Somatoform disorders in cardiac practice


A. Eremeev, Candidate of Medical Sciences
Regional clinical hospital Two, Khabarovsk

The review examines the clinical and psychodynamic aspects of somatoform cardiovascular disorder. The role of biological, psychological and social prerequisites in disease manifestation is analyzed. Particular attention is paid to the importance of the effect of anxiety and depression as cognitive factors that modulate the course of somatoform disorder. Options for correction of the considered pathology are presented.

somatoform disorder
cardiovascular system
psychosomatic balancing.

  1. Pohontsch N.J., Zimmermann T., Jonas C. et al. Coding of medically unexplained symptoms and somatoform disorders by general practitioners – an exploratory focus group study. BMC Fam Pract. 2018; 19 (1): 129. DOI: 10.1186/s12875-018-0812-8
  2. Van Driel T.J.W., Hilderink P.H., Hanssen D.J.C. et al. Assessment of somatization and medically unexplained symptoms in later life. Assessment. 2018; 25: 374–93. DOI: 10.1177/1073191117721740
  3. Psychosomatic disorders in clinical practice. Ed. A.B. Smulevich. 2nd ed. M.: MEDPress-inform, 2019; 774 p. (in Russ.)
  4. Noyes R.Jr. Stuart S.P. Watson D.B. A Reconceptualization of the Somatoform Disorders. Psychosomatics. 2008; 49 (1): 14–22. DOI: 10.1176/appi.psy.49.1.14
  5. Steinbrecher N., Koerber S., Frieser D. The prevalence of medically unexplained symptoms in primary care. Psychosomatics. 2011; 52: 263–71. DOI: 10.1016/j.psym.2011.01.007
  6. Dedov D.V., Ivanov A.P., Elgardt I.A. Risk of relapse of atrial fibrillation in patients with coronary artery disease and arterial hypertension according to the data of the ECG holter monitoring. Journal of Arrhythmology. 2010; 59 (59): 27–32 (in Russ.).
  7. Smulevich A.B., Ivanov S.V., Samushiya M.A. To the problem of bipolar affective disorders borrowing the rhythm of somatic disease. Mental disorders in general medicine. 2012; 2: 4–11 (in Russ.).
  8. Dedov D.V., Ivanov A.P., Elgardt I.A. Electro-mechanical heart remodelling and atrial fibrillation development in patients with coronary heart disease and arterial hypertension. Russian Journal of Cardiology. 2011; 16 (4): 13–8 (in Russ.).
  9. Karavaeva T.A., Kotsyubinsky A.P. Cholistic diagnosis of border mental disorders. St. Petersburg: SpetsLit, 2018; 286 p. (in Russ.).
  10. Tabidze A.A. Theory and practice of genesis of psychogenic diseases. Psychotherapy. 2014; 11: 2–10 (in Russ.).
  11. Sidorov P.I., Novikova I.A. Mental Medicine. M: GEOTAR-Media, 2014; 725 p. (in Russ.).
  12. Brusov O.S., Faktor M.I., Katasonov A.B. Structural and functional brain changes in emotional disorders: foundations of neurocirculatory and neurotrophic hypothesis of depression. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2012; 112 (7): 83–8 (in Russ.).
  13. Chutko L.S., Surushkina S.Iu., Iakovenko E.A. et al. Impairments of cognitive control in patients with somatoform disorders and their treatment. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2019; 119 (4): 32–7 (in Russ.). DOI: 10.17116/jnevro201911904132
  14. Levin O.S., Chimagomedova A.S., Arefieva A.P. Anxiety in the elderly. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2019; 119 (6): 113–8 (in Russ.). DOI: 10.17116/jnevro2019119061113
  15. Dedov D.V., Mazaev V.P., Ryazanova S.V. et al. The study of life quality in interventional and conservative treatments of the patients with stable angina at delayed observations. Cardiovascular Therapy and Prevention. 2014; 13 (5): 31–5. DOI 10.15829/1728-8800-2014-5-31-35 (in Russ.).
