MINISTRY OF HEALTH OF UKRAINE

Bogomolets National Medical University

DEPARTMENT OF MEDICAL PSYCHOLOGY, PSYCHOSOMATIC MEDICINE

AND PSYCHOTHERAPY

«APPROVE»

Head of the Medical psychology,

psychosomatic medicine
and psychotherapy department
Prof. O. Chaban

Jralt
«27» August 2022 y.

METHODICAL RECOMMENDATION
FOR INDIVIDUAL WORK

Psychosomatic medicine. Communication skills

Educational discipline
of the doctor
Module Ne 1
Theoretical and applied foundations of
Content module Nel
psychosomatic medicine.
Concept, basic principles and theories of
Topic 1 psychosomatic medicine
Year of education 4
Specialty Medical

2022-2023
 Topic of lesson No. 1. "Concept, basic principles and theories of psychosomatic
medicine"
(practical lesson - 4 hours)

1. Relevance of the topic. Studying the topic allows students to learn the concept of
the term "psychosomatic”, the history and main tasks of psychosomatic medicine, to study
various scientific directions in the development of psychosomatic medicine

2. Educational goals.
To know: the main definitions and tasks of psychosomatic medicine, the evolution
of psychosomatic theories.
To be able to: identify risk factors for the development of a psychosomatic disease.

3. Basic level of training.

Names of previous
disciplines Acquired skills
Pathophysiology Understanding the main psychological processes
Propaedeutics of | Verification of mental reactions in patients with a somatic
internal medicine profile
Social medicine, | Understanding the importance of professional
public health communication
Medical Methods of psychological diagnosis and medical and
psychology psychological support

4. Tasks for individual work during preparation for class.

4.1. A list of the main terms that a student should learn when preparing for class:
Term Definition
Psychosomatic a broad interdisciplinary field that addresses the interaction of
medicine biological, psychological, and social factors in regulating the
balance between health and disease and provides a conceptual
framework for:
e scientific research on the impact of psychosocial factors
on individual vulnerability, the course and prognosis of
 any disease;
e apersonalized and holistic approach to patient care;
e adding a psychosocial assessment to a standard medical
examination;
e integration of psychological and psychiatric therapy in
the prevention, treatment and rehabilitation of any
disease;
e a multidisciplinary health care organization that
overcomes the artificial boundaries of traditional
medical specialties.
Somatization e as atendency to experience psychological stress at the
physiological level;
o expression of personal and social distress through
physical complaints and seeking medical help;
» using somatic symptoms to achieve psychological goals

4.2. Theoretical questions for the lesson.

1. Etymology of the term "psychosomatic".
2. The role of psychosomatic medicine in modern medical science.
3. Concept of psychosomatic medicine, subject and main tasks.
4. The main tasks of psychosomatic medicine.
5. Evolution of psychosomatic theories

