover, when testing the activity of the endocrine organs, the stimuli should be adequate as physiological activators of the endocrine glands, preferably simultaneously and in different directions influencing them according to the mechanism of their effect.

The use of various stress tests in schizophrenia is justified due to the fact that transient, rudimentary and polymorphic disorders of the functional activity of the endocrine glands usually dominate in schizophrenia.

An analysis was made of the hormonal parameters of the sympathetic-adrenal system (adrenaline and norepinephrine) and the apparatus associated with insulin metabolism.

As you know, one of the catecholamines - adrenaline - reflects the state of the adrenal - hormonal link; the other - norepinephrine - sympathetic - transmission. Estimation of the level of insulin in this case makes it possible to obtain information about the function of the apparatus of the pancreatic islet that produces insulin (Genes G., 1970).

Research results of V.M. Morkovkina and A.V. Kartelishcheva (1988) showed that the endogenous concentration of adrenaline in the blood during an acute attack of schizophrenia as a percentage differs little from the norm, but the content of norepinephrine increases markedly.

In patients with schizophrenia, a decrease in the blood content of adrenaline was noted, in contrast to its increase in healthy individuals one hour after insulin injection. At the same time, there was a lack of decrease in indicators in patients, which is usual for the control group of healthy individuals, by the end of the study against the background of glucose administration. The dynamics of the content of norepinephrine in the blood in schizophrenia differed very sharply from the norm, and the nature of the curve had a qualitative discrepancy with the control at the end of the test. There was a decrease of 50% in indicators instead of their usual stabilization.

Based on the data obtained, the researchers concluded that in the blood of patients with schizophrenia during an acute episode of psychosis, there is an increase in the activity of the sympathetic-adrenal system.

The authors suggested using this test for differential from bipolar affective disorder, since they assumed that schizophrenia is characterized by an increase in the level of norepinephrine in the blood, and adrenaline is characteristic of bipolar affective disorder. With both psychoses, the totality of adrenaline and noradrenaline values ​​turned out to be above the norm.

In general, in patients with bipolar affective disorder, the total activity of the sympathetic-adrenal system is higher than in schizophrenia. The adrenaline / norepinephrine ratio at the same time provides an opportunity to assess the nature of the balance between the activity of the adrenal and sympathetic departments of the neuroendocrine system (Knyazev Yu.A. et al., 1972).

In schizophrenia, there is a pronounced shift in the activity of the sympathetic-adrenal system towards the sympathetic link, which indicates the presence in the acute phase of the disease of dissociation between mediators of the nervous system and hormones. The degree of dissociation decreases by the end of the load test, when carbohydrate metabolism disorders are detected: a decrease in glucose utilization, a combination of hyperglycogenosynthesis with hyperglycolysis.

Many researchers of hormonal activity in schizophrenia noted the existence of a relationship between the level of 17-ketosteroids and the mental state of patients with schizophrenia, the higher the level of these hormones, the more pronounced the excitation of patients.

Most often, in schizophrenia, such “through” manifestations of endocrine system dysfunction as hirsutism, obesity, and infantilism are detected.

According to G.M. Rudenko (1969), obesity and hirsutism can be detected in various forms of schizophrenia, especially at the stage of the manifest period of the disease.

Diseases of the endocrine system in schizophrenia

• Hyperprolactinemia
• Diabetes
• hirsutism
• Obesity
• Infantilism

The syndrome of infantilism manifests itself in schizophrenia, usually under the age of 15 years, obesity syndrome - at the age of 16-20 years, and hirsutism in patients with distinct affective disorders who fell ill after 20-25 years.

Recent data indicate a high prevalence of diabetes mellitus in patients with schizophrenia. Information is provided on a threefold excess of the occurrence of this pathology in patients with schizophrenia compared with the corresponding indicators in the general population. Even more often, 42-65% of patients with schizophrenia are diagnosed with hyperprolactinemia, which may partly be due to the use of psychotropic drugs. Hyperprolactinemia, in turn, leads to the development of hypogonadism in men, persistent galactorrhea, amenorrhea in women, and contributes to the formation of endometrial, breast and prostate cancer (Drobizhev M.Yu., et al., 2006).

