Reactive Anxiety Research Articles

The features of psychological status of pregnant women with an allogeneic fetus

The objective: to establish the peculiarities of the psychological status of pregnant women with an allogeneic fetus.Materials and methods. The psychological status of 120 pregnant women, who were divided into two groups, was assessed. I group included 80 patients after in vitro fertilization (IVF) programs with the formation of an allogeneic fetus, II group (control one) included 40 pregnant women after IVF with the woman’s own oocytes.The psychological state of pregnant women was assessed using the Spielberger-Hanin questionnaire, the Holmes and Rahe stress event scale, the assessment of well-being, activity and mood, the Edinburgh Postnatal Depression Scale, and the SF-36 quality of life questionnaire.Results. A high level of reactive anxiety was significantly more often determined in pregnant women with an allogeneic fetus compared to the pregnant women in the control group (32.50 % and 12.50 %, respectively), as well as uncertain indicators according to the Edinburgh Postnatal Depression Scale (72.50 % and 52.50 %, respectively).During the evaluation of the quality of life in patients of the I group, significantly lower indicators of role-emotional functioning (41.13±5.29 points), social functioning (72.76±4.88 points), as well as role-physical functioning (35.12±7.22 points) and vitality (38±7.11 points) than in the examined women of the II group (62.43±5.45, 84.4±5.02, 46.89±6.51 and 59.56±9.78 points, respectively) were established. The indicators of well-being and mood were also significantly lower in the I group (3.88±1.40 and 4.21±1.27 points, respectively) compared to the II group (4.83±1.55 and 5.13±1.49 points, respectively).Conclusions. The psychological status of pregnant women with an allogeneic fetus is characterized by the presence of statistically significant deviations not only compared to the control group, but also to the normative indicators provided by standardized survey methods. This indicates the necessity for further study of the relationship between these factors and the frequency of complications during pregnancy, childbirth and the postpartum period, as well as the condition of newborns in these women and possible ways of correcting the psychological status to reduce the frequency of obstetric and perinatal complications.

Нейропатичний біль при анкілозивному спондиліті та особливості психопатологічного реагування

The purpose of the work was to study the features of psychopathological symptoms in ankylosing spondylitis with and without neuropathic pain. Materials and methods. We clinically examined 142 patients treated between 2019 and 2022 who were diagnosed with ankylosing spondylitis according to the modified New York criteria. These patients were divided into two groups: the first group had the signs of neuropathic pain; the second group had no signs. The study of the psycho-emotional sphere was carried out using the The Zung Self-Rating Depression Scale, scales for assessing the level of personal and reactive anxiety by S. Spilberger, and the Mini Mental State Examination questionnaire was used to determine cognitive function. Results and discussion. It was found that the basis of psychopathological reactions in ankylosing spondylitis are mild and moderate depressive and anxiety symptoms: the average score on The Zung Self-Rating Depression Scale in patients without neuropathic pain was 48.1 ± 13.1 points, and in patients with neuropathic pain – 58.1 ± 4.6 points (p<0.01). 28.9% had no signs of depression, 45.1% showed signs of mild depression, and 26.0% – moderate depression. In 41.5% of patients without neuropathic pain, no signs of depression were found, in 40.4% – mild depression, in 18.1% – moderate, in patients with neuropathic pain – 4.2%, 54.2%, and 41.6%, respectively. The average value of the reactive anxiety index in the examined was 47.2 ± 12.2 points, in patients without neuropathic pain – 45.5 ± 12.7 points, in patients with neuropathic pain – 50.4 ± 10.5 points (p<0.05); personal anxiety indicator was 45.5 ± 10.1, 43.7 ± 10.6 and 49.0 ± 8.2 points, respectively (p<0.05). A low level of reactive anxiety in patients with neuropathic pain was found in 2.1%, without neuropathic pain – in 13.8% (p<0.05); medium – respectively in 31.3% versus 36.2% (p>0.05), high – respectively in 66.6% versus 50.0% (p<0.05). There were significantly more patients with low levels of personal anxiety among those who did not have neuropathic pain – 20.2% versus 6.3% (p<0.05), and with high levels – among patients with neuropathic pain: 56.2% versus 38.3% (p<0.05). The average value of the Mini Mental State Examination index in all patients was 27.46 ± 1.77 points; in patients with neuropathic pain – 26.29 ± 1.39 points, without neuropathic pain – 28.06 ± 1.64 points (p<0.01). Conclusion. Correlation analysis made it possible to establish the presence of significant correlations between expressiveness of neuropathic pain and depression and anxiety. Depressive and anxious manifestations in ankylosing spondylitis reflect psychopathological reactions to severe disease, pain and somatic discomfort, and personal anxiety as a stable personality characteristic, in ankylosing spondylitis patients primarily reflects the formation of patho-characteristic features as a result of long-term somatogenic influence. Cognitive impairment is probably mediated by depressive and anxiety symptoms and the influence of pain syndrome. The presence of a neuropathic component of the pain syndrome is a factor that aggravates the state of the psycho-emotional sphere, which justifies the feasibility of prescribing psychopharmacological therapy for ankylosing spondylitis

FEATURES OF THE ESTABLISHMENT OF SOCIAL AND PSYCHOLOGICAL ASSISTANCE TO THE UKRAINIAN POPULATION IN THE CONDITIONS OF OPPOSING THE AGGRESSOR