5. Brief content of the topic.

Etymology of the term '"psychosomatic''.
Zinchenko V.P. (1999): "Psychosomatics (from the Greek. psyche - soul and soma -
body) - a branch in medicine that studies the role of psychological factors in the etiology
and pathogenesis of functional and organic disorders of the human body."
Maneghetti A. (2003): "Psychosomatics expresses the concept of hylemorphic unity
(A matter-body, popyt form-soul) - the unity of human action. In the narrower sense, it
means a functional-historical distortion caused exclusively by a mental cause."
The role of psychosomatic medicine in modern medical science.
At present, the interest in psychosomatic problems is especially great, because since
the second half of the 20th century. the load on the human nervous system and psyche
increased sharply. This is due to the fact that most people live in large cities, receiving a
huge amount of redundant information. The rapid development of science and technology,
the saturation of interpersonal relations, and the increase in the pace of life require
increased psycho-emotional stress from a person. Frequent stressful situations can cause
disorders of neuropsychological health (Nikolayeva V.V., 1987; Chaban O.S., 2013,
Simon JG, 2000; Cameron OG, 2011; Rashbaum IG, Sarno JE, 2013; G. Fava, 2016).
In modern science, a big place belongs to the problem of stress. Stress is a general
non-specific adaptive reaction in response to the action of stressogenic factors that has
developed in the process of evolution (Selye H., 1936). Chronic stress is accompanied by a
decrease in non-specific resistance and is the non-specific basis of a number of diseases.
A significant amount of data has been accumulated, testifying to the significant
influence of psychosocial factors on the prevalence, morbidity and mortality from
psychosomatic diseases (Chaban O.S., 2019; Lorenzi P. et al., 2000; Glina DM et al., 2001;
G. Fava , 2016). These factors include:
* acute mental trauma;
« chronic psycho-emotional tension (stress);
« adverse life events and changes;
« psychological characteristics of people (type of behavior, emotional state, temperament,
character traits, protective mechanisms);
« excessive fixation on one's illness.
In the development of psychosomatic disorders, an important role is played by the
fact that during emotional stress, changes occur in the entire multilevel system of
regulating psychophysical relationships. At different levels of this system, regulation is
mainly carried out by psychological or physiological mechanisms. In the formation of
psychosomatic disorders, there are significant changes at each of the interconnected levels.
Most researchers studying the impact of psychosocial stress on the disease analyze
the impact of the total sum of events and separately the role of negative and undesirable
factors. Special importance in the formation and development of the disease is attributed to
negative psychological factors. The occurrence of stress is caused by socio-economic,
technical, demographic, and environmental conditions. According to Chaban O.S.,
Khaustova 0.0. (2010), 30% of people who have problems at work have psychosomatic
disorders.
Stress of organic or mental origin stimulates the hypothalamus, and as a result, the
sympathetic nervous system is activated. The adrenal medulla releases adrenaline, and the
hypothalamus releases a neurohumoral agent. As a result, the anterior lobe of the pituitary
gland is stimulated, which leads to an increase in the secretion of tropic hormones.
C. Howarth (1978) distinguished four aspects of psycho-emotional stress:
1) biological, when a person's way of life is radically different from the one to which he
was adapted in phylogeny;
2) evolutionary, or ontogenetic, when a person's upbringing and education do not meet the
demands directed at him in connection with his lifestyle;
3) social, when a person is forced to act in society with a role that does not correspond to
him or when conflict situations of a social nature are created;
4) phenomenological, when the way of life does not correspond to ideals or aspirations.
In the literature, there are many studies devoted to studying the mechanisms of stress
on the human body (P.I. Sydorov, S.L. Sovershaeva, 2001, O.S. Chaban, O.0. Haustova,
2020; G.Ya. Pylyagina, 2020 ). Thus, in the evolutionary aspect, the human stress reaction
developed as a biological reaction of protection against harmful factors. It includes stress-
realizing and stress-limiting mechanisms aimed at preserving the body's homeostasis.
In the morpho-functional plan, stress is characterized by three stages:
« anxiety, during which there is an emergency mobilization of the body's energy resources;
« resistance to the action of irritants, which is accompanied by adaptation of the body to
new conditions by stressing the body's functional systems;
« exhaustion, when, as a result of the failure of compensatory and adaptive mechanisms,
the risk of serious disturbances of vital activity increases, up to the death of the organism.
The stress-realizing mechanisms of the general adaptation syndrome can be traced at
different stages of stress. The stage of anxiety (fear, struggle, escape) consists in the
emergency mobilization of the body's energy resources and bringing it into a state of
increased readiness to protect against harmful factors. This stage is accompanied by the
formation of emotional coloring (fear, terror, anger, aggression). The duration of the first
phase (the "fear" phase) is short - seconds, sometimes minutes. However, during this time,
as a result of the resulting "vegetative storm", which is characterized by a significant
increase in sympathetic tone, there is a marked activation of the main energy supply
systems - the respiratory system and the circulatory system.
Following the short-term phase of "fear" in the body, processes aimed at the further
mobilization of energy resources necessary to ensure the phases of "fight" and (or)
"escape" continue. Metabolism increases with the predominance of catabolic reactions: the
level of metabolic substrates such as glucose and free fatty acids increases in the blood.
 Depending on the predominance of adrenal or noradrenal type of reactivity, the final
biological effects at the level of behavioral reactions and reactions of target tissues in
individual individuals may differ. Thus, adrenaline, as a hormone of the medulla of the
adrenal glands ("hormone of anxiety"), leads to a more pronounced reaction of fright, fear,
