MINISTRY OF HEALTH OF UKRAINE

Bogomolets National Medical University

1 —

DEPARTMENT OF MEDICAL PSYCHOLOGY, PSYCHOSOMATIC MEDICINE

AND PSYCHOTHERAPY

«APPROVE»

Head of the Medical psychology,

psychosomatic medicine
and psychotherapy department
Prof. O. Chaban

SN
«27» August 2022 y.

METHODICAL RECOMMENDATION
FOR STUDENTS

Psychosomatic medicine. Communication skills

Educational discipline
of the doctor
Module Ne 1
Theoretical and applied foundations of
Content module Nel
psychosomatic medicine.
Classification and main types of
Topic Je2 psychosomatic disorders
Year of education 4
Specialty Medical

2022-2023
 Topic Ne 2. «Classification and main types of psychosomatic
disorders »
(practical lesson - 2 hours )

1. Relevance of the topic. The study of the topic allows students to

study various scientific directions in the formation of modern psychosomatic
medicine and learn the basics of the classification of psychosomatic
disorders.

2. Educational goals.
To know: scientific directions of modern psychosomatic
medicine and learn the basics of the classification of psychosomatic
disorders.

To be able to: determine the classification of certain

psychosomatic disorders.

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
internal medicine | somatic 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 preparing for class.

4.1. A list of the main terms that a student should learn when
preparing for class:
Term Deffinition
Allostatic load e a combination of environmental influences,
significant life events, and other factors that cause
a state of chronic stress
Nosogeny o psychogenic and personal reactions arising in
 connection with a somatic disease (which acts as
a psychotraumatic event as a subjectively
involuntary factor that significantly affects the
patient's quality of life)
Psychogenies o psychogenic functional disorders of organs, in
which no morphological or structural disorders of
these organs are observed.

4.2. Theoretical questions for the class.

1. Psychosocial basis of psychosomatic medicine.
2. Allostatic load.
3. Diagnostic criteria for psychosomatic research.
4. Classification of psychosomatic disorders

5. Brief content of the topic.

Psychosocial basis of psychosomatic medicine.

