Psychopathological Aspects of Somatization in the Works of the Department of Psychiatry of Irkutsk State Medical Institute in the First Half of the 20th Century – from the Origins of the Psychosomatic Medicine to the Present

V. Sobennikov, E. V. Vinokurov, V. V. Sobennikova
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Abstract

The article discusses modern problems of dimensional diagnosis of somatoform disorders including the vagueness of the criteria and the lack of reliance on pathogenetic differences in the selection of separate classification categories. An ongoing discussion on the necessity of revision of the boundaries and of “redistribution” of some somatoform disorders into different categories in accordance with their psychopathological relationship is associated with these problems. As a promising change in the diagnostic criteria of the DSM-V classification, the emphasis is shifted to psychological and behavioral characteristics, which is assessed as an actualization of the classical descriptive diagnostics methodology. As a confirmation of the significance of this, an analysis of the psychopathological study of Irkutsk psychiatrists of the first half of the 20th century, devoted to the delusion of obsession, is given. In 1935, the head of the Department of Psychiatry at the Irkutsk Medical Institute V.S. Deryabin and his student I.S. Sumbaev published a scientific work “Delirium of obsession and somatic sensations”. The authors substantiate the intimate relationship of traditionally understood sensual hysterical and ideatorial hypochondriacal mechanisms in the formation of an integral clinical picture of somatoform disorders. The use of descriptive diagnostics many decades before the introduction of ICD-10 proves the pathogenetic unity of hysterical (sensory) and hypochondriacal (ideatorial) formations within the psychosomatic register of disorders and the legitimacy of combining phenomenologically different states into a circle of somatoform disorders.
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20世纪上半叶伊尔库茨克国立医学院精神病学系著作中躯体化的精神病理学方面——从心身医学的起源到现在
本文讨论了躯体形式疾病的维度诊断的现代问题,包括标准的模糊和在选择单独的分类类别时缺乏对病理差异的依赖。正在进行的关于修改边界的必要性和根据其精神病理关系将某些躯体形式障碍“重新分配”到不同类别的讨论与这些问题有关。作为DSM-V分类诊断标准的一个有希望的变化,重点转移到心理和行为特征上,这被评估为经典描述性诊断方法的实现。为了证实这一点的重要性,对20世纪上半叶伊尔库茨克精神病学家的精神病理学研究进行了分析,致力于痴迷的妄想。1935年,伊尔库茨克医学研究所精神科主任V.S. Deryabin和他的学生I.S. Sumbaev出版了一本科学著作《痴迷和躯体感觉的谵妄》。作者证实了亲密关系的传统理解的感性歇斯底里和理想的疑病症机制在形成一个完整的临床图像的躯体形式障碍。在引入ICD-10之前的几十年里,描述性诊断的使用证明了在身心障碍的记录中,歇斯底里(感觉)和疑病症(观念)形成的病理一致性,以及将现象上不同的状态结合成一个躯体形式障碍的循环的合法性。
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