terror. The predominance of the noradrenal type of reactivity ensures "fight" behavioral
reactions under stress. Carriers of this type have greater endurance and better tolerate states
of severe physical stress.
In the case when the stressor continues, and the changes that occurred in the first
stage of stress are insufficient to compensate for its destabilizing effect, the stage of
resistance develops - this is a state of increased resistance of the body to the action of this
stressor, as well as to many other stimuli. At this stage, such stress-realizing systems as
adrenomedullary, hypothalamic-pituitary-adrenal, hypothalamic-pituitary-thyroid,
somatotropic are activated. Neuroendocrine axes interact with each other both "vertically"
and "horizontally". These interactions depend on the influence of components of stress-
limiting systems, releasing factors of the hypothalamus and tropic hormones of the
pituitary gland, as well as on the condition of peripheral target glands.
Of special importance in the body's reactivity belongs to the hypothalamic-pituitary-
adrenal axis, which is activated by noradrenaline of adrenergic neurons of the cortex of the
large hemispheres, the limbic system and the reticular formation of the brain. Stressors
indirectly, through the sense organs, activate noradrenergic neurons of the brain. The
noradrenaline released at the same time stimulates the production of corticoliberin and
antidiuretic hormone in the hypothalamus. Corticoliberin initiates the synthesis of
adrenocorticotropic hormone in the pituitary gland, under the influence of which the
adrenal cortex begins to intensively secrete cortisol into the blood, and the medulla -
catecholamines (adrenaline and noradrenaline). At the same time, corticoliberin, affecting
other hypothalamic neurons, suppresses the synthesis of releasing factors of somatotropic
hormone and gonadotropins. In addition to glucocorticoids, the synthesis of aldosterone
increases in the cortex of the adrenal glands. Activation of the synthesis of growth
hormone and the thyroid axis, enhancing the reactions of the catabolic series, significantly
increases energy production. However, high levels of thyroid hormones lead to uncoupling
of oxidation and phosphorylation processes in cells. As a result, cellular hypoergosis is
formed, which acts under stress as a factor in the activation of cytokine cascade reactions,
the negative consequences of which lead to the development of pathological processes.
In stress, the immune system also plays a big role. Relationships in the system
"stressor-immune system-endocrine system" represent a series of consecutive and
interdependent reactions. At the same time, the production of cytokines stimulates the
central response, and cortisol suppresses their excessive production.
The stage of resistance is a reversible stage. If the effect of the stressor stops, then
the body gradually returns to the initial level of functioning. In the case of ongoing
stressful stimulation, the central and peripheral stress-realizing systems, and then the
visceral homeostasis support systems, work at the limit of their functional capabilities.
With long-term stressor stimulation, the risk of transition to the stage of exhaustion
increases.
The exhaustion stage is a negative result of stress. Injury reactions develop in the
body. Oncoming atrophy of the cortex of the adrenal glands leads to inhibition of the
mechanisms that block the synthesis of growth hormone and thyroid hormones. Following
this, a sharp increase in the production of hormones of the catabolic series develops, which
causes hypoergosis of tissues. The mechanisms of the anxiety stage aimed at mobilizing
energy are turned on again. However, in an exhausted body, they are destructive.
Anxiety is a central element in the mechanism of formation of mental stress
(Takeichi M. et al., 2001, Chaban O.S., 2020). It is indicated as a feeling of vague threat,
as a feeling of diffuse apprehension, as a result of frustration or its expectation. Anxiety
causes a large part of the disorders that occur during emotional stress, activates the
mechanisms of mental adaptation. Since emotional stress represents the mobilization of all
body systems that prepare it for physical activity (fight-flight), with chronic exposure to a
stress factor, the initial stage of stress - the stage of anxiety with changes in humoral
regulation and transient autonomic reactions turns into the stage of resistance. Chronic
autonomic and humoral activation at the initial stage is manifested by symptoms of
autonomic dystonia and can serve as a basis for the development of more pronounced
psychosomatic disorders. Under the influence of ongoing mental stress, various
psychosomatic disorders develop, the formation and nature of which depend on the genetic
predisposition acquired during ontogenesis, the insufficiency of certain body systems and
personality characteristics.
Psychosomatic reactions are realized with the participation of three main structures
of the brain:
1) the neocortex, which is mainly responsible for the processes of memory, judgment,
speech and inhibitory reactions;
2) hypothalamus - the source of emotions, which integrates and coordinates the activity of
the vegetative and endocrine systems;
3) the limbic system, which is called the "visceral brain", which ensures the interaction of
the two previously mentioned centers and is responsible for the behavioral reactions of a
person in a specific life situation.
Two endocrine ways are closely related to these three brain structures:
1) hypothalamus-pituitary-adrenal cortex, which implements the psycho-emotional stress
response, and
2) hypothalamus-sympathetic-brain substance of the adrenal glands, responsible for the
body's protective reactions.
It is believed that the choice of the organ in which disorders occur under the
influence of psychogenic influences is determined by genetic predisposition (Luria R.A.,
1977). The initiative in choosing a target organ always belongs to the cortical connections,
which in a certain way "charge" the subcortical structures of the brain, which are
responsible for emotions and program the degree of involvement of specific organs in a
stressful situation. The choice of the target organ also depends on the effector path, which
at the moment turned out to be the best for the "exit" of psycho-emotional excitement to
the periphery, the specifics of this emotion, the nervous constitution of a person and his
entire life history, as well as individual "stress resistance" (Engel GL, 1974; Volkov V.T.
et al., 1995; Haustova O.0., 2016).

