NON-PSYCHOTHOTIC DISORDERS OF THE MENTAL SPHERE AND CARDIOVASCULAR RISK IN COMBATES
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2020.3.11526Keywords:
general practice-family medicine, cardiovascular risk, combatantsAbstract
Summary. The increase in the duration of temporary disability and primary disability due to chronic diseases, in particular combined, causes significant economic damage and increases the social significance of research aimed at improving medical and psychological monitoring, early diagnosis, individualization of treatment and risk management; this is extremely important for combatants.
The aim of the study – to examine the frequency and nature of non-psychotic mental disorders among combatants stratified by the level of cardiovascular risk (CVR).
Materials and Methods. The primary information base for the study was the results of a comprehensive clinical and anamnestic examination of 450 combatants, who were previously stratified according to the level of cardiovascular risk, determined by the method of "SCORE".
Results. The frequency of mental maladaptation reactions (MMR) in different risk groups of patients ranged from (37.8±4.4) % to (68.3±4.6) % and was significantly (p≤0.05) higher among patients with implemented CVR than in groups with different levels; at the same time, no significant differences in the frequency of MMR depending on the level of CVR were found, which indicates a relatively equal level of mental maladaptation at the pre-nosological stage of CVR implementation. The frequency of somatogenous asthenic symptom complex (SASC) was found to be the highest among patients with realized CVR (20.2±3.9) % and significantly (p≤0.05) less frequently diagnosed SASC in risk groups of patients with different levels of CV-diseases. It was found that the frequency of SASC was significantly lower among patients with a high level of CVR (minimum CVR – (16.8±3.3) %, high CVR – (8.8±2.8) %, p≤0.05. Thus, the implementation of CVR and, accordingly, the diagnosis of CVD is a significant factor in increasing the incidence of ACS among such patients. Acute neurotic disorders (AND) with the highest (p≤0.05) frequency were diagnosed among patients with high CVR (22.5±4.1) %, their frequency is five times higher than in other risk groups patients with CVD (ranging from 4.8 to 5.0 %) and three times higher than among patients with CV-diseases (7.7±2.6) %). That is, acute neurotic disorders manifest high CVR, whereas in the nosological design of high CVR (when diagnosing CVD) the frequency of AND is significantly reduced. The frequency of neurotic disorders with a prolonged course was found significantly (p≤0.05) higher among patients with risk groups of CVR (ranging from (10.4±2.7) % to (24.4±3.9) % than among patients with CVD was (1.9±1.3) %, while among patients of risk groups of CVR it was the lowest at low CVR and equally higher at medium and high CVR (p≤0.05).
Conclusions. The frequency and nature of non-psychotic mental disorders in combatants with different levels of CVR were determined and the presence of the highest frequency of MMR in the structure of these disorders was proved. It is proved that the frequency of SASC is the highest among patients with realized CVR and exceeds the corresponding indicator of the group of patients with high CVR.
References
Horbas IM. [SCORE scale in clinical practice: ad-vantages and limitations]. Zdorovia Ukrainy. 2008;11(1): 40-1. Ukrainian.
Lichko AYe, Ivanov NYa. [Medical and psycho-logical examination of somatic patients]. Zhurnal nevropatologii i psikhiatrii im. S.S.Korsakova. 1980;80(8): 1195-8. Russian.
Lishchuk VA. [Informatization of clinical medi-cine]. Klinicheskaya informatika i telemeditsina. 2004;1: 7-13. Russian.
Netyazhenko VZ, Puzanova OH. [Patient with high cardiovascular risk: how to improve the prognosis]. Vnutrishnia medytsyna. 2008;5-6: 123-9. Ukrainian.
Organov RG, Shalynova SA, Kalinina AM. [A new way of assessing the individual cardiovascular total risk for the population of Russia]. Kardiologiya. 2008;5: 85-9. Russian.
Panchenko MS. [Prognostic value of medical and psychological factors in the assessment of cardiovascular risk]. Visnyk problem medytsyny ta biolohii. 2013;4(1): 193-7. Ukrainian.
Panchenko MS. [Psychological features of patients with somatic pathology and cardiovascular risk]. Visnyk problem medytsyny ta biolohii. 2013;4(2): 149-53. Ukrainian.
Prikhodko VYu. [High risk patient – who is he?]. Zdorovia Ukrainy. 2010;3: 18-19. Ukrainian.
Sirenko YuM. [Effectiveness of preventive measures to prevent the development of cardiovascular diseases]. Simeina medytsyna. 2006;1: 52-60. Ukrainian.
Shalnova SA, Vikhireva OV. [Assessment of the total risk of cardiovascular disease. Comments on the European guidelines for the prevention of cardiovascular diseases]. Ratsionalnaya farmakoterapiya. 2005;3: 54-6. Russian.
Shklyar SP, Panchenko MS, Pertsev DP, Cher-kashyna LV. [Sanology and clinical medicine: methodological aspects of studying risk factors for psychosomatic disorders]. Problemy ekolohichnoi ta medychnoi henetyky i klinichnoi imunolohii: Zbirnyk naukovykh prats. 2011;6(108): 495-505. Ukrainian.
Bhatt DL, Steg PG, Ohman EM. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295: 180-9. DOI: https://doi.org/10.1001/jama.295.2.180
Tzipkalo AI, Marushchak MI, Krynytska IY. [Fea-tures of nurses' work in the area of combat actions]. BMBR. 2020;(1): 50-3. Ukrainian. DOI: https://doi.org/10.11603/bmbr.2706-6290.2020.1.10939
