Demonstration of a multidisciplinary approach on the example of assessing the psycho- vegetative state in patients with various courses of duodenal ulcer

Abstract

The prevalenceand multifactorial etiology of duodenal ulcer disease (DUD) are of great interest to researchers. We have noticed that besidesthe usual symptoms of DUD, patients report aboutconditions what defi ned as a depressive episode, a decrease in quality of life, autonomic nervous system dysfunction, and sleep disorders. It was decided to compare the presence and severity of nonspecifi c symptoms in the complicated and uncomplicated form of DUD. We examined 110 patients divided into two groups of 55 people according to the form of the course of the disease. The examination included the collection of complaints, anamnesis, gastroenterologist’s examination, esophagogastroduodenoscopy, common blood test + glucose test, long-term monitoring of intragastric pH-metry, questionnaires for assessing the main nonspecifi c complaints of patients: HADS, questionnaire of the National Cardiologic Center of the Russian Academy of Medical Sciences in the Y. M. Rutgizer and A. G. Mikhailov’s modifi cation for patients with the digestive tract diseases, A. M. Vane and Ya. I. Levin’s questionnaire for scoring subjective sleep characteristics. We calculated the Kerdo index and used the A. D. Solovyova’s standard tables method, assessing autonomic dysfunction. We have obtained the following results: patients with a complicated course of DUD are diagnosed with depression twice as often as people with an uncomplicated course. Patients with a complicated course of DUD had the decreased quality of life almost twice as much. As for the departments of the autonomic nervous system imbalance, it was much more common in patients with a complicated form in comparison with the group of patients with an uncomplicated variant of DUD, sympathicotonia was represented by a large number of people. Appreciable sleep disorders were also associated with a complicated course of DUD. Comparing the parameters of the presence of a clinical or subclinical form of depression with the predominant variant of VT, we noticed a connection between depression and sympathicotonia with out reference to the complicated course of the disease. We should note that sleep disorders in DUD are diff erent from those in isolated depression. We found a link between a decrease in the quality of life and the need for treatment in patients with a complicated form of DUD; the disease severely restricts physical activity, as well as social and everyday aspects of life, which can lead to depression. A “viciouscircle” isforming.