MINISTRY OF HEALTH OF UKRAINE

Bogomolets National Medical University

DEPARTMENT OF MEDICAL PSYCHOLOGY, PSYCHOSOMATIC MEDICINE

AND PSYCHOTHERAPY

«APPROVE»

Head of the Medical psychology,

psychosomatic medicine
and psychotherapy department
Prof. O. Chaban

Jralt
«27» August 2022 y.

METHODICAL RECOMMENDATION
FOR INDIVIDUAL WORK

Psychosomatic medicine. Communication skills

Educational discipline
of the doctor
Module Ne 1
Theoretical and applied foundations of
Content module Nel
psychosomatic medicine.
Model of assistance and methods of
Topic 5 intervention in psychosomatic medicine
Year of education 4
Specialty Medical

2022-2023
 Topic Ne 5. «Model of assistance and methods of intervention in psychosomatic
medicine»
(practical lesson — 2 hours)

1. Relevance of the topic. Studying the topic allows students to learn the basic
principles of providing assistance and methods of intervention in psychosomatics.

2. Educational goals.
To know: main approaches to providing assistance and methods of intervention in
psychosomatics.
To be able to: determine the need and amount of psychosomatic help

3. Basic level of training.

Namesdisciplines
of previous Acquired skills
Pathophysiology Understanding the main psychological processes
Propaedeutics of | Verification of mental reactions in patients with a somatic
internal medicine profile
Social medicine, | Understanding the importance of professional
public health communication
Medical Methods of psychological diagnosis and medical and
psychology psychological support

4. Tasks for individual work during preparation for class.

4.1. A list of the main terms that a student should learn when preparing for
class:

Term Deffinition
Psychoeducation | interventions that offer education to people with
psychological disorders or physical illnesses about the
illness itself, its causes and risk factors, intervention
methods, lifestyle, etc.
Psychological is a set of procedures aimed at helping a person solve
counseling problems and make decisions regarding professional
career, marriage, family, personal development, and
interpersonal relationships.
Psychocorrection | a system of measures aimed at correcting deficiencies in
psychological development or human behavior with the
help of special measures of psychological influence.
Psychotherapy complex therapeutic verbal and non-verbal influence on
emotions, judgments, self-awareness of a person with
many mental, nervous and psychosomatic disorders.

4.2. Theoretical questions for the class.

1. The role of the sanitary and security regime of the hospital in preserving and
restoring the psychosomatic health of patients.
2. Models of integrated and joint care for the physically and mentally ill. Medical and
psychological support of patients with somatic diseases.
3. Psychological interventions aimed at the recovery of psychosomatic patients.
Psychohygiene and psychoeducation in psychosomatic medicine. Learning stress
management skills.
4. General concept of psychotherapy and psychocorrection. Psychotherapeutic
conversation. Various forms of psychotherapeutic treatment. Psychodynamic,
cognitive-behavioral, family, body-oriented psychotherapy. Suggestive methods.
Self-help groups. Assessment of treatment results.
5. Prevention and lifestyle modification in psychosomatics. Psychopharmacology in
patients with somatic diseases. Primary psychoprophylaxis. Secondary
psychoprophylaxis. Psychosocial rehabilitation.

5. Brief content of the topic.

The role of the sanitary and protective regime of the hospital in preserving and
restoring the psychosomatic health of patients.
The main psychological requirement for the treatment and security regime in a
medical institution is the neutralization of the negative, harmful effects on the psyche of
the patient of the factors of the medical environment, which are perceived both by high-
frequency receptors (eyes, ears, nose, etc.), and through the second signal system of the
patient - through speech .
Elements of medical and protective regime:
 - friendliness of the staff, sensitivity and attentiveness during the patient's admission
to the hospital and during the entire stay. What will form the patient's trust in the staff and
the entire medical institution;
- the patient's confidence in the high qualification of doctors and medical personnel,
in their ability and willingness to provide him with qualified assistance;
- mutual respect between medical personnel, which contributes to strengthening the
patient's faith in the reliability of the medical team;
- skillful use of psychotherapy methods;
- creation of conditions for the patient's physiological sleep;
- creation of conditions for physical activity of patients due to physical therapy,
dosed walks within the department or in the fresh air, as well as a free regimen as
prescribed by the doctor;
- creating a healthy microclimate in the wards. In the interests of the patient, the
following should be involved: psychohygiene, psychoeducation, psychological counseling,
psychocorrection and psychotherapy.
Models of integrated and joint care for the physically and mentally ill. Medical and
psychological support of patients with somatic diseases.

