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FEATURES OF THE PATHOKINESIS OF ADAPTATION DISORDERS IN MEN WITH
MILD FORMS OF CARDIOVASCULAR DISEASE
Biktimirova Guzal Ravshanova
Samarkand regional mental health hospital, doctor psychiatrist, Samarkand, Republic of
Uzbekistan
Turayev Bobir Temirpulotovich
Assistant of the department of psychiatry, medical psychology and narcology, Samarkand State
Medical University, Samarkand, Republic of Uzbekistan
Ochilova Nigina Ulug’bek qizi
Student of group 328 of the medical faculty of Samarkand State Medical University, Samarkand,
Republic of Uzbekistan
https://doi.org/10.5281/zenodo.10613562
Abstract.
In cardiovascular pathology, data are presented on the peculiarities of the
structure of mental insufficiency, according to which mental disorders of the affective spectrum,
manifested by symptoms of anxiety and depression, which can be combined with hypochondriac
diseases, are more common. In the genesis of mental adaptation, a connection with stress, personal
and psychosocial factors is observed.
Key words:
cardiovascular disease, anxiety, depression, mental retardation.
ОСОБЕННОСТИ ПАТОКИНЕЗА НАРУШЕНИЙ АДАПТАЦИИ У МУЖЧИН С
ЛЁГКИМИ ФОРМАМИ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ
Аннотация.
В сердечно-сосудистой патологии представлены данные об
особенностях структуры психической недостаточности, согласно которым чаще
встречаются психические расстройства аффективного спектра, проявляющиеся
симптомами тревоги и депрессии, которые могут сочетаться с ипохондрическими
заболеваниями. В генезисе психической адаптации наблюдается связь со стрессом,
личностными и психосоциальными факторами.
Ключевые слова:
сердечно-сосудистые заболевания, тревога, депрессия,
умственная отсталость.
Introduction.
As noted in our previous publications, the ability of a person to adapt,
including in the case of illness, is associated not only with the functional state of the organism and
its ability to adequately respond to negative factors, but also with a certain complex of individual
psychological characteristics of the individual [1], as well as with methods of processing
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interpersonal relationships. adventures [2]. The importance of the mental adaptation factor in
cardiovascular diseases, as well as the high frequency of its mental deficiency, justify the
emergence of a separate interdisciplinary direction-psychocardiology, which is located at the
intersection of Cardiology, psychology and psychiatry [3].
This work is devoted to a brief review of Scientific Reports on the peculiarities of the
structure of mental deficiency in patients with cardiovascular diseases, which rely on the most
pronounced psychopathological symptoms in common forms of cardiac pathology [4].
Thus, according to epidemiological studies, a reliable relationship was established between
cardiac pathology and depression. There is more information on the relationship between anxiety
and the development of cardiovascular disease in the general population [5].
Anxiety and depressive symptoms in patients with Arterial hypertension and coronary
artery disease and its effect on cardiovascular prognosis have shown that clinically significant
anxiety symptoms are present in 33 and 38%, respectively 30 and 38% of patients with arterial
hypertension and coronary artery disease have depressive symptoms.respectively [6].
Psychopathological symptoms data have been found to be associated with low levels of
education, low income levels, inadequate physical activity, high levels of chronic psycho-
emotional stress, and high-strength acute stresses, lack of social support, and social isolation,
increased blood pressure, which often leads to patients overuse of health resources [7]. In the initial
examination of clinically identified depression, the presence of patients increases the overall risk
of non-fatal and fatal.
Research with colleagues found that 58,5 percent and 19,5 percent of 530 patients with
coronary heart disease had high stress levels, while 82 percent of men and 79 percent of women
had different levels of depression. In 42% of people with coronary heart disease, clinically specific
anxiety is diagnosed. No statistically significant difference in the frequency of depression and
anxiety has been found between men and women. Every fourth patient with coronary artery disease
needs professional correction of disorders in the psychological state [8-11].
According to many other studies conducted in different countries, mental disorder in the
form of depressive mental disorders is a very important risk factor for the formation of coronary
artery disease and a predictor of coronary death [12].
