Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2023
[Chemotherapy-associated clinical dynamics of nosogenic reactions in breast and ovarian cancer model].
Аннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Golovanova E A, Ivanov S V, Giatsintova A A, Ilyina N A, Rumyantsev A A, Glazkova E V
Аннотация
OBJECTIVE: To study the clinical features, dynamics and factors of nosogenic reactions (NR) development in patients with breast and ovarian cancers at the stage of chemotherapy.
MATERIAL AND METHODS: The study involved 35 patients who underwent chemotherapy. Clinical-psychopathological and psychometric methods were used to assess the mental state.
RESULTS: We distinguished 3 clinical types of nosogenic reactions: anxiety-phobic (n=14, 40%), anxiety-depression (n=13, 37%) and dissociative reaction (n=8, 23%). It was discovered that nosogenic reactions reflect the dynamics of psychopathological disorders associated with chemotherapy and they are connected with premorbid personality structure of the patients. When compared on the Mini-mult scales, differences were found between patients of the anxiety-phobic and dissociative groups: the score on the Anxiety and Depressive Tendencies scale was significantly higher in the group of patients with anxious-phobic NR (p<0.01), as was the score on the scale «Anxiety fixation and restrictive behavior», which was correlated with such personality traits as sensitivity, self-doubt, low self-esteem, obsessive fears (p<0.05). According to the results of the Spielberger-Khanin anxiety scale, in general, the sample was characterized by an increased level of anxiety compared to the norm: the average scores were 49.7 for trait anxiety and 47.7 for state anxiety.
CONCLUSION: Nosogenic reactions can undergo dynamic changes at various stages of treatment. The proposed typology of nosogenies in a more detailed study can have not only scientific, but also practical significance for determining the personalized tactics of psychiatric care for cancer patients at different stages of the disease.
MATERIAL AND METHODS: The study involved 35 patients who underwent chemotherapy. Clinical-psychopathological and psychometric methods were used to assess the mental state.
RESULTS: We distinguished 3 clinical types of nosogenic reactions: anxiety-phobic (n=14, 40%), anxiety-depression (n=13, 37%) and dissociative reaction (n=8, 23%). It was discovered that nosogenic reactions reflect the dynamics of psychopathological disorders associated with chemotherapy and they are connected with premorbid personality structure of the patients. When compared on the Mini-mult scales, differences were found between patients of the anxiety-phobic and dissociative groups: the score on the Anxiety and Depressive Tendencies scale was significantly higher in the group of patients with anxious-phobic NR (p<0.01), as was the score on the scale «Anxiety fixation and restrictive behavior», which was correlated with such personality traits as sensitivity, self-doubt, low self-esteem, obsessive fears (p<0.05). According to the results of the Spielberger-Khanin anxiety scale, in general, the sample was characterized by an increased level of anxiety compared to the norm: the average scores were 49.7 for trait anxiety and 47.7 for state anxiety.
CONCLUSION: Nosogenic reactions can undergo dynamic changes at various stages of treatment. The proposed typology of nosogenies in a more detailed study can have not only scientific, but also practical significance for determining the personalized tactics of psychiatric care for cancer patients at different stages of the disease.