In recent years, a proactive approach to the provision of psychiatric care to patients

of multidisciplinary hospitals has been developed and implemented in the world, based on
the theoretical principles of psychosomatic medicine and its clinical implementation -
consultative and liaison psychiatry. Proactive psychosomatic medicine (PPM) is a new way
of providing psychiatric services in general medical departments, based on the principles
of initiative, purposefulness, intensity and integration with general medical care.
The basis for the evolution of the psychiatric care system was the need to effectively
manage the psychological and social aspects of any illness, because these aspects are partly
an important reason for the insufficient effectiveness of therapy and the long stay of the
patient in the hospital. The first basic studies, meta-analyses and consensuses of experts on
proactive psychiatric consultation from 2011-2018 emphasized that from 20% to 40% of
patients in multidisciplinary hospitals also suffer from mental illnesses, which can
significantly complicate the course, effectiveness of therapy and the prognosis of somatic
pathologies. Mental illnesses in patients of multidisciplinary hospitals sometimes become
an obstacle to timely discharge from the hospital, lead to a greater number of additional
consultations of related specialists and increase the overall cost of medical care. On the
basis of these studies, it was also recognized that psychiatric counseling is important for

4
the treatment of patients with a somatic profile, and the main features of traditional and
proactive models of consultative and liaison psychiatry were determined (Table 1).
Table 1. Consultative liaison psychiatry: traditional and proactive models (modified by
Sledge WH, Lee HB., 2015)
Characteristic Traditional model Proactive model
Type of | Single: psychiatrist Multidisciplinary: psychiatrist,
assistance primary care doctor, nurse,
social worker, psychologist
Case definition Consultation at the request of Screening based on history,
the treating general | medical records, and nursing
practitioner staff report
Method of | Recommendations for the | Co-curation with close
intervention attending physician (entry in | monitoring
the outpatient card/medical
history)
The purpose of Recommendations for Preventing behavioral barriers
the intervention treatment, risk reduction and to care, crisis avoidance,
crisis management provider synergy

Permanent Outside the multidisciplinary Multidisciplinary team in the

location hospital staff of a multidisciplinary
hospital

The conclusions of the HOME study, published in 2019, should be more specific
recommendations on how hospital psychiatric services should be organized and what
specific interventions are needed for certain patients:
1. Early proactive biopsychosocial assessment of newly hospitalized patients using a
biopsychosocial approach to identify all problems, including mental illness.
2. Creation of a plan for complex curation and systematic management of those problems
that create potential obstacles to a quick discharge from the hospital.
3. Implementation of a comprehensive curation plan with daily examinations of the patient
regarding the progress of the psychosomatic condition.
4. Integrated work with the staff of individual departments (doctors, nurses, other
consultants and social care specialists) and outpatient services to ensure the
implementation of the comprehensive care plan.
 In 2019, the American Psychiatric Association Council on Liaison Psychiatry
initiated the development of a resource document on Proactive Liaison Psychiatry, which
was approved for publication on December 12, 2020. This document emphasizes the
implementation of a model of proactive consultation-liaison psychiatry, which also
contains four elements:
« systematic screening for current mental health problems in patients with a somatic
profile (patients who are hospitalized in certain medical institutions are systematically
checked for signs of active mental health problems, especially those that may jeopardize
the provision of care);
« early clinical intervention (proactive measures tailored to individual patients with a
combination of interventions for somatic and mental disorders);
o providing care based on a multidisciplinary team approach (the mental health team
is part of a multidisciplinary hospital and provides comprehensive mental health care
directly in a general hospital);
« integration of care with primary teams and services (a proactive mental health team
closely coordinates work with primary services in real time, often between clinicians of
relevant expertise - from doctor to doctor, from nurse to doctor/nurse, from social worker
to social worker, worker/rehabilitation specialist and vice versa).
STEP-BY-STEP HELP on the example of depression

Who is responsible for care? | What is the focus? | What do they do?

