Assessment Of Psychological Status Research Articles

Correlation between psychological status, revised Müller AO classification and patient-reported outcomes: a prospective cohort analysis.

The impact of psychological status on clinical outcomes is valued in several medical conditions, but rare attention is given to it in orthopedic trauma. We aimed to assess the correlation between psychological status, fracture severity and patient-reported outcomes in fractured patients needing urgency surgical treatment. We prospectively followed 139 consecutive patients undergoing urgency surgical treatment of a lower/upper limb fracture. Before surgery, all patients were divided into grades of fracture severity according to the Revised AO Müller Classification (AO grades). On the 15th and the 120th days after surgery, all patients underwent a psychological status assessment through the Hospital Anxiety and Depression Score (HADS), in addition to a pain evaluation through VAS. One year after surgery, patient-reported outcomes were obtained by using specific scales depending on the site of fracture. AO grades and VAS scores were significantly correlated to scores at HADS-A (anxiety component) and HADS-D (depression component), both on the 15th and the 120th. Patients presenting persistent HADS-A and HADS-D scores equal or greater than 8 points had a risk of more than 2.5 or 2.0 times of experiencing unsatisfactory surgical outcomes, respectively [HADS-A: RR = 2.8 (95% CI: 2.2-3.5)] [HADS-D: RR = 2.2 (95% CI: 1.7-3.1)]. AO grade C and the persistency of significant symptoms of anxiety or depression were independent predictors of unsatisfactory patient-reported outcomes (OR: 1.7, p = 0.03 // OR: 2.9, p < 0.01). Female gender, age, and BMI did not present any statistically significant utility in predicting unsatisfactory patient-reported outcomes. In fractured patients needing urgency surgical treatment, the risk of presenting unsatisfactory outcomes is more than twice as high in patients that present significant persistent changes in psychological status. Changes in psychological status are more frequent in patients presenting more severe pain and more severe fractures. AO grades and HADS scores are independent predictors of unsatisfactory outcomes in these patients.

Assessment of psychological status by a comprehensive approach in thyroid cancer patients undergoing radionuclide therapy: A feasibility study.

This feasibility study evaluated the psychological status of patients with differentiated thyroid cancer (DTC) before, during, and 40 days after administration of I-131 radionuclide therapy (RAI). We investigated the appropriateness of providing patient a comprehensive psychological assessment in an isolation ward. Thirty consecutive patients (Study Group; SG) who received RAI were enrolled. The tools used were the Hospital Anxiety and Depression Scale (HADS) at three different moments, and the Coping Responses Inventory (CRI) at baseline for each patient. A supportive approach was also implemented. Data were collected at the first specialist visit, at the day of admission, and at 40 days follow-up visit. A matched cohort of patients (Control Group; CG), who did not receive psycho-oncological counseling, was retrospectively studied only about their medical needs and requests. Staff exposure to radiation was also compared during SG and CG hospitalization, to assess a possible reduction of radiological risk for them. A significant difference between the basal, intermediate, and final psychological status was observed (p < 0.0001), which was found to be irrespective of the induced hypothyroidism. Patients showed a significant worsening of their status in terms of anxiety and depression after the consent, but it improved 40 days after treatment. Repeated measures analysis showed a similar trend in patients' psychological status over this period. At hospital discharge, patients showed indirect signs of increased well-being. CG required more nursing and medical interventions. Staff exposure was significantly lower during hospitalization of SG as compared to CG. This study demonstrates that timed psychological evaluation and appropriate support may help to reduce anxiety and depression of patients receiving a diagnosis of cancer and undergoing RAI. Moreover, an improvement of workplace safety was recorded.