The purpose of the study is to determine the socio-psychological factors influencing the effectiveness of social-psychological assistance to the Ukrainian population in wartime conditions and their possible approbation as the use of relevant experience to ensure effective professional training of future psychologists in higher educational institutions. Research tasks: 1) determination of the social and psychological needs of the war-affected population of Ukraine; 2) determination of the level of social and psychological provision of assistance to victims; 3) determination of the conditions and means of ensuring the development of social and psychological assistance to the affected population. To solve the research task – to determine the level, conditions and means of ensuring the development of socio-psychological assistance to the affected population, the following research methods were used: theoretical analysis, synthesis and applied research using standardized methods. The state of readiness of Ukrainian psychologists to provide appropriate assistance to the population, development of the necessary psychological and methodological materials was analyzed. The peculiarities of psychological assistance to the injured are highlighted using the example of one of the first psychologists who developed a methodical guide aimed at the psychological and mental rehabilitation of injured Ukrainians. Emphasis is placed on psychological diagnosis and individual and group psychocorrection, psychotherapy (primary psychological assistance to displaced persons, assessment of the severity of the impact of a traumatic event, self-assessment of the level of depression in psychological diagnosis, short psychotherapy in an individual and complex multi-directional approach to getting out of a traumatized state in group work with displaced persons) and the importance of the positive influence on the development of this assistance of the relevant personal and professional qualities and properties of future psychologists. In order to identify the conditions and means of ensuring the development of socio-psychological assistance to the affected population, a number of methods were used in the study: 1) "Self-esteem" test (by S.A. Budassi); 2) Method "Self-assessment of mental state: well-being, general activity, mood (SAN)" (authors: V.A. Doskin, N.A. Lavrentyeva, V.B. Sharay, M.P. Miroshnikov); 3) "Scale of reactive and personal anxiety" (developed by C.D. Spielberger, adapted by Y.L. Khanin); 4) "Professional identity study methodology (MVPI) (author L.B. Schneider). 178 students of the III-IV courses of the Institute of Pedagogy and Psychology of the National Pedagogical University named after M.P. Drahomanov and 5th courses of the Faculty of Psychology named after T.G. Shevchenko and the Faculty of English of the National Linguistic University. From the analysis of the conducted methods, it was found that the researched future psychologists, who are oriented to practical activities under the guidance of mentors, have inadequately inflated self-esteem, an average level of cognitive activity, and an average level of anxiety during training, which correlates with an insufficient level of development of their professional self-identity. This indicates an inadequately inflated self-esteem, insufficient self-determination, inadequate self-satisfaction, self-expression, and insufficient self-regulation of the subjects during training. Therefore, it is necessary to pay special attention to creating conditions, finding means to increase opportunities for future psychologists to achieve a conscious, positive professional identity at the stage of educational and professional training, as this is an important basis for the effective formation of their professional identity in the future, as future reliable qualified specialists, the professional level of which will meet public demands, the needs of psychological assistance to victims of the war in the country. Keywords: socio-psychological assistance, psychological-methodical support, professional self-identity, personal-professional qualities and attributes, future psychologist

Sexual dimophism in plasma nitrogenous metabolites levels and some psycho-neuro-endocrine parameters

Background. We previously showed that the factor structure of the relationships between the plasma levels of nitrogenous metabolites (uric acid, bilirubin, urea, and creatinine), on the one hand, and the parameters of anxiety and neuro-endocrine status, on the other hand, is significantly different in men and women of reproductive age and postmenopausal. The purpose of this study is to identify the metabolic and psycho-neuro-endocrine features of these three cohorts of people. Materials and methods. The object of observation were 31 males (24÷69 y) and 30 females, from among them 18 postmenopausal (45÷76 y) and 12 of reproductive age (30÷42 y), with dysfunction of neuro-endocrine-immune complex. In basal conditions we determined plasma levels of nitrogenous metabolites and adaptation hormones, estimated the severity of the trait and reactive anxiety, recorded the ongoing HRV and EEG. After 4 or 7 days, repeated testing was performed. Results. To achieve the goal, the registered parameters were subjected to discriminant analysis. Along with the quite expected nitrogenous metabolites, age, testosterone and calcitonin (both raw and sex- and age-standardized values), trait anxiety, Kerdö's Vegetative Index, one of the vagal markers (SDNN), as well as 10 EEG parameters emerged as characteristic features of the cohorts. In the information space of two discriminant roots, three cohorts are clearly demarcated. Conclusion. We interpret this as another proof of the existence of connections between nitrogenous metabolites and psycho-neuro-endocrine parameters in line with the concept of the functional-metabolic continuum.

Sexual dimorphism in relationships between of plasma bilirubin and some neuro-endocrine parameters