Step 5: Inpatient care, Risk to life, Medication, combined

crisis teams severe self-neglect treatments, ECT

Step 4: Mental health Treatment-resistant, Medication, complex

specialists, including recurent, atypical and
psychotic depression, and psychological interventions,
crisis teams those at significant risk combined treatments
Step 3: Primary care team, Moderate or severe Medication, psychological
primary care mental depression interventions, social support
health worker
Step 2: Primary care team, Mild depression Watchful waiting, guided self-help,
primary care mental computerised CBT, exercise, brief
health worker psychological interventions
Step 1: GP, practice nurse Recognition Assessment

Stepped Care is a system of providing and monitoring treatment, thanks to which patients
are first provided with the most effective, but least resource-intensive, treatment; only
"step-over" to intensive/specialty services as clinical need dictates. "The right service at the
right place, at the right time, provided by the right person."
 Step one: prevention and promotion Support you can use before seeking medical or
social services: friends and family; self-help, spiritual advice; self-help groups;
professional consultation; national and local organizations of the Ministry of Health;
hotlines; consulting agencies; social rights; dwelling; employment; leisure services;
caregiver support.
Step two: recognition of the problem in primary care "Watchful waiting"...with
further evaluation; self-help; guided self-help; expert advice; short-term brief intervention;
guidance to/mobilization of first step resources
Step Three: Assessment/First Aid Evaluation of MH; short-term psychological
interventions; physical health checks; review of medicines; computerized CBT; social
purpose; support of medical workers; guidance to/mobilization of first step resources
Step Four: Secondary/Specialized Services Comprehensive expert assessment;
specialized functional services — crisis/treatment at home, early intervention, assertiveness
training; official mental health law; rating; specialized medical and psychosocial
interventions; care coordination; risk/relapse plans; crisis placement.
Step five: specialized help A range of inpatient assessment and treatment services
working with high-risk, complex patients requiring specialist intervention; high level of
care coordination/relapse risk management.

Psychological interventions aimed at the recovery of psychosomatic patients.

