Features of the mental status of patients with community-acquired pneumonia, combined with a chronic pathology of the hepatobiliary system of non-viral genesis.

R. V. Razumnyi, I. D. Spirina

Abstract


The aim was to study the characteristics of mental status of patients with community-acquired pneumonia (CAP), combined with a chronic pathology of the hepatobiliary system of non-viral genesis. We observed 165 patients with CAP in the age of 25-57 years. All patients were divided into two representative groups: I group (68 patients) – CAP was comorbid with hepatic steatosis (HS), II group (96 patients) with absence of chronic liver disease. To evaluate the psychological profile of patients’ personality we used a standardized multivariate method of personality research and to evaluate the level of anxiety and depression the scale of Spielberger-Hanin test and Beck’s questionnaire were used. Results of the study revealed that 66.2% of patients with CAP, comorbid with HS, declared the formation of psycho-emotional disorders in the form of neurotic reactions to the disease with prevalence of hypochondria, depression, hysterical manifestations with high psychasthenia, trait anxiety and somatic reactions with prevalence of anxiety and emotional instability, lots of somatic complaints, fixation on their own condition with formation of distinctive thinking mode and behavior by the type of "flight into disease". After completion of the standard treatment of patients with CAP, combined with HS, 42,7% of patients had psycho-emotional disorders, which were moderately expressed. Thus, in the complex of treatment and rehabilitative measures in patients with CAP, combined with HS some characteristics of the psychological profile, in the form of psycho-neurotic reaction to the disease should be considered to take optimal corrective actions.


Keywords


community-acquired pneumonia; fatty liver disease; depression; anxiety

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References


1. Grishchenko EB, Shchekina MI. [Depression and pathology of the liver: modern therapy]. Psychiatry and Psychopharmacotherapy of P. B. Gannushkin. 2014;4:52-57. Russian.

2. Lapach SN, Chuvenko AV, Babich PN. [Basic principles of the use of statistical methods in clinical trials]. Kiev: Morion; 2002. Russian.

3. Medik VA, Tokmachev MS. [Mathematical sta­tistics in medicine: textbook]. M.: Finances and Statistics; 2007. Russian.

4. Nonalcoholic fatty liver disease. Adapted clinical guidelines based on evidence (draft). Available from: http://www.moz.gov.ua/docfiles/dod_akn_dn_20140616_2.pdf

5. Feshchenko YuI, Golubovska OA, Goncha­rov KA. [Community-acquired pneumonia in adults: etio­logy, pathogenesis, classification, diagnosis, antibiotic therapy (draft clinical guidelines) Part I]. Ukrainian pulmonology journal. 2012;4:5-17. Ukrainian.

6. Ovchinnikov BV, Dyakonov IF, Kolchev AI, Lytaev SA. [Fundamentals of clinical psychology and medical psychodiagnosis]. St. Petersburg: ELBI; 2005. Russian.

7. Pertseva TO, Konopkina LI, Huba IuV. [Pecu­liarities of mental status in patients with chronic obstructive pulmonary disease in different phases of the pathological process]. Medicni perspectivi. 2016;21(1):19-23. Ukrainian.

8. On approval of clinical protocols of medical care in the specialty "Pulmonology": Order of the Ministry of Health of Ukraine of 19.03.2007 N128 [electronic resource]. Available from: http://www.moz.gov.ua/­ua/portal/dn_20070319_128.html

9. Yagmur VB. [Non-alcocholic fatty liver disease: modern view on pathogenesis, diagnosis and treatment]. Gastroenterology. 2013;3(49):138-47. Ukrainian.

10. Stewart BJ, Turnbull D, Mikocka-Walus AA, Harley H. [An Aggravated Trajectory of Depression and Anxiety Co-morbid with Hepatitis C: A Within-groups Study of 61 Australian Outpatients]. Clin. Pract. Epide­miol. Ment. Health. 2015;13(11):174-9.