Background. Earlier we found that plasma uric acid, urea and creatinine causes modulating effects on neuro-endocrine parameters, as well as anxiety, but these effects are significantly different in men and women of different ages. The purpose of this study is to analyze the relationships between the plasma bilirubin level and some psycho-neuro-endocrine parameters in the same cohort. Materials and Methods. The object of observation were almost healthy volunteers: 31 males (24÷69 y) and 30 females, from among them 18 postmenopausal (48÷76 y) and 12 of reproductive age (30÷45 y). In basal conditions we determined plasma levels of bilirubin and adaptation hormones, estimated the severity of the trait and reactive anxiety, recorded the ongoing HRV and EEG. After 4 or 7 days, repeated testing was performed. Results. By building regression models with stepwise exclusion, it was found that in men plasma bilirubin upregulates the variability of β- and α-rhythms as well as PSD of β-rhythm in T4 and Fp2 loci, but downregulates the variability of θ-rhythm, PSD of β-rhythm in P4 and δ-rhythm in T6 loci as well as the trait anxiety. The measure of determination is 42,6% In postmenopausal women, bilirubin downregulates the PSD of β-rhythm in T6 locus, but upregulates the Testosterone plasma level, vagal tone as well as PSD of ULF and VLF bands HRV. The degree of determination of neuro-endocrine parameters is 59,2%. In women of reproductive age bilirubin upregulates the PSD of β-rhythm in T4 locus while downregulates the amplitude of θ- and β-rhythms, PSD of β-rhythm in 5 loci, of α-rhythm in 5 other loci as well as the Entropy of EEG in T5, P4 and C4 loci. The degree of determination of EEGs parameters is 97,8%. Conclusion. Plasma bilirubin has a modulating effect on psycho-neuro-endocrine parameters, but this effect is significantly different in men and women of different ages, which is due, apparently, to the influence of sex hormones on the expression of Ah receptors in neurons.

Features of metacognitive beliefs of adolescents with a high level of personal anxiety

The article contains an analysis of the problems of personal anxiety among adolescents. Anxiety is considered as a property of the personality, which is manifested in the cognitive aspect, emotional reaction, physical reaction and behavior of the individual. The general purpose of the study was to identify the metacognitive beliefs of adolescents with a high level of personal anxiety and was realized thanks to the implementation of such tasks as: identifying adolescents with a high level of personal anxiety, studying personal attitudes towards symptoms, determining and comparing the metacognitive beliefs of adolescents with different levels of personal anxiety, determining predictive power of metacognitions of young people with a high level of personal anxiety.
 The results of a study of the prevalence of reactive and personal anxiety among adolescents are presented, a comparative analysis of one's own opinion regarding the presence of symptoms and test results of adolescents with a high level of personal anxiety is carried out. A new approach to the study of personal anxiety from the perspective of metacognitive beliefs is proposed, which is built on the principles of cognitive-behavioral psychology. Metacognition is defined as the basis of automatic thoughts, emotional and physical reactions, and the role of metacognitive processes in the interpretation of information about the level of security, the formation of judgments, assessments. The article proves that the metacognitions of adolescents with a high level of personal anxiety deprive them of flexibility in behavior, limiting the variability of life experience. The metacognitive portrait of young people with a high level of personal anxiety is characterized, in particular: the belief that anxiety is a protection against difficult emotions in anticipation of negative events; a positive attitude towards one's own anxious experiences is reinforced by a desire to prevent negative outcomes. As a result of the conducted research, the prospects for developing a method of targeted psychological influence within the cognitive-behavioral approach have been opened

Клініко-статистична оцінка психоемоційного статусу підлітків на стоматологічному прийомі

The purpose of the study was to assess the level of personal and reactive anxiety in teenagers of the Transcarpathian region during a dental appointment and establish the correlational dependence of parameters. Materials and methods. An assessment of psycho-emotional state and dental status of 384 adolescents aged 12-18 years who were patients of the “University Dental Polyclinic” was carried out. The patient's appeal was both urgent and for the purpose of rehabilitation, planned. Depending on the level of personal anxiety, patients were divided into clinical groups to determine the prevalence, intensity and activity of caries. The first group included 244 teenagers (175 girls and 69 boys) who were diagnosed with a high level of personal anxiety. The second group consisted of 105 adolescents (48 girls and 57 boys) in whom basic anxiety was moderate, the third group consisted of 35 adolescents with low anxiety (10 girls and 25 boys). The level of reactive and personal anxiety was assessed according to the methodology of Ch. D. Spielberger (adapted by Yu. L. Khanin). Indicators of the prevalence, intensity and activity of caries (CPV index) were determined in the examined subjects according to generally accepted methods. Results and discussion. The level of reactive and personal anxiety is determined to be high in both boys and girls, and reactive anxiety caused by visiting the dentist reaches the maximum percentage indicators in both groups and has a significantly higher percentage than personal anxiety. Significant differences in caries activity indicators of the first and second groups and the first and third groups were established, in particular, significantly lower indicators of absent and compensated caries (p <0.05) and significantly higher indicators of subcompensated and decompensated caries (p <0.05). The indicators of decompensated caries differed significantly between the indicators of the second and third groups (25.8%; 14.3%; p <0.05). Conclusion. High personal anxiety is a factor in the formation and progression of carious lesions of hard tissues in adolescents, a direct relationship between the level of personal anxiety and the course of caries in adolescents has been established, with an increase in personal anxiety, the percentage of decompensated caries increases. That is, high personal anxiety is a factor in the progression of dental caries in teenagers

Психологічний та пупілоалгометричний моніторинги стоматологічних хворих під час їх антистресорної терапії