Psychohygiene and psychoeducation in psychosomatic medicine. Learning stress
management skills.
Psychohygiene is a system of scientific knowledge and practical measures aimed at
preserving and strengthening the mental health of the population.
Psychoeducation - interventions during which education is offered to people with
psychological disorders or physical diseases about the disease itself, its causes and risk
factors, methods of intervention, lifestyle, etc.
Psychological counseling is a set of procedures aimed at helping a person solve
problems and make decisions regarding a professional career, marriage, family, personal
development, and interpersonal relationships.
The main recommendations when applying for medical assistance of a person
potentially affected by war distress are: Offer psychological first aid: Listen, but DO NOT
force the person to talk; assess her needs and concerns.
 Help address her most urgent basic physical needs (eg find a shelter where she can
spend the night) and get the services and accurate information she needs (contact family
and/or social services).
Consider teaching the affected person the basics of stress management. Help her
identify and develop positive coping methods and social support models.
Conduct psychoeducation. Explain that people often experience acute stress
as a result of the influence of extremely strong stressogenic factors. However, in most
people, the symptoms of acute stress subside over time. Do not prescribe course treatment
with benzodiazepines, which interfere with the processing and/or deactualization of
traumatic events. Invite the person to return for a follow-up if symptoms worsen or if there
is no improvement within one month of the event. Assess for PTSD and other mental
health disorders at re-examination.
Pay attention to additional strategies for managing the following conditions:
insomnia, nocturnal enuresis, hyperventilation, significant medically unexplained somatic
complaints, etc.
When managing insomnia as a symptom of acute stress, use the above general
strategies for managing symptoms of acute stress. It is also advisable to rule out external
causes of insomnia (such as noise) and treat possible physical causes (such as physical
pain), even if the insomnia started immediately after a stressful event. Provide sleep
hygiene advice (including avoiding stimulants such as coffee, nicotine and alcohol).
Explain that people often develop such problems as a result of extremely strong stressors.
In exceptional cases, when psychological intervention is not available (eg relaxation
techniques, breathing, etc.), short-term treatment (3—7 days) of adults with sleeping pills
can be considered. If the problem persists for more than a month, re-evaluate to identify a
co-occurring mental disorder and treat it, consult with a specialist.
When identifying nocturnal enuresis as a symptom of acute stress in children,
also apply general strategies for managing symptoms of acute stress. Take a history to
confirm that this problem only appeared after a stressful event. Rule out and treat possible
physical causes (eg, urinary tract infection), even if nocturnal enuresis started within one
month of the potentially traumatic event. Be sure to assess the mental disorders and current
stressors of the child's parents/guardians and offer appropriate management. Conduct
psychoeducation: explain that you cannot punish a child for nocturnal enuresis, because
nocturnal enuresis is a normal reaction of children to experienced stress, and punishment is
additional stress. Explain the importance of parents remaining calm and emotionally
supportive of the child; teach not to pay too much attention to the symptom and to give the
child positive attention at other times. Parents should also be taught to use simple
behavioral interventions (such as rewarding the child when he avoids drinking too much
before bed or goes to the toilet before bed). Such rewards can be additional time for games,
stars in a special table, etc. If the problem persists for one month, consult a specialist.
When the patient presents with signs of hyperventilation, generally apply
general strategies for managing symptoms of acute stress, however, be sure to rule out and
treat possible physical causes, even if hyperventilation began immediately after the
stressful event. Always do a basic medical examination to identify its possible physical
causes. Within the framework of psychoeducation, explain that people often have such a
problem due to the influence of extremely strong stressogenic factors. Maintain a calm
attitude toward the patient, eliminate sources of anxiety if possible, and teach proper
breathing (ie, encourage normal breathing, not deeper or faster than normal). As for the
paper bag breathing technique common for panic attacks, it is not an option for patients
with heart disease or asthma. Children should also not be encouraged to breathe into a
paper bag again. If the problem persists for one month, consult a specialist.
Sometimes in the practice of a primary care physician, patients with signs of
sensorimotor dissociation (significant medically unexplained somatic complaints,
medically unexplained paralysis, medically unexplained inability to speak or see, etc.) due
to acute stress are encountered. In such conditions, general strategies for managing the
symptoms of acute stress are used. But it is always necessary to perform a basic medical
examination to identify, treat or rule out possible physical causes of the problem, even if it
appeared immediately after a stressful event. It is important to elicit the patient's own
explanation for the causes of such symptoms, to acknowledge their distress, but at the same
time it is important to avoid supporting any subconscious benefits that the individual may
derive from these symptoms.

General concept of psychotherapy and psychocorrection.

