Psychocorrection of psychic and psychopathological disorders in rheumatologic pathology

Abstract

Rheumatic pathology is one of the most actual and disabling problems of modern medicine that adversely affects physical function and significantly reduces the patients’ quality of life. Aim. To develop a psychocorrection complex for disorders, based on system analysis of clinical, psychic and psychopathological features of patients with rheumatologic pathology. Materials and methods. A total of 124 persons were examined, the average age was 39.5 years; 99 patients with rheumatologic pathology were included in the main group in randomization period. The first group included 48 patients with acute/chronic rheumatic fever (R), and the second group included 51 patients with rheumatoid arthritis (RA). 25 patients with rheumatologic pathology had no mental disorders, so they were not randomized. Clinical and pathopsychological methods were used to identify different levels of psychopathology according to the International Classification of Diseases, 10th revision. Psychodiagnostic methods were used to study patients’ psychopathological characteristics: the M. Luscher test – to study and evaluate the patients’ individual and emotional state (Sobchik L., 2002); color test of relationships – to study the emotional components of patient's attitude towards significant others and oneself, based on the test of color selection of M. Luscher (Bazhin E. F, Etkind A. M, 1985); the Cattell questionnaire – to identify the individual characteristics (16 PF, form A), the self-esteem scale of T. Dembo and S. J. Rubinstein (Bleyher V. M, Crook I. V, 1986) – for the assessment of critical thinking skills. Individual psychocorrection complexes included the Jacobson’s muscle relaxation methods and autogenic training, self-regulation techniques, emotional relaxation, attention switching. Results. The features of psychopathological symptoms were revealed depending on the patients’ age and duration of pathological process. The psychopathological states were studied according to the following headings of the ICD-10: organic asthenic disorder, agoraphobia, mild cognitive disorder, organic personality disorder, mixed anxiety-depression disorder, adjustment disorder, other responses to severe stress, somatoform disorder, neurasthenia, chronic pain syndrome associated with significant psychosocial dysfunction. Psychopathological components of such disorders as emotional-affective including patient's emotional attitude towards significant others and the somatic disease, as well as a personality structure and self-esteem were examined. Based on the clinical, psychic and psychopathological features obtained, the diagnostic and psychocorrection system for the defined psychological and psychic disorders was developed so as to normalize the emotional-affective and cognitive states as well as behavioral problems and personality traits in patients with rheumatologic pathology. Conclusions. In all the patients with rheumatologic pathology, the features of psychic and psychopathological changes associated with the nosology have been revealed. Performing the psychocorrection training sessions with the adaptive skills development has helped to reduce the existing psychological problems severity in the majority of patients (68.0 % of cases). The significant influence of psychocorrection on the psychic and somatic condition has been observed both in improving the patients’ health and lowering the mental disorders severity. The effectiveness of follow-up correction has been confirmed in 76.0 % of patients, a significant improvement – in 28.0 % and a moderate improvement – in 48.0 % of patients.