11. Russ TC, Kivimäki M, Morling JR, Starr JM. [Association Between Psychological Distress and Liver Disease Mortality: A Meta-analysis of Individual Study Participants]. Gastroenterology. 2015;148(5):958-66.

12. Youssef NA, Abdelmalek MF, Binks M, Guy CD. [Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease]. Liver Int. 2013;33(7):1062-70.

13. Hsieh MH, Lee CT, Tsai PJ, Tsai CJ. [Chronic obstructive pulmonary disease and anxiety disorders: a nationwide population-based study in Taiwan]. Gen. Hosp. Psychiatry. 2016;42:1-6.

14. Zhu HP, Gu YR, Zhang GL, Su YJ. [Depression in patients with chronic hepatitis B and cirrhosis is closely associated with the severity of liver cirrhosis]. Ther. Med. 2016;12(1):405-9.

15. Dueñas-Espín I, Demeyer H, Gimeno-Santos E, Polkey MI. [Depression symptoms reduce physical activity in COPD patients: a prospective multicenter study]. Int. J. Chron. Obstruct. Pulmon. Dis. 2016;10(11):1287-95.

16. Feldman C, Anderson R. [Community-ac­quiredpneumonia: still a major burden of disease]. Curr. Opin. Crit. Care. 2016;22(5):477-84.

17. Rivero-Calle I, Pardo-Seco J, Aldaz P, Var­gas D.A. [Incidence and risk factor prevalence of com­munity-acquired pneumonia in adults in primary care in Spain (NEUMO-ES-RISK project)]. BMC Infect. Dis. 2016;16(1):645.

18. Surdea-Blaga T, Dumitraşcu DL. [ Depression and anxiety in nonalcoholic steatohepatitis: is there any association?]. Rom. J. Intern. Med. 2011;49(4):273-80.

19. Younossi ZM, Blissett D, Blissett R, Henry L. [The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe]. He­patology. 2016;64 (5):1577-86.

20. Luna CM, Palma I, Niederman MS, Membriani E. [The Impact of Age and Comorbidities on the Mortality of Patients of Different Age Groups Admitted with Community-acquired Pneumonia]. Ann. Am. Thorac. Soc. 2016;13(9):1519-26.