Correlation analysis of mental health conditions and personality of patients with alcohol addiction

BACKGROUND Alcohol addiction, or alcohol dependence, refers to a psychological state of strong craving for alcohol caused by drinking when both the drinking times and alcohol consumption reach a certain level. Alcohol addiction can cause irreversible damage, leading to mental illness or mental disorders, negative changes in their original personality, and a tendency to safety incidents such as committing suicide or violent attacks on others. Significant attention needs to be given to the mental health of alcohol addicts, which could reflect their abnormal personality traits. However, only a few papers on this issue have been reported in China. AIM To investigate the correlation between mental health and personality in patients with alcohol addiction. METHODS In this single-center observational study, we selected 80 patients with alcohol addiction as the research subjects, according to the criteria of the K10 scale to evaluate the mental health of patients with alcohol addiction, and divided these patients into four groups based on the evaluation results: Good, average, relatively poor and bad. And then analyzed the correlation between mental health conditions and personality characteristics from these four groups of patients. RESULTS The average score of the K10 scale (Kessler 10 Simple Psychological Status Assessment Scale) in 80 patients with alcohol addiction was 25.45 points, the median score was 25 points, the highest score was 50 points, and the lowest score was 11 points. Pearson 's analysis showed that the K10 score was positively correlated with the scores of these two subscales, such as the P-subscale and the N-subscale (P &lt; 0.05). In contrast, the K10 score had no significant correlation with the scores from the E-subscale and the L-subscale (P &gt; 0.05). CONCLUSION The mental health conditions of patients with alcohol addiction are positively correlated with their personality characteristics.

The mechanism, inducement and long-term effects of acquired weakness in intensive care units

With the development of critical care medicine, the case fatality rate in intensive care units (ICU) patients has decreased significantly, but most patients still suffer from the long-term problems of related complications after discharge, which seriously affects the quality of life and social integration after discharge. Complications such as ICU acquired weakness (ICU-AW) and Post-ICU Syndrome (PICS) are not uncommon throughout the treatment of severe patients. The treatment of critically ill patients should not only focus on the treatment of the disease, but also gradually extend to the whole-process physiological-psychological-social medical intervention mode in the ICU, during the stay in the general ward and after discharge. On the basis of ensuring patient safety, patients' physical and psychological status assessment in the early stage of ICU admission, and disease prevention as soon as possible, which can reduce the long-term impact on the quality of life and social work after discharge.

Bioelectric activity of a brain and cerebral hemodynamics in skiers of military age over seasons of the year

INTRODUCTION: The heavy training load in extreme climatic conditions of the European North inevitably requires adaptive reactions from the athlete’s body, consequently, influencing on functional performance of the central nervous system.OBJECTIVE: To identify the patterns of seasonal changes of bioelectric activity and cerebral hemodynamics in skiers of military age.MATERIALS AND METHODS: The study involved 20 skiers of military age. The study was conducted over a year and included 4 stages, relevant to athletes’ preparation stages. In the course of work the indicators of bioelectric activity and brain cerebral hemodynamics were registration, using electroencephalograph NMG «Neurocartograph-8» and reograph «Diamant-R». Psychological status assessment was conducted using the anxiety and depression test, according to the method of A. A. Karelin.RESULTS: As a result of the study, it was found that skiers of military age experience deterioration in cerebral hemodynamics and brain bioelectric activity with the increase in training and negative factors of the North.CONCLUSION: Functioning of the athlete’s body in the European North results in deterioration of cerebral hemodynamics and brain bioelectric activity and increase of anxiety-depressive conditions in the winter preparation stage.

Psychological and Functional Impact of a Small Unruptured Intracranial Aneurysm Diagnosis: A Mixed‐Methods Evaluation of the Patient Journey

Background Following a diagnosis of a small unruptured intracranial aneurysm (sUIA), patients often experience psychological ailments which may be attributable to the neurovascular consultation, referral pathway, or long‐term imaging surveillance. Here, we aim to characterize the early sUIA patient journey and evaluate their psychosocial status. Methods A mixed‐methods analysis of sUIA patients attending a large tertiary neurosciences center was performed. For patients presenting to the neurovascular service in 2020, this included: (i) a thematic analysis of patient perspectives extracted from semistructured telephone interviews, (ii) a quantitative assessment of psychological status using the Hospital Anxiety and Depression Scale and (iii) an evaluation of functional independence using a customized activity of daily living questionnaire. The relationship between service or clinical factors, and Hospital Anxiety and Depression Scale subscale scores was statistically tested. Results The sUIA patient cohort (n=105) had a mean age of 56.8 years (SD=15.8, female=69). Thematic analysis of interview responses (n=33) identified 5 recurrent themes underpinning the sUIA patient experience: referral, diagnosis and information sharing, imaging surveillance, psychological impairment and coping strategies, and activities of daily living, all of which contributed to patient concerns. A total of 53.6% of patients achieved a Hospital Anxiety and Depression Scale score signifying at least mild anxiety and/or depression. Lifestyle changes most frequently affected after diagnosis included avoidance of straining‐intensive exercise, change in patterns of substance use, and work‐related performance. Multivariate analysis revealed no significant service or clinical predictors for anxiety or depression. Conclusion For some patients, an sUIA diagnosis appears to be associated, at least qualitatively, with a psychological burden. This is likely mediated through stressors related to the referral, diagnosis, neurosurgical consultation, and image surveillance. In the absence of evidence‐based guidelines regarding these aspects of the early patient journey, we offer suggestions aimed at improving both the neurovascular service and sUIA patient experience.

