ИСТИНА

Introduction: In psychodermatology delusional infestation and hypochondriacal disorder are psychiatric disorders with delusional beliefs and overvalued ideas, respectively, pathological bodily sensations, self-mutilation and secondary dermatologic symptoms. Despite the intense discussion of their therapeutic challenge there have been few studies evaluating patients’ beliefs about disease and health. Objectives: To reveal specifics of disease and health-related beliefs in delusional infestation and hypochondriacal disorder. Methods: 33 patients with delusional infestation and 16 patients with hypochondriacal disorder with complaints of pathological skin sensations participated in the study. The psychosemantic method “Classification of sensations” was used: patients were asked to select disease and health-related sensations from 80 descriptors from 6 classes of bodily sensations: skin (for example, “itch”), inner body (“sickness”), receptor (“sticky”), emotional (“anxiety”), dynamics (“exhaustion”) and attitudinal (“badly”) descriptors. Fisher's exact test was applied. Results: Associated with disease unhealthy skin sensations (“burning”, “itch”), negative attitudinal (“unbearable”) and emotional (“melancholy”) descriptors were frequently (p≤0,05) chosen in delusional infestation which showed more intense patients’ desperation in comparison to patients with hypochondriacal disorder. Analysis of healthy sensations choices revealed a selection (p≤0,05) of positive emotional descriptors (“peace”, “joy”, “bliss”) in delusional infestation. By contrast, more frequent (p≤0,05) usage of unpleasant skin (“numbness”, “hard’, “heat”), attitudinal (“nasty”), dynamics (“frequent”) sensations was in hypochondriacal disorder which demonstrated more intense attention to bodily sensations and a readiness to experience unpleasant bodily sensations. Conclusions: Altered beliefs about disease and health should be concerned as a factor in adherence reduction in psychiatric and dermatological treatment in delusional infestation and hypochondriacal disorder