[Relationships between psychosomatics and somatopsychiatry in modern medicine].

Progress in many clinical disciplines and neurobiology for the last decades give reason to reconsider some fundamental provisions of psychosomatic medicine and its relationships with somatopsychiatry. The universally accepted biopsychosocial model of the disease as proposed by V.N.Bekhterev implies involvement of psychological and psychosocial factors at early stages of many forms of somatic pathology. Intricate interplay between somatic and psychic components is exemplified by correlation of cardiovascular disorders and depression. Depression is diagnosed in 17-27% of the patients with coronary heart disease undergoing coronary angiography and in 16-45% of the post-infarction cases. Frequency of depression/hypertensive disease comorbidity is estimated at 30%. Similarity of pathogenetic mechanisms of cardiovascular diseases and depressive states is due to stress as their common provoking factor. Another important aspect of the relationship between medicine and psychiatry (disregarded until recently) is high frequency of somatic disorders in psychiatric patients. Cooperation of psychiatrists and representatives of different medical disciplines in such areas as research and practical health care is needed to address this problem.

[Neurasthenia as a variant of the asthenic syndrome: a pharmacotherapeutic analysis modelled on tanakan therapy]. / Nevrasteniia kak variant astenicheskogo sindroma: farmakoterapevticheskii analiz na modeli terapii tanakanom.

25 patients with neurasthenia were examined during 2 months of ambulatory therapy with tanakan. Taking into consideration the data of cluster analysis of symptomatology before the therapy, 2 groups of patients were selected: with hyposthenic (15 patients) and hypersthenic (10 patients) variations of the disease. The main symptom complex in both groups was an asthenic one, but symptomatology in group 1 tended to hyporeactivity and depressive range of affective spectrum, while in group 2--to hyperreactivity, hyperesthesia, irritation, anxious range of disorders. Pronounced improvement was observed in 18 cases, moderate effect--in 4 patients; in 3 cases the treatment was discontinued because of side-effects (headache, allergic reactions, etc). In group 1 efficiency of the treatment was higher and stable positive dynamics of the state was found, while in group 2 there was uneven reduction of the symptoms with partial temporary change (the exacerbation of anxious symptoms). The data obtained support correctness of the division of neurasthenia into hyposthenic and hypersthenic variations and expediency of taking into consideration such differences in therapeutic policy.

[Problems of psychosomatics and somatopsychiatrics in internal medicine]. / Problemy psikhosomatiki i somatopsikhiatrii v klinike vnytrennikh boleznei.

The past 2 decades in our country has been marked by the population's poorer health status, the obvious tendency for the incidence of many somatic and mental diseases to increase. The problem of somatogenic mental diseases and disorders diagnosed in the presence of a somatic disease merits particular attention. The paper considers the background of psychosomatics and somatopsychiatrics, presents the authors' own findings of the mental status in patients with chronic lung diseases. Various somatic disease-detected psychopathological syndrome relationships most common in the treatment of visceral diseases are systematized. Emphasis is laid to the fact that the differentiation of proper mental and somatic diseases, the elaboration of the optimal treatment policy is possible only if therapeutists work in close cooperation with psychiatrists. Principles in the complex therapy of psychopathological disorders in patients with somatic diseases are given.