十二指肠溃疡患者的神经心理学和心理测量参数取决于幽门螺杆菌的存在情况

O.V. Tkachenko, O. Demydas, O. Kononets, L.Yu. Lichman
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To study psychometric and neuropsychological characteristics, the patients were comprehensively tested, in particular using the Beck Depression Inventory for evaluating the severity of depression, the State-Trait Anxiety Inventory for assessing separate dimensions of state and trait anxiety, the Well-being, Activity, Mood (WAM) questionnaire, the Mini-Mental Health Examination for screening cognitive function, the Schulte tables for evaluating the refocusing speeds and performance distribution. Results. The level of depression in H.pylori-positive duodenal ulcer was significantly higher than with H.pylori-negative duodenal ulcer (p < 0.05). The patients from the group 1 had higher scores of state and trait anxiety and the lower ones of the functional state. The concentration of attention detected by means of the Schulte tables was lower in these patients. A direct correlation was found between the degree of depressive disorders and the number of complaints associated with psycho-emotional disorders in the patients with duodenal ulcer (r = 0.61). We found an inverse correlation (p < 0.05) between the anxiety level and the WAM indices, on the one hand, and between depressive disorders and the WAM indices, on the other hand, in the patients with duodenal ulcer. Depression and anxiety were comorbid in 73.3 % of cases in the group 1 and in 30 % of cases in the group 2. Conclusions. The complaints associated with psycho-emotional disorders occurred in the patients with both H.pylori-positive and H.pylori-negative duodenal ulcer; however, they were more frequent in the group 1. The clinical presentations of depression were observed in both groups, but the depression level was significantly higher in the patients with H.pylori-positive duodenal ulcer (p < 0.05). An increase in anxiety was also found in both groups; however, the rates of state and trait anxiety were higher in the group 1. At duodenal ulcer exacerbation, no matter if H.pylori infection was present or not, the patients had unsatisfactory well-being, low activity, and poor mood. The decreased indices of the functional state self-assessment were detected in the group with H.pylori-positive duodenal ulcer. Using the Schulte tables, we found that a decrease in attention concentration was more evident in the group 1 that in the patients with H.pylori-negative duodenal ulcer. Thus, having conducted the neuropsychological and psychometric testing, we conclude that H.pylori infection has not been the main cause of psycho-emotional disorders in duodenal ulcer, but if the patients were infected, the dysfunction was more severe. 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引用次数: 0

