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BackgroundThe method of “rehabilitation training”, developed in the Soviet psychology, based on the idea that the human HMF are realized in complex functional systems, developed during cultural- and ontogenesis.AimsTo show the importance of the development of approaches to the rehabilitation of HMF in Luria's neuropsychology.MethodsThe disturbances in brain activity leads to the neuropsychological syndrome appearance that could be called self-developing system. According to the systemic principles, each neuropsychological syndrome HMF disorders in accordance with brain injury localisation has the common “cause” – destroyed neuropsychological factor. In the case of patients with dementia several neuropsychological factors are usually included. So the rehabilitation processes should be aimed at the maximum preserved and strengthened stereotypes and behavior strategies in past experiences.ResultsThe binary syndrome structure (set of symptoms of destroyed neuropsychological HMF and abnormal neuropsychological factor itself) allows us to define two strategies of neuropsychological rehabilitation programs. The first strategy involves choice as a “target” of the most destroyed mental function. The second strategy could be directed to the rehabilitation of abnormal neuropsychological factor that should be accompanied by the rehabilitation of several systemic interrelated mental functions. Recourse to past knowledge, interests and emotionally important topics is assisting and supporting the rehabilitation processes.ConclusionsUse of both strategies ensures targeted restoration of cognitive functions within Vygotsky-Luria approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionOne of the dominant methodological principles of Russian clinical psychology (the Vygotsky-Luria School) is the principle of Psychological syndrome analysis (PSA). It can also be heuristically applied to psychosomatics.ObjectiveTo identify a psychosomatic syndrome in patients with mitral valve prolapse (MVP).Materials and methodsWe applied various techniques for a qualitative and statistical data analysis of clinical and psychological study. We explored our patients’ individual personality profiles, anxiety level (Spielberger et al., 1983), features of achievement motivation (Heckhausen, 1963), emotion regulation strategies (ERS) (Zinchenko, Pervichko, 2014; Pervichko, 2015), dynamics of the patient's emotional state in stress conditions, and degrees of manifestation of MVP clinical symptoms. The study comprised 134 MVP patients, mean age was 24.8 ± 1.2 years, and 73 healthy subjects, mean age was 27.5 ± 1.3 years.ResultsMVP patients proved to be more prone to emotional stress; they were also inclined to choose less effective ERS as compared to healthy subjects. ANOVA data revealed dependence of intensity of such clinical symptoms as cardialgia, tension headaches and psychogenic dyspnea on the degree of anxiety level and the presence of dysfunctional ERS in MVP patients. The interpretation of the study results with PSA method suggested that the patients’ psychological and clinical characteristics form into a psychosomatic syndrome. The first syndrome-generating factor is the presence of the approach – avoidance motivational conflict in achievement settings. Dysfunctions of emotion regulation appear as a second syndrome-generating factor in psychosomatic syndrome in MVP patients.ConclusionsPSA (the Vygotsky-Luria School) can be used as a means to approach diagnostic and prognostic tasks in Clinical psychology and Psychosomatic medicine.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe diagnostics of cognitive disorders (CD) in patients with essential arterial hypertension (EAH) is often necessary for the choice of treatment strategy.ObjectiveTo assess the role of neuropsychological and motivational factors in cognitive efficiency of elderly EAH patients.Materials and methodsTwenty-five patients with EAH took part in the study, stage 1–2, mean age was 67.6 ± 6.1. The assessment of cognitive functions embraced a quantitative measurement of intelligence quotient (IQ) with the Wechsler Adult Intelligence Scale (Wechsler, 1955), and investigation into qualitative features of cognitive processes with Luria's neuropsychological assessment scheme (Luria, 1980) and Zeigarnik's procedure of pathopsychological study (Zeigarnik, 1972).ResultsWithin the psychological syndrome structure of CD in EAH patients the leading part is played by the neuro-dynamic factor, manifested in general lability, slowing down, and sudden exhaustion caused by reduction in energy of mental activity. The conclusion is supported by the high frequency of described symptoms among EAH patients and low dynamics of their reduction against the antihypertensive therapy (Pervichko et al., 2014, 2015). However, performance of experimental tasks makes 30% of EAH patients reveal reduced motivation. They would achieve poor results in general scoring, if compared with the group of highly motivated participants. Correlation analysis data show the interconnection