对遗传性乳腺癌相关基因突变携带者的心理支持

L. D. Firsova, V. Ogarev, A. Kanatbek kyzy, N. V. Romashkina, T. Yanova, A. Danishevich, N. Bodunova
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摘要

的相关性。告知患者携带致病突变可能导致心理创伤,其特征是急性应激反应、创伤后应激障碍症状或焦虑抑郁障碍。这突出了心理咨询的重要性。探讨心理支持对遗传性乳腺癌相关基因突变患者的有效性。材料和方法。描述患者的病史和通过基因检测确定CHEK2基因致病性突变后的工具心理诊断结果,该突变使患乳腺癌的风险增加到20 - 40%。在这种情况下,情绪反应的性质是由个人历史决定的——将自己可能患有的疾病与母亲的疾病相一致。进行的心理咨询减轻了急性应激反应,并最大限度地减少了接受遗传信息作为心理创伤事件的感知。此外,在适应性压力评估策略的形成、对自身心理资源的认识以及对动态观察计划的依从性的强化方面,观察到显著的正向变化。结论:在涉及鉴定与遗传性乳腺癌相关基因突变的情况下,患者需要个性化的方法。制定心理支持标准的目的不仅是在信息披露后立即改善患者的生活质量,而且要长期改善患者的生活质量。
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Psychological support for carriers of mutations in genes associated with hereditary breast cancer
Relevance. Informing patients about the carriage of a pathogenic mutation may result in a psychologically traumatizing situation, characterized by acute stress reactions, post-traumatic stress disorder symptoms, or anxiety-depressive disorder. This highlights the importance of psychological counseling.Objective. To investigate the effectiveness of psychological support in a patient with mutations in genes associated with hereditary breast cancer.Materials and methods. Description of patient's medical history and results of instrumental psychological diagnosis after identifying a pathogenic mutation in the CHEK2 gene, which increases a risk of developing breast cancer to 20–40 % via genetic testing.Results. The nature of emotional response in this case is determined by personal history — identification of ideas about one's possible disease with mother's one. The conducted psychological consultations mitigated acute stress reactions and minimized the perception of received genetic information as a psychologically traumatic event. Furthermore, significant positive shifts were observed in the formation of adaptive stresscoping strategies, awareness of one's own mental resources, and reinforcement of adherence to the dynamic observation plan.Conclusion: Patients in situations involving the identification of mutations in genes associated with hereditary breast cancer require a personalized approach. Development of criteria for psychological support should be aimed at improving patients' quality of life not only in the immediate aftermath of information disclosure but also in the long term.
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