Schizophrenia in patients with pathology of the endocrine system is often characterized, as well as the relative frequency of occurrence of its atypical manifestations. In the clinical picture of the disease, hypothalamic disorders, senesto-hypochondriac symptoms are noted (Orlovskaya D.D., 1974).

Recent studies of the hormonal background in schizophrenia have shown correlations between blood levels of testosterone, gonadotropins, prolactin and the severity of negative symptoms in men with schizophrenia (Akhondzadeh S., 2006).

Studies by J. Kulkarni and A. De Castella (2002) revealed the dependence of the level of psychotic symptoms on the estrogenic background. The authors also noted that the dynamics of psychosis is more favorable in combination therapy with antipsychotics and estrogens.

Schizophrenia is often combined with severe osteoporosis. Some researchers associate this phenomenon with hypoestrogenism, but the final mechanism of osteoporosis in schizophrenia should be recognized as unclear.

Gastrointestinal disorders

Many psychiatrists have drawn attention to the frequent combination of schizophrenia, especially including catatonic symptoms, with gastrointestinal disorders.

It was noted that patients in this case complain of pain in the region of one or another segment of the gastrointestinal tract, often with pain radiating to other organs of the abdominal and thoracic cavities.

Psychiatrists noted in patients with schizophrenia complaints of nausea, intolerance to a particular type of food, discomfort in the mouth.

Among doctors, it is well known that patients with schizophrenia, along with complaints of pain, also often note peculiar sensations in the gastrointestinal tract, reminiscent of the descriptions of senestopathy: “tension”, “contraction”, “burning”, “heaviness”, “cold” and others

Some domestic psychiatrists noted the “spasm phenomenon” of the intestine in schizophrenia, drawing an analogy with the symptoms of catatonia and considering this spasm as a somatic manifestation of the latter (Goldenberg S.I., Gofshtein M.K., 1940).

In our practice, we have noticed that gastrointestinal disorders in schizophrenia are often combined with generalized symptoms of dysfunction of the autonomic nervous system. Sweating, dizziness, fainting, chilliness are typical complaints of such patients. In the clinical picture of patients prone to gastrointestinal disorders, various vasomotor disorders are also recorded in the form of acrocyanosis, blanching and coldness of the extremities.

At the same time, with a history of schizophrenia, sometimes before the onset of psychosis, liver diseases and gastrointestinal disorders may be noted, indicating the presence of toxicosis.

Comparatively often, patients with sluggish schizophrenia complain of pain of a different nature in the stomach or intestines. Clinicians often suspect peptic ulcer of the stomach and duodenum. In some cases, patients are diagnosed with "cholecystitis", "hepatitis", "duodenitis". However, almost always this diagnosis is accompanied by a diagnosis concerning one or another degree of severity of dysfunction of the autonomic nervous system.

The group of patients with schizophrenia who complain of pain in the intestinal region often resembles those patients who have mild hemorrhagic disorders.

The focus of attention of many researchers in the early and mid-twentieth century was the study of intestinal diseases in schizophrenia, it was assumed that the latter play an important role in the etiology of this mental disorder. In the 1970s, interest in this topic revived in connection with the hypothesis of the involvement of gluten in the pathogenesis of schizophrenia. Based on this hypothesis, a diet therapy was proposed, specially designed for patients with schizophrenia, providing for the restriction of cereals and milk (Dochan F., Grasberg J., 1973). However, later studies aimed at detecting antibodies to reticulin in patients with schizophrenia refuted the hypothesis of the etiological significance of intestinal disorders in the genesis of schizophrenia (Lambert M. et al., 1989). At the same time, there are statements in the literature that a gluten-free diet significantly improves the mental state of young children with autism and that children with schizophrenia are prone to various intestinal diseases (Perisic V. et al., 1990).

According to H. Ewald et al. (2001) in patients with schizophrenia, cases of appendicitis are slightly less common than in the general population, which, according to the authors, is associated with a number of factors, including a genetic predisposition to these diseases, features of antipsychotic therapy, and lifestyle of patients.