Prevalence of Anxiety, Depression, and Sleep Disturbances Associated With the COVID-19 Outbreak in Riyadh, Saudi Arabia.

BackgroundCOVID-19 became a global respiratory pandemic as it disrupted millions of lives and commerce. The implementation of strict lockdown measures to confine the outbreak can negatively affect people’s overall sleep quality and mental health. We aimed to assess the prevalence of sleep disturbance and the psychological impact associated with the spread of COVID-19 in Riyadh, Saudi Arabia. Materials and methodsA cross-sectional study was conducted in Riyadh, Saudi Arabia. A nationally online questionnaire was sent to participants aged >18 years to assess their socio-demographic information, assessment of psychological status by Hospital Anxiety and Depression Scale (HADS), and assessment of sleep disturbance by Athens Insomnia Scale (AIS) and Insomnia Severity Index (ISI) scales. ResultsThe total sample consisted of 399 participants. The mean age was 34.70 ± 12.57 years; predominant responses were from females (69.4%). The study sample was mostly made up of students (32.1%), and more than half of the participants (52.6%) were married. The prevalence of anxiety, depression, and insomnia was 38.6%, 33.1%, and 54.9%, respectively. Participants with comorbidities were significantly at higher risk of having symptoms of depression in comparison to subjects free from chronic diseases (OR=2.19 95% Cl: 1.24-3.86, p=001). ConclusionThese findings suggest that the prevalence of poor sleep quality and worsening mental health in Riyadh, Saudi Arabia was high during the COVID-19 lockdown, which articulates the requirement for raising the awareness, screening, and management of worsening sleep quality and mental health due to the unwholesome effect they may have on the individual’s health.

ABNORMAL UTERINE BLEEDING IN PUBERTAL GIRLS, MANAGEMENT TACTICS

Abnormal uterine bleeding (AMC) is one of the most common pathologies of the reproductive system in girls of the pubertal period, which is certainly a medical and social problem. The solution of this issue has been relevant for many years, the main area of which is the development of preventive, diagnostic and therapeutic measures. The aim of the study was to study the features of the clinical picture of pubertal AMC, assessing the effectiveness of therapy. The study involved 140 girls from the city of Togliatti aged 10 to 15 years, who underwent a full clinical examination, assessment of psychological status, excluded chronic somatic diseases and diseases associated with a violation of the hemostasis system, sexual development according to Tanner corresponded to age norms. Two groups were formed: the first 30 girls diagnosed with abnormal uterine bleeding, who were on inpatient treatment, 110 girls received outpatient therapy. It has been established that AMCs are recurrent, which certainly requires preventive measures. The method of hemostasis in AMC should be selected individually, depending on the severity of bleeding and the characteristics of the clinical course. Antianemic therapy is necessary for all patients with signs of ZHD depending on severity, choosing the routes of administration of the drug, the duration of therapy.