The purpose of the study was to investigate the psychological status and pain sensitivity by the pupillometric method in dental patients during preoperative antistress drug therapy. Materials and methods. In 100 patients, during their initial examination, signs of psychological stress were detected in them in social conditions during the last month before surgical interventions, using the PSM-25 scale of Lemoureux-Tessier-Fillion. The level of anxiety and depressive symptoms were determined using the Hospital Anxiety and Depression Scale. Pain sensitivity in patients was studied by measuring the reaction of the pupil of the eye to the action of an algogenic mechanical factor using the developed proprietary technique of digital pupillometry. Depending on the applied schemes of antistress drug therapy, patients were divided into two clinical groups. The control group included 50 people with different levels of psychological stress. During premedication, they were given Gidazepam for sedation. The main group included 50 patients who were under psychological stress. At the stage of preoperative preparation (for 7 days), they were prescribed a course of antistress therapy: enterally the drug “Antistress” (which contains L-tryptophan) and endonasally – dalargin solution. Results and discussion. Psychological stress acquired by patients in social conditions is a favorable background for the appearance of clinical manifestations of anxiety and depression before the start of operations. The use of Gidazepam by stress-labile dental patients of the control group during premedication made it possible to provide antistressor protection only in 8 cases. These patients had a moderate level of psychological stress. The results of psychological testing and pupillo-algometry confirm the need to use alternative medication schemes of antistressor protection for emotionally labile dental patients during their preparation for planned surgical interventions. In patients of the main group with an average level of psychological stress before surgical interventions, antistressor protection was achieved in 100% of cases. The effectiveness of the applied medicinal scheme was statistically significant in comparison with the standard scheme of treatment of psychoemotional tension used by patients of the control group – χ2 - 15.771 (р<0.001). Preoperative antistress therapy was not sufficiently effective for only 16.7% of patients in the main group with a high level of psychological stress. When comparing the results of stress-protective therapy with those of patients in the control group, statistically significant differences were also found – χ2 - 16.875 (р<0.001). Conclusion. In dental patients who are in a state of chronic psychological stress, psychoemotional tension (reactive anxiety) increases and pain sensitivity increases before the start of planned surgical interventions, which is confirmed by psychological tests and digital pupillo-algometry. One-time use of Gidazepam by stress-sensitive patients during premedication is not effective enough to normalize their psycho-emotional state. Prescribing a course of drug antistress therapy (L-tryptophan and dalargin) to dental patients diagnosed with chronic psychological stress allows to statistically reliably normalize their psychoemotional state and reduce pain sensitivity before the start of surgical interventions

FEATURES OF MICROCRYSTALLIZATION AND MINERALIZATION POTENTIAL OF ORAL FLUID IN 15-YEAR-OLD ADOLESCENTS WITH DIFFERENT LEVELS OF ANXIETY

Aim of the research. Study the features of microcrystallization of oral fluid in children; monitor the relationship between the level of anxiety, the type of microcrystallization and the mineralizing potential of children's oral fluid.
 Materials and methods. 75 adolescents aged 15 years of Ivano-Frankivsk region, which belongs to the regions with iodine deficiency in the environment, were examined. Among the examined teenagers there were 25 people with low, medium and high levels of anxiety. The morphological type of microcrystallization was studied by the method of dehydration of a drop of oral fluid. Evaluation of the level of mineralizing potential of saliva was carried out on a 5-point scale, taking into account the nature of crystal formation in three fields of vision, and the average value was calculated. The assessment of the psycho-emotional state was carried out on the basis of the results of questionnaires of children using the "Scale for assessing the level of reactive and personal anxiety" by Ch.D. Spielberger and Y.L. Khanina (State-Trait Anxiety Inventory, STAI).
 Results. The study of the crystallographic pattern of oral fluid of adolescents revealed the predominance of type II crystals (44.00±5.73% of cases). Crystals of the most favorable type I occurred in 30.67±5.32% of cases, and crystals of type III, the most unfavorable in prognostic relation to the occurrence of dental caries, occurred in 25.33±5.02% of cases. We have studied the type of oral fluid crystals in children, taking into account the level of anxiety. In the mixed saliva of children with a low level of anxiety, type I crystal formation predominated (52.00±9.99%). Crystal formation according to the second type was recorded in 40.00±9.80%, and according to the III type - in 8.00±5.43% of cases. In children with an average level of anxiety, the number of cases of observation of type II crystals did not change (40.00±9.80%). In addition, a 1.3-fold decrease in the specific gravity of type I crystals was noted from 52.00±9.99% to 40.00±9.80%, p˃0.05, resulting in 20.00±8.00 % of cases, type III crystals occurred in the oral fluid. In children with a high level of anxiety, the specific weight of type II crystals increased from 40.00±9.80% to 52.00±9.99%, p˃0.05, and the specific weight of type III crystals increased from 20.00±8.00 % to 48.00±9.99%, p<0.05. On the other hand, not a single case of crystal formation according to type I was recorded. In this group of children, extremely unfavorable type III crystals dominated in the oral fluid. The evaluation of the mineralizing potential of saliva revealed that its average value was 2.48±0.12 points. This testified to the satisfactory level of this indicator. We investigated the mineralizing potential of oral fluid in children, taking into account the level of anxiety. Among adolescents with a low level of anxiety, the MPS was rated as satisfactory, and the average value was the highest (3.04±0.16 points). In children with an average level of anxiety, the MPS was also satisfactory, but the average value was slightly lower - 2.76±0.21 points (р˃0.05). In adolescents with a high level of anxiety, the MPS had the lowest value (1.64±0.14 points), which was interpreted as low (р˂0.05). It was found that with an increase in the level of anxiety, there was a tendency to a decrease in the specific gravity of type I crystals, an increase in the specific gravity of type III crystals, and a decrease in the mineralizing potential of mixed saliva. The lowest indicators of mineralizing potential were at a high level of anxiety.
 Conclusions. Analysis of the morphological picture of mixed saliva in children with different psycho-emotional states showed that adolescents with a high level of anxiety in the oral fluid are predominantly type III crystals, and the mineralizing potential is low. Reduced mineralizing properties of oral fluid lead to demineralization with subsequent progression of the carious process. Therefore, there is a need for differential prevention measures for children with different psycho-emotional states.