Depression spectrum disorders are detected in 40,7% of patients in the first week after acute
myocardial infarction, according to diagnostic criteria, depressive disorders make up a quarter of
the total observation, anxiety-depressive reactions within adaptation disorders-13,9%, organic
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Affective Disorders – 2,8%, dysthymia-1,8%. In the year of observation, the total number of all
identified cases of depressive spectrum disorder increases by 10,2% [13-16].
Depressive spectrum disorders in Cardiological diseases are characterized by
polymorphism and the severity of somatovegetative and psychopathological manifestations, and
significantly complicate the clinical picture of cardiovascular diseases. In cardiovascular diseases,
a stable combination of anxiety, depression, somatovegetative manifestations is detected in the
structure of depressive disorders [17-20].
Believes that depressive and anxiety disorders associated with the development of
cardiovascular disease, as well as masked and aberrant hypochondriac-type diseases, can be
considered as psychosocial risk factors for coronary heart disease in patients. Some hypochondria
disorders (neurotic hypochondria, hypochondria, and "new life" - type development) associated
with adherence to higher treatment may be associated with a positive prognosis [21-28]. The
structure of mental deficiency in patients with cardiovascular diseases is expressed as follows: in
patients with hypertension-anxiety in 41,6% of patients, depressive disorders – in 36,4% of
patients. Anxiety disorders in patients with different forms of atrial fibrillation are found in 39,4%
of cases, depressive disorders in 28,3%. In patients with coronary heart disease, the following
comorbid psychopathological diseases are distinguished: depression in 20,6%, anxiety disorders
in 5,9%, pathocharacterological development (hypochondria masked by "excellent apathy"
phenomena in 4,4%, neurotic hypochondria with cardioneurosis phenomena in 4,4%, "new life"
type in 10,3%, aberrant hypochondria in 29,4%).%) [29-34].
Mental disorders (depression 21,5%, anxiety disorder 6,2%) and pathocharacterological
hypochondria development (masked hypochondria-10,8%, neurotic hypochondria-43,1%, "new
life" type-6,9%, aberrant hypochondria-11,5%) in patients with coronary artery disease. Their
negative prognosis is associated with paranoid and dissocial personality disorders, comorbid
depressive and anxiety disorders, as well as nosogenic development of the individual, such as
masked and aberrant hypochondria [35-40].
The purpose of the study:
Study of the features of the pathokinesis of adaptation disorders
in men with mild forms of cardiovascular disease
Materials and research methods.
The study involved men between the ages of 30 and 60
with non-severe forms of cardiovascular disease: stage I-II hypertension with a level of 1-3 arterial
hypertension, risk of cardiovascular complications no more than 3, lack of circulation no more
than NIA and stable angina PK I-III tension NC no more than NIA without myocardial infarction,
clinical-psychopathological and statistical-mathematical methods were used with a
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Results and their discussion.
2 groups of patients with hypertension and stable tension
angina who suffered from adaptation disorders of the anxiety and/or depressive spectrum were
studied. The first group includes 93 men with hypertension and adaptation disorders, the average
age is 37,75 years, the second group includes 128 men with stable tension angina pectoris, the
average age is 47,16 years.
The group of patients with clinical-psychopathologically stable tension angina was
presented as follows: short - term anxiety reaction - 46 patients (35,94%), long - term anxiety
reaction– 25 patients (19,53%), mixed anxiety-depressive reaction-34 patients (26,56%), short-
term depressive and long-term depression reactions-23 (17,97%).
The group of patients with clinical-psychopathologically stable tension angina was
presented as follows: anxiety reaction - 19 patients (20,43%), long - term anxiety reaction - 15
patients (16,13%), mixed anxiety – depressive reaction-35 patients (37,63%), short-term
depressive and long-term depression reactions-24 (25,81%).
In the process of studying the prevalence of patients with adaptation disorders with a predominance
of depressive symptoms by the leading type of effect, it was found that anxiety effects were
significantly greater in the clinic of depressive adaptation disorders in men with hypertension and
stable tension angina pectoris (66,67% and 73,91%, respectively), significantly less common. sad
(29,17 and 21,74% respectively) and the rarest apathetic (4,16% and 4,35% respectively).