Peptic ulcer in schizophrenia is relatively rare and, according to some authors, is recorded in only 2.69% of cases, which is almost 5 times higher than the prevalence of peptic ulcer in the general population (Heinterhuber H., Lochenegg L., 1975). It has been suggested that the low activity of the hypothalamus in schizophrenia to some extent excludes the influence of stress on the formation of gastric and duodenal ulcers. In our opinion, the presence of a certain antagonism between the predisposition to certain psychosomatic diseases, for example, to bronchial asthma or peptic ulcer, and the etiopathogenesis of schizophrenia cannot be ruled out here either. It should be noted that earlier some authors cited statistical information indicating approximately the same prevalence of peptic ulcer in schizophrenia and among the population of the general population (Hussar A., ​​1968).

Respiratory diseases

According to many clinicians, respiratory diseases are relatively common in schizophrenia and are one of the reasons for the shorter life expectancy of patients.

Among patients suffering from schizophrenia, the fact of a high prevalence of pulmonary tuberculosis is known (Ozeretskovsky D.S., 1962).

In the presence of tuberculosis in patients suffering from schizophrenia, the dynamics of the condition of patients depends on exacerbations of these diseases, as a rule, increasing the rate of increase in symptoms (Orudzhev Ya.S., Zubova E.Yu., 2000).

In our practice, we rarely met among patients with schizophrenia people suffering from bronchial asthma. Probably, the classic psychosomatic disease, which is bronchial asthma, has a different genetic background than schizophrenia.

In patients with schizophrenia, risk factors for the development of bronchopulmonary pathology, in particular, smoking, are identified. In addition, the neuronal connection between the brain centers of respiration, fear and the autonomic nervous system explains the occurrence of complex disorders of the respiratory system and the mental sphere. Abnormal breathing reflexively affects behavioral disorders, reveals a relationship with disorders of the central nervous system function. Hyperventilation is often accompanied by pain and senestopathies, anxiety and restlessness. Hypoxia enhances the severity of cognitive impairment.

Schizophrenia often complicates the treatment of respiratory diseases. In patients with a long course of the disease, reactivity may be reduced, which leads to mild symptoms of pneumonia, and immunodeficiency states contribute to its unfavorable course. All of the above requires special attention of the doctor to the state of the respiratory system of a patient with schizophrenia.

Musculoskeletal disorders

Osteoporosis is a bone disease characterized by a decrease in bone density due to a decrease in the content of minerals in it. Osteoporosis usually makes itself felt after menopause. The literature describes cases of so-called secondary osteoporosis, which develops as a result of taking certain medications. Prolactinemia, developed as a result of taking antipsychotics, plays a role in the development of osteoporosis in patients with schizophrenia. It is assumed that as a result of estrogen deficiency in women, osteoporosis can also develop, and hypogonadism is considered a risk factor for this pathology. Decreased testosterone levels lead to osteopenia. Despite the fact that androgens play a role in the development of osteoporosis, the latter is much more common in women than in men.

Some authors believe that osteoporosis partly develops in patients with schizophrenia due to an increase in negative symptoms and a sedentary lifestyle. In addition, in the genesis of osteoporosis, one can assume the influence of polydipsia (impaired electrolyte balance), increased activity of interleukins, frequent alcohol intake, smoking, and dietary disorders (lack of vitamins).

Oncological diseases

The first studies on the prevalence of cancer among patients with schizophrenia appeared at the beginning of the 20th century. In the 1970s, it was generally accepted that people with schizophrenia were not susceptible to cancer as a somatic disorder.

Recent studies by Israeli scientists have again shown a low incidence of neoplasm, regardless of its location, among patients with schizophrenia (Barac Y. et al., 2005). It has been suggested that even at the genetic level there is an antagonism between schizophrenia and oncological pathology (Grinshpoon A., et.al., 2005).

Later, there were reports that significant differences in the prevalence of cancer among patients with schizophrenia and healthy individuals could not be identified (Dalton S. et al., 2005). Some authors have suggested a higher percentage of oncological diseases in schizophrenia.