Sexual dimorphism in relationships between of plasma creatinine and some neuro-endocrine parameters

Background. Earlier we found that plasma uric acid and urea causes modulating effects on neuro-endocrine parameters, as well as reactive anxiety, but these effects are significantly different in men and women of different ages. The purpose of this study is to analyze the relationships between the plasma creatinine level and some psycho-neuro-endocrine parameters in the same cohort. Materials and Methods. The object of observation were almost healthy volunteers: 31 males (24÷69 y) and 30 females, from among them 18 postmenopausal (48÷76 y) and 12 of reproductive age (30÷45 y). In basal conditions we determined plasma levels of creatinine and adaptation hormones, estimated the severity of the trait and reactive anxiety, recorded the ongoing HRV and EEG. After 4 or 7 days, repeated testing was performed. Results. By building regression models with stepwise exclusion, it was found that in men plasma creatinine downregulates the level of Cortisol (r=-0,41) while upregulates the levels of Testosterone (r=0,36) and Calcitonin (r=0,30). The degree of determination of endocrine parameters is 31,9%. In postmenopausal women, creatinine also upregulates Testosterone (r=0,43) while downregulates the amplitude and PSD of β-rhythm in different loci as well as causes right lateralization of β-rhythm. The degree of determination of neuro-endocrine parameters is 61,2%. In women of reproductive age creatinine upregulates the PSD of ULF band HRV and α-rhythm in 5 loci as well as the Entropy of EEG in F3 locus while downregulates the Entropy in T6 locus, F3-δ and T6-θ PSD as well as Cortisol level. The degree of determination of neuro-endocrine parameters is 94,0%. Conclusion. Plasma creatinine has a modulating effect on neuro-endocrine parameters, but this effect is significantly different in men and women of different ages.

Efficacy of secondary prevention and rehabilitation programs with distant support in patients with atrial fibrillation after intervention procedures: impact on psychological status

Aim To evaluate the effectivity of secondary prevention/rehabilitation programs with remote support for the psychological condition of patients with paroxysmal atrial fibrillation (AF) following interventional procedures (radiofrequency catheter ablation and cryoablation).Material and methods This prospective, controlled, randomized clinical study was performed in three parallel groups. Each group consisted of 45 patients with AF after interventional procedures. In groups 1 and 2, secondary prevention/rehabilitation programs with remote support were performed, including a single individual in-hospital counseling (on risk factors of AF and their control and on major aspects of the disease, treatment and prevention of complications) and three months of remote support (by phone in group 1 and by e-mail in group 2). Patients of group 3 (control group) received standard recommendations at discharge from the hospital. The psychological status was evaluated using the Hospital Anxiety and Depression Scale, the PHQ-9 questionnaire, the Spielberg-Hanin scale for reactive and personal anxiety, and the visual analogue scale for stress assessment. The follow-up duration was 12 months.Results At the end of the follow-up period, the proportion of patients with anxiety symptoms considerably decreased in both intervention groups (р<0.001 for each group) and was significantly less than in the control group (р<0.001 for both comparisons). Also, in intervention group 1, the proportion of patients with clinically pronounced anxiety symptoms was significantly decreased. For 12 months of follow-up, the severity of depressive symptoms significantly decreased in all three groups. However, in both intervention groups, this decrease was significantly greater than in the control group (р<0.001 for group 1 and р=0.020 for group 2). In both intervention groups at 12 months, the stress level was significantly reduced whereas in the control group, it remained practically unchanged. The greatest (50% on average) decrease in the stress level was observed in intervention group 2.Conclusion Secondary prevention and rehabilitation programs with remote support during a 12-month follow-up resulted in improvement of the psychological status in patients with AF after interventional procedures.

ОПЫТ ПРОФИЛАКТИКИ ЭМОЦИОНАЛЬНОГО СТРЕССА С ПОМОЩЬЮ МЕТОДИК МУЗЫКОТЕРАПИИ И МЕДЛЕННЫХ МАНИПУЛЯЦИОННЫХ ДВИЖЕНИЙ У РЫБАКОВ ВО ВРЕМЯ ДЛИТЕЛЬНОГО МОРСКОГО РЕЙСА

Under the effect of extreme factors, compensatory and adaptive mechanisms are triggered in the body that change the metabolism and functional state of organs and tissues. With short-term exposure to these factors, homeostasis practically does not change, and with prolonged and repeated effects, stress and corresponding pathology may occur. In marine medicine, the problem of stress is particularly relevant. The adaptation of the seafarers' body should be carried out to a significant number of adverse factors in a relatively short time with sharp changes in the navigation regions. There are many ways to improve or correct a person's condition. Among them, relatively simple and inexpensive ones are of interest. The aim of the study is to evaluate the results of the use of various methods of psychological relaxation for the prevention and reduction of emotional stress among fishermen during a long sea voyage. Materials and methods: seafarers were examined during a long fishing voyage for psychoemotional stress detecting. Seances of psychological and emotional relaxation – music therapy and exercises of the technique of slow manipulative movements were conducted among individuals with identified signs of reactive anxiety. Results of the study: upon completion of all full cycles of emotional and psychological unloading, a positive effect was revealed in most of the subjects. 6 days after the start of the music therapy cycle, the level of reactive anxiety normalized in half of the participants, and after another 4 days, almost all individuals achieved a decrease in anxiety to at least moderate. In an experiment with the technique of slow manipulative movements (counting rosaries), after a week, the normalization of the level of anxiety occurred in 20% of the subjects, and in more than 2/3 of the sailors it decreased to moderate. A week later, almost all the subjects' anxiety levels returned to normal.