Each stressful impact is reflected in bodily sensations and processes
both in normal and pathological conditions. Psychovegetative syndrome, as
an indispensable physiological process, acquires a pathological character
with excessive affective stress for a person; chronic emotional states
inevitably lead to viscero-vegetative disorders that become chronic.
Socialization of emotional manifestations is the use of organic
manifestations of emotions to influence others; restructuring of behavior,
which leads to the transformation of emotional reactions into reactions,
relatively adequate situations. To go from individual behavior to social
behavior means to submit it to the judgment of another and even turn it into a
rivalry. Repetition in a certain rhythm of such situations with anxiety states
is the basis of neurosis.
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.
Allostatic load.
Among the psychosocial variables that affect individual vulnerability, the
course and outcome of any disease, the role of chronic stress (allostatic load /
overload) is defined as a decisive factor.
In order to confirm the presence of allostatic overload in a patient
according to the revised version of the Diagnostic Criteria for Psychosomatic
Research (DCPR), the following criteria must be evaluated:
Criterion A (required) - Presence of a current identifiable source of stress
in the form of recent life events and/or chronic stress; the stressor is rated as
exceeding the patient's individual coping skills when all are fully engaged.
Criterion B (required) - The stressor is associated with at least one of the
following 3 symptoms that occurred within 6 months after the onset of the
stressor:
(1) At least 2 of the following symptoms: difficulty falling asleep, restless
sleep, early morning awakening, lack of energy, dizziness, generalized
anxiety, irritability, sadness, demoralization;
(2) Significant impairment of social or professional activity;
(3) Significant increase in environmental dominance (feeling overwhelmed
by the demands of everyday life).
Diagnostic criteria for psychosomatic research.
The wupdated version (2016) of the diagnostic criteria for
psychosomatic studies covers allostatic overload, type A behavior,
alexithymia, maladaptive pain behavior patterns, demoralization,
hypochondria, irritable mood, and somatic symptoms associated with
psychiatric disorders. A personalized and holistic approach to the patient
includes the integration of medical and psychological therapy at all stages of
the disease.
Two personality constructs that potentially influence general
vulnerability to illness, Type A behavior and alexithymia, have received
considerable attention.
Type A behavior derives from the "specific emotional complex"
observed in patients with heart disease and recognized in 36.1% of
individuals at risk of coronary heart disease and in 10.8% of patients with
non-cardiac disease. Alexithymia is associated with increased risk and
worsening of disease outcomes such as cardiovascular disease,
gastrointestinal disorders, cancer, and altered immune response to stress.
To define Type A behavior according to the revised version of the
DCPR, Criterion A is required: at least 5 of the following 9 characteristics
must be present:
(1) An excessive level of involvement in work and other activities that have
clearly established deadlines;
(2) A persistent and pervasive sense of urgency;
(3) Display of motor-expressive signs (fast and explosive speech, sharp body
movements, tension of facial muscles, hand gestures), which indicates that
the patient is under time pressure;
(4) Hostility and cynicism;
(5) Irritability;
(6) Propensity to accelerate physical activity;
(7) Tendency to accelerate mental activity;
(8) High desire for achievement and recognition;
(9) High competitiveness.
Criterion A is required to define alexithymia according to the revised
version of the DCPR: at least 3 of the following 6 characteristics must be
present:
(1) Inability to use appropriate words to describe emotions;
(2) Tendency to describe details instead of feelings (eg, circumstances of an
event rather than feelings);
(3) Lack of rich imagination of life;
(4) The content of thoughts is more related to external events than to fantasy
or emotions;
(5) Ignorance of general somatic reactions that accompany the experience of
various feelings;
6) Occasional but violent and often unacceptable outbursts of affective
behavior.
Classifications of psychosomatic disorders.
The close interweaving and mutual influence of mental and somatic
disorders allows us to distinguish within the pathology of this circle five
types of states that reflect a different structure of psychosomatic
relationships:
 1. Somatized mental reactions — somatoform disorders formed as a result
of emotional-psychosomatic pathology within the formations of neurotic
or individual-constitutional registers (neurotic disorders, neuropathies,
and personality disorders).
2. Psychogenic and personal reactions (nosogenies) arising in connection
with a somatic disease (which acts as a psychotraumatic event, as a
subjectively involuntary factor, independent of the will, which
significantly affects the patient's quality of life) — secondary neurotic
disorders acute and prolonged types.
3. Organ or systemic somatic lesions of a psychosomatic nature, arising
in response to a constellation of social-psychogenic, personal- and
bioconstitutional factors (in the form of a "response" of the target organ
or system — locus minoris resistentia).
4. Reactions of an exogenous type (somatogenesis), which develop as a
result of the neurotoxic effect of a somatic disease, in the form of neurotic
or psychotic organic symptoms.
5. Somatopsychic comorbidity is a relatively independent parallel flow of
somatic disease and pathology of the mental sphere.
Concept and classification of somatoform disorders.
In ICD-10, this group includes: somatized and hypochondriac
disorders, somatoform autonomic dysfunction, chronic somatoform pain
disorder. Close to the listed are aggravation, simulation and psychosomatic
disorders: bronchial asthma, ulcerative colitis, rheumatoid arthritis, essential
hypertension and migraine, peptic ulcer disease, neurodermatitis, diffuse
toxic goiter, coronary disease.
Somatized disorders are distinguished by periodic complaints about
the somatic condition, although the examination does not reveal pathology.
Patients with hypochondriac disorders are convinced that they have somatic
diseases, although there is no objective data. The term somatoform
autonomic dysfunction refers to organ neuroses (vegetoneuroses). The
diagnosis of chronic somatoform pain disorder is made when the pain is not
caused by a somatic disease, does not correspond to the innervation, and is
closely related to the conflict. Involuntary attempts to increase symptoms are
called aggravation.
Simulation (simulatio - pretense, Latin) is a deliberate representation of a
certain disease, often with the help of medication.
Concept and causes of somatization.
The concept of somatization was introduced by Z. Freud's closest student V.
Shtekel in 1943 to denote conversion disorders - hysteroform somatic
