 Keywords: psychology, feature, psychological features of patients with a peptic ulcer, a stomach, a pathology, a duodenal intestine, enea-type, Cung, the test, research, the psychological status, the ulcerative patient, a peptic ulcer of a stomach, a peptic ulcer of a stomach, a peptic ulcer of a duodenal intestine, a stomach ulcer, a ulcer of a duodenal intestine, an erosive gastritisRESEARCH OF THE PSYCHOLOGICAL STATUS OF PATIENTS BY THE PEPTIC ULCERIn the modern literature appears more and more publications, devoted to psychosomatic diseases. The psychosomatic pathology, as is known, meets enough frequently. As a rule, patients with psychosomatic frustration (a peptic ulcer of a stomach and a duodenal intestine, ischemic illness of heart, a ulcerative colitis, a neurodermite and other illnesses) are treated in somatic hospitals, and, almost always these diseases do not recover, t. To. In a basis of their genesis the psychopathology which is not taken into account by the attending physician, and, accordingly, lays treatment does not bring desirable result. Each psychosomatic disease including the peptic ulcer of a stomach or a duodenal intestine in the basis has specific psychological features of the person though it it it is considered (Alexander, 1934), that " ulcerative type of the person " does not exist. Allocate some psychological types. So, for example, Overbeck and Biebl (1975) offer separation of ulcerative patients into 5 types:
The majority of authors (Freyberger, 1972; Balint, 1969; Loch, 1963 and others) allocate 2 types (hyperactive and passive). It is considered, that almost at all patients with a peptic ulcer the internal conflict on type takes place "to take - give" - struggle between two opposite aspirations (to dependence and phobias openly to show this dependence). At passive type patients enjoy advantages of dependence and do not undertake steps to independence. In the foreground at such patients it is necessary to be unconscious pavor left. At hyperactive ulcerative type of desire of dependence are meaningly rejected. These patients care of others, try to be leaders, constantly search success, but do not find it. Some researchers (Zander, 1976) consider, that the starting factor is envy - " the ulcer arises, when the person with hungry installation should see as another eats ". It is known, that the meal represents the first obvious satisfaction of retseptivno-collective desire. In ideas of the child desire to be by loved and desire to be fed are connected very deeply. When at more mature age the desire to receive the help from another causes shame or shyness that the desire it is frequent in a society which main value considers independence, finds regressive satisfaction in the raised bent for to absorption of nutrition. This draft stimulates a secretion of a stomach, and chronic rising of a secretion at the predisposed individual can result in a ulceration. On the basis of gastrointestinal branch of a city hospital of ¹3 cities of Voronezh inspection of patients with a peptic ulcer of a stomach or a duodenal intestine was carried out. The purpose was studying an internal picture of illness and psychological features of patients by inquiry, the collecting of an anamnesis, and also use of psychological tests. During conversation especially important it was represented to find out, to what the patient binds the disease. Questionnaires of a self-rating of uneasiness and Cung depression, and also a technique of definition of enea-types were used. Special interest represents research of enea-typological frame of the person on Claudio Naranho. This technique is applied now seldom enough though has series of advantages before other questionnaires - the patient, for example, has no opportunity to choose answers desirable for as variants are approximately interconvertible. This questionnaire will consist of 9 variants on 20 statements. The patient is offered to choose from these 9 variants with what it identifies itself(himself). In a basis of each enea-type the certain passion lays. So for I type the anger, for II - pride, III - vanity, IV - envy, V - avidity, VI - pavor, VII - gluttony, VIII - desire, IX - laziness is characteristic. During dialogue with patients it was found out, that the most part of patients, binds the disease to the psychological reasons that proves to be true and authentically raised level of uneasiness and depression (on the average on 10-15 items (20-25 %)) in comparison with patients who do not correlate illness to mental factors, and the level of uneasiness on 5-7 items was higher than a level of depression. The raised level of uneasiness is connected both to personal features of patients, and with a presence of patients in stressful conditions of hospitalization. Patients marked, that in domestic conditions they feel like much more comfortably and freely. At research of enea-typological frame special interest was represented by patients about IV (envy) and VII (gluttony) types which under the assumption, according to modern concepts of psychosomatic medicine, can tend to disease by a peptic ulcer. An example ¹1 (enea-type IV): patient Ê.; 52 years; for the first time the revealed peptic ulcer of a stomach; an erosive gastritis, a pancreatitis; the invalid of II group. Counts itself the extremely emotional person - " on this background and the ulcer " has developed. An erosive gastritis within 30 years. Life perceives tragically, feels like lonely though there is a son of 17 years. 3 years ago from it the husband has left, mother who was the most close person recently has died. It is severe in relation to other people. Frequently cries. The leader never aspired to be. These features are characteristic for IV of the enea-type having the basic passion envy. K.Naranho characterizes such people as looking happiness through a pain. Also the passive type of the ulcerative patient is obvious. Probably, this patient is the "psychosomatic" patient with a ulcer (on Overbeck, Biebl) as has poor imagination, feels like lonely, has an accompanying pathology and the ulcer has developed after loss of object of dependence (mother). An example ¹2 (enea-type VII): patient Ç.; 55 years; for the first time the revealed peptic ulcer of a stomach; an erosive gastritis; 6 months ago has transferred a microinsult; the invalid of II group. Is married, adults the son and the daughter. A situation in family estimates as good. Itself counts the emotional person. Considers, that the ulcer has the psychogenic nature. It is cheerful, marks, that " all is good ". Speaks, that in collective aspired to be the leader, to be allocated among others, to like men. Marks, that very strongly experiences concerning failures. Speaks, that very much likes to care of other people. Such features are characteristic for " opportunistic idealists " (enea-type VII), having passion insatiability, gluttony. The hyperactive type of the ulcerative patient is obvious. On Overbeck, Biebl she, most likely, is the ulcerative patient with a neurosis of character - long experience of failures takes place. Thus research of enea-typological frame of the person helps to understand better personal features of the patient, to predict his behaviour in those or other situations. At research it was found out, that the most part of patients has characteristic for ulcerative patients types of behaviour. Hence at treatment of patients by a peptic ulcer it is necessary to take into account mental features of patients and to carry out psychotherapeutic correction. Patients have been adjusted benevolently, to pleasure contacted. Also it was found out, that many patients with a peptic ulcer have transferred in the recent past any mental trauma (divorce or mors of one of parents). The appreciable part from them now lives in socially unsuccessful situation. Similar experience of interaction of the student with the patient is very important for formation of the person of the future doctor, it helps to understand better psychological features of the patients treated in somatic hospitals. Studying psychopathology of somatic patients is especially important for the future psychiatrists and psychotherapists as in medical high school not enough time is given studying of medical psychology. For training students creation of additional cycles on clinical faculties on studying personal features of somatic patients, and also diagnostics of psychosomatic frustration is necessaryInteraction of the student with the patient can be useful and for the patient. In fact during such dialogue at the patient positive installation that can facilitate his condition can be generated. Almost all patients after inspection marked improvement of mood. Thus, it is possible to tell, that interaction of the student with the patient is one of important amounting in training the student - physician. The special attention should be given research of psychological frame of the person. To discuss a material at a forum of a site Keywords: psychology, feature, psychological features of patients with a peptic ulcer, a stomach, a pathology, a duodenal intestine, enea-type, Cung, the test, research, the psychological status, the ulcerative patient, a peptic ulcer of a stomach, a peptic ulcer of a stomach, a peptic ulcer of a duodenal intestine, a stomach ulcer, a ulcer of a duodenal intestine, an erosive gastritis Main | Abstracts, compositions, lectures | Psychiatry | Links
|