Подготовка и сопровождение тревожного пациента офтальмологической клиники при амбулаторной хирургии

The question of preoperative anxiety in an ophthalmological patient and its relief in an outpatient setting is becoming increasingly relevant due to the improvement of the technique and equipment of ophthalmic surgery, when the practice of "one-day surgery" is becoming increasingly common. Purpose. To analyze the relationship between the level of anxiety during preoperative preparation and the choice of the optimal approach for the relief of preoperative anxiety in an ophthalmological patient in a "one day" clinic. Material and methods. 89 adult patients of both sexes referred for outpatient surgery were included into trials. Clinical psychotherapeutic interviewing, a scale of situational and personal anxiety C.D. Spielberger (adapted by Y.L. Khanin), a questionnaire for analyzing satisfaction with the quality of medical services provided in outpatient settings were used. Statistical: Microsoft Excel spreadsheet editor for Windows; the STATISTICA application software package version 6.1. were taken. The condition for determining statistically significant differences is the value р ≥ 0.05. Results. The study revealed an average and high level of situational anxiety in 66 % of patients referred for refractive surgery, in 81 % of patients referred for cataract surgery. Against the background of the performed anxiolytic therapy in the preoperative period, the proportion of people with a high level of reactive anxiety decreased significantly (p ≥ 0.05) (from 24 % to 8 %), while personal anxiety did not significantly change. Conclusions. The study showed the possibility of providing better quality medical services in "one-day" eye surgery, which expands the availability of outpatient ophthalmic surgical care to patients with anxiety disorders. Keywords: outpatient surgery, refractive surgery, situational anxiety, preoperative preparation

Features of psychophysiological status and level of myocardial stress in wrestlers with masked hypertension

Aim. To reveal the features of the psychophysiological status and the level of myocardial stress in wrestlers with masked hypertension.Materials and methods. We examined 125 athletes, aged 18 to 30, male, Yakut nationality, high sportsmanship (candidate master of sports, master of sports). Depending on the level of blood pressure, athletes were divided into 2 groups: group 1 ‒ athletes with normal blood pressure (n=80, 64.0%); group 2 ‒ athletes with masked hypertension (n=45, 36.0%). A clinical examination, anthropometry, measurement of office and daily blood pressure levels, echocardiography of the left ventricle were performed.Results. In athletes with masked hypertension, a high level of reactive anxiety prevails, which increases the relative chance of developing hypertension by 2.6 times (OR 2.601 [95% CI: 1.123‒6.023], p<0.05), a sympathicotonic type of regulation of the cardiovascular system was noted, an increase in systolic myocardial stress and high levels of left ventricular wall thickness compared with athletes with normal blood pressure.Conclusion. High reactive anxiety can serve as a risk factor for the development of masked hypertension in athletes. A comprehensive assessment of the psychophysiological status and individual typological characteristics of athletes is necessary to prevent the development of prepathological and pathological changes in the cardiovascular system in athletes.

Sexual dimorphism in relationships between of plasma urea and some psycho-neuro-endocrine parameters

Background. Earlier we found a strong urato-neural relationships in both men and women. Moreover, in women, the factor structure of the neural root is almost completely different from that in men. In addition, significant differences were found between the profiles of urato-neural correlations of women of reproductive age and postmenopausal women. The purpose of this study is to analyze the relationships between the plasma urea level and some psycho-neuro-endocrine parameters in the same cohort. Materials and Methods. The object of observation were almost healthy volunteers: 31 males (24÷69 y) and 30 females, from among them 18 postmenopausal (48÷76 y) and 12 of reproductive age (30÷45 y). In basal conditions we determined plasma levels of urea and adaptation hormones, estimated the severity of the trait and reactive anxiety, recorded the ongoing HRV and EEG. After 4 or 7 days, repeated testing was performed. Results. By building regression models with stepwise exclusion, it was found that in men plasma urea positively determines (R2=0,499) the level of circulating catecholamines and power spectrum density (PSD) of δ-, θ- and β-rhythms in different loci. In postmenopausal women, urea downregulates the amplitude and PSD of δ-rhythm in different loci, instead, it upregulates the PSD of α-rhythm in T5 locus, entropy of EEG in 2 loci and vagal tone. The degree of determination of neural parameters is 71,6%. In women of reproductive age the degree of determination of neural parameters is similar (69,9%), but the factor structure of the model is completely different. Urea upregulates the PSD of β-rhythm in F7 locus while downregulates the levels of reactive anxiety, vagal tone, entropy of EEG in 3 loci and P4-θ PSD as well as causes left lateralization of θ- and α-rhythms. Conclusion. Plasma urea has a modulating effect on EEG&HRV parameters, as well as reactive anxiety, but this effect is significantly different in men and women of different ages.

