General preconditions of formation of “psychosomatic symptom complexes” in cardiovascular diseases

Abstract

Objective:To study preconditions of formation of psychosomatic symptom complexes in cardiovascular diseases.Methods:We have examined 832 patients (361 male and 471 female, age 49,5±6,4 years) of Borderline States Department with AH (700 persons), IHD (132 persons) and mental disorders of neurotic and affective level. Interrelationship of somatic, mental, psychosocial factors has been studied by methods of system statistical analysis.Results:In 40,8% of cases rationale of patients with AH and IHD to consult a psychiatrist was subjective non-satisfaction with his/her condition (р=0,001). Women were fixed on psychotraumatizing situation: life events, interpersonal relations, everyday factors. They perceived themselves as severe ill, experienced anxiety, depressed mood, suicidal ideation, tearfulness. Men recognized themselves as “nervous” or “somatic” patients or denied the illness as a whole (anosognostic reaction). They were characterized by fear of death, inclination to ideas of self-humiliation or self-guilt. Significant psychotraumatizing factors were medical (presence of somatic disease) and working ones.Mental disorders in patients with HI, IHD were accompanied by somatovegetative symptoms: insomnias (86,7%; p=0.002), paresthesias (88,6%; р=0,002), inner palpitation (77,1%; р=0,001), a lump in the throat (56,6%; р=0,001), hyperventilation disturbances (41,9%; р=0,001), heart beating (29,4%; р=0,001), skin itch (15,4%; р=0,046), dysuria (10,7%; р=0,001), dysphagia (3,1%; р=0,028). Alalgical “masks”: cephalgias (92,9%; р=0,001), abdomenalgias (64,7%; р=0,012), cardialgias (60,1%; р=0,001), arthralgias (36,8%; р=0,001). Emotional lability (78,4%; р=0,037), irritability (73,9%; р=0,001), anxiousness (54,2%; р=0,001), paroxysms of fear of death (21%; р=0,001.Conclusions:Variability and polymorphism of extracardial symptom complicates recognition, differential diagnosis and therapy of cardiovascular diseases.