Внутренняя картина болезни и модели отношения к лечению у женщин с соматизированными расстройствами

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–stigmatization is being studied to a greater extent in severe mental disorders: the connection of self–stigmatization with social identity, a sense of self–worth, internal stability, and the ability to cope with stressful situations. The issue of developing destigmatized forms of care for patients with non–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–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–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–stigmatization in women suffering from somatization disorders with manifestations of «psychiatrist–avoiding behavior», 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’ motivation to seek help from a psychiatrist and the level of self–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: «model of denial», «model of fixation», «model of ignoring» , confirmed by the presence of regressive connections and the «dubious benefit» 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>