Concept of psychosomatic medicine, subject and main tasks.

Psychosomatic medicine is a general approach to solving medical problems, the
conceptual basis of which is taking into account the complexity of somatopsychosocial
interaction when assessing the mechanisms of occurrence, features of the course and
therapy of diseases. There are many definitions of the term "psychosomatics", none of
which is exhaustive.
Petrovskyi O.V., Yaroshevskyi M.H. (1990): "Psychosomatics is a branch of
medical psychology that studies the influence of psychological factors on the occurrence of
a number of somatic diseases (bronchial asthma, hypertension, angina pectoris, duodenal
ulcer, ulcerative colitis, neurodermatitis, chronic polyarthritis, endocrine disorders,
malignant neoplasms".
Nikolayeva V.V., Aryna G.O. (1996): "Psychosomatics is the study of the physical
relationship between mental and somatic processes in the body".
N.D. Bilkina (1997): "Psychosomatic medicine, or psychosomatics, is a branch of
interdisciplinary research (philosophy, physiology, medicine, and other sciences) aimed at
studying the psyche and the body - the soul and the body, that is, the psychosomatic
problem.”
Brotygam V. et al. (1999): "Psychosomatic medicine is the science of the
relationship between mental and somatic processes that closely connect a person with the
environment."
Giovanni A. Fava (2016): Psychosomatic medicine is a broad interdisciplinary field
concerned with the interaction of biological, psychological, and social factors in regulating
the balance between health and disease and provides a conceptual framework for:
o scientific research on the influence of psychosocial factors on individual
vulnerability, the course and prognosis of any disease;
e apersonalized and holistic approach to patient care;
e adding a psychosocial assessment to a standard medical examination;
e integration of psychological and psychiatric therapy in the prevention, treatment and
rehabilitation of any disease
o a multidisciplinary health care organization that overcomes the artificial boundaries
of traditional medical specialties.
The main tasks of psychosomatic medicine.
In the domestic medical terminology, the concepts discussed above corresponded to
a slightly different meaning in recent decades. For example, according to the current
provision on the psychosomatic department, it provides for the treatment of mental patients
with concomitant somatic pathology, which does not correspond to the very essence of the
psychosomatic approach recognized in world medicine. It is necessary to pay attention to
such a psychosomatic aspect, which is insufficiently covered in the domestic literature, as
interaction in the patient-doctor systems; the patient - his family; the doctor - the patient's
family. Many arguments can be given that indicate the necessity and even the economic
feasibility of optimizing these relations.
It is another matter with specific knowledge and practical skills in the field of
psychology of these relationships. Such a situation, of course, is not caused by insufficient
humanity of our doctor. The reason is related to the gap in his overall fundamental
education. After all, in the curriculum of medical educational institutions, a few hours are
devoted to these questions, and during postgraduate training they are not returned to at all.
Because of this, the medical worker is forced to use purely "common sense psychology".
At the same time, the patient and his relatives are given advice to "take care of yourself",
"relax", etc. However, "household psychology and psychotherapy" are far from always
effective. It should be added that the above-mentioned significant shortcomings largely
arose as a result of the fact that in the second half of the 20th century, for known reasons,
the outstanding achievements of domestic scientists and practical specialists in the field of
psychoanalysis and other personality-oriented psychotherapeutic approaches, which are not
an integral part of psychosomatic medicine.
Ideas about the connection between mental processes and somatic disorders can be
found in ancient medical treatises. For example, in the 3rd century BC, it was believed that
a woman's unsatisfied desire to have a child leads to uterine movements that cause pain in
the lower abdomen. This picture of the disease was called hysteria. Hypochondria, on the
contrary, was considered an organic disease localized in the right hypochondrium. At the
current stage of the development of medicine, psychosomatic medicine studies the
relationship between somatic diseases and mental processes.
Luban-Plotza B. (1997) defines psychosomatic medicine as a theory or teaching
about the spiritual-physical unity of the patient in the environment of social relations.
Thus, psychosomatic medicine affirms the biopsychosomatic unity of a person and
describes exactly how biological, psychological and social factors affect the occurrence,
course and overcoming of physical diseases. In the narrower sense, only those diseases are
considered psychosomatic, in which psycho-social factors play a leading role in the
occurrence of the disease, and when this is clearly confirmed by the course of the disease.
Psychosomatic medicine can also be seen as a fundamental principle of treatment
that defines biomedical, psychotherapeutic and social therapeutic plans as complementary
parts of interactive (“holistic”) medicine. The integration of these aspects is carried out in
medical practice in two ways: either through the expansion of the psychosomatic
competence of one doctor, or through the close cooperation of a "physical doctor" and a
"spiritual doctor" or a psychologist. Then the doctor will be reliably prepared to overcome
difficult medical situations, and the patient, regardless of age, illness and its severity, can
be sure that attention will be paid to all aspects of his problem; biological, spiritual and
social. O. Chaban (2017) considers psychosomatic medicine as a method of treatment and
a science of the relationship between mental and somatic processes that closely connect a
person with the surrounding environment.

