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№4' 2014
PSYCHIATRYInternational Medical Journal, Vol. 20., Iss. 4, 2014, P. 9−13.
MENTAL SPHERE DISORDERST IN PATIENTS WITH ACUTE SOMATIC CONDITIONS
Regional Hospital − Center for Emergency and Catastrophe Medicine, Kharkiv, Ukraine
At present psychological aspects of the problem of acute therapeutic profile remain understudied health issues. Coronary artery disease (CAD), myocardial infarction (MI), crisis states in patients with arterial hypertension (AH), transient ischemic attack (TIA) and acute stroke (AS), gastric and duodenal ulcer (GDU) are among the most common diseases. Investigations have shown a high level of affective and neurotic disorder in these patients. The clinical features, dynamics, current and immediate associations with the medical condition are not fully understood, which was the basis of our research, the purpose of which was to identify mental disorders in patients with acute state of therapeutic profile. The study involed 187 patients (65 % men and 35 % women aged 20−60), of them 34 patients with CAD, 37 with MI, 38 with TIA, 39 with hypertension, 39 patients with GDU. The main research method was clinical and psychopathological. Structured analysis allowed identifying four main options of disorders: nosogenic reaction of psychological maladjustment; somatogenic asthenic symptom; reaction of psychological maladjustment; acute stress reactions in patients with severe pain. Stratification of the structure of psychopathological symptoms and signs allowed systematizing them in 4 different manifestations: asthenia; anxiety; subdepressive; somatoform. Thus, clinical and psychopathological study showed that most patients had nonpsychotic disorders. This was the basis for the determining the objects in the psychological adjustment of medical−psychological support of these patients.
Key words: acute somatic diseases, nonpsychotic mental disorders, nosogenic reactions of mental deadaptation.