In this chapter, we explore the fine line where the psyche meets the body. You will learn how a patient subjectively experiences their illness, which is the internal picture of the disease (IPD). Understanding the IPD determines compliance and the success of any therapy, from cardiology to surgery.
The section consists of three key blocks. First, we examine the concept of the IPD and types of reaction to a diagnosis. Then we move on to classical psychosomatic disorders—physical illnesses in which psychological factors play a leading role (the famous "Chicago Seven"). The final block is dedicated to nosogenies—psychogenic reactions of the patient to the mere fact of having a severe somatic disorder.
During practical classes and exams, you will certainly be asked to differentiate between true psychosomatic disorders and nosogenies. Instructors also place special emphasis on Lichko's types of reaction to illness: the hypochondriac, anosognosic, and ergopathic coping variants must be known by heart. This knowledge will be useful to you in any medical specialty.