1634 – Different nosogenic reactions in patients withbreast cancer

Abstract

Problem of malignant tumors is one of leading for modern society due to large prevalence and lethality of these diseases in Russia. In this association, increasingly greater relevance is acquired by problem of diagnostics of nosogenias and rehabilitation of patients with nosogenic reactions. In our investigation, sample included 30 patients at the age from 28 to 71 years (in average 49,7±11,1 years) with diagnosis “breast cancer” at Russian Oncological Scientific Center in pre- and post surgery period of radical mastectomy. Average length of disease at baseline has constituted 6,8±1,2 months. In all studied cases, nosogenic reactions flew at two stages - manifestation and clinical differentiation. At stage 1 - manifestation - in all studied female patients, acute (“universal”) affective reaction developed (reaction of apparent death - according to E. Kretschmer). At stage 2 clinically differentiated reaction of one of 4 types formed: anxiety-depressive, anxiety-dissociative, anxiety-phobic and hypomaniacal. Anxiety-dissociative reaction formed predominantly in patients with hysteric personality disorder. Anxiety-phobic was more typical for persons with anxiety-avoidant personality disorder. Hypomaniacal nosogenic reaction was revealed in female patients with combined schizoid traits and schizotypal personality disorder (group of expansive schizoids). Peculiarity of these patients is signs of hyponosognosia in family history that explains seeking the oncologist at remote stages of disease (stage IIIIV of breast cancer at admission). For more successful therapy and rehabilitation of patients with breast cancer it is necessary to develop differentiated indications of psychopharmacotherapy of nosogenic disorders in this diseases.