Features of routing patients with somatoform disorders

Features of routing patients with somatoform disorders

 

Authors

 

A.M. Karpushkin

Federal State Budgetary Educational Institution of Higher Education “Novosibirsk State Medical University”

of the Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation

A.A. Ovchinnikov

Federal State Budgetary Educational Institution of Higher Education “Novosibirsk State Medical University”

of the Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation

I.Yu. Klimova

Federal State Budgetary Educational Institution of Higher Education “Novosibirsk State Medical University”

of the Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation

D.A. Starichkov

Federal State Budgetary Educational Institution of Higher Education “Novosibirsk State Medical University”

of the Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation

 

https://doi.org/10.26617/1810-3111-2023-4(121)-89-96

 

Journal:Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 4 (121): 89-96.

 

Abstract

Background. Untimely referral of patients with somatoform disorders (SFD) to specialists leads both to a deterioration in the quality of life of these patients and the possibility of iatrogenic complications, as well as a significant increase in the burden on primary health care and, consequently, an increase in the costs of providing medical services. The delay in receiving help by affected persons is associated with the shortcomings of the existing scheme for routing psychiatric patients. Objective: to identify factors, including psychopathological and psychological, that make it difficult to adequately route patients with SFD to specialists. Knowledge of the factors leading to late routing of this category of patients to psychiatric services can contribute to the improvement of diagnostic techniques aimed at early detection of SFD, optimization of clinical tactics and algorithm for the management of patients with SFD. Material. The study included patients (n=165) with SFD who  underwent examination and treatment in psychiatric institutions. Based on the comparative routing data of patients, two groups were formed. The main group (n=97) – patients with late contact with a psychiatric unit, who were observed by doctors of the general somatic network for more than a year. The comparison group (n=68) included patients who were less than a year from the moment they contacted doctors in the general somatic network until they were routed to psychiatry specialists. Each patient was provided with a standard form of informed consent to participate in a scientific study with the explanation of the goals, objectives and methods used. Methods: clinical-psychopathological method (including standard psychiatric interview), psychometric testing (Beck Depression Scale, Spielberger Anxiety Scale, Toronto Alexithymia Scale, PHQ-15 module of the Patient Health Questionnaire). Results. It has been established that the presence of comorbid symptoms such as depression and anxiety, as well as a high level of somatization, contribute to the timely and rational individual routing of patients with SFD to the psychiatric service, while pronounced alexithymic personality traits, on the contrary, lead to a long-term stay of the patient in the general somatic network.

 

Keywords: somatoform disorders, alexithymia, compliance, somatization, depression, anxiety.

 

Article(pdf)

 

Contacts

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Materials

For citation: Karpushkin A.M., Ovchinnikov A.A., Klimova I.Yu., Starichkov D.A. Features of routing patients with somatoform disorders. Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 4 (121): 89-96. https://doi.org/10.26617/1810-3111-2023-4(121)-89-96

 

REFERENCES

  1. Creed F, Barsky A. A systematic review of the epidemiology of somatisation disorder and hypochondriasis. J Psychosom Res. 2004 Apr;56(4):391-408. doi: 10.1016/S0022-3999(03)00622-6. PMID: 15094023.
  2. Herzog A, Shedden-Mora MC, Jordan P, Löwe B. Duration of untreated illness in patients with somatoform disorders. J Psychosom Res. 2018 Apr;107:1-6. doi: 10.1016/j.jpsychores.2018.01.011. Epub 2018 Jan 31. PMID: 29502757.
  3. Reddy B, Das S, Guruprasad S. Research challenges in somatoform disorders: A narrative review. Asian J Psychiatr. 2018 Apr;34:65-66. doi: 10.1016/j.ajp. 2018.04.018. Epub 2018 Apr 3. PMID: 29656277.
  4. Wessely S, Nimnuan C, Sharpe M. Functional somatic syndromes: one or many? Lancet. 1999 Sep 11;354(9182):936-9. doi: 10.1016/S0140-6736(98)08320-2. PMID: 10489969.
  5. Alexithymia and methods for its determination in borderline psychosomatic disorders: Manual for psychologists and doctors / DB Eresko, GL Isurina, EV Kaidanovskaya [and others]. St. Petersburg: St. Petersburg Research Psychoneurological Institute named after V.M. Bekhterev, 2005:25 (in Russian).
  6. Karpushkin AM, Ovchinnikov AA, Klimova IYu. The role of a dysfunctional family in the formation of a psycho-pathological personality profile of patients with somatization disorder. Siberian Herald of Psychiatry and Addiction Psychiatry. 2022;1(114):65-71. https://doi.org/10.26617/1810-3111-2022-1(114)-65-71(in Russian).
  7. Karpushkin AM, Ovchinnikov AA, Klimova IYu. Comparative characteristics of the psychopathological profile of patients with somatoform disorders at the primary outpatient (somatic) and psychiatric level. Siberian Herald of Psychiatry and Addiction Psychiatry. 2022;3 (116):72-79. https://doi.org/10.26617/1810-3111-2022-3(116)-72-79(in Russian).
  8. KarpushkinAM, OvchinnikovAA. Somatoform disorder: historical aspect and state-of-the-art of the problem in modern conditions (literature review). Siberian Herald of Psychiatry and Addiction Psychiatry. 2021;4(113):79–92. https://doi.org/10.26617/1810-3111-2021-4(113)-79-92 (in Russian).
  9. Kostin AK, Rudnitsky VA, Sazonova OV, Nikitina VB, Epanchintseva EM, Ivanova AA, Garganeeva NP, Tsybulskaya EV, Perchatkina OE, Belokrylova MF. Clinical and socio-psychological factors determining adherence to treatment of patients with somatoform disorders. Siberian Herald of Psychiatry and Addiction Psychiatry. 2020;2(107):14-25. https://doi.org/10.26617/1810-3111-2020-2(107)-14-25(in Russian).
  10. Lyashkovskaya SV, Tashlykov VA, Semenova NV. Approaches to the definition and typology of psychotherapy targets in the context of the tasks of improving individual psychotherapy programs. Review of Psychiatry and Medical Psychology named after V.M. Bekhterev. 2017;1:89-98 (in Russian).
  11. Malygin VL, Troitsky MS, Khrenov PA. Somatoform disorders in Russian literature (brief literature review). Bulletin of New Medical Technologies [Electronic edition]. 2019;13(5):72-79doi: 10.24411/2075-4094-2019-16552(in Russian).
  12. Ovchinnikov AA, Aksenov MM, Latypova OV. Complex pathomorphosis of neurotic anxiety-depressive disorders. Tomsk Ivan Fedorov: Publishing House, 2011:170 (in Russian).
  13. Sobennikov VS. Somatization and somatoform disorders. Irkutsk, 2014:304(in Russian).