between frequency disturbances in motivation and frequency in occurrence of various signs of cognitive decline, such as low efficiency in memorization and delayed recall, as well as low IQ indices.ConclusionsThe data provide a strong argument to support the hypothesis of particular importance of motivational factor of cognitive efficiency in elderly EAH patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionEssential hypertension (EH) is one of the most common diseases of the cardiovascular system. Today, scientists discover more and more patients whose BP values during work appear to be higher than those values during free time. This form of EH is called “hypertension at work”.ObjectiveTo study the role emotion dysregulation in the pathogenesis of EH.Materials and methodsA projective study of emotion regulation was undertaken with our modified version of Rosenzweig Picture-Frustration Test (Zinchernko, Pervichko). At the second stage of the study, the simulation of emotional stress with the aspiration level modelling was carried out. The level of state anxiety, BP values and levels of catecholamines, renin and angiotonin I were taken before and after the experiment. Eighty-five patients with “hypertension at work” (mean age: 45.9 ± 2.8), 85 patients with “classical” EH (mean age: 47.4 ± 4.5 years) and 82 healthy subjects (mean age: 44.9 ± 3.1) took part in the study.Results“Hypertension at work” patients significantly more frequently than patients from the second group and healthy subjects are more prone to rumination, disasterization and repression of their emotions. They will seldom employ the strategy of subjective-objective interactive transformations; their edibility to actualize new meanings in traumatic situations is diminished. We showed that emotion regulation strategies in “hypertension in the work” patients were ineffective in overcoming the emotional tension and created the conditions for chronization of high blood pressure, and could be considerded as the central link in pathogenesis of stress-induced hypertension.ConclusionThe results contributes to enrich our understanding of etiology and pathogenesis of EH.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionEssential hypertension (EH) is one of the most common diseases of the cardiovascular system. Today scientists discover more and more patients whose blood pressure values during work appear to be higher than those values during free time. This form of EH is called “hypertension at work”.ObjectivesTo indicate psychological defense mechanisms in patients with “hypertension at work”, as compared with ‘classical’ EH and healthy individuals.Materials and methodsDefense mechanisms were evaluated by the survey “The Life Style Index”. Eighty-five patients with ‘Hypertension at work’ (mean age was 45.9 ± 2.8) and 85 patients with ‘classical’ EH (mean age was 47.4 ± 4.5 years) took part in the study.ResultsThe results showed the dominance of low level psychological defences. The most common mechanisms were denial, projection and regression. More mature defense processes included reaction formation and rationalization. The patients with ‘Hypertension at work’ significantly (P < 0.05) differs from second group by more frequent representation of displacement, denial, projection and reaction formation. Comprehensive interpretation of our findings suggested that affection of EH patients (specifically ‘Hypertension at work’) can be characterized by dominance of negative emotions and aggressive tendencies which would be projected, denied or suppressed. Such a complex of defense mechanisms is typical for those, who knows, based on own experience, that uncontrolled negative emotional reactions could be unsafe in social environment.ConclusionsOur findings can be considered as a basis to define a “risk group” amongst EH patients by an attribute of “emotional well-being” disorder and to develop psychological recommendations for them.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introduction‘Hypertension at work’ today is found one of the most frequent forms of stress-induced hypertension.ObjectivesTo inquire into the specifics of psychological and psychophysiological mechanisms of stress reaction in patients with ‘hypertension at work’, as compared with ‘classical’ essential hypertension (EH).Materials and methodsThe study developed simulation of emotional stress with the aspiration level (AL) modeling. The level of state anxiety (SA), BP values, urine catecholamine levels and levels of renin and angiotonin I in blood plasma were taken before and after the experiment. Eighty-five patients with ‘hypertension at work’ (mean age was 45.9 ± 2.8) and 85 patients with ‘classical’ EH (mean age was 47.4 ± 4.5 years) took part in the study.ResultsRates of ‘hypertension at work’ patients, when compared with second group patients, revealed a significant increase (Р < 0.001) of systolic BP in response to stress loads (on average, for 16.1 ± 1.9 mmHg and 4.1 ± 0.7 mmHg, respectively). Initially ‘hypertension at work’ patients had significantly lower levels of catecholamines, than