Evolution of psychosomatic theories

Among the various models that describe the occurrence of psychosomatic diseases,
the most important today is behavioral (behavior) and psychoanalytical concepts.
 Table 1. Psychoanalytic concepts of psychosomatic medicine

Z. Freud Conversion model | With the appearance of a somatic

symptom, the patient feels emotional
relief due to the easing of the oppression
of the unconscious conflict
F. Alexander A model of Unconscious conflict without a solution
autonomic in the appropriate external manifestation
neurosis leads to emotional tension with
persistent changes in the autonomic
nervous system, changes in tissues,
damage to organs
M. Shur The concept of As a result of unfavorable development
desomatization and frustrations, the normal process of
desomatization can turn into a
regression in the form of resomatization
of affect.
J. Engel, A. The model of Feelings of loss, disconnection between
Shmale giving up faith in | past and future, hopelessness lead to
the future psychosomatic disorders.
A. Mitscherlich A model of a two- If the first line of defense (mental) does
echelon line of not work, the second echelon defense is
defense activated - somatization, which leads to
structural changes in the organs

Psychotic symptomatology
O. Kernberg the third level of
protection
H. Freiberger The concept of Leading psychodynamic factors -
object loss psychosomatic line of development
(symptom, conflict, personal
characteristics)

Table 2. Basic psychosomatic theories

A model of There is a violation of the

P. Kutter fighting for your psychosomatic patient's
body communication with his body (fatigue
or internal exhaustion is not
 perceived), which leads to
psychosomatic disorders
M. Balint Model of initial | The patient's negative feelings turn
disturbance against him, contributing to the
development of a psychosomatic
disorder
M. Seligman The theory of An encounter with uncontrollable
"learned events leads to a cognitive and
helplessness" emotional deficit, which transforms
into "acquired helplessness" and then
into a psychosomatic illness.
F. Dunbar The personality | Types of personal premorbidity (for
of the example, coronary type -
psychosomatic workaholics: dominant, aggressive,
patient impatient, etc.)
P. Federn Weakness of the | Accumulation of unprocessed
Ego experiences leads to psychosomatic,
affective, addictive disorders
J. McDougall Lack of self- A psychological threat is also
centeredness perceived by the patient as a physical
one, which causes somatic symptoms
G. Crystal Transfer Patients experience physical pain
formation along with or instead of emotions
G. Ammon Restoration of Psychosomatic process as protection
the integration of against complex life problems
the individual

