Clinical, personality-psychological and sociodemographic factors hindering patients with somatization disorders from seeking specialized care
Автор: Pogosov Albert V., Bogushevskaya Julia V.
Рубрика: Клиническая психиатрия
Статья в выпуске: 4 (97), 2017 года.
Introduction. Late seeking for psychiatric help by patients with somatization disorders is medico-social and economic problem. The formation of the unique “avoiding psychiatrist behavior” in patients with somatization disorders causes relevance of the paper. Objective is to study the reasons, which hinder the timely seeking by patients with somatization disorders for specialized psychiatric help. Methods: clinical-psychopathological, psychological (standardized multifactor method of investigating the personality by L.N. Sobchik, the Taylor Manifest Anxiety Scale, the questionnaire “Methods of Coping Behavior”), statistical. Results. The results of study of the reasons are presented, which hinder the timely seeking by patients with somatization disorders (SD) the psychiatrist. The groups of factors are designated: sociodemographic, clinical, information, organizational, psychological. The sociodemographic portrait of a patient with SD is described. The influence of clinical manifestations of somatization disorders, information resources and organizational changes in the system of public health on the selection by the patients of the specialists of primary medical network is shown. Personality traits, mechanisms of coping behavior are analyzed. Conclusion. Sociodemographic portrait of the patients with SD who seek psychiatric help late, is as follows: these are the separated women - the inhabitants of rural locality, with the secondary vocational education, temporarily those employed with the low-qualified forms of activity. Clinical variety and type of the somatization disorders determines selection by the patient of the corresponding specialist. For the patients with the behavior avoiding the psychiatrist the wide spectrum of medical specialties is typical, whom they sought internist, neurologist, cardiologist, endocrinologist). Confidence to the stories of acquaintances and to information from the Internet acts as the constraint against seeking the psychiatric aid. The changes in the system of public health occurred in recent years have great significance with the realization by the patients of the selection of specialist, diagnostic measures. The psychological traits of patients with SD act as the constraint against seeking the psychiatric aid. The more expressed indices according to the scales of hypochondria, anxiety, psychopathy and rigidity are the special features of personal profile of patients with SD and behavior avoiding the psychiatrist. For them disadaptive forms of coping behavior are typical. The obtained information will become the basis of practical recommendations for the specialists of the primary healthcare.
Somatization disorders, factors hindering seeking a psychiatrist
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