the second group, while the levels of renin and angiotensin I were comparable. During the experiment, the patients in the first group showed a significant decrease in all parameters. After the experiment, the patients with ‘HTN at work’ did not show increase of SA, but revealed more frequent inadequacy (69.4%) and instability (56.5%) on the AL. Patients with ‘classical’ EH more often demonstrate adequate AL and lower growth of BP after the experiment.ConclusionsPatients with ‘hypertension at work’ are more prone to repress their emotions. They reveal physiological features of chronic stress and psychophysiological exhaustion, if compared with second group patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionExisting polysemy in definitions of human consciousness creates the major difficulty in its understanding. With the development of intensive care modern methods, the number of patients survived after coma and dwelling in disorders consciousness conditions rises.AimsAmong, the most important practical questions of neuropsychology is estimation of the patient's consciousness current condition. The solvation of these problems requires precise denotation of consciousness neuropsychological criteria.MethodsAll of definitions of consciousness in Russian psychological school, have the binarity as a common feature: in one hand, in view of the world, yourself, and another hand–extraction and differentiation of yourself from the ambient world (self-consciousness).ResultsNeuropsychological model of consciousness (in particular, self-consciousness) includes all higher psychological functions (HPF). However, condition of none of them cannot be sufficient criterion of consciousness estimation. In Russian psychology it is suggested to study the consciousness through its own characteristic, among which one can designate reflexivity, which includes cognitions and personal meanings.ConclusionsIt is possible to determine the quality of consciousness at a specific instant of time, through the system of human relations, as activity is motivated the knowledge is acquired, the affective side of the activity is determined, the self-consciousness is formed exactly through the personal meaning. Personal meaning can act as that quantity of consciousness (self-consciousness) analyses where the external reality and human attitude to this reality are differentiated. One can judge about a degree of contact between a human and a real world by indirect difference between them.Disclosure of interestThe authors have not supplied their declaration of competing interest.

BackgroundUrgency of psychophysiological examination of mitral valve prolapse (MVP) patients is suggested by a high incidence of anxiety disorders among these patients.ObjectivesTo study glucocorticoid function activity and emotional stress resistance in MVP patients with autonomic dysfunction (AD).MethodsThe trait anxiety level (TA) was assessed with the State-Trait Anxiety Inventory (Spielberger). Emotional stress resistance was undertaken with our modified version of Rosenzweig Picture-Frustration Test (Zinchenko, Pervichko). The cortisol level in blood plasma was measured by radioimmunoassay technique with radioimmune assay kit of cortisol in human blood plasma ‘KORT-3N’ (Belarus). There were 32 MVP patients (mean age was 28.5 ± 1.6 years) and 15 healthy people (mean age was 27.5 ± 1.3 years) who took part in the study.ResultsAmong reactions to frustration revealed by MVP patients the following categories are dominating: extrapunitive (Е), ego-defensive (ED), and obstacle-dominance (OD). There was revealed a direct correlations: TA and Е (r = 0.49, Р < 0.001); TA and ED (r = 0.46, Р < 0.01); TA and indexes of AD (r = 0.43, Р < 0.01).There was displayed a higher level of cortisol in MVP patients with severe grade of AD, against the level revealed by patients with average grade of AD (433.9 ± 78.0 mmol/L vs. 299.3 ± 42.9 mmol/L; Р < 0.05). Direct correlations were established between the cortisol level and the level of TA (r = 0.45; Р < 0.01); between the frequency of E-reactions in Modified Rosenzweig Test and cortisol level (r = 0.42; Р < 0.01).ConclusionAlong with low stress resistance, registered AD and high level of TA, MVP patients reveal higher indexes of cortisol in blood plasma.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionIt is known for a fact that a number of psychological factors may affect heart pain perception in patients with coronary artery disease (CAD). However, psychosemantics of pain in CAD patients was hardly ever explored.ObjectiveTo study the features of pain psychosemantics in CAD patients.MethodsThere were applied McGill Pain Questionnaire (Melzack, 1975); the psychosemantic technique “Classification of sensations” (Tkhostov, Efremova, 1989); the 20-item Toronto Alexithymia Scale (Bagby, Taylor, Parker, 1994); and State-Trait Anxiety Inventory (Spielberger et al., 1983). Fifty-four CAD patients took part in the study, the mean age was 55.9 ± 7.6 years. CAD duration was 5.8 ± 2.6 years.ResultsCAD patients with the high level of trait anxiety (28%) choose