disorders, which are considered in psychoanalysis as a symbolic expression
of an unconscious conflict, mainly a hidden sexual one. Nowadays, motor
and sensory pseudoneurological disorders are called conversion (hersioform)
disorders, in which the symptoms do not correspond to the expected
localization, are symbolic and allow the patient to receive a "secondary
benefit". The term somatization refers to the process of real organic changes
that occur as a result of exposure to certain stresses that cannot be dealt with
at the psychological level.
The sexual revolution has led to a decrease in gross conversion
disorders. But in an industrial society with an accelerated pace and a
breakdown of the traditional way of life, social stresses arise and somatoform
disorders arise against their background. Their difference is a special
resistance to drug treatment and a pronounced tendency to chronicity.
The main feature of somatoform disorders is the patient's constant
health complaints, which persist despite the negative results of medical
examinations and the absence of any pathological process that would explain
their occurrence. Patients often experience undefined and literally
indescribable suffering. They make up a quarter of all patients, and each of
them costs the state 10 times more than an ordinary patient. Not finding help
from doctors, they turn to representatives of paramedicine and
parapsychology.
Establishing the psychogenic origin of the disorders is hindered by the
alexithymia characteristic of this group of patients — a disturbance of the
affective and cognitive spheres, which manifests itself as difficulty in
understanding and portraying emotions, a general limitation of affective life
and fantasy. It is difficult for them to find words to describe feelings and
sensations, they rarely cry and almost never dream. The affect is mostly
inadequate. Actions, often impulsive, are the dominant way to achieve a
goal. The personality is narcissistic, avoidant, passive-aggressive or passive-
dependent. Motors are rigid. Interpersonal relationships are poor, with
pronounced dependence or loneliness, weak connections with the social and
cultural background. Dependent attitude to a certain medical institution,
which becomes the center of the patient's life, was called the albatross
syndrome. Dependent attitude to surgeons with numerous unnecessary
operations - Munchausen syndrome. Under the influence of stress,
alexithymics show a tendency to abuse - food, alcohol, medication. They
may develop masked depression with suicidal tendencies and sexual
perversions (perversus — distorted, Latin).
Step-by-step development of psychosomatic disorders.
Non-specific mechanisms of the body's resistance, implemented at
different stages of the general adaptation syndrome, are accompanied by a
change in functional activity at all levels: from the organism (behavioral
reactions) to the organ (hyperfunction of individual organs or their systems)
and cells (activation of the synthesis of cytokines - cellular materials).
Excessive reactivity, as well as depletion of compensatory reactions, are risk
factors for the development of pathological processes.
The stereotype of the organization of psychosomatic relations includes
individually significant frustrating situations, increasing tension, increasing
anxiety, which lead to the mobilization of psychological defenses,
insufficient reaction of emotions, mainly due to disharmonious features of
the personality. The growth of anxiety and emotional tension leads to the
inclusion in the described stereotype of the development of psychosomatic
disorders of integrative cerebral systems, including hypothalamic structures,
through which a complex of physiological changes is realized, which
determines, together with the state of the mental sphere, the nature of
psychosomatic disorders and specific features of the psychophysiological
reaction. The variety of physiological changes that occur during emotional
stress allows us to believe that it can act as a pathogenetic factor in various
forms of somatic pathology.
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). In which organ the psychosomatic
disease will be localized depends on the architecture of the emotion as a
complete functional system, and on the long-term memory, which
stores the entire life experience of a person and is, as a rule, emotional
memory. It can be any experience, upheaval, strong emotional
excitement that left an unforgettable mark in a person's long-term
memory. It can also be frequently repeated or prolonged stressful
situations that form the matrix of long-term memory. The presence of
endograms of long-term memory (ready-made models of previously
transferred pathological processes) conditions the possibility of
stereotypical reproduction of the somatic symptoms of a previously
transferred pathological process with the reproduction of the same
 reflex reactions, biochemical and functional shifts, etc., while the
damaging effect of psycho-emotional stress is localized selectively in
that visceral system or organ, which is the most vulnerable in the
imagination of this individual, the most vulnerable for the vital activity
of the organism and its existence in general.
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).
At first, these changes are functional in nature, but with long-term
and frequent repetition, they can become organic, irreversible. So,
psychosomatic disorders are somatic disorders (in the sense of
biological medicine), the pathogenesis of which includes specific (bio-
psycho-social) mechanisms of somatic syndromogenesis and dynamic
pathological homeostasis as a reaction to a displaced or incorrectly
replaced affect in a situation where the body cannot master excessive
stress-traumatizing challenges for him.
The role of the psychological factor in the occurrence and course
of somatic diseases.
There are a number of different directions of different authors, which from
different positions complement and clarify the definition of psychosomatic disorders.
Author Definition
Petrovskyi O.V., Psychosomatic disorders are disorders of the functions of internal organs
Yaroshevskyi and systems, the occurrence and development of which are largely
M.H. associated with neuropsychological factors, the experience of acute or
chronic psychological trauma, and specific features of the emotional
response of an individual.
Kaplan I., Sadock Psychosomatic disorders are considered as psychological factors affecting
1. physical condition; these are those psychologically significant stimuli
from the environment that reliably, at least partially and temporarily,
cause the weakening or strengthening of a physical disease in which there
is a clear organic pathology or some known pathophysiological process.
Antropov Yu.F. Psychosomatic disorders are disorders of the functions of organs and
systems caused by mental, in particular affective, disturbances that occur
in functionally overloaded, constitutionally deficient or damaged visceral
systems.
Berezyn F.B. et al. Psychosomatic disorders mean such forms of somatic pathology, in the
occurrence and clinical course of which psychophysiological
relationships play a decisive role.