Various forms of psychotherapeutic treatment.
Psychocorrection is a system of measures aimed at correcting deficiencies in
psychological development or human behavior with the help of special measures of
psychological influence.
Psychotherapy is a complex therapeutic verbal and non-verbal influence on
emotions, judgments, self-awareness of a person with many mental, nervous and
psychosomatic disorders.
 The choice of psychotherapy is carried out at the beginning of the interaction between
the doctor and the patient in the process of the first stage. Taking into account the modern
data of leading research institutions, presented in meta-analyses, comparative studies of
psychotherapeutic interventions for disorders associated with mental trauma as a leading
direction of therapeutic tactics it is recommended to use trauma-focused cognitive-
behavioral psychotherapy, which leads to a significant reduction of the main symptoms,
but does not have side effects, usually inherent in psychopharmacotherapy.
Psychotherapeutic methods should be distinguished by approaches, forms, methods of
treatment of the consequences of trauma and traumatic experience.
For treatment, the following types of psychotherapy are recommended, in accordance
with the order of application (first and second line of choice, respectively), which
contribute to:
a) trauma exposure (repeated reproduction of a traumatic experience in combination
with "in vivo exposure”, emotional processing of a traumatic experience) - cognitive-
reconstructive prolonged exposure;
6) cognitive restructuring of trauma (Socratic dialogue for awareness and correction of
subjective negative emotions, judgments, beliefs as a result of trauma, for example, such as
auto-aggressive behavior, mistrust, etc.) - cognitive psychotherapy and trauma-focused
cognitive-behavioral psychotherapy;
B) cognitive restructuring of the meaning and integration of the traumatic experience into
the past with the formation of a sense of control over the trauma (imaginal impression,
written narrative processes, methods of relaxation and metaphorical closure of rituals) -
short eclectic psychotherapy (psychodynamic approach);
r) integration into life and search for the meaning of traumatic experience (structured
process of verbal description of life, impressions during numerous traumatic experiences
during life) - narrative exposure therapy.
Prevention and lifestyle modification in psychosomatics.
It is becoming increasingly clear that we can improve the medical care of
psychosomatic patients in the primary network by paying more attention to psychological
aspects within the framework of comprehensive therapy, (with special emphasis on the role
of stress and a number of other factors involved in modulating the individual vulnerability
of the patient to the disease. It is also worth considering that some factors (such as a
healthy lifestyle and psychological well-being) have a positive effect on strengthening
health, and not only on reducing the number of diseases.
 An unhealthy lifestyle is a major risk factor for many of the most common diseases,
such as diabetes, obesity and cardiovascular disease.
That is why the need to change the sick behavior of patients must be taken into
account in the reorganization of primary medical practice, taking into account the
dynamics of the biopsychosocial resource base against the background of changes in the
personal life strategies of patients.
Prospective studies of the population have also found a relationship between social
support measures and mortality, psychiatric and physical morbidity, effectiveness of
therapy and rehabilitation of chronic diseases.
In many clinical studies from the standpoint of evidence-based medicine, it has been
proven that events and situations in a person's life, which are significant for him
personally, can cause changes in the state of somatic health. With the use of structured
methods of data collection and comparison with control groups, the relationship between
life events and a number of diseases was substantiated: endocrine, cardiovascular,
respiratory, gastrointestinal, autoimmune, skin and oncological.
There is no doubt that medical and psychological intervention, as a non-invasive
method that has almost no contraindications and does not give side effects when combined
with pharmacotherapy of the underlying disease, is the most acceptable and effective
means of such correction. Medical-psychological intervention can be used even in the most
acute moments of the disease, except for cases, of course, when the patient is in an
unconscious state.
At the first stage, the main mechanism of therapeutic action is passive learning
through providing the patient with the necessary information and emotional support. This
makes it possible to satisfy the needs and expectations of the patient, to improve his well-
being. In contrast, in the following stages, the change in personality and its attitudes occurs
mainly consciously, through active relearning. In the hospital, the method of collective
group psychotherapy is used.
When the patient returns to home conditions, but is not yet included in active work,
psychotherapeutic work is carried out to actively switch him to self-care and transition to
dosed activity in household behavior (going outside, walking, etc.).
Next comes the stage of full transfer of the patient to calm personal activity in
everyday life and work while forming the skills of full mastery of one's emotions, etc.
The last stage of rehabilitation is the complete liberation of the patient from the
thought that he is sick, and the assertion of confidence that he is completely healthy,
capable and should work. Together with the doctor of somatic practice, the psychotherapist
takes into account the limits of labor and social readaptation and creates orientation of the
patient either for full-fledged professional work, or for the need to transition to other forms
of work.

6. Control materials for the main stage of the lesson.

6.1. Questions for control and self-control:
Models of integrated and joint care for the physically and mentally ill.
=

Medical and psychological support of patients with somatic diseases.

Psychological interventions aimed at the recovery of psychosomatic patients.
AL

Psychohygiene and psychoeducation in psychosomatic medicine.

Learning stress management skills.
Different forms of psychotherapeutic treatment.
Prevention and lifestyle modification in psychosomatics.
N

7. Materials for the final stage of the lesson

Discussion of essays and reports

Models of integrated and joint care for the physically and mentally ill.
Medical and psychological support of patients with somatic diseases.
R BN

Stress management skills.

PN

Psychodynamic, cognitive-behavioral, family, body-oriented psychotherapy.

Self-help groups.
Psychopharmacology in patients with somatic diseases.
Primary psychoprophylaxis. Secondary psychoprophylaxis.
Psychosocial rehabilitation.

8. Materials for methodical support of students' self-training (questions for

students' individual work)

1. Execution of written work:

- What do you know about the basic concepts and principles of psychosomatics?
According to the plan:
* What books or articles on this topic have you studied?
« Have you set priorities for yourself in studying the topic? What are they caused
by?
- Name the possibilities of practical application of theoretical knowledge obtained after
studying the topic.