greater variety of descriptors for pain definition, revealing an impaired ability to differentiate between emotional states and physical sensations. They show higher scale values for McGill Pain Questionnaire. Patients with high indices of alexithymia (31%) require significantly fewer words for description of painful and dangerous perceptions within the “Classification of sensations”. This may testify to a certain bafflement in verbal description of the pain. With that, intensity of alexithymia does not correlate significantly with the high level of state and trait anxiety (P > 0.05). The method of “Classification of sensations” revealed that patients with trait anxiety, as well as those with alexithymia, define the pain with significantly more numerous metaphorical and affective descriptors (Pervichko, Zinchenko, 2013).ConclusionsReceived results prove an important role of psychological factors in etiology of chest pain in CAD patients with the high level of trait anxiety and alexithymia, which supports the urgency of psychotherapy for them.References not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionEmotion regulation (ER) efficiency dwells among the most pressing issues of contemporary psychology and psychiatry. Further development of the methods of reliable assessments for ER makes it the task of current importance.ObjectiveTo modify Rosenzweig Picture-Frustration Test for the study of ER in health and in disease.MethodsIn the initial stage of testing participants had to look through a succession of Rosenzweig's pictures, and select potentially traumatizing situations.In the second stage they answered the following questions:– what would you say in this particular situation?– what would you have in mind, saying this?– could you think of an answer that would taper down the traumatizing character of the situation in your own perception? (Zinchenko, Pervichko, 2014).A total of 85 patients with stress-induced hypertension (mean age was 45.9 ± 2.8) and 82 healthy subjects (mean age was 44.9 ± 3.1) took part in the study.ResultsWe came to distinguish among four classes of ER strategies: internal, cognitively non-mediated; internal, cognitively transforming; external, cognitively non-mediated; and external, cognitively transforming (Pervichko, 2015). Hypertensive patients significantly more frequently than healthy subjects reveal wider set of emotionally grave events (19.8% vs 11.2%, P < 0.001), they are more prone to rumination, disasterization (19.0% vs 11.1%, P < 0.001) and suppression in display of their emotions (31.9% vs 20.2%, P < 0.001). The patients will seldom employ the strategy of interactive subject–subject transformations; their capability to actualize new meanings in traumatic situations is diminished.ConclusionsApplication of the described modification of Rosenzweig Picture-Frustration Test allows to distinguish and classify various ER strategies, and to demonstrate peculiarities in ER related behaviour of hypertensive patients as opposed to healthy subjects.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionTwo thirds of adolescents with mitral valve prolapse (MVP) show signs of anxiety disorders. They display difficulty in emotion regulation (Van Der Ham et al., 2003; Scordo, 2007).ObjectiveTo investigate into emotion regulation strategies in MVP adolescents.MethodsA projective study of emotion regulation was undertaken with our modified version of Rosenzweig Picture-Frustration Test (Zinchenko, Pervichko, 2014). Thirty-six adolescents with MVP (mean age was 17.1 ± 0.8 years) and 40 healthy adolescents (mean age was 16.7 ± 0.6 years) took part in the study.ResultsMVP adolescents significantly more frequently (P < 0.001) would mark Rosenzweig's situations as potentially traumatizing. Ego-defence (E-D) and extrapunitive (E) reactions appear to be significantly (P < 0.05) more frequent among MVP adolescents. MVP adolescents are more than healthy subjects prone to avoid open verbal revelations of their thoughts and feelings that emerge in the situation of frustration. Content analysis of responses conditioned by cognitive control (when the task was to taper off arbitrarily the traumatizing effect of the situation) revealed that suppression of emotions was displayed by MVP adolescents in 52% of answers, and for healthy participants - 29% of answers (P < 0.001). Cognitive reappraisal strategy was displayed by MVP adolescents in 27% of answers, and for healthy participants – 38% of answers (P < 0.05). Twenty-one percent of answers of MVP adolescents and 33% of answers of healthy participants suggested cognitive transformation of emotional experience and actualization of new meanings in traumatic situations (P < 0.05).ConclusionsMVP adolescents appear to be more sensitive of frustrations and differ from healthy peers in more frequent use of the strategy of suppression of emotions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionRehabilitaton of concurrent psychiatric disorder and brain injury is a major challenge. E. underwent neurosurgery for right fronto-parietal astrocytoma. Before illness he was