СОМАТОФОРМНІ РОЗЛАДИ В РОБОТІ ЛІКАРЯ ЗАГАЛЬНОЇ ПРАКТИКИ: ОСНОВНІ ПРИНЦИПИ ПРОФЕСІЙНОГО ПІДХОДУ ДО ПАЦІЄНТІВ

Abstract

General practice doctors play a pivotal role in the recognition and treatment of psychiatric illnesses. Psychosomatic disorders, which according to ICD-10 (International Classifi cation of Diseases- 10th revision) and DSM-V (Diagnostic and Statistical Manual of Mental Disorders – Vth edition) are assigned to class of «Somatoform disorders», take main part among them. Nearly 20% of all costs to healthcare system are used by this category of patients. That is why, it is very important to be able to recognize somatoform disorders to choose right treatment tactic and to build professional dialogue. In this paper are represented preconditions and results of research about general practice doctors and patients with somatoform disorder collaboration. The main aim of this research is fi nding new features to improve treatment process of patients with psychosomatic disorder. Particularly, are given a review of diagnostic criteria of somatoform disorders, results of empirical research that shows frequency of somatoform disorders among all the cases in general practitioner work which is nearly 21,9% (MWM De Waal, 2004). Also were analyzed general principles of complex medical aid to patients with somatoform disorders and determined level of medical help, which can be provided by general practitioner. Analyze of all this data shows that frequency of somatoform disorders is very high. To verify diagnosis and to choose treatment strategy for “hard” therapeutical patients is recommended to make psychological tests (Toronto Alexithymia Scale, Hospital Scale of Anxiety and Depression). Pharmacological therapy provides usage of SSRIs (Selective serotonin reuptake inhibitors) or nonbenzodiazepine anxiolytics. For better results, pharmacological treatment should be accompanied by psychotherapy. It is necessary to remember that doctor have an authority before patient, so he need to be very careful with verbalization of his thoughts, and to build professional dialogue according to medical ethics and deontology rules.