(mental disorders in somatic diseases). Mental disorders arising in connection with the pathology of internal organs and systems constitute a special section of psychiatry - somatopsychiatry. Despite the variety of psychopathological symptoms and clinical forms of somatic pathology, they are united by a commonality of pathogenetic mechanisms and patterns of development. The diagnosis of "somatogenic psychosis" is made under certain conditions: the presence of a somatic disease is necessary; temporary relationship between somatic and mental disorders, interdependence 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 on the individual characteristics of the patient, such as heredity, constitution, nature, gender, age, the state of the body's defenses and the presence of additional psychosocial harms. According to the mechanism of occurrence, 3 groups of mental disorders are distinguished.
1. Mental disorders as a reaction to the fact of the disease, hospitalization and the related separation from the family, the familiar environment. The main manifestation of such a reaction is a different degree of depression of mood with one or another shade. Some patients are full of painful doubts about the effectiveness of the treatment prescribed by him, in the successful outcome of the disease and its consequences. Others are predominantly anxious and afraid of the possibility of serious and prolonged treatment, of surgery and complications, the likelihood of disability.
Some patients are burdened by the very fact of being in the hospital, homesick for relatives. Their thoughts are occupied not so much with illness as with 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 of improvement, an indifferent attitude to oneself and to the outcome of the disease may arise. Patients indifferently lay in bed, refusing food, from the treatment "anyway one end." However, in such externally emotionally inhibited patients, even with a slight influence from the outside, anxiety, tearfulness, self-pity and a desire to receive support from others can occur.
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 natugia (see Psychosomatic diseases), along with pronounced symptoms of internal diseases (hypertension, peptic ulcer, diabetes mellitus), neurotic and patho-characterological reactions are observed.
The third group includes patients with acute impaired mental activity (psychoses). Such conditions develop either in severe acute diseases with a high temperature (croupous pneumonia, typhoid fever) or severe intoxication (impaired renal failure), or in chronic diseases in the terminal stage (cancer, tuberculosis, night diseases)
In the clinic of internal diseases, despite a wide variety of psychological reactions and more pronounced mental disorders, the following are most often encountered: 1) asthenic; 2) affective (mood disorders); 3) deviations in characterological reactions; 4) delusional states; 5) confusion syndromes; 6) organic psychosyndrome.