[Paranoid nosogenic reactions in patients with somatoform disorders]

The authors examined 16 patients with ischemic heart disease who had psychogenic disorders with ideas of rationalization of therapy. Paranoial personality disorders (paranoial psychopathy) was diagnosed in 11 patients, pseudopsychopathy in residual schizophrenia in 5 patients. The patients had either a fanatic idea of creating new methods of self-therapy and an autoaggressive behavior (performing some dangerous manipulations, usage of non-medicamentous substances, etc.). The premorbid state of such patients was characterized by inclination to paranoial reactions and a special predisposition to them combined with an egodystonic attitude to corporal manifestations. Paranoial reactions of such type were reversible and disappeared in the course of somatic state improvement.