Abstract
Objective: to study clinical-biological features of affective disorders including their comorbidity with coronary artery disease and personality disorders and efficacy of psychopharmacotherapy in these patients.Material and Methods. In the first group at a heart station 290 patients with chronic coronary artery disease and affective disorders (209 men and 81 women) were fully examined. The second group included 120 patients (40 men and 80 women) of a psychiatric hospital with affective disorder comorbid with personality disorders. The third group included the study of 29 patients with depressive disorders and a control group (n=21).Results. Data on significant clinical-dynamic, biological and therapeutic features of affective disorders comorbid with coronary artery disease were obtained. It was revealed that presence of a comorbid personality disorder in the case of affective disorders causes the necessity to use a combined psychopharmacotherapy more frequently, worsens indicators of the efficacy of the psychopharmacotherapy of current episode of depression, and increases negative estimation of their social adaptation by these patients. Dysregulation of the processes of programmed cell death in patients with depressive disorders was found.Conclusion. Obtained data testified to the high degree of comorbidity of affective disorders with coronary artery disease and personality disorders which worsened the prediction of the course and indicators of the efficacy of psychopharmacotherapy of these disorders. In patients with depressive disorders the specific weight of mononuclears of peripheral blood was increased in the state of apoptosis.
Highlights
Objective: to study clinical-biological features of affective disorders including their comorbidity with coronary artery disease and personality disorders and efficacy of psychopharmacotherapy in these patients
It was revealed that presence of a comorbid personality disorder in the case of affective disorders causes the necessity to use a combined psychopharmacotherapy more frequently, worsens indicators of the efficacy of the psychopharmacotherapy of current episode of depression, and increases negative estimation of their social adaptation by these patients
Obtained data testified to the high degree of comorbidity of affective disorders with coronary artery disease and personality disorders which worsened the prediction of the course and indicators of the efficacy of psychopharmacotherapy of these disorders
Summary
В 1-й группе исследования определялась клиническая характеристика АР и особенности холестеринового обмена у больных хронической ИБС. В исследование включены 290 пациентов (209 мужчин, средний возраст — 57,9±7,2 года, и 81 женщина, средний возраст — 63,5±9,4 года, р=0,004) с хронической ИБС и выявленными АР в отделении реабилитации больных НИИ кардиологии Томского НИМЦ. При выявлении повышенного уровня тревоги и депрессии пациенты были осмотрены психиатром (по условиям информированного согласия). Вторую группу исследования составили 120 пациентов психиатрического стационара с АР в коморбидности с расстройствами личности (40 мужчин и 80 женщин). Изучалась эффективность фармакотерапии текущего депрессивного эпизода (ДЭ) при сочетании расстройств настроения и РЛ по сравнению со случаями «чистых» АР с учетом уровня социальной адаптации у соответствующих пациентов. Третья группа включала 29 пациентов с ДР, у которых оценивалась выраженность апоптоза мононуклеаров крови больных.
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