Role of anxiety and depressive disorders in the genesis of psychosomatic disorders

Abstract

Patients and methods. The results of clinical and psychodiagnostic examination using the Minnesota Multiphasic Personality Inventory (MMPI) were analyzed in 210 therapeutic inpatients from 4 groups of psychosomatic diseases (coronary heart disease, hypertensive disease, duodenal ulcer disease, asthma, and bronchitis with an asthmatic component) and 3 groups of diseases in whose genesis the psychosomatic mechanisms (pneumonia, gastritis, renal diseases) played a lesser role. Healthy individuals (n=38) served as a control group. The correlation coefficients between the first scale reflecting the number of somatic complaints and the magnitude of their hypochondriacal fixation and the second one characterizing the degree of anxiety and depressive disorders were calculated within each disease group. Results. In psychosomatic diseases, the correlation coefficients between the first and second MMPI scales proved to be insignificant and substantially lower than those in the healthy individuals. This suggests that in such patients, a larger number of somatic complaints and their enhanced hypochondriacal fixation alleviate anxiety and depressive disorders, which may be regarded as an indication that there is psychosomatic defense that lessens anxiety due to a somatic disease. In somatic diseases that are not referring to as psychosomatic ones, the correlation coefficient between the first and second scales is highly significant and considerably higher than that in the healthy individuals and particularly higher than in the group of psychosomatic diseases. In the patients of these groups, an increase in anxiety and depression aggravates autonomic dysregulation reflecting in the larger number of hypochondriacal complaints. This direct relationship between autonomic functions and the level of anxiety and depression may be a risk factor for developing these disorders.