摘要

研究背景目的是研究十二指肠溃疡患者幽门螺杆菌(H.pylori)对神经心理学和心理测量评分的影响。材料和方法。我们对 60 名年龄在 25-60 岁(平均 39.80 ± 1.29)的十二指肠溃疡患者进行了全面的临床、神经学、神经心理学和心理测量学检查。根据是否检测到幽门螺杆菌感染(第 1 组)将所有患者分为两组(第 2 组)。对照组包括 30 名表面健康、无躯体异常的人。为了研究心理计量学和神经心理学特征,对患者进行了全面测试,特别是使用贝克抑郁量表评估抑郁的严重程度,使用状态-特质焦虑量表评估状态焦虑和特质焦虑的不同维度,使用幸福、活动、情绪(WAM)问卷,使用小型心理健康检查筛查认知功能,使用舒尔特表评估重新集中注意力的速度和表现分布。结果显示幽门螺杆菌阳性十二指肠溃疡患者的抑郁程度明显高于幽门螺杆菌阴性十二指肠溃疡患者(P < 0.05)。第 1 组患者的状态和特质焦虑得分较高,而功能状态得分较低。这些患者通过舒尔特表检测到的注意力集中程度较低。在十二指肠溃疡患者中,抑郁障碍程度与心理情绪障碍相关主诉数量之间存在直接相关性(r = 0.61)。我们发现,十二指肠溃疡患者的焦虑程度与 WAM 指数之间以及抑郁障碍与 WAM 指数之间存在反相关关系(p < 0.05)。在第一组和第二组中,分别有 73.3% 和 30% 的病例合并有抑郁和焦虑。结论幽门螺杆菌阳性和幽门螺杆菌阴性十二指肠溃疡患者都会出现与心理情绪失调相关的主诉,但这些主诉在第一组中更为常见。两组患者都出现了抑郁的临床表现,但幽门螺杆菌阳性十二指肠溃疡患者的抑郁程度明显更高(p < 0.05)。在十二指肠溃疡加重时,无论是否存在幽门螺杆菌感染,患者的幸福感都不尽人意,活动量少,情绪低落。幽门螺杆菌阳性的十二指肠溃疡患者的功能状态自我评估指数有所下降。通过使用舒尔特表,我们发现幽门螺杆菌阴性十二指肠溃疡患者的注意力集中程度在第一组中下降得更为明显。因此,在进行了神经心理学和心理测试后,我们得出结论:幽门螺杆菌感染并不是十二指肠溃疡患者心理情感障碍的主要原因,但如果患者受到感染,其功能障碍会更加严重。幽门螺杆菌感染增加了患者的心理情绪主诉频率,恶化了患者的幸福感,增加了焦虑和抑郁障碍的程度。
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Neuropsychological and psychometric parameters in the patients with duodenal ulcer depending on Helicobacter pylori presence
Background. The purpose was to study the effect of Helicobacter pylori (H.pylori) in duodenal ulcer on the neuropsychological and psychometric scores. Materials and methods. We conducted a comprehensive clinical, neurological, neuropsychological, and psychometric examination of 60 patients with duodenal ulcer aged 25–60 (the mean of 39.80 ± 1.29) years. All of them were divided into two groups considering whether H.pylori infection was detected (group 1) or not (group 2). The control group included 30 apparently healthy individuals with no somatic abnormalities. To study psychometric and neuropsychological characteristics, the patients were comprehensively tested, in particular using the Beck Depression Inventory for evaluating the severity of depression, the State-Trait Anxiety Inventory for assessing separate dimensions of state and trait anxiety, the Well-being, Activity, Mood (WAM) questionnaire, the Mini-Mental Health Examination for screening cognitive function, the Schulte tables for evaluating the refocusing speeds and performance distribution. Results. The level of depression in H.pylori-positive duodenal ulcer was significantly higher than with H.pylori-negative duodenal ulcer (p < 0.05). The patients from the group 1 had higher scores of state and trait anxiety and the lower ones of the functional state. The concentration of attention detected by means of the Schulte tables was lower in these patients. A direct correlation was found between the degree of depressive disorders and the number of complaints associated with psycho-emotional disorders in the patients with duodenal ulcer (r = 0.61). We found an inverse correlation (p < 0.05) between the anxiety level and the WAM indices, on the one hand, and between depressive disorders and the WAM indices, on the other hand, in the patients with duodenal ulcer. Depression and anxiety were comorbid in 73.3 % of cases in the group 1 and in 30 % of cases in the group 2. Conclusions. The complaints associated with psycho-emotional disorders occurred in the patients with both H.pylori-positive and H.pylori-negative duodenal ulcer; however, they were more frequent in the group 1. The clinical presentations of depression were observed in both groups, but the depression level was significantly higher in the patients with H.pylori-positive duodenal ulcer (p < 0.05). An increase in anxiety was also found in both groups; however, the rates of state and trait anxiety were higher in the group 1. At duodenal ulcer exacerbation, no matter if H.pylori infection was present or not, the patients had unsatisfactory well-being, low activity, and poor mood. The decreased indices of the functional state self-assessment were detected in the group with H.pylori-positive duodenal ulcer. Using the Schulte tables, we found that a decrease in attention concentration was more evident in the group 1 that in the patients with H.pylori-negative duodenal ulcer. Thus, having conducted the neuropsychological and psychometric testing, we conclude that H.pylori infection has not been the main cause of psycho-emotional disorders in duodenal ulcer, but if the patients were infected, the dysfunction was more severe. It was subject to the increased frequency of psycho-emotional complaints, the deterioration in the patients’ sense of well-being, the increased levels of anxiety and depressive disorders.
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