In recent years, it seems that some oncological diseases, especially in men (cancer of the prostate or rectum), are really rare in schizophrenia, for other oncological pathologies, the combination with schizophrenia does not differ significantly from the situation that develops on this issue in the general population. . The opposite point of view has also been registered; so, in particular, in the presence of smoking in men suffering from schizophrenia, cancer of the larynx is more often recorded, in women, uterine cancer and breast cancer are more often noted (Grinshpoon A. et al., 2001).

Australian scientists noted that in the case of cancer in patients with schizophrenia, the course of oncological disease is extremely unfavorable and the mortality rate is increased (Lawrence D. et al., 2000).

Among the factors hindering the development of oncological pathology in patients with schizophrenia are: early detection of precancerous diseases due to more frequent hospitalizations in a psychiatric clinic, a decrease in the number of carcinogens, less exposure to the sun due to more indoor exposure, the use of phenothiazines, according to some authors preventing the development of cancer. On the contrary, the factors contributing to the occurrence of neoplasms include: decreased sexual activity (breast cancer and cervical cancer), an increase in prolactin levels due to treatment with certain antipsychotics (breast cancer).

An analysis of the literature on the problem of the relationship between oncological diseases and schizophrenia allows us to conclude that, despite the fact that for some types of cancer the probability of its occurrence in schizophrenia is quite small, for others, on the contrary, it is increased. In addition, the unfavorable course of neoplasm when it occurs in patients with schizophrenia, as well as a high mortality rate, seems to be a fairly characteristic feature of the combination of these diseases.

Sexual disorders

Sexual dysfunction in schizophrenia occurs in 50% of men and 30% of women. This somatic pathology may be due to the social influence of the disease, the peculiarities of its symptoms, impaired activity of neurotransmitters and the influence of drugs (antidopaminergic, anticholinergic, antiadrenergic, antihistamine effects).

The existence of a large number of factors influencing human sexual activity, including the diverse effects of antipsychotics, is confirmed by the fact that in some patients antipsychotics improve sexual function, comparable to the period when they were already ill, but not yet treated. In other patients, antipsychotics may cause sexual dysfunction, even if there is a fairly good remission of the disease.

In the majority of patients with schizophrenia taking classical antipsychotics, sexual disorders are observed in almost 45% of cases, while in the general population they are recorded in only 17% of people (Smith S. et al., 2002). In the mechanism of development of sexual disorders that have developed in the process, the main role is played by the sedative effect of drugs and an increase in prolactin levels, the latter is especially significant for women with schizophrenia.

D. Aizenberg et al. (1995) conducted a comparative study aimed at identifying sexual dysfunctions in patients with schizophrenia: those who were treated with antipsychotics and those who did not take these drugs, and in this study, a control group of individuals who did not suffer from schizophrenia was identified. It turned out that patients with schizophrenia not treated with antipsychotics tended to have a low level of sexual activity, while patients treated with antipsychotics showed mainly erectile dysfunction and orgasm. According to the results of the study, it was suggested that antipsychotics restore sexual desire, but at the same time lead to sexual dysfunctions.

In a study by S. Macdonald et al. (2003) found a correlation between the severity of negative symptoms and sexual disorders in women with schizophrenia.

It is noted that the doctor's attention to the sexual problems of a patient with schizophrenia significantly improves compliance with the latter.

In patients with schizophrenia, as a rule, there is a cross-sex accentuation of sex-role behavior: in men, the feminine radical dominates, while in women, on the contrary, the masculine one (Alekseev B.E., Konovalova E.M., 2007).

Gynecological diseases

In women with schizophrenia, galactorrhea is often detected due to long-term use of antipsychotics, especially. High prolactin levels inhibit the release of gonadotropin-releasing hormone, which can lead to ovarian dysfunction, manifested by irregular periods and even amenorrhea. At the same time, some authors deny the significant role of prolactin in the genesis of menstrual disorders (Perkins D., 2003).