Kisker K.P. et al. Psychosomatic diseases are diseases in which psychosocial factors are
recognized as primary and partly causal in the emergence and further
course of these disorders, while also taking into account convincing
biological aspects.
Smulevich A. B. Psychosomatic disorders are a group of painful conditions that arise on
the basis of the interaction of mental and somatic factors and are
manifested by the somatization of mental disorders, mental disorders that
reflect a reaction to somatic diseases, or the development of somatic
pathology under the influence of psychogenic factors.
 The close interweaving and mutual influence of mental and somatic disorders allows
us to distinguish within the pathology of this circle five types of states that reflect a
different structure of psychosomatic relationships:
1. Somatized mental reactions are somatoform disorders formed as a result of
emotional-psychosomatic pathology within the formations of neurotic or individual-
constitutional registers (neurotic disorders, neuropathies, and personality disorders).
2. Psychogenic and personal reactions (nosogenies) arising in connection with a
somatic disease (which acts as a psychotraumatic event, as a subjectively involuntary
factor, independent of the will, which significantly affects the patient's quality of life)
— secondary neurotic disorders of acute and protracted types.
3. Organ or systemic somatic lesions of a psychosomatic nature, arising in response to
a constellation of social-psychogenic, personal- and bioconstitutional factors (in the
form of a "response” of the target organ or system — locus minoris resistentia).
4. Reactions of an exogenous type (somatogenesis), which develop as a result of the
neurotoxic effect of a somatic disease, in the form of neurotic or psychotic organic
symptoms.
5. Somatopsychic comorbidity is a relatively independent parallel flow of somatic
disease and pathology of the mental sphere.
Peculiarities of mental activity in chronic somatic diseases.
M. Bleiler described the types of psychosomatic disorders as follows:
1. Organic somatic diseases, in the development of which the psychogenic component
plays a major role. As a rule, this includes peptic ulcer disease of the stomach and
duodenum. It is controversial to include in their number myocardial infarction,
migraine, bronchial asthma, rheumatoid arthritis, ulcerative colitis and neurodermatitis.
As for psychogenic death, its cause can be neurotic anorexia with complete refusal to
eat and extreme irritation of the adreno-cortical system in a state of terror. A model of
such a reaction is the death of some hypersensitive creatures, for example, "scalar" fish,
in response to a sharp impulse-impact on the glass of the aquarium. Another example of
psychogenic death is death from breaking a taboo in native tribes that believe in it.
2. Psychogenic functional disorders, when they are short-lived and less pronounced,
are on the border of the norm, but sometimes they are classified as neurotic diseases.
We are talking about cardioreaction, pronounced sweating, stuttering, tics, vomiting,
constipation, enuresis, sexual disorders.
3. Psychosomatic disorders in a broader, indirect sense. The disorder is caused by the
corresponding relationship arising from the characteristics of the individual and his
experiences; this attitude leads to behavior that results in ill health.
3.1. Susceptibility to injuries. According to Buresh, who summarized the material of
more than 70 authors, in persons with an increased tendency to injuries, we are talking
about properties that are the opposite of those that usually correspond to such concepts
as accuracy and thoroughness.
3.2. Obesity. Eating is not only a biological and physiological act. The reception of
exquisite exotic dishes can cause a feeling of bliss in foodies, ordinary curiosity in
others, and in some - repulsion. Some patients eat tasteless diet meals with pleasure,
realizing that dietary nutrition is an important component of successful treatment, in the
success of which they believe, while others perceive the diet as an unpleasant attribute
that accompanies the disease, and nothing good comes from the disease and the
prescribed diet it will be, even if it is worse. The quality and quantity of food can be an
indicator of social prestige; food plays the role of a reward; fullness is often considered
by people subconsciously as a sign of solidity and prudence (Norman Mailer:
"politicians dare not be thin. Thin people in leading positions do not inspire
confidence"). According to the views accepted among psychoanalysts, the tendency to
obesity can be a defense against an unwanted marriage, or an alibi for failures in social
relations and in life. For obese people, it is necessary to find out to what extent their
needs in life are satisfied and their plans are fulfilled, for example, the need for self-
affirmation, recognition, security, erotic satisfaction. Increased food consumption may
be a substitute, a subconscious compensation for dissatisfaction in one or most of these
areas, a compensation quite reliably. , as in most cases it is easily accessible (at least it
was until recent times). Thus, an obese woman examined by R. Nakonechnyi and M.
Boukhan expressed her opinion about such compensation in a short but exact phrase:
"Are you surprised that I like to eat so much? But do I have anything in the world
besides food?” It is clear that these compensations also take place in actual mental
disorders, namely depressions (especially hidden ones) and neuroses.

