Internal Picture of the Disease and Patterns of Attitude to Treatment in Women with Somatic Disorders

Author:

Bogushevskaya J.V.1ORCID,Vasileva A.V.2ORCID,Ivchenko A.I.1

Affiliation:

1. Kursk State Medical University (FGBOU VO KSMU of the Ministry of Health of Russia)

2. V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology

Abstract

<p><strong>Relevance.</strong> The category of patients with somatization disorders (SD) poses a serious problem for primary health care, where their prevalence reaches 40%. There is an opinion that in modern society there is a phenomenon of stigma, and a stigmatizing attitude towards the mentally ill persists. Currently, the phenomenon of self&ndash;stigmatization is being studied to a greater extent in severe mental disorders: the connection of self&ndash;stigmatization with social identity, a sense of self&ndash;worth, internal stability, and the ability to cope with stressful situations. The issue of developing destigmatized forms of care for patients with non&ndash;psychotic disorders, primarily psychotherapeutic offices in the primary health care network, remains relevant. <strong>The purpose</strong> of the study is to study differences in the severity of self&ndash;stigmatization and indicators of attitude towards the disease and treatment in patients with SD who sought help from a psychiatrist or psychotherapist and in women who avoided contacting specialized specialists. <strong>Methods.</strong> Questionnaire for assessing self&ndash;stigma I.I. Mikhailova, V.S. Yastrebova, a questionnaire to study attitudes towards the disease and treatment of B.D. Karvasarsky, correlation and regression analysis. The article presents <strong>the results</strong> of an empirical study of the relationships and parameters of motivation for treatment and the level of self&ndash;stigmatization in women suffering from somatization disorders with manifestations of &laquo;psychiatrist&ndash;avoiding behavior&raquo;, on the basis of which the authors describe models of attitude towards treatment. <strong>Conclusions.</strong> Based on the identified relationships between the parameters of patients&rsquo; motivation to seek help from a psychiatrist and the level of self&ndash;stigmatization, it was possible to describe models of attitude towards treatment in patients with somatization disorders who have not sought specialized psychiatric help for a long time: &laquo;model of denial&raquo;, &laquo;model of fixation&raquo;, &laquo;model of ignoring&raquo; , confirmed by the presence of regressive connections and the &laquo;dubious benefit&raquo; model, justified by the presence of a positive linear correlation. The data obtained will form the basis for the development of a program of psychotherapeutic assistance and clinical and psychological support for patients with CP not only at the inpatient, but also at the outpatient stages of treatment.</p>

Publisher

Moscow State University of Psychology and Education

Reference20 articles.

1. Bogushevskaya J.V. Klinicheskiye faktory, prepyatstvuyushchiye svoyevremennomu obrashcheniyu bol'nykh somatizirovannymi rasstroystvami za psikhiatricheskoy pomoshch'yu [Clinical factors preventing the timely treatment of patients with somatic disorders for psychiatric care]. Kremlevskaya meditsina. Klinicheskiy vestnik, 2022, no. 1, pp. 36¾41 (In Russ.).

2. Vasileva A.V. Problemy zhenskogo psikhicheskogo zdorov'ya – mezhdistsiplinarnyy rakurs [Problems of women's mental health – an interdisciplinary perspective]. ​​Russian Medical Journal, 2018, no. 10, pp. 51¾54. (In Russ.).

3. Vasileva A.V.  Razrabotka konstrukta vnutrenney kartiny bolezni dlya optimizatsii mediko–psikhologicheskoy reabilitatsii [Development of the construct of the internal picture of the disease for optimizing medical and psychological rehabilitation]. Human Ecology, 2019, no. 12, pp. 32¾40. (In Russ.).

4. Karavaeva T.A. Somatoformnyye rasstroystva [Somatoform disorders] / T.A. Karavaeva, A.V. Vasilyeva / In the book: Psychotherapy. Textbook. Moscow, 2022, pp. 516¾543. (In Russ.).

5. Karyagina T.D. Lichnost' i perezhivaniye v kontekste eksperimental'noy psikhoterapii [Personality and experience in the context of experimental psychotherapy]. Counseling psychology and psychotherapy, 2017, vol. 25, no. 3, pp. 11¾32. (In Russ.).

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