In schizophrenia, obstetric pathology is often noted: intrauterine growth retardation of the fetus, premature birth, perinatal death, stillbirth, low fetal weight. Children of women with schizophrenia tend to have low Apgar scores. As noted above, in women with schizophrenia, more often than in the general population, such oncological diseases as breast and cervical cancer are recorded. In relation to cancer of the body of the uterus, the literature data are often contradictory.

Diseases of the ENT organs

According to R. Mason, E. Wilton (1995), the relative risk of middle ear diseases in patients with schizophrenia is 1.92. The authors hypothesized that in some cases this pathology may be of etiopathogenetic significance in schizophrenia, since the temporal lobe may be involved in the pathological process. In addition, diseases of the middle ear can contribute to the appearance of negative symptoms in schizophrenia, as they increase the isolation of the patient from the external environment, as well as enhance cognitive impairment, in particular, the patient's attention.

In schizophrenia, vestibular disorders are recorded relatively often and are often the cause of constant complaints from people suffering from this disease. In the literature, one can find separate statements regarding the role of vestibular disorders in the genesis of schizophrenia. However, in the opinion of most authors, such hypotheses do not stand up to serious experimental testing.

Deafness in schizophrenia occurs with the same frequency as in the general population, however, in the presence of this pathology, the clinical picture of the course of a mental disorder often changes, in particular, there is a tendency to develop a paranoid syndrome, which is especially noticeable in elderly patients. According to A. Cooper (1976), the appearance of deafness in adolescence contributes to the unfavorable and may play a role in its pathogenesis.

Dental diseases

Dental diseases in schizophrenia, as part of somatic disorders, are more often observed in those patients who are in psychiatric hospitals for a long time. The more malignant the course of schizophrenia, the more pronounced the negative symptoms, the older the age of the patients, the more pronounced dental diseases. In women and patients with a distinct manifestation of the defect, there are more cases of caries, lack of fillings and more frequent loss of teeth. Patients with schizophrenia rarely monitor oral hygiene.

There are reports in the literature about the negative effect of phenothiazines on diseases of the oral cavity.

Spanish dentists, examining a large group of patients with schizophrenia who received antipsychotics, found in these patients in almost 8% of cases putrefactive dental caries, the absence of any teeth in 17% of patients (Velasco E. et al., 1997). Studies by scientists in India have shown that only 12% of patients with schizophrenia have no signs of caries, 88% need conservative treatment by a dentist, and 16% of patients require complex periodontal therapy (Kenkre A., Spadigam A., 2000). Chinese experts in the examination of patients with schizophrenia revealed cases of caries in 75.3% (Tang W. et al., 2004).

A. Friedlander, S. Marder (2002) believe that patients with schizophrenia receiving antipsychotics are prone to such aversive orofacial effects as xerostomia.

Some authors attribute diseases of the temporomandibular region and oral dyskinesia to dental problems. E. Velasco-Ortega et al. (2005) revealed in 32% of patients with schizophrenia evidence of any pathology of the joints of the temporomandibular region. Manifestations of oral dyskinesia, as noted above, are usually a consequence of classical antipsychotic therapy.

Most dentists believe that people with schizophrenia should have regular dental check-ups to prevent and treat oral disease.

Dermatological diseases

Patients with schizophrenia are prone to allergic reactions. As a rule, they have a change in the immune status and, in particular, an increase in immunoglobulin E. (IgE). At the same time, compared with patients with schizophrenia, persons suffering from affective disorders almost twice demonstrate sufficiently pronounced hypersensitivity (Rybakowski J. et al., 1992).

According to E. Herkert et al. (1972) we can talk about some comorbidity of schizophrenia and tuberous sclerosis, as well as schizophrenia and pellagra, which manifests itself as vitamin B3 deficiency. At the same time, the comorbidity of pellagra and affective disorders manifests itself more clearly. In affective disorders, in the genesis of which, as well as schizophrenia, changes in the metabolism of serotonin in brain tissues play a certain role. There is no doubt that such changes occur due to the imbalance of amino acids, nicotinic acid and tryptophan. Note that with pellagra and with schizphorenia, there is some commonality of symptoms of mental disorders.