2. An indicative map for working with literature:

Task Instructions Notes

Menuuna Work out textbook topics Recapitulate
HICUXOJIOTisE: related to the subject of the
B2-x T T. 2. lesson
CreuianbHa
MenYHa
MCUXO0JI0Tis/
[ r.s.
[unsrina,
0.0.
Xaycrosa,
H.O. Mapyra
Ta iH.]; 3a
pen. I
IMunsrinoi. -
Binnuus:
Hoga
Knura,2020.-
496 c.
Yabaun O.C., Study the textbook, write new Additionally,
SAmyxk B.T., terms and concepts in the orally process
Hecroposuy dictionary the literature
SI.M. [cuxiune from the list
3110pOB's - related to the
ITinpyynuK, specified topic.
Tepuomninb,
TAMY, Bunas.
»YKMeJIKHUra”,
2008.
[TpakTuyna Study the manual, find Recapitulate
 ncuxocomark | information on the subject of
Kka: jemnpecis. | the lesson
Hapuanbuuit
nociounk/ 3a
3ar. pea O.C.
Yabana, O.0.
XaycToBoi. -
K.:
BunaBuuunii
M
Menknura,
2021.-216 ¢

9. Recommended literature
Basic literature
1.Mennuna ncuxonoris: B 2-x T. T. 1. 3aranbHa menuuna ncuxosnorist/ [ I'.51. Iunsrina,
0.0. Xaycrosa, O.C. Yaban Ta in.]; 3a pea. I'.5l. ITunarinoi. - Binunus: Hosa Kunra,
2020. - 288 c.
2.Meanuna neuxonoris: B 2-x 1. T. 2. CneuianeHa Meanuna ncuxosoris/ [ I'.5. Iunsrina,
0.0. Xaycrosa, H.O. Mapyra Ta in.]; 3a pen. I'.S. [Tunsrinoi. - Binauns: Hosa Kuura,
2020. - 496 c.
3.IlpaktuyHa ncuxocoMaruka: JAiarHocTuyHi wkanu. HaBuyaneHuit nociOHuk/3a 3ar. pen.
0.C. Yabana, O.0. XayctoBoii. npyre Bunanus- Kuis:, 2019 - 108 c.
4 IlpakTnyHa ncuxocomaruka: aenpecis. Hapuansumii nocionux/ 3a 3ar. pex O.C. Uabana,
0.0. XaycroBoi. - K.: BuzaBuuuuii 1im Meznkuura, 2021. - 216 c. ISBN 978-966-1597-
77-17
5.Hesinknanna nornomora B ncuxiarpii ta Hapkosorii / Yaban O.C., Xaycrosa O.0.,
Owmensosuy B.1O./ 3-te Bunanns Kuis: Meaxuaura, 2019. - 156 c.
6.Yaban O.C, Xaycroa O.0. [lcuxocomaruyna MeauuuHa (acrneKTH IiarHOCTMKH Ta
nikyBanHs): [Tociouuk . — Kuis: TOB "JICT JIta", 2004.— 96 c.
7.Anexcannep @. Ilcuxocomarnueckas wmemunuua./ @. Amnekcanmep . — M.
Menununckas kaura, 2011. — 320 c.
8.Chaban, O., Khaustova, O., Trachuk, L., & Bezsheiko, V. (2017). Meroauuni
pexkoMeHauil 10 BUKOHAHHS Ta 3aXUCTY KYPCOBHX POOIT ISl CTYyIAEHTIB 6 Kypcy
MeJIMKO-TICHXO0NIOTiYHOro (akyaprery. IlcMxocoMaTnyHa MeENWIMHA Ta 3arajibHa
 NPaKTUKA, 2(4), €020495. Retrieved i3 https://uk.e-
medjournal.com/index.php/psp/article/view/95
9.Ilcuxorepanesruueckas kiuHuka. Xpecromarus. Tom 1/ ITon pexn. B.I1.Camoxsanosa,
0.C. Yabana. — Tepronons: TTMV, 2012. — C. 428
10. XaycroBa O.0. Merabouniunuii cunapom X (mcuxocomariunuii acrekr). bibmioreka
npaxtukytodoro nikaps / 0.0.Xaycrosa. - Kuis: Menknura, 2009. - 126 c. , in.
11. XaycroBa 0O.0. Ilpodinaktuka ayroarpecHBHOI MOBEIiHKM B NEPBUHHIA Mepexi
(ncuxocomatnunuii miaxin). Meroanunuii noci6uuk / 0.0. Xaycrosa, O.I1. Pomanis
OJI.-K.: LAT & K, 2015. - 67 c.

