(mental disorders with somatic diseases). Mental disorders arising in connection with the pathology of internal organs and systems constitute a special section of psychiatry - somatopsychiatry. Despite the diversity of psychopathological symptoms and clinical forms of somatic pathology, they are united by a common pathogenetic mechanisms and patterns of development. The diagnosis of somatogenic psychosis is made under certain conditions: the presence of a somatic illness is necessary; temporal relationship between somatic and mental disorders, interdependencies and mutual influence in their course.
Symptoms and course depend on the nature and stage of development of the underlying disease, its severity, the effectiveness of the treatment, as well as the patient’s individual characteristics, such as heredity, constitution, character, sex, age, state of the body's defenses and the presence of additional psycho-social hazards. According to the mechanism of occurrence, there are 3 groups of mental disorders.
1. Mental disorders as a reaction to the fact of the disease, hospitalization and the resulting separation from the family, the familiar environment. The main manifestation of this reaction is the varying degree of depressed mood with a particular shade. Some patients are full of painful doubts about the effectiveness of the treatment prescribed by them, in the successful outcome of the disease and its consequences. Others are dominated by anxiety and fear of the possibility of serious and long-term treatment, before surgery and complications, and the likelihood of becoming disabled.
Some patients suffer from the fact of being in the hospital, they are homesick and close to their homes. Their thoughts are occupied not so much by disease, as household chores, memories and dreams of discharge. Outwardly, such patients look sad, somewhat inhibited. With a long, chronic course of the disease, when there is no hope for improvement, an indifferent attitude towards oneself and the outcome of the disease can occur. Patients lay flat in bed, refusing to eat, from the "one way end" treatment. However, even in such outwardly emotionally inhibited patients, even with little influence from outside, anxiety, tearfulness, self-pity and a desire to get support from others can arise.
The second, significantly larger group consists of patients whose mental disorders are, as it were, an integral part of the clinical picture of the disease. These are patients with psychosomatic tension (see. Psychosomatic diseases), along with severe symptoms of internal diseases (hypertension, peptic ulcer disease, diabetes mellitus), there is neurotic and pathocharacterological reactions.
Patients with acute mental disorders (psychosis) relate to the third group. Such conditions develop either in severe acute diseases with a high temperature (croupous inflammation of the lungs, typhoid fever) or severe intoxication (dying out of renal insufficiency), or in chronic diseases in the terminal stage (cancer, tuberculosis, diseases of the nights)
In the clinic of internal diseases, despite the large variety of psychological reactions and more pronounced mental disorders, the most common are: 1) asthenic; 2) affective (mood disorders); 3) deviations in characterological reactions; 4) delirium; 5) confusion syndromes; 6) organic psychosyndrome.