Patients with schizophrenia often show signs of skin hyperpigmentation, which some authors explain by long-term use of classical antipsychotics that can increase the concentration of melanin in the skin. In the literature, you can also find data indicating the ability of a number of antipsychotics to cause lupus erythematosus (Gallien M. et al., 1975).

Rarely, schizophrenia is associated with rheumatoid arthritis, skin cancer, and malignant melanoma.

The negative correlation between rheumatoid arthritis and schizophrenia may be explained by the anti-inflammatory and analgesic effects of some antipsychotics, as well as by the prostaglandin and estrogen deficiencies often found in individuals with schizophrenia. Some authors suggest that changes in the metabolism of serotonin and tryptophan play a role here. In addition, some variants of hyperprolactinemia may contribute to the suppression of autoimmune reactions that underlie the pathogenesis of rheumatoid arthritis. Probably, the psychosomatic nature of rheumatoid arthritis may be another argument explaining the antagonism of schizophrenia and this disease.

It often happens that there are no physiological causes for the disease, but nevertheless, the disease actively manifests itself.

Many scientists and psychotherapists believe that they caused by feelings and psychological trauma and call them somatic diseases.

How to treat psychosomatic diseases? Learn about it from ours.

What does it mean: definition of concepts

Somatic diseases- these are various physical disorders that have arisen as a result of a psychological disorder or injury.

The appearance of such diseases is explained very simply: our body is a single mechanism, that is, if one element breaks down (in this case, the psyche), then this can affect other components (physiology).

Somatic state- this is a person's feeling of direct bodily well-being, the physical state of the body. That is, this is how we feel ourselves, how we feel our body, what processes we notice in it.

concept "somatic status" mainly used when writing a medical history. This includes:

• general condition of a person, his height and weight;
• condition of the skin and mucous membranes;
• a brief description of the main organs and systems of a person (digestion, blood circulation, respiration, etc.).

The somatic status of a person greatly affects his functional capabilities. In himself, he collects and generalizes the diverse properties of a person.

Somatic dysfunction- this is a violation or change in the work of any structures, leading to the appearance of various symptoms, including limited movement, sensitivity or pain.

Somatic irritation- this is a direct reaction of the physical body of a person to mental irritation.

Somatically healthy- what does this mean? Somatic health is physical health, reflecting the state of organs and systems of the body.

Thus, somatically healthy can be called physically healthy person who does not feel and has no problems with the body.

"ICD 10" stands for "International Classification of Diseases, Tenth Revision". It includes 21 sections reflecting diseases and human conditions.

Somatically healthy, according to ICD 10, can be considered a person who does not have an established diagnosis and complaints and has undergone a general examination (code Z00).

Senestopathy

Senestopathy- these are unpleasant, sometimes even painful bodily (somatic) sensations that have no physiological basis.

Usually they appear if a person has mental disorders: paranoia, (at his depressive stage, hypochondria and others).

When examining a patient reasons for his discomfort are not found.

But despite this, sensopathies cause great inconvenience to a person and can even complicate the course of his mental illness.

Psychiatrists treat sensopathies.

Sensopathies are of the following types:

• thermal sensations (cold, chills, fever, burning);
• feeling of tension;
• fluid sensations (transfusion, clogging, uncorking, pulsation);
• feeling of burning pain;
• sensations of movement (moving, twisting, turning).

A distinctive feature of sensopathies is the presence of somatic complaints - this is when the patient experiences significant difficulties in describing his sensations.

They also have a great variety and emotional richness. Because of this man Difficulty relaxing or relaxing: all his thoughts are concentrated around these sensations.

Somatic sensations usually occur in the head region, in the chest and abdomen much less frequently. Sensopathy in the extremities is practically not found.

Symptoms and signs

The most common somatic symptoms are:

Susceptible to somatic diseases children.

Yes, there is somatic weakness of the child- this is the name of neuropathy, which creates some difficulties in the development of the child, both emotional and psychophysical.

At the same time, in childhood, somatic diseases, as a rule, have the following signs:

• high sensitivity to various types of infections;
• emotional instability (sudden mood swings, frequent whims, etc.);
• predisposition to allergies;
• dependence of mood or well-being on weather conditions;
• weak immunity, lowering the body's defenses;
• the presence of tics, stuttering or other psychomotor disorders.

