Study of clinical and social-psychological aspects of mental disorders associated with somatic diseases with distinguishing the basic pathogenetic factors and development of stepwise therapeutic programs.

Analyzed material – persons seeking for psychiatric help at primary care units on eastern frontier territories of Kazakhstan and Russia. Factorial analysis has identified the most significant factors (somatic-vegetative, psychopathological syndromes, somatic pathology, age peculiarities) in formation of combined mental and somatic diseases. With account for specifics of the contingent of patients, age structure, therapeutic-diagnostic complex of general primary care units, stepwise rehabilitative programs have been developed.

Basic stages of therapy have been distinguished: initial, basic and maintenance. Rehabilitative programs have been developed and introduced: for patients with neurotic disorders, organic mental disorders, personality disorders, affective disorders, alcohol dependence, and separately for persons of younger and elder age. Basic principles of rendering of medical assistance have been structured: complexity, sufficiency, individual-differentiated approach, continuity, cooperativeness.

Use of base of general somatic primary care units, integrative approach during rendering of specialized psychiatric assistance to patients with mental disorders appeared to be most effective and lesser economically expensive as compared with institutional assistance at a profile institution.