Table 3. Additional psychosomatic theories

K. Menninger "Partial suicide" Neurotic self-harming

E.G. Eidemiller Hypothesis of Psychosomatic disorders are one of the
self-harming varieties of self-destructive behavior.
behavior
Yu.G. Frolova Control - Underestimation (overestimation) of
helplessness capabilities, inadequate control,
anxiety, despair
M. Friedman, R. Types of Type A: counterattack; type B: non-
Rozerman personality of the resistant
patient
T. Morris, S. Greer The personality of Type C: Depression, acquired
a cancer patient helplessness, suppression of negative
emotions, lack of social support
V.D. Topolyanskyi Emotional Stormy ambivalent affective reactions,
M. V. Strukovska infantilism fixation of emotional conflict leads to
somatization
J. Basiaans Fixation points of | Failure to regulate or sublimate
aggression aggressive impulses contributes to
somatization
P. Marty, M. de Model of Violation of verbal and symbolic
Meuzant alexithymia expression provokes a psychosomatic
disorder
Y. Yu. Eliseeva Psychological Internal conflict, motivation,
sources of suggestion effect, identification, self-
psychosomatic punishment, past traumatic experience,
diseases alexithymia
S. Minukhin Typical patterns of Somatic illness becomes a common
a psychosomatic means of "resolving" hidden family
family conflicts
E.G. Eidemiller, Family "harms" Emotional tension, disruption of family
V.V. Yustytskyi communication and structural-role
interaction
H. Steyerlin Types of parental Binding, alienation, delegation
family
relationships

Table 4. Integrative psychosomatic theories

R.P. Lieberman Peculiarities of Psychosomatic family as a rigid

psychosomatic system where the existence of illness
families prevents confrontation with intra-
family interpersonal conflicts
H. Schaefer Systemic approach The influence of the environment,
- sociopsycho- interpersonal conflicts and frustrations
somatics through "body language" on the self-
realization of the individual
D. Oudtshoorn Integrative Six levels: environment, family, "I",
approach psychodynamics, personality, body
H. Weiner Integrative model Health, illness and a painful condition
 of health, illness create a single continuum, the location
and disease state of a person is determined by the
influence of a number of factors
Th. Uexkull Biopsychosocial Preparedness diseases as a result of the
W. Weisiack model interaction between a person and the
environment (dynamic integrity)

Viktor Freiherr Medical Psychosomatic diseases as a result of

von Weizséicker anthropology pathological adjustment

6. Control materials for the main stage of the lesson.

Questions for control and self-control:
. Concept of psychosomatic medicine.
. Psychosocial factors of the occurrence of psychosomatic diseases.
W=

. Concept and general characteristics of psychosomatics.

. Psychoanalytic theories of psychosomatics.
R

. Basic psychoanalytic theories.

. Additional psychosomatic theories.
O

. Integrative psychosomatic theories.

N

1. Materials for the final stage of the lesson

Discussion of essays and reports
Essay topics:
. A healthy lifestyle in the prevention and treatment of psychosomatic diseases.
=

. Basic living conditions affecting the psychosomatic health of young people.

N

. Factors in the development of psychosomatic disease

W

. The place of urbanization in the genesis of psychosomatic pathology.

. Classifications of psychosomatic diseases according to different concepts
. Name the factors that negatively affect a healthy lifestyle.
N

. Effectiveness of the health care system in the formation of a healthy lifestyle.

~N

8. To determine the effectiveness of prevention of self-destructive behavior

psychosomatic medicine.

9. Materials for methodical support of students' self-training (questions for

students' individual work)
 1. Execution of written work:
« What do you know about the basic concepts and principles of psychosomatics?
According to the plan:
» What books or articles on this topic have you studied?
*» Have you set priorities for yourself in studying the topic? What are they caused
by?
« Name the possibilities of practical application of theoretical knowledge obtained
after studying the topic.

2. An indicative map for working with literature:

Ne Task Instructions Notes

n/n
1. | Menuuna Work out textbook topics Recapitulate
nicuxoJiorisi: B 2-X T. | related to the subject of the
T. 2. CnenjanbHa lesson
MeJuuHa
ricuxoJoris/
[ .4, Iunsrina,
0.0. Xaycrosa,
H.O. Mapyra Ta
in.]; 3a pex. I'.51.
[Munsriyof. -
Binnuus: Hoa
Kuura,2020.- 496 c.
2. |Yaban O.C., SAmyxk | Study the textbook, write new | Additionally, orally
B.T., Hecroposuu | terms and concepts in the process the
SIM. Icuxiune | dictionary literature from the
3710pOB'st - list related to the
ITinpy4nuxk, specified topic.
Tepuonins, TAMY,
BHJIaB.
,,YKMenkaura”,
2008.
 3. | [Ipaktuuna Study the manual, find Recapitulate
MICHXOCOMATHKa: information on the subject of
nerpecisi. the lesson
HaBuaneuuit
nociOHuK/ 3a 3ar.
pen O.C. Yabana,
0.0. XaycToBof. -
K.: BunaBunuuit
nim MeikHura,
2021.-216 ¢