  16. Dedov D.V., El’gardt I.A., Ryazanova S.V. et al. Kachestvo zhizni bol’nykh IBS posle chreskozhnykh koronarnykh vmeshatel’stv. Profilakticheskaya meditsina. 2014; 17 (2-2): 23 (in Russ.).
  17. Neznanov N.G., Kotsyubinsky A.P., Mazo G.E. Biopsychosocal psychiatry. M.: «SIMK», 2020; 901 р. (in Russ.).
  18. Sheehan B. Somatoform disorders in the elderly. Aging Health. 2006; 2(6): 1035–9. DOI: 10.2217/1745509X.2.6.1035
  19. Druk I.V., Loginova E.N., Vershinina M.V. et al. Features of the psychological status of persons of young age with connective tissue dysplasia. Omsk Psychiatric Journal. 2019; 21 (3): 5–9 (in Russ.).
  20. Sivolap IuP. Panic disorder: clinical phenomena and treatment options. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2017; 117 (4): 112–6 (in Russ)]. DOI: 10.17116/jnevro20171174112-116
  21. Belyalov F.I. Psychosomatics. M.: GEOTAR-Media, 2018; 339 p. (in Russ.).
  22. Müjgan Ö.E., Nergis A.S.Z., Solmaz T.A. et al. Somatization in Depression and Anxiety Disorders. J Psychiatry Neurol Sci. 2010; 23: 60–5. DOI: 10.5350/DAJPN2010230109
  23. Dedov D.V. Analysis and comparison of characteristics of life quality during interventional and conservative treatment of patients with stable form of ischemic heart disease (results of long term observation). Tver Medical Journal. 2015; 2: 99–110 (in Russ.).
  24. Albantova K.A. Cardioneurosis (aspects of psychopathology and dynamics). Mental disorders in general medicine. 2010; 4: 10–8 (in Russ.).
  25. Makolkin V.I. Sulimov V.A. Pain in the area of the heart: a guide for doctors. M.: MIA; 2015; 187 p. (in Russ.).
  26. Eremeev A. Sinus tachycardia as a psychosomatic phenomenon (clinical case). Vrach. 2021; 32 (4): 60–5. DOI: 10.29296/25877305-2021-04-11 (in Russ).
  27. Poltorak S.V., Mizinova E.B., Tsurinova E.A. et al. The description of a clinical case of the patient with ventricular arrhythmia of psychogenic character. News of psychotherapy. 2015; 54 (59): 70–89 (in Russ.).
  28. Kushakovsky M. S. Heart arrhythmias. Violations of a warm rhythm and conductivity. St. Petersburg: Foliant, 2014; p. 640 (in Russ.).
  29. Gittenberger-de Groot A.C., Bartelings M.M., Deruiter M.C. et al. Basics of cardiac development for the understanding of congenital heart malformations. Pediatr Res. 2005; 57 (2): 169–76. DOI: 10.1203/01.pdr.0000148710.69159.61
  30. Jongbloed M.R., Mahtab E.A., Blom N.A. et al. Development of the cardiac conduction system and the possible relation to predilection sites of arrhythmogenesis. Scientific World Journal. 2008; 8: 239–69. DOI: 10.1100/tsw.2008.40
  31. Rosenstrauch L.V., Fedorov V.V, Sharifov O.F. et al. Isoproterenol potentiates atrial flickering caused by acetylcholine. Russian physiological journal. 2001; 10: 1296–308 (in Russ.).
  32. Alekseeva D.Yu., Tsurinova E.A., Poltorak S.V. et al. The psychomatic approach to the management of patients with ventricular arrhythmias. Kardiologiya i Serdechno-Sosudistaya Khirurgiya. 2015; 8 (6): 107–13 (in Russ.)]. DOI: 10.17116/kardio201586107-113
  33. Malev E., Reeva S., Timofeev E. et al. Echocardiographic and biochemical predictors of ventricular arrhythmias in young patients with mitral valve prolaps. Eur Heart J. 2013; 34 (Suppl. 1): 4747. DOI: 10.1093/eurheartj/eht310.p4747
  34. Syrkin A.L., Medvedev V.E., Kopylov F.Y. et al. Impact of pathocharacterological disorders on the course of hypertension. Vrach. 2007; 4: 10–2 (in Russ.).