What somatic diseases are caused by malnutrition of a child? Find out from the video:

Types of pathologies

General somatic diseases include many components. For convenience, they are classified into the following varieties:

Separately, it is necessary to highlight somatic neurosis. It can be accompanied by appetite disorders (both its complete absence and a sudden increase), problems with the digestive tract, the occurrence of wandering pain, an almost incessant headache, dizziness and weakness, heart rhythm disturbances, jumps in blood pressure, impaired coordination and trembling in the limbs.

Chronic somatic diseases. This category of somatic diseases differs in that, as a rule, they manifest themselves at a young age and rarely occur after 30 years.

They are exposed to a greater extent women.

At the same time, the likelihood of chronic somatic diseases in women who inherited similar problems.

Drug and drug addiction can increase the chances of this type of disease.

To chronic somatic diseases include the following:

• problems with the digestive system (eg, ulcers, gastritis);
• asthma or bronchitis;
• ulcerative colitis;
• kidney disease;
• arthritis
• etc.

Severe somatic diseases. Chronic somatic diseases include the following:

• blood clotting disorder;
• neurodermatitis;
• hepatitis;
• pneumonia;
• etc.

Causes and treatment

First of all, it must be said that it is impossible on our own identify the causes of and the development of such a disorder. a regular feeling of discontent (most often growing);

fears (which are mostly unfounded and unsupported);

strong nervousness.

If the listed factors do not find a way out (anxiety only increases, anger does not pour out, stress increases, discontent does not subside), then they cause damage to somatic health.

As we have already noted, treatment should be comprehensive. under the supervision of several experts. Before starting therapy, the specialist must:

1. Find the source of the disease, its cause;
2. Determine if this disorder is hereditary;
3. Take all the necessary tests and study the results.

The most effective way to treat a somatic disease is considered psychotherapy.

This is due to the fact that it acts directly on the original cause of the appearance of the disease, on its basic mechanism of work.

In addition, the specialist may also prescribe antidepressants, tranquilizers or other medications. Even traditional medicine can be used to achieve the best result.

In any case, treatment will be most effective only if it is carried out in a complex manner.

Somatic diseases are very diverse, and there are quite a few reasons for their appearance. But they are treatable, for this it is only necessary find a competent specialist who will understand the origins of the disorder and offer high-quality comprehensive treatment.

And hello again, our dear regular readers who come to us to get some new information about interesting problems. We are glad to welcome in our blog and those who looked, attracted by an unusual or unfamiliar name. Somatic diseases are a huge and voluminous topic, because all diseases of the body are included in it.

Soma, translated from Greek, means the body, therefore, the topic of today's conversation does not include pathologies associated with mental health disorders, which are called mental illnesses in medicine. But somatic are bodily diseases, and it is difficult even for a professional doctor to deal with their differentiation.

What are somatic diseases

The most common definition in the near-scientific literature for somatic diseases are two main points. The first is that these are different bodily diseases, of which there are many, and they are of a different nature. The second is that somatic diseases are by no means mental failures, because the psyche knows the category of such ailments.

Mental disorders are a completely different branch of medicine that deals with what various sources call mental illness, mental illness or mental illness. In competent sources that are interested in the accuracy and relevance of each definition, it is argued that these are somewhat different concepts.

They determine the degree of development of pathology and responsibility of a person for his actions and his ability to adapt in the social stratum, awareness of his actions or the degree of awareness of what surrounds him from different angles of view.

If we clearly distinguish between the concepts of somatic and mental illness, we will have to assume that they have nothing to do with each other. Although in reality it is not. All processes occurring in the body are the result of the interaction of organs and systems. Brain pathologies, violations of natural biochemical processes often lead to mental illness. They affect not only the senses and vision, but also the instinct of self-preservation, the ability of the brain to adequately perceive the objective picture that comes with the help of nerve impulses.

One of the famous Latin sayings says that a healthy mind exists only in a healthy body. And this means that the psycho (soul) and soma (body) are still closely related. Hence the term psychosomatics appeared, the prerogative of which is the study of the influence of a mental state on diseases of internal organs.