10. Recommended literature

Basic literature
1.Mennuna ncuxosnoris: B 2-x T. T. 1. 3aranpHa meanuna ncuxosnoris/ [ 'S, IMunsrina,
0.0. Xaycrosa, O.C. Yaban Ta in.]; 3a pexa. I'.S1. [Tunsrinoi. - Binnuns: Hosa Kuura,
2020. - 288 c.
2.Mennuna ncuxosorisi: B 2-x T. T. 2. CrienianbHa Meauyna ncuxodorisy/ [ I'.51. Iunsrina,
0.0. Xaycrosa, H.O. Mapyta Ta in.]; 3a pea. I'.S1. [Tunsrinoi. - Binnnus: Hoa Kuura,
2020. - 496 c.
3.IlpakTuyHa ncuxocoMaruka: JiarHocTHyHi wikanu. HaBuyaneHuit nociGHuk/3a 3ar. pej.
0.C. Yabana, 0.0. XaycroBoii. npyre Buganns- Kuis:, 2019 - 108 c.
4.IlpakTuyHa ncuxocomaruka: penpecis. Hapuanbuuii nocionux/ 3a 3ar. pexy O.C. Yabana,
0.0. XaycroBoi. - K.: BunaBuuuuit nim Meznkuura, 2021. - 216 c. ISBN 978-966-1597-
T7-7
5.Hesinknagna nomnomora B rcuxiarpii ta napkosorii / Yadan O.C., Xaycrosa O.0.,
OwmenstnoBud B.1O./ 3-Te Bunanns Kuis: Menknura, 2019. - 156 c.
6.Yaban O.C, Xaycroa O.0. [lcuxocomaruyna MeauuuHa (acrekTd IiarHOCTUKH Ta
nikyBanHs): [Tocionuk . — Kuis: TOB "JICT" JIta", 2004.— 96 c.
7.Anexcannep @. Ilcuxocomarnueckas wmeauuuHa./ @O. Anekcanugep . — M.
Menuuunckas kaura, 2011. — 320 c.
8.OCHOBM NICHXOCOMATHKH: METOA. BKa3. M0 Opr. Ta IUIAHYB. CAMOCT. POOOTH CTY. JEHHOT
Ta 3a04. (opM HaBY. HANpsM niaroroBku 6.030103 Tpakruyna ncuxonorist/ YKp. iHx.-
nex. akaz.; ynopsia. M. B. Banymok. - X.: [6. B.], 2013. - 12 c.
9.Chaban, O., Khaustova, O., Trachuk, L., & Bezsheiko, V. (2017). Meroauuni
peKoMeHalii 10 BUKOHAHHS Ta 3aXMCTy KypCOBUX POOIT Iisi CTyIEHTIB 6 Kypcy
 MeJIMKO-TICUXO0NoriyHoro - dakynprery. IlcnmxocoMaTnyHa MeIWIMHA Ta 3arajibHa
MPaKTHKa, 2(4), €020495. Retrieved i3 https://uk.e-
medjournal.com/index.php/psp/article/view/95
10. TlcuxotepaneBruueckas kiunuka. Xpecromarus. Tom 1/ TTox pen. B.IT.CamoxBaiosa,
0.C. Yabana. — Tepuonous: TTMVY, 2012. — C. 428
11. XaycroBa 0.0. Meraboniunnii cunapom X (mcuxocomaTnunuii acrekr). bibmioreka
npaktukyrodoro jikaps / 0.0.Xaycrosa. - Kuis: Menxuura, 2009. - 126 c. , in.
12. XaycroBa 0.0. Ilpodinaktuka ayToarpecHBHOI MOBEAIHKH B MEPBHHHINA Mepexi
(neuxocomatnunuii miaxin). Meroanunuii nocionuk / 0.0. Xaycrosa, O.I1. Pomanis
OJIL. -K.:LAT & K, 2015. - 67 c.