Holy Seven
Among many psychosomatic diseases, the most researched group of the so-called
"seven sacred cows" of psychosomatics is traditionally singled out, which includes:
peptic ulcer disease of the stomach and duodenum; nonspecific ulcerative colitis;
 bronchial asthma; thyrotoxicosis (Bazed's disease); essential hypertension; rheumatoid
arthritis; atopic dermatitis (the old name is neurodermatitis).
Harmful mental factors are found almost always in the socio-psychological field of
modern civilization. Hence the name "diseases of civilization", a large part of which
refers to psychosomatosis. As people age, the frequency of so-called "normal”
(according to the terminology of V.M. Dilman, 1987) major non-infectious diseases
increases. It increases especially quickly after the completion of the body's
development. These diseases include:
- decreased carbohydrate tolerance (accompanied by hyperglycemia,
hyperinsulinemia, insulin resistance);
- obesity, which is associated with an increase in the sensitivity threshold of the
ventromedial center of the hypothalamus to glucose and insulin, hyperinsulinemia;
- atherosclerosis (accompanied by hypercholesterolemia, hypertriglyceridemia,
hyperinsulinemia);
- hyperadaptation (with simultaneous increased activity of the sympathetic-adrenal and
hypothalamic-pituitary-adrenal systems);
- hypertensive disease;
- metabolic immunodepression (associated with the accumulation of cholesterol in cell
membranes, the effect of corticosteroids and hypercholesterolemia);
- mental depression (related to a violation of the exchange of biogenic amines in the
hypothalamus);
- autoimmune disorders (accompanied by a decrease in the function of T-suppressors);
- cancrophilia (which is expressed in the creation of conditions that promote the
development of tumors: a decrease in immune reactions, the emergence of foci of
intense cell division under the influence of compensatory reactions;
- climax (decrease in estrogen production and sharp increase in gonadotropin
production).
The speed of development of these diseases and their combination in each individual
largely depends on genetic predisposition, and the external pathogenetic factors that
cause them are primarily overeating, as well as periodic acute or chronic stress.