All patients were engaged in medical or non-drug correction of adaptation disorders for 2 weeks.
After two months, all patients with hypertension and stable tension angina who suffered from
adaptation disorders were re-advised.
Conducting a catamnestic study revealed the following characteristics of the pathokinesis
of adaptation disorders:
1) rapid and complete decline (in most cases)under the influence of a situation that has changed
positively due to self-correction or adequate timely therapy;
2) the re-development of psychopathological symptoms by the "cliché" type when new traumatic
tools appeared, which contributed to a long-lasting course, accompanied not only by an expansion
of the spectrum of clinical manifestations, but also by a tendency to stabilize phenomenological
complexity and adaptation disorders;
3) changes in adaptation disorders with the formation of neurotic, affective, endogenous or
addictive mental disorders.
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In this study, 81,63% of adaptation disorders occurred without transformation, 9,19% had
neurotic manifestations, 4,08% were addictive (alcohol dependence), and 5,10% were
endogenous.
With the predominance of depressive symptomatology, adaptation disorders became
33,85% cases (of which 18,46% went to subclinical 1 episode with endogenous manifestation,
15,39% to initial manifestation of depressive episode). Adaptation disorders with mixed anxiety-
depressive symptoms in 17,71% of cases (of which subclinical Part 1 endogenous manifestation
and initial manifestation of depressive episode 3,13%, panic disorder and general anxiety disorder
2,08%, agoraphobia with panic disorder 1,04% and Addiction Disorder 4,17%).
Adaptive disorders in which anxiety symptoms prevail have become 11,28% of cases
(panic disorder and general anxiety disorder – 0,75% each, specific isolated phobias - 1.50%,
agoraphobia with panic disorder – 2,26% and addiction disorders – 6,02%).
Thus, with the predominance of depressive symptomatology, ra subclinical to 1 episode
with endogenous manifestations and the initial manifestation of a depressive episode, with the
predominance of anxious symptomatology - with anxiety-phobic and other annoying, as well as
addictive diseases and with a mixture - to all of the above.
The highest level of transformation of adaptation disorders was observed in adaptation
disorders with a predominance of depressive symptoms-33.85% of cases, the lowest - in adaptation
disorders with a predominance of anxiety symptoms – 11,28% of cases, mixed anxiety-adaptation
disorders with depressive symptoms occupied an intermediate position in 17,71% of cases.cases.
In the course of the study, prognostically unfavorable signs were identified in terms of
changing adaptation disorders: the predominance of sad and indifferent influence in depressive
reactions, the long duration of adaptation disorders, the characteristics of sensitive and
asthenoneurotic premorbid signs, the loss of direct correlation of the dynamics of emergence and
manifestation of a psychotraumatic situation and (in neurotic manifestations, the state changes
depending on the change of - does not depend on them), the patient's passivity in dealing with
current situations.
In addition, according to the results of a catamnestic study, more than half of patients with
cardiovascular disease in Group 1 recorded a stable retention of the results of the treatment of
cardiovascular diseases (86 people-58,11%), in 2 subgroups – 38,36 % (28 people), in 3
subgroups-20,55% (28 people).
Conclusions.
Thus, as a result of the study, the peculiarities of the pathokinesis of
adaptation disorders were identified, as well as prognostically unfavorable signs in terms of
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changing adaptation disorders that allow to increase the quality of assistance provided to this
contingent of patients.
The structure of psychopathological diseases in patients with Arterial hypertension is
characterized by a combination of diseases of neurotic and neurosis-like Origin. Analysis of the
structure of the syndrome indicates the presence of depressive (55,8%), anxiety (15,8%),
hypochondria (12,5%), hysterics (10,8%) and obsessive-phobic (5%) syndromes.
Summarizing the features of the structure of mental insufficiency in cardiovascular
diseases, it can be noted that patients often have mental disorders of the affective spectrum,
manifested by symptoms of anxiety and depression, which can be combined with hypochondria.
In the genesis of mental adaptation, a connection with stress, personal and psychosocial factors is
observed.
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