Psychological status and coping behavior in liquidators of the consequences of the accident at the Chernobyl nuclear power plant in the remote period

Relevance. The large-scale accident at the Chernobyl nuclear power plant raised the problem of overcoming its economic, medical, social and psychological consequences. This is extremely important for liquidators of the Chernobyl accident consequences (LACs) with more than 15 different somatic diseases that reduce their quality of life and coping resources, negatively affect the psychological status, the effectiveness of treatment and medical rehabilitation.Intention. Assessment of psychological status and coping behavior in LACs in the remote period and justification of the need to provide them with psychological and psychotherapeutic assistance.Methodology. Using psychological tests, 101 LACs undergoing inpatient treatment for somatic pathology were examined. The psychological status (health, activity, mood; state and trait anxiety, the impact of a traumatic event) and coping strategies were assessed. The results were compared with a control group using the Student’s t-test for different-sized unrelated samples.Results and discussion. The features of the psychological status and coping behavior in LACs in the remote period are shown. Indicators of well-being, activity, mood are presented; state and trait anxiety, the impact of a traumatic event and coping strategies are comparatively assessed. The most significant markers of psychological disorders and maladaptive coping strategies are identifiedConclusion. The data presented in the article are an important basis for including psychological and psychotherapeutic assistance in the programs of specialized medical care for LACs in the inpatient settings within state guarantees of free medical care for citizens of the Russian Federation.

Association of psychological status with first diagnosed pulmonary tuberculosis in men

The aim. Assessment of the initial psychological status of men with first diagnosed pulmonary tuberculosis and the study of its associations with the clinical course of the disease.&#x0D; Materials and methods. The study involved 54 men with first diagnosed pulmonary tuberculosis. Patients had a dynamic complex clinical, laboratory and instrumental examination with an assessment of the psychological status according to the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI).&#x0D; Results. The evaluating of initial psychological status in patients with first diagnosed pulmonary tuberculosis, depressive states of varying severity were found in 47.05 % of patients, moderate state anxiety – in 74.51 % of patients, moderate trait anxiety – in 35.29 %. We revealed associations of the levels of anxiety and depression with the degree of bacterial excretion and the duration of the intensive phase of therapy.&#x0D; Conclusions. To assess the psychological status of patients with first diagnosed infiltrative pulmonary tuberculosis, it is advisable to use the STAI and the BDI.&#x0D; Patients with first diagnosed infiltrative pulmonary tuberculosis in 100 % of cases have psychological status disorders with a predominance of moderate state anxiety and the absence of depressive disorders in only half of them. More expressed violations of the psychological status (anxiety, depression) identifies patients who are married and have a steady job.&#x0D; In patients with first diagnosed infiltrative pulmonary tuberculosis, an increase in the severity of anxiety and depression is associated with more expressed bacterial excretion, decrease in body weight, greater frequency of destruction of lung tissue, prevalence of the tuberculosis process by more than 2 lung segments, decrease in the effectiveness of standard therapy and prolongation intensive phase of treatment.

Psychological status before and after surgery in patients with trigeminal neuralgia

ObjectiveTo analyze the psychological status in patients with trigeminal neuralgia before surgery and in the early postoperative period after microvascular decompression of the trigeminal nerve. MethodsPsychological features of personality were studied in 56 patients aged from 28 to 80 years with trigeminal neuralgia. To study the psychological status, such scales as Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale and Patient's Subjective Assessment of Treatment Effectiveness Scale (PSATES) were used with special attention paid to presence of suicidal thoughts. ResultsThe signs of anxiety were clinically significant in 7%, absent - in 66 % of the patients. There were no signs of depression in 63 % of cases, while 7% of the patients suffered from clinically significant depression. Pain catastrophizing was observed in 76.8 % of patients. None of the patients rated the intervention as "excellent" on PSATES despite the complete pain relief in the majority of patients (78.6 %), and only 16.1 % of the patients rated it as "good". The aggravation factor had a significant influence on this evaluation (p = 0.01). ConclusionsGeneral psychological status assessment can be used to objectify the indicators of the questionnaires and pain scales, as well as to determine the treatment tactics in this group, especially when it is necessary to clarify indications for an intervention and to decide on its proper time. Regardless of the outcome, the patients need time and psychological help for social adaptation due to changes in their social status.

Assessment of Psychological Status and Oxidative Stress in Postmenopausal Women: A Cross-Sectional Study.