managing automatization of big companies, but was fired after the operation. E. felt into severe depression and anxiety with catastrofization of his illness, suicidal ideation. He resisted multiple prescriptions for SSRI, admitting a sect pretending to “treat” oncology by “psychological” methods. Half a year after operation he attended our center.Objectives and aimTo help E. return to paid employment.MethodsE. was evaluated by neurologists, psychiatrist, neuropsychologists. Current depressive episode appeared to be the second one with underlying schizoid and perfectionist characteristics. He had moderate text comprehension difficulties, confabulations, slight executive dysfunction. Neuropsychologist educated patient on his difficulties and developed compensatory strategies – an alternative to catastrofisation. After psychoeducational session E. agreed to receive fluvoxamine. However, he deformed the received information due to brain injury, so psychotherapy had only minor effects. Infra-low frequency neurofeedback at T4P4 and T4Fp2 sites was started to promote restoration of right brain functions. E. gradually did better, and 3 months later was able to complete CBT course along with relaxation training.ResultsImprovements in emotional status along with ability to cope with cognitive difficulties allowed E. to return to a job similar to the previous. Six month after the start of treatment medications are tapered off, E. has no signs of depression and only slight anxiety.ConclusionsInterdisciplinary holistic rehabilitation may be effective in concurrent psychiatric disorder and brain injury.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introduction In Russian clinical tradition and psychological research of Vygotsky-Luria school much consideration is given to relationships between the doctor and the patient, regarding it as an efficiency factor of treatment and rehabilitation. Objectives To evaluate the concordance with treatment adherence and those psychological factors that affect the treatment compliance in patients with essential arterial hypertension (EAH). Methods A questionnaire-based study was undertaken with EAH patients attending public hospitals in Moscow, Russia. There were applied a Questionnaire for Interpersonal Relationships Assessment (Sobchik, 2005), Questionnaire for Assessment of Types of Attitudes Towards the Disease (Wasserman, 2005), Psychodiagnostic Interview for Treatment Adherence, Drug Attitude Inventory, and Multidimensional Scale of Perceived Social Support (Zimet et al., 1988). 170 EAH patients took part in the study, the mean age was 46.7±4.1 years, EAH duration was 7.2±2.6 years. Results It was found that 75.3% of the patients defied the doctor's prescriptions. Forgetfulness, lack of tendance, and negligence were ranked as the top three reasons for this non-compliance. A statistically significant relationship with non-compliance was found for anxious, melancholic and neurasthenic types of attitude towards the disease, as well as predominance of distrustfully-skeptical interaction style in a dyad 'doctor-patient' and the lack of social support, and such characteristics, as age and education level. Patients with high compliance have predominantly sensitive type of attitude towards the disease, high intensity of social support, and dependent-obedient style of interaction with doctor. Conclusions These results indicate the need to consider the psychological factors to improve treatment adherence in EAH patients.

Introduction Physicians discover more and more patients with Hypertension (HTN) whose blood pressure (BP) values during work appear to be higher than those values during free time. This form of HTN is called ‘HTN at work’ (Stork at al., 1992). Objectives To evaluate the specifics of psychophysiological mechanisms of stress reaction in patients with HTN at work, as compared with patients with essential HTN. Methods 170 patients with EAH, stage 1-2 took part in the study. Among them 85 patients with HTN at work (mean age is 44.7±4.3years) and 85 patients with essential HTN (mean age is 47.4±4.5 years). The research was carried out with the implication of methods of psychological experiment, psychological testing, and methods of physiological data registration. Results Patients with HTN at work, were characterized by reliably greater increase of Systolic BP (on the average by 16 and 4 mmHg respectively) as a reaction to emotional stress. The BP increase in this group was revealed in combination with a lowering of the level of anxiety, gradual decrease of catecholamines' level in urine and renin and angiotensin-1 in blood plasma during the experiment, the fluctuant aspirations' level, and scarcity of behavioral manifestations accompanied by an abundant variety of facial expressions. This psychophysiological combination is an indicator of repression of emotions, chronic stress and psychophysiological exhaustion. Conclusions Repression of emotions come as a significant pathogenetic factor in genesis of psychosomatic syndrome among patients with HTN at work, as opposed to patients with essential HTN.