6. Materials for monitoring the initial (initial) level of students' knowledge.

6.1. Test questions:

1. Allostatic load is:
A) a combination of environmental influences, significant life events, and other factors
causing chronic stress;
B) the relationship between mental and somatic processes that closely connect a person
with the environment;
C) the functioning of the entire system as a whole, which is determined by how "fit" its
elements are to each other, how harmoniously they interact.

2. The diagnostic criteria for type A behavior do not include:

A) Irritability;
B) Exhaustion;
C) High competitiveness.
3. Nosogenies are:
A) psychogenic functional disorders of organs, in which no morphological or structural
disorders of these organs are observed.
B) psychogenic and personal reactions arising in connection with a somatic disease (which
acts as a psycho-traumatic event as a subjectively involuntary factor that significantly
affects the patient's quality of life)
C) reactions of an exogenous type, which develop as a result of the neurotoxic effect of a
somatic disease, in the form of neurotic or psychotic organic symptoms
D) somatic disorders (in the sense of biological medicine), the pathogenesis of which
includes specific (bio-psycho-social) mechanisms of somatic syndromogenesis and
dynamic pathological homeostasis as a reaction to displaced or incorrectly replaced affect
in a situation where the body cannot master excessive stress-traumatizing challenges
4. Psychogenies are:
A) psychogenic functional disorders of organs, in which no morphological or structural
disorders of these organs are observed.
B) psychogenic and personal reactions arising in connection with a somatic disease (which
acts as a psycho-traumatic event as a subjectively involuntary factor that significantly
affects the patient's quality of life)
C) reactions of an exogenous type, which develop as a result of the neurotoxic effect of a
somatic disease, in the form of neurotic or psychotic organic symptoms
D) somatic disorders (in the sense of biological medicine), the pathogenesis of which
includes specific (bio-psycho-social) mechanisms of somatic syndromogenesis and
dynamic pathological homeostasis as a reaction to displaced or incorrectly replaced affect
in a situation where the body cannot master excessive stress-traumatizing challenges
 6.2. Practical tasks:
Complete the statement:
1. Psychosomatic medicine is the science of relationships ... and ... processes that
closely connect a person with the environment.
A) internal and external
B) mental and somatic
C) physical and chemical

2. Somatogenies are ... disorders of organs in which no morphological or structural

disorders of these organs are observed.
A) psychosomatic
B) imaginary somatic
C) psychogenic functional

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

7.1. Questions for control and self-control:
1. Psychosocial factors of the occurrence of psychosomatic diseases
2. Allostatic load and overload.
3. General characteristics of the main mechanisms of the pathogenesis of
psychosomatic disorders.
4. Concept and general characteristics of Diagnostic criteria for psychosomatic
research.
5. Psychosomatic and somatopsychic relationships.
6. Classification of psychosomatic disorders.