Supporting literature
. Xaycrosa O. O. Ilcuxocomaruuni Macku tpusoru / O. O. Xaycrosa // YkpaiHCbKuii
Meu4Hui yaconuc. - 2019. - Ne 4(1). - C. 53-60.
2. Chaban O., Khaustova O., Bezsheyko V. New Quality of Life Scale in Ukraine:
reliability and validity //Indian J Soc Psychiatry. — 2016. — T. 32. — Ne. 4. — C. 473.
3. Chaban O. S., Khaustova O. O. Psychosomatic comorbidity and quality of life in
elderly patients /NeuroNEWS. —2016. - T. 1. — Ne. 2. — C. 8-12.
4. Chaban OS, Khaustova OO, Bezsheiko VG. Reliability and validity of Chaban
Quality of Life Scale. Viena: ECNP; 2016.
URL: https://www.ecnp.eu/presentationpdfs/70/P.2.h.301.pdf
5. Anexcannep @. Ilcuxocomarnueckast Mmeauuuua. IIpuHUMIBL M MpaKkTHUYECKOE
npumenenue / ®. Anekcanjep ; nep. ¢ auri.: Morunesckuii C. — M. : DkeMo-tpecc,
2002. - 351 c.
6. bpoiituram B. Ilcuxocomarnueckas menuuuHa : kpat. y4ueO. / B. Bpoiituram, II.
Kpucruan, M. ¢on. Pan ; [Ilep. ¢ Hem. ObyxoBa I'.A.]. - M. : I'>0Tap MeanuuHa,
1999. - 373 c.
7. House, A., Guthrie, E., Walker, A., Hewsion, J., Trigwell, P., Brennan, C., ... &
Tubeuf, S. (2018). A programme theory for liaison mental health services in
England. BMC health services research, 18(1), 1-11.
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3539-2
8. Archer, C. S., MacNeill, S. J., Mars, B., Turner, K. M., Kessler, D. S., & Wiles, N. J.
(2022). Rise in prescribing for anxiety in UK primary care between 2003 and 2018: a
population-based cohort study using Clinical Practice Research Datalink. British
Journal of General Practice. https://doi.org/10.3399/BJGP.2021.0561
9. Mangolini, V. L., Andrade, L. H., Lotufo-Neto, F., & Wang, Y. P. (2019). Treatment
1
 of anxiety disorders in clinical practice: a critical overview of recent systematic
evidence. Clinics, 74.https://www.scielo.br/j/clin/a/4XfwjbNKfG9x3nk8vSGzN3f/?la
ng=en

Information resources
https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/409_psychosomatic_me
d 2017-07-01.pdf?ver=2017-05-03-161534-910
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.573.6804 &rep=rep | &type=pdf
https://www.sfu.ac.at/wp-content/uploads/Textbook of Psychosomatic Medicine.pdf
https:/freepsychotherapybooks.org/product/431-changing-theoretical-concepts-in-
psychosomatic-medicine
https:/freepsychotherapybooks.org/product/178-from-the-mind-into-the-body
https://freepsychotherapybooks.org/product/218-the-teaching-of-psychosomatic-medicine-
consultation-liaison-psychiatry
https:/freepsychotherapybooks.org/product/215-complex-problems-of-pain-as-seen-in-
headache-painful-phantom-and-other-states
https:/freepsychotherapybooks.org/product/200-depressive-states-and-somatic-symptoms
http://www.psychol-ok.ru/lib/alexander/pm/pm_01.html
http://bookmate.com/books/IUIz8f40
http://elib.bsu.by/bitstream/123456789/40258/1/frolova_psihosom i psi_zdor uch_pos.pd
f
http://www.mif-ua.com/archive/article/6454
http://publishing-vak.ru/file/archive-psycology-2012-4/2-fusu-mariann.pdf