NON-MEDICINAL APPROACH TO THE TREATMENT OF ANXIETY-DEPRESSIVE DISORDERS IN PATIENTS UNDER KIDNEY REPLACEMENT THERAPY

Abstract

SUMMARY. The aim – to analyze the impact of non-drug treatment, art therapy on the level of anxiety and depressive disorders in patients with RRT.

Materials and Methods. The study was conducted on the basis of the Center for Nephrology and Dialysis of the Public Enterprise "Poltava Regional Clinical Hospital. M.V. Sklifosovsky Poltava Regional Council". The study involved 114 patients, of whom 44 were on programmed hemodialysis, 21 – peritoneal and 49, who were in the control group – patients with stage I–II CKD. Of the 114 patients, only 42 agreed to receive specific non-drug treatment. The other 72 patients were in the observation group. The study was conducted during the year. Patients were re-surveyed to determine anxiety/depression, quality of life, which was also conducted at the beginning of the study. The method of non-drug treatment was a kind of art therapy iso-therapy. The HADS questionnaire was used to determine anxiety and depression, and the SF-36 questionnaire was used to determine quality of life.

Results. Re-examination of patients revealed that the rates of SBP and DBP in patients who underwent art therapy were significantly lower than in those who did not receive such therapy, p<0.05 in groups HD1, HD2, PD1 and PD2. Significant significant differences were found when comparing anxiety and depression at the beginning of the study and after a year. For example, in HD1 at the beginning of the study the level of anxiety was 9.2±0.9, and a year later – 6.2±1.2. Similar data are also observed in the groups HD2, PD1 and PD2 and when comparing the indicators of depression in these groups. In the study of quality of life indicators, the average indicators show a positive effect of art therapy after a year of observation. General health and mental health have a special place in the indicators of QOL. In our study, these indicators showed a statistically significant difference in the internal structure of each of the studied groups after a year of observation, p<0.05.

Conclusions. In patients who included art therapy in the complex treatment, 12 months after the start of therapy there was a statistically significant decrease in anxiety and depression, improvement in quality of life. At the same time, patients who were on RRT showed a statistically significant decrease in both systolic and diastolic blood pressure, which, of course, reduced the degree of cardiovascular risk.