Multi-Criteria Complex Differential Diagnostics of Neurotic Phobias
In the article, there are discussed the problems of complex differential diagnostics of neurotic phobias. The paper reflects the results of integrative (clinical-psychopathological, socio- psychological, and clinical-laboratory) analysis of phobic symptoms in the structure of neurotic and somatoform disorders. The article presents the data on the features of sexual functioning in patients with anxiety-phobic disorders. It is proved that for all phobic disorders, significant deviations in the ratios of biologically active substances are revealed, as well as their relationship with the products of cellular metabolism that determine the formation of specific biochemical architectonics and clinical manifestations of phobic symptoms. The most typical phenomenon for patients with phobic syndrome in the structure of neurotic disorders is desynchronization of biochemical processes that occur in the hypothalamic-pituitary-adrenal, hypothalamic-pituitary-gonadal, β-endorphin, renin- angiotensin, and histamine axes. A theoretical generalization is presented and a new solution to the urgent diagnostic problem is proposed, which is studying the features of clinical manifestations of phobias in relation to biochemical, socio-psychological and individual psychological indicators. The structural-component architectonics of the phobic syndrome is described with the justification of its differential diagnostic criteria for neurotic and somatoform disorders to optimize the diagnostic process and improve the quality of medical and preventive care for this group of patients.