Pantohematogen Efficacy Evaluation in Complex Sanatorium Rehabilitation of Patients with post-COVID-19 Syndrome: an Open Randomized Cohort Study

INTRODUCTION. To expand the range of the pantohematogen based drugs usage, to develop indications for their use in various forms and methods, scientific research is necessary and appropriate on evaluation of the effectiveness of the antler drugs use for the rehabilitation of patients with post-coronavirus syndrome, which is detected in most patients after the coronavirus infection COVID-19 and is characterized by various changes in metabolism and hemostasis, autonomic nervous system, external respiration, indicators of central and peripheral hemodynamics, reduced exercise tolerance, quality of life and working capacity of patients. AIM. To scientifically establish and develop of a comprehensive program of COVID-rehabilitation of patients with the use of pantohematogen at the sanatorium-resort stage. MATERIAL AND METHODS. We conducted randomized study in parallel groups. The study included women aged 39 to 65 years (mean age 53.9±1.18 years) – 30 patients. The rehabilitation program of the patients who had pneumonia associated with COVID-19 novel coronary virus infection was evaluated 3-4 months after the disease. The study group was additionally prescribed 1 capsule of pantohematogen, three times a day with meals, for 10-12 days (dietary supplements with increased iron content). The comparison group received the same rehabilitation program, but without the use of pantohematogen. RESULTS AND DISCUSSION. According to the severity of post-COVID pneumonia, 66.6% were diagnosed with pneumonia of moderate severity and 33.4% with mild severity. Mild degree of dyspnea was revealed in 63.3% of patients, physical asthenia was diagnosed in 70% of patients. The use of pantohematogen showed an advantage in terms of a more significant decrease in the level of physical asthenia, a decrease in dyspnea during physical exertion, a decrease in the frequency of autonomic disorders, an improvement in the psycho-emotional status, and a more significant decrease in reactive anxiety in these patients. In order to prolong the effectiveness of the post-COVID rehabilitation program for patients, it is advisable to continue taking pantohematogen in outpatient or home conditions for 2 weeks, 1 capsule three times a day. CONCLUSION. For the first time the possibility and expediency of using pantogematogen with additional iron content to increase the efficiency of the health center rehabilitation program has been studied and proved; it can be used in patients with postCOVID conditions for normalization of functional disorders, vegetative-status and normalization of psycho-emotional status in all organizational forms of sanatorium-resort organizations, as well as at home.

STUDY OF STRUCTURAL AND FUNCTIONAL ACID RESISTANCE OF PERMANENT TOOTH ENAMEL IN CHILDREN DEPENDING ON THE CHARACTERISTICS OF DIFFERENT LEVELS OF ANXIETY

Aim of the research. To study the level of structural and functional acid resistance of enamel using the enamel resistance test (TER-test) according to V.R. Okushko, L.I. Kosareva; to identify the level of personal and reactive anxiety in adolescents according to the method of Ch.D. Spielberger and Yu.L. Khanina; to trace the relationship between the structural and functional acid resistance of tooth enamel and the level of anxiety of diagnosed adolescents living in the area with existing iodine deficiency.
 Materials and methods. In comparative aspect, the results of the study of structural and functional acid resistance of enamel of permanent tooth on the background of different psycho-emotional state in 180 students aged 15 years of educational institutions of Ivano-Frankivsk region, which is characterized by existing iodine deficiency. The study of the level of functional resistance of tooth enamel to acid was performed using the test of enamel resistance (TER-test) developed by V.R. Okushko, L.I. Kosareva (1983), the essence of which is to assess the depth of the microdefect of the enamel after dosed acid trauma. To determine the level and nature of anxiety, we used the "Scale for assessing the level of reactive and personal anxiety" C.D. Spielberger and J.L. Hanin.
 Results. The results of the survey indicated that among the surveyed adolescents, the dominant level of anxiety on the scale of reactive and personal anxiety was average (respectively, 45.00±3.71% and 40.56±3.66%). A significant proportion of adolescents had a high level of anxiety (33.89±3.53% in RA and 26.11±3.27% in PA). The average value of the test of acid resistance of enamel among all examined adolescents was 4.28±0.15 points, which indicated the average level of SFARE. Comparative analysis of the results showed a decrease in acid resistance of tooth enamel as the level of anxiety increases regardless of its nature, which was accompanied by a significant increase in numerical values of TER (from 2.61±0.25 points to 6.00±0.17 points (p˂0,05) at RA and from 2.53±0.20 points to 6.64±0.14 points (p˂0.05) at PA). As a result of the conducted researches it was found that low and medium level of RA and PA was most often observed in adolescents, respectively, with significant and medium structural and functional resistance of enamel. High levels on the scale of RA and PA were determined mainly in the group of children with low structural and functional stability of tooth enamel. We did not find a high level of anxiety among schoolchildren with high enamel resistance to caries. As the level of enamel resistance and resistance of teeth to caries decreased, there was a decrease in the proportion of children with low anxiety (with RA from 60.53±3.64% to 5.26±1.66%, with PA from 63.34±3.59% to 3.33±1.38%) and an increase in the proportion of children with high anxiety (with RA from 37.70±3.61% to 62.30±3.61%, with PA from 14.89±2.65% to 85.11±2.65%). As the level of enamel resistance and tooth resistance to caries decreased, it was accompanied by a decrease in the proportion of children with low anxiety and an increase in the proportion of children with high anxiety.
 Conclusions. As a result of the research, a certain connection was found between the level of anxiety and the structural and functional acid resistance of tooth enamel. Adolescents with reduced structural and functional resistance of enamel and low resistance of teeth to caries have a higher level of both reactive and personal anxiety compared to children with significant and moderate structural and functional resistance of enamel and, accordingly, high and medium resistance of teeth to caries. The obtained data can be the basis for substantiating the prevention of dental caries in children with various psycho-emotional states.

