Smulevich A B
Mental Health Research Center, Moscow, Sechenov First Moscow State Medical University, Moscow.
Zh Nevrol Psikhiatr Im S S Korsakova. 2016;116(1):4-9. doi: 10.17116/jnevro2016116114-9.
Based on the conception of correlations between independent endogenous factors (positive and negative disorders), the author present a psychopathological model of psychosomatic (hypochondriac) symptoms in deficit disturbances, comorbid with the changes of «verschroben» type, observed in general medical practice. The psychosomatic symptoms are represented by a wide range of symptom complexes (from idiopathic pain and conversions to restricted hypochondria, organ neuroses, encapsulated organ psychosis) and defined as a syndrome of endoform of somaticized disorders. The syndrome is interpreted beyond schizophrenia as «the second disease», a type of schizophrenia spectrum disorders, in which negative process changes have stopped while the other component (positive psychopathological symptoms) continues to develop.
基于独立内源性因素（阳性和阴性障碍）之间相关性的概念，作者提出了一种心身（疑病症）症状的精神病理模型，该模型存在于一般医疗实践中观察到的、与“verschroben”型变化共病的缺陷障碍中。心身症状由广泛的症状复合体（从特发性疼痛和转换症状到局限性疑病症、器官神经症、隐匿性器官精神病）表示，并被定义为躯体化障碍的内形式综合征。该综合征在精神分裂症之外被解释为“第二种疾病”，是精神分裂症谱系障碍的一种类型，其中阴性过程变化已经停止，而其他成分（阳性精神病理症状）继续发展。
