The role of a dysfunctional family in the formation of a psychopathological personality profile of patients with somatized disorder

Background. The negative impact of a complex of psychosocial risk factors, which include upbringing in a dysfunctional family, determines a decrease in the qualitative indicators of mental health and an increase in the number of people with psychosomatic disorders in the general population. This is associated with the high prevalence of the phenomenon of somatization in society, somatized neuroses, somatized depression, and anxiety. Patients with somatized disorders have been observed by internists of general practice for a long time, do not address to a psychiatrist at an early stage of the disease, that is the reason for pronounced clinical dynamics, rapid progress and an unfavorable prognosis. Objective: to study the influence of family dysfunction on the formation of the psychopathological profile of patients with somatized disorder. Materials and Methods. According to the purpose of the study, a group of patients (n=79) with an established diagnosis of somatized disorder (F45.0) according to the criteria of ICD-10 was enrolled. The work uses clinical-psychopathological and clinical-dynamic methods, including psychiatric interviews, clinical-psychological diagnostics using psychometric tests: the Scale of Family Adaptation and Cohesion (Olson FACES-3 test), the Toronto Scale of Alexithymia (TAS), the scale of somatic symptoms PHQ-15 a fragment of the Questionnaire for assessing the patient's health (Patient Health Questionnaire, PHQ). Results. The study groups were formed taking into account the evaluation of the results of the Olson test performed by the subjects. The main groupis patients with dysfunctional patterns of family interaction, the comparison group includes patients with more favorable intra-family relationships. Patients of the main group showed high rates of alexithymia and somatization, low level of compliance, low adherence to drug therapy. In addition, patients of the main group more often expressed disagreement with the established diagnosis, demonstrated distrust of the recommendations of the attending physician, unwillingness to undergo psychotherapeutic treatment than patients of the comparison group. Conclusion. The adverse effect of a dysfunctional family structure is confirmed by higher rates of alexithymia and somatization in patients of the main group. Data obtained from the study materials demonstrate clinical manifestations of somatized disorder, supported by evidence of objectively unconfirmed severity of somatic pathology, pronounced maladaptation of patients due to lengthening periods of work unemployment, unjustified refusal of treatment, decreased ability to establish compliant relationships with specialists of both somatic and psychiatric networks.