ObjectivesDuring menopause, women may experience some physical changes that can affect their psychological status. Oxidative stress also increases with menopause, as decreasing levels of estrogen reinforce the deterioration of antioxidant status. To assess total antioxidative capacity, malondialdehyde, superoxide dismutase, and glutathione peroxidase and the correlation between psychological status and oxidative stress in postmenopausal women.MethodsThis cross-sectional study was undertaken on 100 postmenopausal women (40–59 years). Blood malondialdehyde, superoxide dismutase, glutathione peroxidase, and total antioxidative capacity were analyzed, and psychological status was assessed using Rosenberg's self-esteem test, Zung's self-rating anxiety scale, and Zung's self-rating depression scale.ResultsOf the women, 38.0% had mild to moderate symptoms of anxiety (mean ± standard deviation, 50.15 ± 4.89), 21.0% showed depression, and 19.0% had low self-esteem. Twelve percent of the study population had mild to moderate symptoms of all three disorders. A statistically significant difference was found in the scores of anxiety and self-esteem (P = 0.001 and P < 0.001 in women with and without psychological disturbances, respectively). With regard to oxidative stress parameters, only superoxide dismutase levels showed a statistically significant difference (P = 0.001), with lower levels found in women with psychological disturbance.ConclusionsWomen with depression, anxiety, and low self-esteem are in an oxidative challenge, which might be associated with estrogen depletion. A lower superoxide dismutase level is associated with higher depression and anxiety scores in postmenopausal women.

Psychosocial Impact of COVID 19 Pandemic on Healthcare Workers in Selected Hospitals in Khartoum State, Khartoum, Sudan, 2020

Psychosocial Impact of COVID 19 Pandemic on Healthcare Workers in Selected Hospitals in Khartoum State, Khartoum, Sudan, 2020 Zeinab Swar Eldahab MBBS, MD, Mohamed Al Seiddig, Gaffar Alemam,Mohammed Ishag, Abdullatif Yasir, Mohammed Hussein, Almothanna Zaki, Ammar Tarig Abstract Background: COVID-19 is highly transmissible disease from human to human and associated with high morbidity and fatality. The outbreak affects not only physical health of infected individuals but also psychological and mental health. Healthcare workers (HCWs) are the most vulnerable group to the mental health effects of this pandemic Objective: Assessment of psychological status and the potential risk factors of healthcare workers (HCWs) during the COVID-19 Pandemic. Method: A total number of 163 health care workers (doctors and nurses) dealing with suspected COVID-19 patients were selected from accessible hospitals adopting COVID-19 management protocols. Data was collected by the medical students research team using anonymous online Google form questionnaire. Data was analyzed using SPSS computer program. Result: Participants had a mean age of 26.4±3.6 years, predominantly females (54.6%,) and 87.7% of them were medical doctorsalmost76% and 68% had a mild form of depression and anxiety respectively, 14.6% showed moderately severe depression. Most of them were not trained on how to use personal protective equipment. The majority of the HWs believe that PPEs protect against COVID19 infection. There is increased financial stress among HWs compared to pre pandemic period. Full Text: PDF DOI: 10.15640/ijmp.v9n1a5

Атрофический вагинит у пациенток репродуктивного возраста

Objective. To study the effectiveness of the use of Acilact Duo for relieving the symptoms of atrophic vaginitis against the background of antiestrogen therapy. Patients and methods. The study included patients of reproductive age (n = 21) who were treated with goserelin (10.8 mg once every 3 months) in combination with tamoxifen (20 mg per day) for previously diagnosed breast cancer (luminal A type). Inclusion criteria were: age 28–45 years, complaints of vaginal dryness and micro-cuts, dyspareunia, breast cancer in anamnesis. Microscopic and bacteriological examination of the vaginal discharge was carried out. Patients filled out an individual questionnaire on the symptoms of atrophic vaginitis and dynamics of psycho-emotional state according to the Spielberger–Khanin scale. Results. The most common patients’ complaints were: dryness (up to 6.1 points) and the presence of vaginal micro-cuts (1.5 points), dyspareunia (1.3 points). After the course of treatment with Acilact Duo, the severity of symptoms decreased by 1.5 times. The assessment of psychological status demonstrated a low subjective evaluation of health and quality of life (36.7 ± 1.4 points). Twelve days after treatment, a mean anxiety score improved and amounted to 30.9 ± 0.6 points (р &lt; 0.05). The intensity of vaginal microbial colonization in atrophic vaginitis is low and characterized by the absence of lactoflora and the predominance of enterobacteriaceae, atopobium vaginae, staphylococci, streptococci and peptostreptococci. After local therapy with Acilact Duo, there was an increase in colonization by lactobacilli (by 5.1 times, р &lt; 0.05), a decrease in the level of colonization by streptococci (by 1.7 times, р &lt; 0.05), staphylococci (by 2 times, р &lt; 0.05), peptostreptococci (by 4.3 times, р &lt; 0.05) and enterobacteriaceae (by 4 times, р &lt; 0.05). Conclusion. A short 10-day course of treatment with Acilact Duo for patients with atrophic vaginitis can significantly reduce the severity of symptoms and improve the quality of life of women of reproductive age. Key words: atrophic vaginitis, genitourinary syndrome, lactobacilli, dyspareunia, breast cancer

