Somatoform disorders in the development of visceral systems pathology

Abstract

Introduction. Somatoform disorder (vegetative dysfunction), which occurs against the background of endocrine changes in the body during adolescence, is clinically inadequate vegetative regulation. Up to 50 percent of patients with primary care have physical symptoms that can not be explained by the general health status. In recent years, much attention has been paid to the problem of somatoform disorders in hypertension, chronic heart failure (CHF). There is a high prevalence of anxiety-depressive disorders, especially in patients with CHF. Unexplained symptoms of somatoform disorders often lead to more frequent visits to doctors, unnecessary visits to the clinic and laboratory tests or costly and potentially dangerous invasive procedures. The aim is to study autonomic dysfunction in patients with chronic heart failure and anxiety-depressive disorders and electrophysiological aspects of somatization of pathology in irritable bowel syndrome (IBS). Material and methods. The study was conducted in 35 patients with somatoform disorders in irritable bowel syndrome accompanied by severe abdominal pain. The study involved 25 patients with a functional class of chronic heart failure (CHF) NYHA II-III against a background of arterial hypertension (AH) of ischemic origin and 30 patients with arterial hypertension of II degree and abdominal obesity (AO). Results. All patients showed signs of anxiety-depressive or somatoform disorders, asthenia. The presence of signs of anxiety and depressive disorders in patients with CHF and AH was accompanied by violations of autonomic regulation of blood pressure level, activity of the sympathetic nervous system, frequent occurrence of cardiac arrhythmias, decreased tolerance to physical activity and deterioration of the quality of life of this category of patients. The IBS was studied by electromyography. In the descending part of the colon, an increase in the frequency and amplitude of slow waves was observed, and the power of contraction was increased to 3 times. Conclusions. Imbalance of the sympathetic / parasympathetic systems in favor of the sympathetic part of the ANS contributes to worsening of the compromised function of the vascular endothelium. These changes significantly increase the risk of developing a lethal outcome of acute myocardial infarction. The high prevalence and the associated increase in morbidity and mortality make it necessary to continue research into the regulation of regulation of somatoform disorders in chronic heart failure.