GOST Style Citations


  1. Грищенко Е.Б. Депрессии и патология печени: современные возможности терапии / Е.Б. Грищенко, М.И. Щекина // Психиатрия и психофармакотерапия им. П.Б. Ганнушкина. – 2014. – № 4. – С. 52-57.
  2. Лапач С.Н. Основные принципы применения статистических методов в клинических испытаниях / С.Н. Лапач, А.В. Чубенко, П.Н. Бабич. – Киев: Мо­рион, 2002. – 160 с.
  3. Математическая статистика в медицине: учеб. пособие / В.А. Медик, М. С. Токмачев. – Москва: Фи­нансы и статистика, 2007. – 800 с.
  4. Неалкогольна жирова хвороба печінки. Адап­тована клінічна настанова, заснована на доказах (проект) [Електронний ресурс] – Режим доступу до ресурсу: http://www.moz.gov.ua/docfiles/dod_akn_dn_­20140616_2.pdf
  5. Негоспітальна пневмонія у дорослих осіб: етіологія, патогенез, класифікація, діагностика, анти­бактеріальна терапія (проект клінічних настанов) Частина І / Ю.І. Фещенко, О.А. Голубовська, К.А. Го­нчаров [та ін.] // Укр. пульмонол. журнал. – 2012. – № 4. – С. 5-17.
  6. Основы клинической психологии и меди­цин­ской психодиагностики: учеб. пособие. / Б.В. Овчин­ников, И.Ф. Дьяконов, А.И. Колчев, С.А. Лытаев. – СПб.: Элби, 2005. – 320 с.
  7. Перцева Т.О. Особливості психічного статусу хворих на хронічне обструктивне захворювання ле­гень у різні фази патологічного процесу / Т.О. Пер­цева, Л.І. Конопкіна, Ю.В. Губа // Медичні перспек­тиви. – 2016. – Т. 21, №1. – С. 19-23.
  8. Про затвердження клінічних протоколів на­дання медичної допомоги за спеціальністю "Пульмо­нологія": Наказ МОЗ України від 19.03.2007 № 128 [Електронний ресурс] – Режим доступу до ресурсу: http://www.moz.gov.ua/ua/portal/dn_20070319_128.html
  9. Ягмур В.Б. Неалкогольна жирова хвороба печінки: сучасний погляд на патогенез, діагностику та лікування / В.Б. Ягмур // Гастроентерологія. – 2013. – № 3 (49). – С. 138-147.
  10. An Aggravated Trajectory of Depression and Anxiety Co-morbid with Hepatitis C: A Within-groups Study of 61 Australian Outpatients / B.J. Stewart, D. Tur­nbull, A.A. Mikocka-Walus, H. Harley // Clin. Pract. Epi­demiol. Ment. Health. – 2015. – Vol. 13, N 11. – P. 174-179.
  11. Association Between Psychological Distress and Liver Disease Mortality: A Meta-analysis of Individual Study Participants / T.C. Russ, M. Kivimäki, J.R. Mor­ling, J.M. Starr [et al.] // Gastroenterology. – 2015. – Vol. 48, N 5. – P. 958-966.
  12. Associations of depression, anxiety and anti­dep­res­sants with histological severity of nonalcoholic fatty liver di­se­ase / N.A Youssef., M.F Abdelmalek., M. Binks, C.D.Guy [et al] // Liver Int. – 2013. – Vol. 33, N 7. – P. 1062-1070.
  13. Chronic obstructive pulmonary disease and an­xiety disorders: a nationwide population-based study in Taiwan / M.H. Hsieh, C.T. Lee, P.J. Tsai, C.J. Tsai [et al] // Gen. Hosp. Psychiatry. – 2016. – Vol. 42. – P. 1-6.
  14. Depression in patients with chronic hepatitis B and cirrhosis is closely associated with the severity of li­ver cirrhosis / H.P. Zhu, Y.R. Gu, G.L. Zhang, Y.J. Su [et al.] // Exp. Ther. Med. – 2016. – Vol. 12, N 1. – P. 405-409.
  15. Depression symptoms reduce physical activity in COPD patients: a prospective multicenter study / I. Due­ñas-Espín, H. Demeyer, E. Gimeno-Santos, M.I. Polkey [et al.] // Int. J. Chron. Obstruct. Pulmon. Dis.– 2016. – Vol. 10, N 11. – P. 1287-1295.
  16. Feldman C. Community-acquired pneumonia: still a major burden of disease / C. Feldman, R.Anderson // Curr. Opin. Crit. Care. – 2016. – Vol. 22, N 5. – P. 477-484.
  17. Incidence and risk factor prevalence of com­munity-acquired pneumonia in adults in primary care in Spain (NEUMO-ES-RISK project) / I. Rivero-Calle, J. Pardo-Seco, P. Aldaz, D.A. Vargas [et al.] // BMC Infect. Dis. – 2016. – Vol. 16, N 1. – P. 645.
  18. Surdea-Blaga T. Depression and anxiety in nona­lcoholic steatohepatitis: is there any association? / T. Sur­dea-Blaga, D.L. Dumitraşcu // Rom. J. Intern. Med. – 2011. – Vol. 49, N 4. – P. 273-280.
  19. The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe / Z.M. Younossi, D. Blissett, R. Blissett, L. Henry [et al] // Hepatology. – 2016. – Vol. 64, N 5. – P. 1577-1586.
  20. The Impact of Age and Comorbidities on the Mortality of Patients of Different Age Groups Admitted with Community-acquired Pneumonia / C.M. Luna, I. Palma, M.S. Niederman, E. Membriani [et al] // Ann. Am. Thorac. Soc. – 2016. – Vol. 13, N 9. – P. 1519-1526.


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