Perfil da qualidade de vida três meses ou mais após o término da radioterapia adjuvante utilizada para o tratamento do câncer de cabeça e pescoço em um Centro de Assistência de Alta Complexidade em Oncologia

The treatment of head and neck cancer (HNC) is multimodal and can generate different physical and psychological impairments. The aim of this study was to assess the quality of life profile of patients with HNC, in search of possible therapeutic targets that can be improved. This is a descriptive, cross-sectional, observational study, developed at a High Complexity Care Center in Oncology. Data were collected through anamnesis and the University of Washington quality of life questionnaire (UW-QOL). The sample consisted of 68 patients with head and neck cancer who underwent adjuvant radiotherapy for at least 90 days. There was a predominance of males (89%) and an involvement of the oropharynx (69%). In addition to radiation therapy, 53% of individuals also underwent surgery and 65% chemotherapy. Stomatognathic functions were the most affected, followed by negative implications related to activities of daily living and psychological aspects. According to the nature of the domains found in the UW-QOL Questionnaire, the low scores observed in the questions related to the activities of daily living and in the components of the psychological status assessment, it is pertinent to assume that the late complications imposed by both the pathophysiology of the HNC as well as the antineoplastic treatment should be approached by a multidisciplinary team aligned with the synergistic objective of rehabilitating stomatognathic functions, nutrition, and physical capacity. Although our data do not suggest emotional impairments, additional support from a psychologist could be considered in order to strengthen and motivate engagement in the rehabilitation of the complex clinical condition intrinsic to HNC.

The status of menopause outpatient clinics in maternal and children health institutions and general hospitals in 11 provinces of China

Objective: To understand the status of menopause outpatient clinics in maternal and children health (MCH) institutions and general hospitals. Methods: A total of 314 health administrative departments, MCH health institutions and general hospitals in 11 provinces of China were enrolled by using multi-stage random sampling method. A self-made questionnaire was used to investigate the development of normative documents for menopausal health work, and the establishment, services, health resources, system and information management of menopause outpatient clinics. The current situation of menopause outpatient clinics in MCH institutions was compared with that in general hospitals. Results: All health administrative departments did not formulate normative documents for menopausal health care. Among MCH health institutions and general hospitals, 53.4% (111/208) established menopause outpatient clinic. About 60.9% (64/105) of MCH institutions established menopause outpatient clinic, which was higher than that of general hospitals [45.6% (47/103)] (P<0.05). From high priority to less, the services of menopause outpatient clinics were menopausal disease diagnosis and treatment, counseling, health education and disease referral. 90.1% (100/111) of menopause outpatient clinics provided routine medical examinations, and only 55.9% (62/111) and 59.5% (66/111) of them provide psychological and nutritional status assessment. The allocation rate of commonly used examination equipment in menopause outpatient clinics was 81.1%-96.4%, while only 28.8%-37.8% of them had psychological status assessment tool, human body composition analyzer and nutrition status assessment tool. Among 111 menopause outpatient clinics, 46.8% (n=52), 36.0% (n=40), and 34.2% (n=38) of them established outpatient consultation process, referral (consultation) work system, and follow-up work system, and 49.5% (n=55), 29.7% (n=33), 42.3% (n=47), and 17.1% (n=19) of them established visit registration, health records, follow-up records of referrals, and reported outpatient services, respectively. Conclusion: Menopause outpatient clinics in 11 provinces of China have been initially established, and policy guidance and human resources allocation should be further strengthened.

