medinfoАктуальные проблемы теоретической и клинической медициныActual Problems of Theoretical and Clinical Medicine2790-12892790-1297Казахстанско-Российский медицинский университет10.64854/2790-1289-2026-51-1-13medinfo-1032Research ArticleОБЗОР ЛИТЕРАТУРЫREVEWSСОМАТИЗИРОВАННЫЕ ПСИХИЧЕСКИЕ РАССТРОЙСТВА В ПЕРВИЧНОЙ МЕДИКО-САНИТАРНОЙ ПОМОЩИ: ПРОБЛЕМЫ ДИАГНОСТИКИ И МОДЕЛИ ИНТЕГРАЦИИ ПСИХИЧЕСКОГО ЗДОРОВЬЯSOMATIZED MENTAL DISORDERS IN PRIMARY HEALTH CARE: DIAGNOSTIC PROBLEMS AND MENTAL HEALTH INTEGRATION MODELShttps://orcid.org/0000-0001-7857-3480РахальскаяН. Н.RakhalskayaN. N.n.rakhalskaya@medkrmu.kzhttps://orcid.org/0000-0002-3477-2565ЕшимбетоваС. З.YeshimbetovaS. Z.s.eshimbetova@medkrmu.kzНУО «Казахстанско-Российский медицинский университет»КазахстанNEI «Kazakh-Russian medical university»Kazakhstan20260104202601187203Copyright © Рахальская Н.Н., Ешимбетова С.З., 20262026Рахальская Н.Н., Ешимбетова С.З.Rakhalskaya N.N., Yeshimbetova S.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://kazrosmedjournal.krmu.edu.kz/jour/article/view/1032Актуальность

Актуальность. Соматизированные психические расстройства и персистирующие физические симптомы являются важной, но часто недостаточно распознаваемой проблемой в системе первичной медико-санитарной помощи. Такие пациенты обычно сначала обращаются к врачам первичного звена, однако разнообразие симптомов, их сочетание с тревогой и депрессией, стигматизация и диагностические трудности затрудняют своевременное выявление. В связи с этим важными задачами являются интеграция психического здоровья в систему первичной помощи и развитие междисциплинарных моделей оказания медицинской помощи.

Цель

Цель. Систематизировать современные данные об эволюции терминологии, причинах недостаточного распознавания, инструментах ранней идентификации и организационных моделях интеграции психического здоровья, значимых для диагностики соматизированных психических расстройств на уровне первичной медико-санитарной помощи.

Материалы и методы

Материалы и методы. Исследование выполнено в формате нарративного обзора с систематическим поиском литературы в базах данных PubMed, Scopus и Web of Science, а также анализом документов Всемирной организации здравоохранения, Всемирная организации здравоохранения/Европа и WONCA. Основное внимание уделялось публикациям за период 2015-2025 гг., однако также были включены более ранние работы, имеющие концептуальное значение. В результате первичного поиска было выявлено 107 публикаций, из которых после скрининга заголовков, аннотаций и удаления дубликатов в окончательный анализ включено 43 источника.

Выводы

Выводы. Современные научные данные показывают, что переход от понятий соматоформных расстройств и медицински необъяснимых симптомов к концепциям расстройства соматических симптомов, телесного дистресс-расстройства и персистирующих физических симптомов имеет важное значение для клинической практики в первичной медико-санитарной помощи. Диагностика этих состояний должна основываться на поэтапной клинической оценке, включающей использование скрининговых инструментов (PHQ-15, SSS-8, SSD-12), динамическое наблюдение и оценку функционального статуса. Интеграция психического здоровья в систему первичной помощи и развитие мультидисциплинарного подхода будут способствовать более раннему выявлению и улучшению доступа к медицинской помощи.

Relevance

Relevance. Somatized mental disorders and persistent physical symptoms are an important but often insufficiently recognized problem in primary health care. Such patients usually turn to primary health care doctors first; however, the variety of symptoms, accompanied by anxiety and depression, stigma, and diagnostic difficulties, hinders their timely detection. In this regard, it is important to integrate mental health into the primary health care system and develop interdisciplinary care models.

Objective

Objective. To systematize current evidence on the evolution of terminology, the causes of underrecognition, the tools for early identification, and the organizational models of mental health integration relevant to the diagnosis of somatized mental disorders at the primary health care level.

Materials and Methods

Materials and Methods. This study was conducted as a narrative review, with a systematic literature search across PubMed, Scopus, and Web of Science, and an analysis of documents issued by the World Health Organization, World Health Organization /Europe, and the World Organization of Family Doctors. The main focus was placed on publications from 2015 to 2025; however, earlier works of conceptual importance were also included. The initial search identified 107 publications, of which 43 sources were included in the final analysis after title and abstract screening and duplicate removal.

Conclusions

Conclusions. Current scientific data show that the transition from the concepts of somatoform disorders and medically unexplained symptoms to the concepts of Somatic Symptom Disorder, bodily distress disorder, and persistent physical symptoms is important for clinical practice in primary health care. The diagnosis of these conditions should be based on periodic clinical assessment, including screening tools (PHQ-15, SSS-8, SSD-12), dynamic monitoring, and functional status assessment. The integration of mental health into primary health care and the development of a multidisciplinary approach will contribute to early detection and improved access to health care.

соматизированные психические расстройствастойкие физические симптомырасстройство с соматическими симптомамипервичная медико-санитарная помощьранняя диагностикаинтеграция в области психического здоровьясовместный уход.somatized mental disorderspersistent physical symptomssomatic symptom disorderprimary health careearly diagnosismental health integrationcollaborative care.ReferencesLöwe, B., Toussaint, A., Rosmalen, J. G. M., Huang, W. L., Fischer, T. W., Henningsen, P., et al. (2024). Persistent physical symptoms: Definition, genesis, and management. Lancet, 403(10444), 2649-2662. DOI: https://doi.org/10.1016/S0140-6736(24)00623-8Löwe, B., Toussaint, A., Rosmalen, J. G. M., Huang, W. L., Fischer, T. W., Henningsen, P., et al. (2024). Persistent physical symptoms: Definition, genesis, and management. Lancet, 403(10444), 2649-2662. DOI: https://doi.org/10.1016/S0140-6736(24)00623-8Löwe, B., Levenson, J., Depping, M., et al. (2022). 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The authors declare that there are no conflicts of interest present.