Structural differences in the internal picture of the disease and their relationship with discriticality in anxiety-phobic and somatoform disorders

Abstract

Purpose: To investigate nosospecific features of the internal picture of the disease by studying the prevalence and severity of certain types of attitude to the disease, identifying dependencies between the types of attitude to the disease in patients with anxiety-phobic and somatoform disorders. 48 patients with anxiety-phobic disorder — F40 (ICD-10) (group 1) and 54 patients with somatoform disorder — F45(ICD-10) (group 2) were examined using the methods “Type of attitude towards illness”, Toronto Alexithymia Scale (TAS-20), Hospital Anxiety and Depression Scale (HADS). In group 1, the types of attitude towards the disease prevailed: anxious (33.33 %), sensitive (31.25 %), anosognostic (16.67 %). A higher level of anxious type (25.54 vs. 19.59 points in group 2, p < 0.05), sensitive type (25.10 vs. 20.37 points, p < 0.05) was found. Hypochondriac (38.89 %), sensitive (25.93 %), anxious (24.07 %) prevailed in group 2. Hypochondriac (26.87 vs. 19.10 points in group 1, p < 0.01), apathetic (14.57 vs. 11.52 points in group 1, p < 0.01), egocentric (20.87 vs. 16.19 points in group 1, p < 0.05). The prevalence of the anosognostic type of attitude in both groups was the same. The significant difference in anxiety-phobic disorders was at a higher level for anxious and sensitive types (p < 0.05). With somatoform disorders, it is higher for hypochondriac, melancholic, apathetic, egocentric types (p < 0.05). In anxiety-phobic disorders, the internal picture of the disease is characterized by a feeling of loss of control over one's own condition and the sphere of emotions. This is indicated by a positive correlation between the level of anxious attitude towards the disease and TAS-EOT scores (0.3741, p < 0.05). Discriticality is manifested by the formation of an anosognostic attitude to the disease with a decrease in anxiety (inverse correlation between anosognostic type and anxiety: –0.5264, p < 0.05). Or an emphasis on controlling one's own emotional sphere and supporting avoidant behavior. With somatoform disorders, the internal picture of the disease was dominated by a hypochondriac type of attitude to the disease, an increased level and a more significant role of alexithymia. Alexithymia also has a significant impact on the development of discriticality in somatoform disorders. Key words: anosognosia; alexithymia; internal picture of disease; discriticality; clinic; neurosis; anxiety; anxious-phobic disorder; somatoform disorder