Introduction The form of Hypertension (HTN), when blood pressure values during work appear to be higher than those values during free time, is called 'HTN at work'. Among the psychological factors causing the development of HTN at work we find dissatisfaction with prospects of promotion. However, no study of perfectionism in patients with 'HTN at work' has ever been conducted. Objectives To conduct a comparative analysis of perfectionism structure in patients with 'HTN at work' against the indices of patients with essential HTN, and to establish correlations between perfectionism indices and burnout intensity in HTN patients. Methods 85 patients with HTN at work and 85 patients with essential HTN took part in the study. There were employed Russian versions of Maslach Burnout Inventory (MBI) and Multi-dimensional scale of Perfectionism by Hewitt and Flett (MPS). Results Both groups of HTN patients reveal high scores on 'socially prescribed perfectionism' (SPP) scale and relatively lower scores on the scales 'other-oriented perfectionism' and 'self-oriented perfectionism' in MPS. Patients in both groups had burnout signs. But patients with 'HTN at work' significantly differ from the second group patients in higher scores of 'emotional exhaustion' and 'depersonalization'. The correlation analysis showed significant (p Conclusions Research results expand the scientific views on perfectionism, burnout syndrome and psychological mechanisms of psychosomatic syndrome genesis. Neurotic perfectionism should be taken into consideration in arranging medical treatment.

Introduction The current situation in medicine, as described by many researchers, reveals a more pronounced 'dehumanization' and 'technification' of medical diagnostics and health care (Mezzich, 2007; Fulford, Christodoulou, Stein, 2011). Hence, the issues of methodology come to the foreground of scientific endeavors in modern psychiatry and clinical psychology. Objectives To demonstrate that the concept of Psychological syndrome analysis (PSA) (Vygotsky-Luria school), considered from the perspective of the postnonclassical academic view, go in tune with personalized care models in medicine. Methods The main method of presented research was methodological reflection upon scientific legacy of L. Vygotsky and A. Luria in the context of the analysis of scientific rationality types: classical, nonclassical, and postnonclassical (Styopin, 2003). Results Our results verify that main provisions of the concept of PSA correspond to the principles of postnonclassical model of scientific rationality. They embrace the idea of a syndrome as a structure shaped by a constellation of causally-related, multilevel symptoms; the understanding of primary and secondary symptoms as different in nature: secondary symptoms are purely psychological phenomena; the selection of symptoms, those that indicate disorders or features of adaptation and compensation (Vygotsky, 1934; Luria, 1972). Using these methodological principles we described the psychosomatic syndromes in patients with mitral valve prolapse and in patients with stress-induced hypertension. Application of PSA methodological principles in clinical practice provides important information for establishing a comprehensive diagnosis. Conclusions PSA methodological principles (Vygotsky-Luria school) considered from the perspective of postnonclassical academic view go in tune with personalized care models in medicine.

Introduction There are some cases of indications of anxiety disorders (AD) that go with mitral valve prolapse (MVP). There is a reduction in the intensity of clinical symptoms after the courses of psychotherapy and anxiolitic treatment (Scordo, 2007). Objectives To assess the psychological well-being rating and dynamics of clinical symptoms in MVP patients with AD receiving long-term integrative psychotherapy. Methods 32 MVP patients with AD attended integrative psychotherapy (1-2 sessions per week, individual assessments). Among them 56.3% of patients received psychotherapy in addition to Alprazolam medication. Duration of psychotherapy courses ranged from 5 months to 2 years. The psychotherapy program consisted of the elements of CBT, Gestalt therapy, Interpersonal psychotherapy, and Psychodynamic psychotherapy. Psychological and clinical examinations of the patients were made before and after the therapy courses, and in the follow-up study after 2, 5, and 10 years. Results 78.1% of patients that attended psychotherapy demonstrated valid improvements of psychological well-being rating, the reduction of anxiety level, and the application of more effective coping-strategies. Positive dynamics of development of personality reflection, with improved skills of self-regulation, and growing awareness of actual needs and resources of personality – all this was associated with reduction of MVP clinical symptoms such as frequency and intensity of chest pain, psychogenic gastrointestinal disorders, neurogenic hyperventilation syndrome, and tension-type headache. 75% of interviewed patients were reported by the psychiatrist to be in sustained remission. Conclusions MVP patients with AD receiving psychotherapy showed a certain improvement in psychological well-being rating and characteristics of disease pattern.