From Big Medical Encyclopedia

HYPOCHIONDRIAL SYNDROME (Greek hypochondrion area of a body under cartilaginous departments of edges, in the ancient time — location of a disease; a syndrome) — patholologically the exaggerated fear for the health, and also conviction available this or that disease in the absence of the valid disease.

Morbid depression was described by Hippocrates; K. Galen suggested it to call morbus hypochondriacus believing that the reason consists in frustration in the field of hypochondrium.

At early stages of development of psychiatry morbid depression was considered as an independent disease; later the opinion was claimed that it is only a syndrome at the most various diseases. And only the few researchers continued to protect nozol, independence of morbid depression: V. M. Bekhterev (1928) called it a somatophrenia, Reykhardt (M. Reichardt, 1923) — autokhtonno the arising morbid depression, Pilovsky (L. Pilowsky, 1970) — primary morbid depression.

Structural features And. pages are defined by a disease, against the background of to-rogo it develops. Therefore speak not about one And. page, and about their whole group. S. S. Korsakov (1901) considered that morbid depression exists both within a neurasthenia, and in the form of hypochiondrial psychoses, to the Crimea it carried hypochiondrial melancholy and hypochiondrial insanity.

In group I. pages enter:

1. Phobic, or neurotic, And. page, arising at neurosises. Usually it is the thoughts of heavy cordial suffering, a malignant tumor, syphilis etc. which are constantly disturbing the patient. Such fears have a psychogenic origin and give in to a razubezhdeniye. Somatic feelings at them depend on the accompanying vegetative disturbances and are accurately localized. In some cases signs of a frivolous somatopathy are found.

2. Depressive And. page, taking place in a wedge, a picture of a depression. Against the background of the suppressed mood there are permanent, not giving in corrections of a thought of any incurable disease. Of it patients are convinced by painful pains with rather clear localization. Depressive And. the page remains until the depression proceeds. It is observed usually at maniac-depressive psychosis.

3. Senestopathetically - the hypochiondrial syndrome observed in the dobredovy period of inertly current schizophrenia extended in time. G. N. Momot gave its detailed description (1959). The concept of «senesthopathias» was for the first time put forward by Dyupre and Camus (E. Dupre, P. Camus, 1907). They considered similar states as burdensome unusual feelings on a body surface, under skin, in the head, in extremities, in a body. Patients describe feelings so: «... touch skin with fur, on it carry continuously out by a metal brush, warm up skin, pull, under skin there is some movement, through the head there pass streams of cold, vessels in it strain, burst, in joints sand is felt, extremities are deformed, burns down interiors, they turn over, stick together, etc.». Senesthopathias at schizophrenia are plentiful, diverse and are not comparable with usual feelings, they are a constant and important component senestopathetically - a hypochiondrial syndrome. Senestopathetically - the hypochiondrial syndrome arises, besides, at organic diseases of c. N of page of various genesis, craniocereberal injury, vascular diseases of c. N of page, at a row hron, somatopathies (diabetes etc.). Single senesthopathias meet in clinic of neurosises. Attempts of a systematics of senesthopathias became Yarreyssom (W. Jahrreiss, 1930), K. A. Skvortsov (1935), G. A. Rotstein (1961).

4. Crazy And. page, noted in paranoiac, paranoid and paraphrenic options, at schizophrenia. At paranoiac And. page development of interpretive nonsense with conviction available of a serious illness takes place, and sometimes proofs are scooped from experiences of the past. Patients persistently try to obtain all new and new researches, accuse doctors of an inattention. At growth of nonsense there are ideas of the prosecution organized by doctors.

In a wedge, a picture paranoid And. the page nonsense is combined with the phenomena of mental automatism. Earlier being senesthopathias get a sign of concreteness and are endured already as hallucinations of the general feeling (see. Hallucinations ). The ideas of influence are widely presented. The patient considers that it is irradiated at distance with special devices, a dark light passes through his body, destroys a brain and internals. Sometimes there are ideas of obsession.

At further development of a disease forms paraphrenic And. page. The nonsense gains fantastic, grandiose character. Influence is perceived as proceeding from other planets, there is a feeling that all body is exposed to destructive changes. Hallucinations are plentifully presented: general feeling and algichesky senesthopathias.

Also nigilistic hypochiondrial nonsense as a part of a Cotard delusion is allocated (see. Kotara syndrome ). Patients are convinced that their interiors decayed, there is no heart, functions stopped fiziol. Such nonsense is especially often observed at presenile psychoses.

Pathogeny And. by page it is studied insufficiently, however the tendency to establishment being its cornerstone fiziol, disturbances was outlined in domestic psychiatry for a long time. Under the influence of I. M. Sechenov's ideas

S. S. Korsakov (1901) spoke about a role of «the general hyperesthesia» in an origin of morbid depression, V. P. Serbian (1912) specified «reduction of the threshold of consciousness for feelings from internals» at it.

Treatment And. page — treatment of a basic disease.

Bibliography: Bekhterev V. Somatophrenia, Obozr, psikhiat., nevrol, and reflexology, No. 1, page 5, 1928; M about m about G. N. K t to a question of a senestopathetic syndrome at schizophrenia, Zhurn, a neuropath, and psikhiat., t. 59, No. 5, page 563, 1959; Pashchenkov of Page 3. Morbid depression (Clinical aspect of a problem), Tashkent, 1974, bibliogr.; Rotstein G. A. Hypochiondrial schizophrenia, M., 1961, bibliogr.; J ahrreiss W. Das hypochondrische Denken, Arch. Psychiat. Nervenkr., Bd 92, S. 686, 1930; P i 1 o w s k at I. Primary and secondary hypochondriasis, Acta psychiat. scand., v. 46, p. 273, 1970.

D. S. Ozeretskovsky.