  35. Wu E.-L., Chien I.C., Lin C.-H. Increased risk of hypertension in patients with anxiety disorders: A population-based study. J Psychosom Res. 2014; 72 (6): 522–7. DOI: 10.1016/j.jpsychores.2014.10.006
  36. Barsukov A.V., Vasilyeva I.A., Karimova A.M. Arterial hypotension (current diagnosis, prevention and treatment ). St. Petersburg: ELBI-St. Petersburg, 2012; 140 p. (in Russ.).
  37. Laederach-Hofmann K, Rüddel H. Pathological baroreceptor sensitivity in patients suffering from somatization disorders: Do they correlate with symptoms? Biological Psychology. 2008; 79 (2): 243–9. DOI: 10.1016/j.biopsycho.2008.06.003
  38. Pavri B.B. Fainting: a guide for doctors. Transl. from engl. Ed. A.V. Pevzner. M.: GEOTAR-Media, 2016; 172 p. (in Russ.).
  39. Volel B.A., Troshina D.V. Somatic depression with cognitive impairment in a female patient with hypertension. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, neuropsychiatry, psychosomatics. 2017; 9 (4): 60–4 (in Russ.). DOI: 10.14412/2074-2711-2017-4-60-64
  40. Troshina D.V., Volel B.A., Kopylov F.Y. The optimal approach to the treatment of autonomic disorders in cardiology practice. Consilium Medicum. 2016; 18 (10): 82–6 (in Russ.). DOI: 10.26442/2075-1753_2016.10.82-86
  41. Ivanets N.N., Sysoeva V.P., Kinkul’kina M.A. et al. Anxiety disorders in elderly patients: psychopathological characteristics, diagnosis, similarities and differences with anxious depression. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2014; 114 (5): 4–11 (in Russ.)].
  42. Paleev N.R., Krasnov V.N. Relationship of Psychomatics and Somatopsychiatry in Modern Medicine. Clinical Medicine. 2009; 12: 4–7 (in Russ.).
  43. Slyunyaeva M.K., Tsaturova K.N., Kolesnichenko E.V. Screening of anxiety and depression levels in primary healthcare patients. Bulletin of Medical Internet Conferences. 2016; 6 (5): 729–31 (in Russ.).
  44. Dyakonova E.N., Makerova V.V. Effective therapy of vegetovascular dystonia in young patients. Lechashchii vrach. 2016; 2: 17–23 (in Russ.).
  45. Allen L.A., Woolfolk R.L., Escobar J.I. et al. Cognitive-behavioral therapy for somatization disorder: a randomized controlled trial. Arch Intern Med. 2006; 166 (14): 1512–8. DOI: 10.1001/archinte.166.14.1512
  46. Aragona M., Bancheri L., Perinelli D. et al. Randomized double-blind comparison of serotonergic (Citalopram) versus noradrenergic (Reboxetine) reuptake inhibitors in outpatients with somatoform, DSM-IV-TR pain disorder. Eur J Pain. 2005; 9 (1): 33–8. DOI: 10.1016/j.ejpain.2004.03.003
  47. Iakupov É.Z., Troshina Iu.V. Anxiety, insomnia, depression — in conjunction with or opposite to functional disorders. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2016; 116 (5): 119–24 (in Russ.). DOI: 10.17116/jnevro201611651119-124
  48. Decoutere L., van den Eede F., Moorkens G. et al. Antipsychotic agents in the treatment of somatoform disorders; a review. Tijdschr Psychiatr. 2011; 53 (3): 163–73.
  49. Dedov D., Mukailov N., Yevtyukhin I. Medicines with potassium and magnesium in complex prevention of complications with patients with AH and IHD. Vrach. 2013; 8: 45–6 (in Russ.).
  50. Khabibulina M.M., Smolentseva A.A. Terapiya trevozhnykh rasstroistv u zhenshchin s arterial’noi gipertenziei v period premenopauzy na ambulatornom etape. V sb.: V s»ezd kardiologov Ural’skogo federal’nogo okruga. Mat-ly s’ezda. Ekaterinburg, 2011; s. 282–4 (in Russ.).