Clinical and functional characteristics of the cardiovascular system in patients with paroxysmal atrial fibrillation

Annotation. Atrial fibrillation (AF) is a potentially dangerous heart rhythm disorder that is diagnosed in 2 % of the population. Patients with AF have a five times higher risk of thromboembolic events. The reason for its appearance is stable coronary heart disease, hypertension, cardiomyopathy, hyperthyroidism. However, a review of recent studies suggests that psychological stress may also be a risk factor for AF paroxysm. The aim of the study was to investigate the clinical, psychological and functional characteristics of the cardiovascular system in patients with paroxysmal AF, considering the anxiety and depressive symptoms. The psychometric method combines the use of materials such as: psychosocial scale L. Reeder’s stress and perceived stress-10; hospital scale of anxiety and depression (HADS) to study the presence and level of affective disorders; PHQ-15 health questionnaire to assess somatization disorders; PHQ-9 health questionnaire to detect mental disorders of the non-psychotic register. The statistical processing of the obtained results was subjected to mathematical and statistical analysis using the computer program STATISTIKA-19 and the package of statistical functions of the program “Microsoft Office Excel”, classical methods of variation statistics. The results of the study show that the appointment of mebicar eliminates the manifestations of astheno-vegetative syndrome. Significantly reduces stress, anxiety and depressive symptoms, improves myocardial conduction and increases its contractility, normalizes lipid profile and electrolyte balance. Thus, the addition of mebicar to the standard of care helped to reduce stress and somatization disorders, reduces the score of anxiety and depression, increases the ejection fraction of the left ventricle and potentiates the manifestations of dyslipidemia. The prospect of clinical research is the feasibility of further implementation of the results in clinical practice.

The Role of Culture, Values and Trauma in Shaping Abnormal Bodily Experience in Migrants

The way somatization is expressed—including the actual somatoform symptoms experienced—varies in different persons and in different cultures. Traumatic experiences are intertwined with cultural and social values in shaping the resulting psychopathological phenomena, including bodily experiences. Four ideal-typical cases are presented to show the different levels involved. The effects of trauma, culture and values may be pathofacilitating (creating a social context which is necessary for the experience to take place), pathogenetic (taking a causal role in the onset of the psychopathological reaction), pathoplastic (shaping the form such a psychopathological reaction takes) or pathointerpretive (different interpretation of the same symptoms depending on the patient’s beliefs). While the roles of trauma and culture were already well recognized in previous accounts, this chapter adds an exploration of the importance of values, including cultural values, in the aetiology, presentation and management of somatization disorders. As a consequence, the therapeutic approach has to be adjusted depending on the way these factors intervene in the patient’s construction of mental distress.

Somatization disorders of affective and neurotic registers during the COVID-19 pandemic (analysis of clinical cases)

The COVID-19 coronavirus pandemic has added additional difficulties to the differential diagnostic evaluation of the status of patients with disorders of affective and neurotic registers. In such conditions, the works describing and analyzing specific clinical cases are of considerable interest. The paper describes three clinical cases of somatization mental disorders manifesting themselves during the COVID-19 pandemic, with an account of their history, somatic and mental status, psychopathological classification of the condition, and a rationale for the therapy regimen. Itching, dysuria, and hyperventilation without a somatic basis come to the fore in the clinical picture. These somatic symptoms developing in the pattern of mental disorders of the affective and neurotic registers substantially make the diagnosis, specialized care provision, and medical routing of patients difficult. An integrated psychosomatic approach to clinically evaluating psychopathological disorders that are partially realized in dermatological, urological, and pulmonological spheres, contributes to their adequate diagnosis and effective therapy.

Features of mental disorders and their correction in patients with cardiac pathology

In everyday practice, the doctor rarely encounters only one specific disease, more often a patient with comorbid pathology comes to him. Such a group of concomitant diseases are mental disorders. Their prevalence in cardiology practice reaches 80%. Mood affective, anxiety and somatization disorders, as well as cognitive impairment are observed most often. The review looked at mental disorders that occur in cardiac diseases with the highest number of deaths, such as coronary heart disease, including myocardial infarction and cardiac arrhythmias, arterial hypertension and cerebrovascular diseases. Including attention is paid to the senile asthenia syndrome, which is accompanied by cognitive impairment, loss of previous vital interests and depression. The review highlights the questions of regular and adequate psychopharmacotherapy of cardiovascular diseases, which leads to a statistically significant decrease in the frequency of their exacerbations, which reduces the number of doctors who come to see for somatogenic symptoms, and also allows to improve the prognosis of the underlying disease and significantly reduce mortality. It was observed that the doctor should take into account the fact that modern cardiological preparations have effects that can cause side effects in the form of mental disorders when choosing a therapy. Understanding the processes of formation and occurrence of mental diseases in a patient with cardiovascular pathology, as well as methods for their correction, can increase the effectiveness of the therapy and improve the prognosis of the underlying disease.

Relationship between taking medical care of people infected with COVID-19 and mental health of healthcare professionals

The COVID-19 pandemic induced by the SARS-CoV-2 virus causes huge health burden. It influences physical and mental state of both, people who are infected and those who take care of them. The particularly exposed are healthcare professionals who have direct contact with patients infected with the SARS- CoV-2 virus. Workers belonging to this group especially often report anxiety, fear, mood disorders, frustration, loneliness, low quality of sleep, somatization disorders and phobias. Current efforts of the authorities are focused on preventing and limiting the spread of infection. What is missing, are specific interventions aimed at mental health care of the whole society, including healthcare professionals – doctors, nurses, paramedics, especially exposed to infection due to performed profession.

The problem of somatization disorders: clinical picture, misdirected health encounter, psychoeducation

In a cross-sectional clinical-psychopathological and psychological trial aiming to study the causes of misdirected health encounter of patients with somatization disorders, the analysis of factors contributing to the emergence of «a psychiatrist avoidance behavior» has been conducted. The influence of somatization disorders clinical manifestations, socio-demographic characteristics, information resources, administrative changes in health care service and psychological features has been demonstrated. The necessity to introduce psychoeducational programs in the primary health care setting has been substantiated for: priority specialists for patients with somatization disorders — therapists, neurologists, cardiologists; somatization disorders patients with «a psychiatrist avoidance behavior»; psychiatrists, psychotherapists, clinical psychologists.