ПСИХОСОМАТИЧЕСКИЙ ПОРОЧНЫЙ КРУГ ИНФАРКТА МИОКАРДА

Представлен обзор исследований, демонстрирующих соматические изменения при психологических процессах, принятых как факторы риска острого инфаркта миокарда: депрессия, стресс, тревога. На основании метафорического обозначения “идеальный шторм” показаны воспалительные, иммунологические, нейрогуморальные предпосылки развития инфаркта миокарда, а равно таковые изменения, являющиеся соматическим субстратом психологических состояний, способствующих развитию инфаркта миокарда посредством поведенческих и биологических факторов риска: “болезненное поведение”, “депрессионная болезнь”. Два эти процесса входят в психосоматический “порочный круг”. В статье делается акцент на важности индивидуализации подхода к реабилитации и вторичной профилактике инфаркта миокарда, поскольку с биопсихосоциальной точки зрения восходящие и нисходящие психосоматические связи у каждого пациента уникальны.

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