Personal and situational anxiety in young patients with the combined course of gastroesophageal reflux disease and autoimmune thyroiditis

Abstract

Objective — to assess the psychoemotional status of young patients with gastroesophageal reflux disease (GERD) associated with autoimmune thyroiditis (AIT). Materials and methods. The examinations involved 57 students with a combined course of GERD and AIT with the mean age of of 22.1 ± 2.11 years. The male subjects prevailed (56.1 %). The GERD screening was conducted with the use of GERD Screener questionnaire. Verification of GERD form was carried out endoscopically. The clinical data, instrumental examinations, the level of antibodies to the thyroid gland (TG), its function was taken into account in the diagnosis of AIT. Statistical processing included the calculation of the chi-square test with the Yates correction (Yates’ᵪ2). Results . Erosive GERD form was established in 9 patients (15.8 %). The presence of AIT was confirmed by an increase in the level of antibodies to TG. Euthyroidism was observed in 75.4 % of cases, a decrease in thyroid function was detected in 17.5 % of the examined patients, hyperthyroidism was diagnosed in 7.0 % of patients. Testing by the Spielberger-Hanin technique showed the following results. A high level of situational anxiety was observed in 39 (68.4 %) cases, moderate manifestations of situational anxiety occurred in 11 (19.3 %) patients, «relative comfort» was noted by 7 patients. Assessment of personal anxiety showed that the majority of patients with GERD and AIT (from 80.7 % to 93 %) indicated serious manifestations of this type of anxiety. They predisposed to the perception of certain incentives, as dangerous for self-esteem. The levels of personal and situational anxiety correlated among themselves in 45 (78.9 %) individuals. However, in 12 cases there was a dissonance between the T-property and the T-state, including: in 2 patients with hyperthyroidism; in 5 patients with hypothyroidism; in 5 patients with an euthyroid status. Hormonal thyroid dysfunction significantly influenced the development of «personality-situational anxiety dissonance». At the same time, the relationship between manifestations of anxiety and morphological changes in the mucosa of the esophagus has not been noted. Conclusions. The students refer to the category of subjects with prerequisites for changes in the central nervous system and in the behavioural sphere due to the specifics of the learning process and interpersonal communication. The combined course of GERD and AIT in young people occurs against the background of heightened situational and personal anxiety, or under conditions of «personality-situational anxiety dissonance». These psychoemotional disorders can aggravate the clinical manifestations of diseases and promote their frequent recurrence (exacerbation, progression).