Clinical and psychopathological features of course and correction of depressive disorders in patients with brain tumors, prevention and rehabilitation

V. Ogorenko, A. Kyrychenko, O. Hnenna
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Abstract

The article studys the psychological characteristics in patients with brain tumors of different localization which allows to reduce the diagnostic period and, as a result, minimize the time of early detection and the consequences of the surgical treatment of this pathology, and to cause a positive effect on preventing the development of psychopathological disorders at the hospital stage. Analysis of the clinical manifestations of depressive disorders of the subclinical level revealed their polymorphism: depression was accompanied by various variants of asthenic (prevalence of dyssomnias, psychalgia, adynamia and anxiety component) and anxiety (prevalence of senestopathies, hypochondria, phobia) states. The revealed symptom complexes of psychopathological and pathopsychological characteristics of the patient's condition were the clinical justification for the choice of methods of psychotherapeutic correction. Adjuvant psycho­logical therapy, individual rational and family psychotherapy were used as the basic method of psycho­therapeutic influence. Pharmacological correction included: anxiolytics, antidepressants, atypical mild antipsychotics in low doses. The results of the SCL-90-R test demonstrate the effectiveness of the comprehensive treatment aimed at preventing and reducing the manifestations of psychopathological symptoms. Comparison of the mean values of the SCL-90-R test revealed significant differences in such indicators as somatization (p<0.05), depressiveness (p<0.01), anxiety (p<0.05); high statistical significance is noted in the “index of symptom severity” integral indicator (p<0.01). Obtained results of psychological and psychiatric research became the basis for the development of differential diagnostic criteria for the diagnosis and prevention of the development of mental disorders.
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脑肿瘤患者抑郁症的临床和精神病理特点、病程及纠正、预防与康复
本文研究了不同定位脑肿瘤患者的心理特点,缩短了诊断周期,从而最大限度地减少了该病理的早期发现时间和手术治疗的后果,对预防医院阶段精神病理障碍的发展产生了积极的作用。亚临床水平抑郁症的临床表现分析显示其多态性:抑郁症伴有各种衰弱状态(睡眠障碍、精神痛、动力不足和焦虑成分)和焦虑状态(感觉障碍、疑病症、恐惧症)的变体。所揭示的精神病理和病理心理特征的症状复合体是选择心理治疗矫正方法的临床依据。辅助心理治疗、个体理性治疗和家庭心理治疗是心理治疗影响的基本方法。药物矫正包括:抗焦虑药、抗抑郁药、非典型轻度低剂量抗精神病药。SCL-90-R测试结果证明了以预防和减少精神病理症状表现为目的的综合治疗的有效性。SCL-90-R测验均值比较,躯体化(p<0.05)、抑郁(p<0.01)、焦虑(p<0.05)指标差异有统计学意义;“症状严重程度指数”积分指标有较高的统计学意义(p<0.01)。获得的心理学和精神病学研究成果成为制定诊断和预防精神障碍发展的鉴别诊断标准的基础。
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