Affective disorders and сognitive impairment in the early stages of Parkinson’s disease

Background: Parkinson's disease (PD) is an age-related neurodegenerative disease in developed countries. The prevalence of PD ranges from 41 per 100,000 in the fourth decade of life to more than 1,900 per 100,000 in people over 80 years of age. Neurodegeneration associated with Parkinson's disease probably occurs several decades before the onset of motor symptoms. Affective and cognitive impairments are one of the most frequent non-motor manifestations of PD, which can lead to a number of adverse outcomes. Aim: to evaluate affective and cognitive impairments in patients at the early stages of PD. Methods: 61 patients with PD participated in the study. All the participants were divided into two groups depending on the presence or absence of a diagnosis of depression verified by psychiatrists: Group 1 was the main group (n=48), group 2 was the control group (n=13). The control group included patients without depression. The average age of the participants was 62.29.6 years. The analysis of the PD stages was carried out in both groups. In the main group, stage II PD was diagnosed in 75%, in the control group in 31% of patients. The average duration of the disease was 2.51.6 years. A clinical examination was carried out using the Beck depression questionnaire, apathy scale, Spielberger anxiety questionnaire and anxiety assessment scale in PD (to assess emotional disorders), cognitive function assessment scale in PD (SHOBP-Cog, Scopa-Cog), digital symbol replacement test (symbols-numbers test), Montreal assessment Scale cognitive functions (MoCA test), a test for connecting numbers and letters, and a Stroop test (for evaluating cognitive functions). Results: It was revealed that in the early stages of PD, the prevalence of depression, clinically significant apathy, personal and reactive anxiety was high. Significantly higher rates of depression severity, depression level, apathy level and personal anxiety were noted among the patients with stage II PD compared to the patients with stage I PD. There was a marked tendency to a decrease in cognitive functions at stage I of PD, aggravated at stage II of the disease, which was confirmed by the results of the tests: a low level of cognitive functions on the Montreal scale was detected in 52%; 70% of patients, regardless of the PD stage, showed a low rate of completion of the 1st and 2nd parts of the Stroop test for their age; the results of the digital character replacement test were below normal in 75% of cases. Conclusion: The most common affective disorders in the early stages of PD are depression and anxiety. Apathy and depression have a negative impact on the cognitive functions of patients, which worsen with the progression of the disease.

Temperamental Change in Adolescence and Its Predictive Role on Anxious Symptomatology.

Growing evidence supports the hypothesis that temperamental traits are not static throughout adolescence. The known links between both reactive and regulatory temperament and anxiety symptoms should be investigated bearing this hypothesis in mind. This study collected self-reported data on behavioral inhibition system (BIS) sensitivity, attentional control (AC), and anxiety symptomatology, from 296 adolescents (64.2% girls; M = 12.96 years at the first assessment, SD = 0.47) every six months, four times over eighteen months. The relationships between temperament factors (AC and BIS sensitivity), considered longitudinally (by means of their trajectories) and anxiety symptoms were investigated using Multigroup Latent Growth Modeling (MLGM), as well as the mediating effect of sex on trajectories and anxiety. BIS sensitivity decreased over time and showed differential patterns across sexes. AC remained relatively stable and we found no sex influence on its trajectory. On the other hand, we observed that the BIS sensitivity trajectory was a significant predictor of anxiety symptomatology at age 15. In conclusion, temperamental changes between the ages of 13 and 15 seem to play a relevant role in explaining subsequent anxiety symptomatology, under the mediating influence of sex.

New strategies for multimodal analgesia in patients with high-risk geriatric cancer in perioperative period.

12046 Background: Perioperative pain (POP) in high-risk geriatric patients with cancer (HRGCP) is an important issue. The purpose of this study was to optimize perioperative analgesia in HRGCP. Methods: This randomized study of the quality and effectiveness of perioperative analgesics included 115 HRGCP aged 64-88 years who underwent surgeries on the organs of the chest, abdomen and pelvis for various cancers. The patients were divided into 2 groups. Group 1 (n = 52): patient-controlled analgesia with morphine and nonsteroidal anti-inflammatory drugs (NSAIDs); group 2 (n = 63): ultrasound-guided bilateral transversus abdominis plane (TAP) block with ropivacaine. Intraoperative and perioperative analgesia was maintained with a continuous infusion of lidocaine, magnesium sulphate, microdoses of fentanyl and NSAIDs. Results and pain syndrome were assessed by monitoring the Efficacy Safety Score (ESS), personal and reactive anxiety, stress response (cortisol, insulin, lactate, glucose), rates of functional activity recovery, the need for opioid analgesics, frequency of postoperative nausea and vomiting (PONV). Results: Patients in group 2 showed a significant decrease in the perioperative need for opioid analgesics and significantly decreased POP. Analysis of variance of mean values revealed statistically lower scores of ESS, visual analogue scale and POP (p < 0.05) during the first 24 hours of perioperative period in group 2 compared with group 1. Patient-controlled analgesia showed analgesic effect in 88.5% (p < 0.05) cases. However, the effect was less pronounced, compared to multimodal analgesia, and did not reduce cognitive disorders. In group 2, opioid-sparing analgesic effect was 95.3% (p < 0.05). Multimodal analgesia reduced the stress response (p < 0.05) in perioperative period and did not cause cognitive dysfunction while reducing PONV episodes, unlike morphine. Despite the minimal doses of narcotic analgesics in group 2, multimodal analgesia provided safe analgesia and functional activity recovery in perioperative period with minimum negative effects of opioids. Conclusions: The strategy of multimodal analgesia based on a combination of intraoperative TAP block and infusions of lidocaine and microdoses of fentanyl can significantly improve the quality of analgesia in perioperative period.