Hypochondriacal ideas - dominiruschie view of the danger (usually exaggerated) and the futility of the treatment of somatic diseases, its poor outcome and social consequences, fear of disturbing (up to phobias), not related to the actual eigenvalues ??and relating to the functioning of internal organs and organism as a whole. II Violations of psychosomatic correlations (must have at least 1 of the criteria under the letter A or B). A. Inconsistency manifestations somatovegetative disorder severity and nature of SP (eg, dramatic weight loss and menstrual disorders in mild hyperthyroidism with a slight increase in thyroid hormone levels in the blood longer, not cropped nitroglycerin algii with the projection on the heart area, but not typical for angina voltage characteristics (in particular circumstances arising and cessation of pain), fatigue-resistant iron-deficiency anemia in the unexpressed; agripniya prolonged in patients with bronchial asthma or coronary heart disease in the absence of nocturnal seizures). B. Inconsistency of the dynamics of somatic disorders, the nature of the current SP, the discrepancy between the persistence of the polymorphism of clinical manifestations of disease and the relatively favorable dynamics of the somatic component (eg, persistent nausea, pain in upper abdomen, anorexia and other complaints with healed gastric ulcer or duodenal ulcer, asthenia , sleep disturbances, decreased libido, anhedonia, persisting in the clinical picture, despite the successful treatment of hypothyroidism). Unusual for the dynamics of SP modification somatovegetative manifestations (variability, mobility, and the sudden appearance and disappearance, the enrichment range of symptoms) under the influence of new (especially individually meaningful) information. III History, premorbid, heredity (all signs are among the non-binding). 1. Depressive and hypomanic episodes and suicide attempts in history. 2. Tsiklotimny, hyperthymic, anxious and insecure, hysterical and schizoid constitutional warehouse with features of reactive lability (tendency to the formation of affective disorders). 3. Depression, alcoholism and suicide in the immediate family. References: 1. Luria RY Internal picture of disease and iatrogennye disease. - M., 1988. - 111. 2. Mosolov SN Clinical use of modern antidepressants. - St., 1995. - 565 sec. 3. Paradise, VA Psychotropic drugs in the clinic of internal medicine. - M., 1988. 4. Smulevich AB Psychosomatic disorders / Social and clinical psychiatry. - 1997. - № 1. - S. 5-18. 5. Smulevich AB, Morozova MA Effects timoleptikov in the aspect of a new clinical taxonomy of depressive syndrome, Zh. nevrol. psychiatrist. - 1997. - № 7. - S. 22-26. 6. Smulevich AB, Syrkin AL, Drobizhev MY Diagnosis and pharmacotherapy of depression in medically ill / / Depression and comorbid disorders. - M., 1997. - S. 250-260. 7.
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