Models of pathogenesis of psychosomatic disorders and the concept of psychosomatic scenario

   Currently, there is a significant prevalence of psychosomatic disorders: from 15 to 50% in the general population, 21-33 % in outpatient and 28-53% in inpatient somatic institutions. However, taking into account the variety of clinical manifestations of psychosomatic disorders and patients' seeking help not only from psychiatrists, but also from doctors of other specialties and representatives of nontraditional medicine, in reality these indicators are significantly higher. Untimely detection of the psychosomatic factor in the development of somatic disease often leads to the appointment of unreasonable and expensive treatment, including invasive interventions. The main cause of psychosomatic disorders is stress, prolonged exposure to which on the body leads to functional changes in the organs and their gradual destruction.   Due to the high relevance of the problem of verification of psychosomatic disorders, the aim of this study was to develop an integrated approach to the diagnosis of psychosomatic diseases based on the analysis of existing concepts and notions; to achieve this goal, a literature review was conducted using Scopus, PubMed, Cochrane Library and CyberLeninka electronic libraries using keywords "psychosomatic disorder", "psychosomatics", "psychosomatic medicine".   The concept of psychosomatic scenario of the disease (certificate of deposit No. 2207787) is suggested, based on combining the knowledge of classical western, Eastern medicine and psychotherapy, which allows the doctor to analyze, realize the psychosomatic scenario of the disease and see, what psychoemotional conflicts of the person himself and/or inherited from parents and ancestors, as well as distorted ideas about his present and future, was launched by the mechanism of adaptation to these distortions in the physical body in the form of a disease.