8. Materials for the final stage of the lesson

Discussion of essays and reports
Essay topics:
. Psychosocial factors of psychosomatic disease development
. Allostatic load in the genesis of psychosomatic pathology
R

. Secondary lifestyle factors in the formation of psychosomatic diseases

O

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

. Diagnostic criteria for psychosomatic research - history and development prospects.
[
 6. Effectiveness of the health care system in the prevention of psychosomatic disorders.
7. A healthy lifestyle in the prevention and treatment of psychosomatic diseases.
8. Criteria for the belonging of a somatic disorder to psychosomatic disorders.

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:

NeNe Task Instructions Tpumitkn

n/n
1. | Menuuna Work out textbook topics Recapitulate
nicuxoJorisi: B 2-X T. | related to the subject of the
T. 2. CnenianbHa lesson
MeJMuHa
ncuxoJoris/
[ T4, Munsrina,
0.0. Xaycrosa,
H.O. Mapyra ta
in.]; 3a pen. I".51.
[Munsrixof. -
Binnuus: Hosa
Kuura,2020.- 496 c.
2. |Yaban O.C., Amyx | Study the textbook, write new | Additionally, orally
B.T., HecropoBuu | terms and concepts in the process the
 SIM. Icuxiune | dictionary literature from the
3710pOB'st - list related to the
[linpyunuk, specified topic.
Tepuonins, TAMY,
BH/IaB.
L, YKMEJIKHUTa”,
2008.
3. | [Ipakruuna Study the manual, find Recapitulate
MICUXOCOMATHKa: information on the subject of
Jierpecisi. the lesson
Hapuaneuuit
nocioHuk/ 3a 3ar.
pea O.C. Yabana,
0.0. XaycToBof. -
K.: BunaBunumii
Jiim MeikHvra,
2021.-216¢

10. Recommended literature

Basic literature
1.Menununa nicuxosoris: B 2-x T. T. 1. 3aranpHa meanuna ncuxosnoris/ [ IS, Iunsrina,
0.0. Xaycrosa, O.C. Yabau Ta in.]; 3a pea. I'.5l. [Tunsrinoi. - Binaus: Hosa Kuura,
2020. - 288 c.
2.Meanuna ncuxonoris: B 2-x 1. T. 2. CneuianbHa Meanuna ncuxosoris/ [ I'.5. Iunsrina,
0.0. Xaycrosa, H.O. MapyTa Ta in.]; 3a pea. I'.S1. ITunsrinoi. - Binnnus: Hoa Kuura,
2020. - 496 c.
3.IlpaktuyHa ncuxocoMaruka: JiarHocThyHi wkanu. HaByaneHuit nociOHuk/3a 3ar. penu.
0.C. Yabana, 0.0. XaycroBoii. npyre Bunanns- Kuis:, 2019 - 108 c.
4.IlpakTnyHa ncuxocoMaruka: aenpecis. Hauanbuuii nociOnuk/ 3a 3ar. pex O.C. Yabana,
0.0. XaycroBoi. - K.: BunaBunuuit nim Meznkuura, 2021. - 216 c. ISBN 978-966-1597-
77-7
5.Hesinknanna nomomora B mcuxiatpii ta napkosorii / Yadan O.C., Xaycrosa O.0.,
Owmenstnosud B.1O./ 3-Te Bunanns Kuis: Menknura, 2019. - 156 c.
6.Haban O.C, XaycroBa O.O. Ilcuxocomarnuna MmenuiuHa (acrmeKTH AIArHOCTUKHM Ta
nikyBanHs): [Tociouuk . — Kuis: TOB "JICT" JIta", 2004.— 96 c.
7.Anekcannep ®. Ilcuxocomaruyeckas wmemuuuna./ @. Anekcanmep . — M.
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