Supporting literature
. Xaycrosa O. O. Ilcuxocomarnuni Macku Tpuoru / O. O. Xaycrosa // YkpaiHCbKHi
Meanunuit yaconuc. - 2019. - Ne 4(1). - C. 53-60.
2. AcanoBa A, Xaycroa O. Tumosi cknagni cutyanii y B3aemonii ikap-
nanient. [IcuxocoMariyHa MeIMLMHA Ta 3arambHa mnpaktuka .2018; 3 (3): 1-
12. doi: https://doi.org/10.26766/pmgp.v3i3.125
3. Khaustova O. PesucrtenTHa nenpecis: Kputepii BH3Ha4YeHHs, (aKTOpu PH3HKY i
TepaneBTuyHi crparerii //Psychosomatic Medicine and General Practice. — 2017. — T.
2.—Ne.3.—C.e020338
4. Chaban O., Khaustova O., Bezsheyko V. New Quality of Life Scale in Ukraine:
reliability and validity //Indian J Soc Psychiatry. — 2016. — T. 32. — Ne. 4. — C. 473.
5. Chaban O. S., Khaustova O. O. Psychosomatic comorbidity and quality of life in
elderly patients /NeuroNEWS. —2016. - T. 1. — Ne. 2. — C. 8-12.
6. Chaban OS, Khaustova OO, Bezsheiko VG. Reliability and validity of Chaban
Quality of Life Scale. Viena: ECNP; 2016.
URL.: https://www.ecnp.eu/presentationpdfs/70/P.2.h.301.pdf
7. Anexcannep @. Ilcuxocomarnueckas Mmeauuuua. IIpuHUMIBL M MpakTHUECKOE
npumenenue / O. Anekcannep ; nep. ¢ anri1.: Morunesckuii C. — M. : Dkemo-tipecc,
2002. - 351 c.
8. bone3nb Anbireiimepa: Tuxas snujaemus norepsiHioit namstu. / [Yabau O., XaycroBa
E., Jleana O.]. - Kuip: «ABannoct-ITpum», 2013. - 87 c.
9. bpoiituram B. Ilcuxocomaruueckas menuuuHa : kpar. yueO. / B. Bpoiituram, I1.
Kpucruan, M. ¢on. Pax ; [Ilep. ¢ nem. OGyxoBa I'.A.]. - M. : I'>0Tap MeaunuuHa,
1999.-373 c.
 10. Cunopos I1.W. Icuxocomarnueckas MeauIUHa: pyk. 1uist Bpayeii / ILW. Cunopos, A.
I'. ConoseeB, M. A. HosukoBa; nox pexa. Il. M. Cumoposa. - M. : ME]Inpecc-
undopm, 2006. - 564 c.
11.Xomynenko T.b.OcHoBu ncuxocomaruku. / T.b. Xomynenko. — X.: HoBa knwura,
2009. - 120 c..
12.Khaustova, O. (2017). PesuctenTHa senpecis: Kputepii BU3HaYeHHsI, HaKTOPH PU3HKY
i TepaneBTuyHi crparerii. [lcuxocomarnyHa MeIMIKMHA Ta 3arajpHa MpaxkTuka, 2(3),
€020338. https://doi.org/10.26766/pmgp.v2i3.38

Information resources
https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/409_psychosomatic_me
d 2017-07-01.pdf?ver=2017-05-03-161534-910
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.573.6804 &rep=rep 1 &type=pdf
https://www.sfu.ac.at/wp-content/uploads/Textbook of Psychosomatic Medicine.pdf
https:/freepsychotherapybooks.org/product/431-changing-theoretical-concepts-in-
psychosomatic-medicine
https:/freepsychotherapybooks.org/product/178-from-the-mind-into-the-body
https://freepsychotherapybooks.org/product/218-the-teaching-of-psychosomatic-medicine-
consultation-liaison-psychiatry
https://freepsychotherapybooks.org/product/215-complex-problems-of-pain-as-seen-in-
headache-painful-phantom-and-other-states
https:/freepsychotherapybooks.org/product/200-depressive-states-and-somatic-symptoms
http://www.psychol-ok.ru/lib/alexander/pm/pm_01.html
http://bookmate.com/books/IUIz8f40
http://elib.bsu.by/bitstream/123456789/40258/1/frolova_psihosom i psi zdor uch pos.pd
f
http://www.mif-ua.com/archive/article/6454
http://publishing-vak.ru/file/archive-psycology-2012-4/2-fusu-mariann.pdf