The role of generalized muscule hyperfacilitation in pathogenesis and clinical picture of myofascial pain syndrome. Possible option of its correction

Introduction. Psychoemotional stress contributes to the increase of the muscle tone and the development of general muscle hyperfacilitation. This in turn makes the diagnostics by manual muscle testing impossible and complicates the course of myofascial pain syndrome, which explains the interest of practitioners in methods of its correction. However, possible methods of correction described in literature do not always lead to the desired result, which is the cause of the further search for solutions to this problem. The goal of research — was to determine the clinical effi cacy of Bach remedies selected with the help of vegetative resonance testing and manual muscle testing in treatment of patients with myofascial pain syndrome against the background of generalized hyperfacilitation.Materials and methods. A prospective, controlled, randomized trial was conducted in the period from January to December 2018 at the Department of Restorative Medicine, Rehabilitation and Balneology at the Sechenov First Moscow State Medical University. The work is based on the results of observation and treatment of 60 patients aged 21 to 65 years. Before and after the treatment practitioners performed osteopathic diagnostics, manual muscle testing according to the methodology, used in applied kinesiology. Assessment of psychological status was carried out using the Spielberger–Khanin test and Well-being-activity-mood questionnaire (WAM questionnaire). The level of pain manifestation was assessed with the use of the visual analogue scale (VAS). All patients were divided into two statistically comparable groups of 30 people using the method of simple randomization. Patients of both groups underwent osteopathic correction of dysfunctions with a frequency of one time per week, only 3–5 sessions. Patients of the 1st group, in addition to osteopathic treatment, underwent therapy with individually selected Bach remedies.Results. In all patients of the 1st group, generalized muscle hyperfacilitation regressed already by the 2nd–3rd procedure, while in the 2nd group it was eliminated only by the 4th procedure in 12 (40%) patients, and in the remaining patients it stopped only by the end of the course. The study of the regression of myofascial pain syndrome showed a difference in the rate of occurrence of the analgesic effect in the groups. So, patients of the 1st group experienced a persistent antinociceptive effect after the 2nd procedure, and in the 2nd group a similar effect was noted only by the 4th–5th session. In patients of the 1st group, the severity of pain after treatment averaged 10,4±4,5 points according to VAS, in patients of the 2nd group it averaged 20,3±4,3 points (p&lt;0,01). The results of psychological testing according to the Spielberger–Khanin questionnaire also revealed a positive dynamics in the psychoemotional state of patients of both groups. After treatment, in 27 (90 %) patients of the 1st group, the results of the test showed the norm (&lt;30 points), while in the 2nd group the test showed the norm only in 19 (63,3 %) patients. A comparative analysis of the results of psychological testing by the WAM method, performed at the end of the treatment, showed a positive dynamics in the psychoemotional state (categories of well-being, activity, mood) in patients of both groups, but in the 1st group the changes were more pronounced (p=0,05). It should be noted that only in patients of the 1st group this indicator was in the range of 5–5,5 points after the treatment, which corresponds to the norm criteria for this questionnaire.Conclusion. The use of Bach remedies individually selected with the help of manual muscle testing and the vegetative resonance testing helps to increase the effectiveness of the treatment of myofascial pain syndrome in patients with generalized muscle hyperfacilitation formed against the background of the chronic stress.

Assessment of psychological status of inpatients with head and neck cancer before surgery

