[Hyperventilation syndrome in bronchial asthma, essential hypertension and organic neurosis. Clinical picture and external respiration function]. / Giperventiliatsionnyi sindrom pri bronkhial'noi astme, gipertonicheskoi bolezni i organnom nevroze. Klinicheskaia kartina i funktsiia vneshnego dykhaniia.

The external respiration function was studied in 100 patients with hyperventilation syndrome (HVS) divided into 3 groups: 40 patients with HVS and bronchial asthma (group 1) consisting of 15 males and 25 females (age median--45 years, 25 percentile--37 years, 75 percentile--53 years); 39 patients with HVS and essential hypertension (group 2) consisting of 8 males and 31 females (age median 49, 25 percentile--40 years, 75 percentile--57 years); 21 patients with HVS without concurrent somatic diseases of group 3 (7 males, 14 females, age median 45 years, 25 percentile--28 years, 75 percentile--45 years). It is shown that different disorders of pulmonary ventilation correspond to different clinical manifestations of HVS. Thus, in bronchial obstruction (group 1) HVS manifests with "weak respiration", in restrictive pulmonary disorders (group 2) HVS manifests as "heavy respiration", in high parameters of bronchial permeability (group 3)--"shallow respiration".

[Visceral neuroses: clinical approaches to the problem]. / Organnye nevrozy: klinicheskii podkhod k analizu problemy.

Visceral neuroses are regarded as psychosomatic pathology represented by functional symptom complexes common for both psychic (personality, psychopathologic disorders of anxietyphobic, affective, hypochondriac spectrum) and somatic pathology. Two hundreds fourteen patients: 67 with hyperventilation syndrome (HVS), 77 with Da Costa syndrome (DCS), 70 with irritable bowl syndrome (IBS) have been studied. The study suggest that visceral neuroses represent a group of independent diseases. In contrast to converse neuroses, a topical projection (respiratory, cardiovascular system, gastrointestinal tract, etc.) of visceral neuroses reflects not only a psychosomatic disorder's specificity but also the course and prognosis regularities inherent to them. HVS course is wavy with periodic exacerbations and incomplete remissions, DCS one is phased (remissive), IBS is chronic without distinct phases and intervals. HVS and DCS are comorbid to milder psychic (personality and anxiety phobic disorders) and somatic pathology. IBS is associated with not only more severe mental disorders (overvalued, hypochondriac, affective) but also with chronic somatic diseases (alimentary system).

[Anxious-phobic disorders in patients with dyspnea]. / Trevozhno-fobicheskie rasstroistva u bol'nykh s narusheniiami dykhaniia.

The examination included 35 patients (21 women, 14 men, mean age 47.2 +/- 2.4 years) with anxious-phobic disorders (APD) and dyspnea phenomena combined bronchial asthma (BA) and hyperventilation syndrome (HVS). There was established that APD in these cases develops more frequently similarly to the panic attacks (PA) and HVS was PA component. Three PA types with dyspnea phenomena were recognized: cognitive ones (with prevalence of cognitive anxiety--8 cases); somatized PA (with prevalence of somatized anxiety--18 cases) and PA with both cognitive and somatized anxiety (9 cases). PA of the first type amplifies BA attack (psychopathologic structure of PA was integrated with manifestations of the acute bronchial obstruction). PA of the second type duplicates (because of the pronounced somatized anxiety associated with asphyxia) an acute bronchial obstruction between BA paroxysms. PA of the third type imitates somatic pathology forming without its participation (polymorphic conversion disorders were found first of all). The link of severity of the anxious-phobic and pulmonary pathology can be interpreted in the ranges of psychosomatic conception of the "reciprocal correlations".

[Clinical course, internal picture of the disease and pathogenic reactions in patients with bronchial asthma]. / Klinicheskoe techenie, vnutrenniaia kartina bolezni i nozogennye reaktsii u bol'nykh bronkhial'noi astmoi.

AIM: To study clinical features of bronchial asthma (BA) associated with internal picture and nosogenic reactions. MATERIAL AND METHODS: Clinical features of BA were studied in 108 patients (38 males and 70 females, mean age 44.7 +/- 1.4 years, mean BA duration 6.6 +/- 0.76 years) treated in the clinic of the I. M. Sechenov Moscow Medical Academy in 1995-1998. RESULTS: Clinical and statistical analysis of BA clinical course allowed to single out three leading variants of BA course: persistently obstructive (stable and definite respiratory disturbances with progressive deterioration of bronchial permeability), moist (associated chronic bronchitis, allergic rhinosinusopathy, chronic maxillary sinusitis, intestinal dysbacteriosis, repulsive symptoms, e.g. discharge of much sputum et cet), paroxysmal (short-term episodes of asphyxia arrested by inhalations of beta 2-agonists, absence of stable respiratory disorders). The above variants of BA course significantly correlated with types of the internal picture (IP) and types of nosogenies. Persistently obstructive, moist and paroxysmal BA variants were characterized with vital, defensive and coping IP, respectively, neurotic reactions with hypochondria, hypochondriac depressions; pathocharacterological sensitive reactions; neurotic and affective reactions with "la belle indifference" and "euphoric pseudodementia", respectively. CONCLUSION: The above correlations can be used for planning and conduction of psychocorrective measures aimed at optimisation of patient-doctor compliance.

[Clinical aspects of somatic disease and internal course of the disease (heart ischemia and bronchial asthma model)]. / Klinicheskie osobennosti somaticheskogo zabolevaniia i vnutrenniaia kartina bolezni (na modeli ishemicheskoi bolezni serdtsa i bronkhial'noi astmy]

Criteria of subjective severity (SS) and subjective control of the condition (SC) associated with establishment of the disease internal picture (DIP) were determined in 67 patients with verified coronary heart disease (CHD) and 68 with verified bronchial asthma (BA). Essential for SS were: severity of the subjective symptoms, features of the somatic condition debut, the speed of the disease progression. Essential for SC were the following components: effectiveness of self-care, severity of noticeable or ugly symptoms, features of the triggers (attack provokers). SS and SC criteria can be used for differentiation of the interventions to change the patient's attitude to their disease and therapy in the direction of more compliance with the doctor.