Anxiety-depressive disorders in patients with arterial hypertension who were in a combat zone

Abstract

Objective — to study the frequency and severity of anxiety‑depressive disorders in patients with arterial hypertension (AH) who were in the war zone.
 Materials and methods. Examinations involved 42 patients with AH of the II stage, 2—3 degree (20 men and 22 women), aged from 46 to 65 years (average age — (52.4±4.3 years), who were in the combat zone during the war in the city of Kharkiv and Kharkiv region of Ukraine. The degree and stage of hypertension were assessed in accordance with current recommendations. All subjects underwent general clinical laboratory and instrumental examination, as well as psychological testing using special questionnaires: Hospital Anxiety and Depression Scale — HADS, Hamilton Anxiety Scales (HAM‑A), Hamilton Depression Scales (HAM‑D), Spielberger‑Hanin Personality and Reactive Anxiety Scales, Posttraumatic Stress Disorder (PTSD) Screening Questionnaire (MH of Ukraine, 2016) and the Civilian Mississippi Scale for PTSD. Statistical analysis of the obtained data was carried out with standard methods using Microsoft Excel 7.0 and «SPSS 19.0» application programs.
 Results. The anxiety and depressive disorders of varying severity, and PTSD symptoms have been established in the majority of AH patients, who were in the combat zone. The most frequent anxiety disorders were subclinical anxiety (according to HADS), anxiety symptoms and anxiety state (according to the (HAM‑A). Examinations with the use of Spielberger Personality and Reactive Anxiety Scale — Khanin showed an increased level of both personal and reactive anxiety, but the frequency of high‑level reactive anxiety was significantly higher than this indicator of personal anxiety. In the vast majority of examined patients with AH, subclinical depression (according to HADS) and mild or moderate depressive disorder (according to HAM‑D) have been established. In a third of the patients, depressive disorders were combined with anxiety disorders. Some of the patients with AH after being in the combat zone showed individual PTSD symptoms or developed clinical variant of PTSD (according to the Civilian Mississippi Scale for PTSD). Clinically expressed signs of anxiety and depression and PTSD symptoms were significantly more common in women than in men.
 Conclusions. The negative impact of the presence of patients with hypertension in the combat zone on mental health indicators was established. In most of the examined patients, it was manifested as anxiety and depressive disorders of various degrees of severity, and PTSD symptoms. These violations require early diagnosis and timely adequate correction.