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SUMMARY The study of a representative group including 97 patients (age — 30—60 years, average illness duration — 14,5±2,3 years) has allowed to differentiate 2 types of somatoform disorders (SD): 1st type, so-called "polymorphous" (70 cases) and 2nd — so-called "isomorphous" (27 cases). Polymorphous type of SD is characterized by both a big variety of symptoms, changeable in localization, and by instability of functional disorders of inner organs. Somatization was realized by mechanism of reactive lability in majority of observations. Duration of somatoform reactions varied from a few days to 2—3 months. SD of isomorphous type (mostly monosymptomous) are local and uniform, and invariable in zone location. SD of this type, as a rule, manifest spontaneously. The duration of phases and exacerbations is from 2—3 weeks to 6 months. In the premanifest period the persons in both investigated groups reveal and accentuation of somatopsychic sphere (neuropathic constitution in the form of somatopathy and somatotony). It was also found that pathocharacterological predisposition can be a predictor of typological differentiation for SD. So, among the patients with polymorphous type SD and accumulation of personality disorders of hystero-psychastenic spectrum. Among persons suffering from SD of isomorphous type personality deviations of paranoid-schizoid and epileptoid types has been found. Polar distribution of patocharacterologic features in personal disorders of patients suffering from SD mate it possible to identify the cluster "impulsiveness-rigidness, according to C. Cloningers theory of personality disorders. Patients of SD polymorphous type manifested as "impulsiveness" revealing constitutional predisposition: traits of emotional lability, heightened impressionability, anxiousness, proneness to dramatization, inability to go through the routine conditions and monotonous activity. The predisposition of persons with isomorphous type SD made it possible to identify such personality cluster traits as "rigidness": proneness to affects sedimentation, to supervalued complexes, pedantism with a tendency to over detailed functioning, conformity with monotonous way of life. |
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Тревожно-фобические и Соматоформные расстройства |
Ипохондрия и соматоморфные расстройства |
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Полученные в настоящем исследовании эпидемиологические данные (см. ниже) свидетельствуют в пользу тесной взаимосвязи анксиозных и соматоформных расстройств. Связь тревожно-фобических расстройств и соматизации, констатируемая еще в работах старых авторов [74, 77, 323, 370], привлекает особое внимание в последние десятилетия и является предметом исследований ряда как отечественных, так и зарубежных авторов. — 54 —
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