关于心身医学的 10 个神话

V. Soldatkin, S. V. Soldatkina
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摘要

本文专门讨论心身医学的实际问题。文章讨论了一些常见的迷思,根据这些迷思,只有七种心身疾病是已知的(限制性解释),或者所有人类疾病都是心身疾病(扩张性解释)。文章介绍了心身疾病的现代分类、有关心身疾病易感性的信息,并强调了发病机理的主要概念。文章关注躯体形式障碍、器质性神经官能症、鼻源性障碍的主要形式,并阐明了疑病症问题。这篇文章关注了综合治疗心身疾病的必要性,包括对精神和躯体成分的影响。文章给出了在心身医学中使用精神药物的要求,强调了 "最低限度 "原则,即要求使用小剂量的安全药物,既能治疗心身症状,又能治疗已确诊的精神障碍。文中介绍了旨在纠正心身疾病的主要非药物方法。作者深信,在心身医学领域,"反运动 "概念--精神科医生和内科医生的跨学科互动--提供了成功诊断和治疗的机会,其本质是迫切需要精神科医生和内科医生的跨学科合作,这增加了在心身医学这样一个复杂且充满神话的领域成功提供援助的机会。
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10 Myths about Psychosomatics
This article is devoted to the actual problems of psychosomatic medicine. Common myths are discussed, according to which only 7 psychosomatic diseases are known (restrictive interpretation), or alternatively, all human diseases are psychosomatic (expansive interpretation). The article presents a modern classification of psychosomatic disorders, information on predisposition to them, and highlights the main concepts of pathogenesis. Attention is devoted to the main forms of somatoform disorders, organic neuroses, nosogenic disorders, and the problem of hypochondria is illuminated. In this article attention is paid to the need for an integrated approach to the treatment of psychosomatic disorders, including the impact on both mental and somatic components. The requirements for the use of psychopharmacological drugs in psychosomatic medicine are given, emphasis is placed on the principle of «minimum sufficiency», which requires the use of minor doses of safe drugs that can cure the psychosomatic symptoms and are capable to treat the diagnosed mental disorders. The main non-drug methods aimed at correcting psychosomatic disorders are presented. The authors are convinced that in the field of psychosomatics the chances for successful diagnosis and therapy are given by the concept of «counter movement» – the interdisciplinary interaction of psychiatrists and internists, the essence of which is the urgent need for interdisciplinary cooperation of psychiatrists and internists, which increases the chances of successful assistance in such a complex and myth-rich field like psychosomatics.
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