CHANGES IN QUALITY OF LIFE AND EXPRESSION OF ANXIETY AND DEPRESSION IN PATIENTS WITH DIVERTICULAR COLON DISEASE

Abstract

The constant increase in the incidence of diverticular disease (DD), especially in middle-aged and elderly people, the establishment of new additional etiological factors of development and pathogenetic mechanisms of progression make the problem of this nosology extremely relevant. The presence of persistent symptoms such as abdominal pain, stool disorders, which constantly bother 20% of patients and frequent recurrences of diverticulitis and their complications, which occur in 25% of such patients, lead to high levels of stress. Diverticular disease has a negative impact on the quality of life of patients, which worsens with increasing duration of the disease. Most studies on quality of life and the development of anxiety and depression concern patients with complicated diverticular disease and patients after surgery for their complications. At the same time, there is limited information and statistics on the relationship between uncomplicated diverticular disease and anxiety, depression and reduced quality of life.
 The aim of the study: to assess the severity of anxiety and depression and reduced quality of life in patients with diverticular disease of the colon.
 Materials and methods. The study included 48 patients with diverticular disease, 32 - with irritable bowel syndrome and 15 healthy individuals. Depending on the severity of clinical manifestations, the nature of the course, the results of laboratory, radiological, sonographic results and computed tomography used classification of DD according to B. Lembske, and among patients such types as 0, 3a, 3b prevailed, which was 87.5 %. Taylor scales, the Hospital Anxiety and Depression Scale (HADS), and the Spielberg-Hanin situational anxiety level were used to assess the severity of anxiety and depression. The quality of life of patients and patients in the control group was assessed using the GIQLI questionnaire and the WSAS questionnaire (appendices A and D).
 Research results. According to the Taylor scale, a high level of anxiety (35.8 ± 0.8 points) occurred in 58.3%, and average (23.9 ± 0.7 points) in 22.9% of respondents, while in healthy people the indicator was low (12.0 ± 1.1 points). In 20.8% of patients with diverticular disease, symptoms of depression prevailed with an index of 12.2 ± 1.1 points. According to the results of the Spielberg-Hanin questionnaire, 72.9% of patients with DD had moderate anxiety (39.7 ± 1.2 points), and 20.1% had depression (6.7 ± 1.0 points). There is a direct correlation between anxiety indicators according to the Taylor, Spielberg - Khanin scale (r = 0.71 p <0.05).
 The quality of life of patients with DH decreased by 30.2% due to intestinal symptoms and slightly less due to the emotional component. Diverticular disease decreased physical status (by 18.7 points) and social activity (by 9.3 points). Appendix D of the WSAS also confirmed a decline in employment and social activity and a quality of life (Appendix A).
 Conclusions. Thus, uncomplicated diverticular disease causes anxiety in 81.2%, and depression - in 20.8%, and according to Spielberg - Khanin - in 72.9% and 20.1%, respectively. Diverticular disease also reduces the quality of life according to the GIQLI questionnaire by 37.64%. Assessment of manifestations of anxiety and depression and reduced quality of life will allow to choose further tactics of treatment of patients with diverticular disease.