Therefore, if you ask somatic - what kind of diseases, it is more correct to voice the definition of somatic disorders as follows: this is any disease of the body that has arisen as a result of endogenous (internal) or exogenous (external) negative impact, not associated with mental activity. There are quite a few such diseases, and conditionally they include a huge percentage of all existing diseases. Although it is likely that there is a psychic effect in some of them, it is simply not yet fully understood.

Types and categories of bodily pathologies

Perhaps, in the first part of our study, it was not very possible to explain clearly. Therefore, we will consider in more detail which diseases still fall under a specific term, which is understandable so far only to physicians. Let us find out why exactly these pathologies fell into the category of diseases of the body that are not related to the psyche. The list includes the following ailments:

Some are wondering if poisonings are somatic diseases, perhaps there are more interesting examples of ailments that are subject to doubt. Dear readers! If you still have any questions on this topic, we will definitely analyze them in detail in future publications. To do this, write your questions to our blog.

Why do questions like this arise?

Difficulties in perception that arise when considering the concept of somatic diseases are often associated with incorrectly presented information. Pregnancy, for example, is not a disease, but a normal physiological condition that can lead to the development of a somatic disease (kidney pathology, genetic disorder, endocrine pathology caused by hormonal changes).

The suffering of a patient in a chronic form, the stage of exacerbation or complications, is still associated with somatic pathology, that is, with a disease of the body. It is not necessary to distinguish between chronic and acute stages in this classification, because it matters when the appropriate therapy is prescribed.

The authors of near-medical publications stubbornly confuse somatics and psychosomatics, and argue that only those caused by psychological reasons belong to somatic diseases. The division into bodily pathologies and mental disorders has long lost its relevance, because it is purely conditional.

And when a reliable diagnosis is carried out, using progressive research, it turns out that many diseases of the body are caused by nerves, and mental disorders are caused by certain bodily ailments. But this is not a reason to assert that patients have been taking medication for years, due to the fact that the nature of somatics is inherent in psychiatry.

Poisoning, injury, wounds and burns are bodily diseases classified as somatic because their symptoms are associated with pathogenic thermal or traumatic influences. If you really try, you can remember that mental illness causes suicidal tendencies and indirectly causes wounds or burns when the patient opens the veins or sets himself on fire in front of the crowd.

But to say that they are caused by mental health disorders in all other cases is incorrect. Sleep disturbances, pain, sexual disorders, limited mobility and digestive pathologies, classified as mental disorders (symptoms of somatic diseases), are associated with very real biochemical reactions that have taken an abnormal form.

In children, such diseases are associated with functional disorders of the natural activity of systems located in the body. Children's pathologies include congenital and acquired malfunctions of the internal organs, and treatment is prescribed depending on the location. Older people can develop mental illness and disorders of mental activity against the background of chronic diseases, age-related degradation of the body. Their prevention is carried out by preventing the aging process of the body, and complete rehabilitation is rarely possible, due to the fact that age-related changes occur.

It is impossible to deny that some types of gastritis, vegetovascular dystonia and a number of other specific pathologies are associated with emotional stress and nervous stress. But they are not somatic. Why do you think they can't be included in this list? That's right, because they are provoked by a mental state, and it was at the beginning of our reasoning that we were originally talking about it.

Somatic diseases are singled out in a separate category in the event that pathologies are not present in the development and are not affected by mental disorders, mental illness, mental disorders, mental illness and any synonyms used to refer to pathological conditions.

Before reading that childhood medical illnesses are anything but those caused by an infection, or that illnesses of the body can only be somatic if they are associated with mental disorders, try to understand and build on the basic definition.

Many publications on this topic are written by people who are incompetent or sincerely mistaken. Not only are they confusing themselves, but they also confuse others. We hope that the essence of the problem is stated here in sufficient detail, and you will not need to turn to other sources for clarification. And if you still have questions, ask, we will be happy to answer them. Subscribe to our blog updates, recommend us to your friends on social networks. See you soon!