Objective: To investigate the prevalence and psychosocial characteristics in inpatients with head and neck cancer before surgery. Method: From September 2015 to December 2016, 237 consecutive inpatients with head and neck cancer who had been scheduled for surgery were prospectively enrolled in Department of Head and Neck Surgery of Shanxi Provincial Tumor Hospital. Mental health symptoms were systematically investigated using three psychological instruments: symptom checklist-90 (SCL-90), Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS). SPSS 17.0 software was used to analyze the data. And he results of SCL-90, SAS and SDS were compared with the Chinese norm. For all statistical analyses, a P value <0.05 was considered statistically significant. Result: Of 237 patients, 228 (96.2%) completed all the questionnaire. The scores of SCL-90 (1.60±0.44), SAS (46.67±8.51)and SDS(47.50±11.43)in patients with head and neck cancer were significantly higher than those of Chinese norm (t=3.093, t=17.29, t=4.29 respectively and P=0.003, P=0.001, P=0.001 respectively). Positive proportion identified by three measure tools are 32.9%, 35.5% and 36.8% respectively. And 42 patients (18.4%) suffered from both anxiety and depression. The SCL-90 scores were significantly higher than those of the normal standard population, including dimension of somatization obsessive-compulsive, anxiety, hostility, phobic-anxiety and psychoticism (t=4.47, 3.04, 2.87, 2.58, 5.46, 4.15 respectively, all P<0.05). Conclusions: This study offers important information regarding psychological status in inpatients with head and neck cancer before surgery. Identifying these patients using proper screening instrument is of great important clinical implications for the early detection, management, and reduction of the distress associated with head and neck cancer.

ДИНАМИКА ТУБЕРКУЛЕЗНОГО ПРОЦЕССА У ПАЦИЕНТОВ С РАЗЛИЧНЫМ ПСИХОЛОГИЧЕСКИМ СТАТУСОМ

The objective of the study: to investigate the changes in the course of tuberculosis in the patients with different psychological status. Subjects and methods. The changes in the course of tuberculosis were studied in 249 new pulmonary tuberculosis patients who had in-patient treatment in CTRI. The groups within the study were formed basing on the results of psychological status assessment: Group 1 included patients with favorable psychological status (171; 68.7% of patients) and Group 2 included patients with different psychological disorders (78; 31.3% of patients) (p &lt; 0.001). Among patients from Group 2 women (66; 84.6%) significantly prevailed over men (12; 15.4%) (&lt; 0.001). Results. It has been found out that groups with different psychological status did not confidently differ in their clinical and X-ray signs before the treatment start. Whereby, in patients from Group 2 versus patients from Group 1, the abnormalities in the results of laboratory tests were registered confidently more often (87.2 versus 75.4% cases) (p &lt; 0.05), as well as multiple drug resistance (58 versus 41.4% of cases) (p &lt; 0.05). The frequency of adverse events caused by anti-tuberculosis drugs was higher in Group 2 versus Group 1 (25; 32.1% and 28; 16.4% of cases) (p &lt; 0.05). After management of adverse events, the number of patients with poor tolerance was still confidently higher in Group 2 (14; 17.9% of cases), compared to Group 1 (11; 6.4%) (p &lt; 0.05). It was found out that the efficiency of in-patient treatment did not confidently differ in the patients with different psychological status.

A study to evaluate the prevalence and determinants of stress coping strategies in heart failure patients in Poland (CAPS-LOCK-HF sub-study).

We aimed to evaluate the prevalence and determinants of different stress coping strategies in Polish patients suffering from heart failure with reduced ejection fraction (HFREF). This manuscript is a sub-study of the CAPS-LOCK-HF multicentre psychological status assessment of patients with HFREF. Patients with > six-month history of HFREF and clinical stability for ≥ three months and left ventricular ejection fraction (LVEF) < 45% were enrolled in the study. Demographic and clinical variables were obtained from medical records, while a standardised Coping Inventory for Stressful Situations (CISS) was applied to all subjects. The study comprised 758 patients (599 men; 79%) with a median age of 64 years (IQR 58-71). Median LVEF was 33% (25-40). Subjects most commonly used task-oriented coping strategies (median CISS score 55 points; IQR 49-61), followed by avoidance (45 points; 39-50) and emotion-oriented coping strategies (41 points; 34-48). Distraction-based avoidance coping strategies (20 points; 16-23) were more pronounced than social diversion strategies (16 points; 14-19). Multiple regression analysis showed that higher New York Heart Association (NYHA) class and lower systolic blood pressure were independent predictors of task-oriented style. Emotion-oriented coping was more common among females and higher NYHA classes, and in patients who did not take angiotensin-converting enzyme inhibitors. Patients who used avoidance-oriented strategies were more frequently those in sinus rhythm on assessment and those who had less history of neoplastic disease. Patients with HFREF most commonly use favourable task-oriented coping strategies. However, female patients and those with higher NYHA classes tend to use potentially detrimental emotion-oriented coping strategies.