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y^K 616.89-02:616.43
Askarova K.I. assistant
Scientific advisers: Agranovsky M.L., MD, professor
Muminov R.K. senior lecturer Saliev M.M. assistant Azimova G.A. assistant
Andijan State Medical Institute Department of Psychiatry and Addiction MENTAL DISORDERS IN THE CLINIC OF ENDOCRINE DISEASES
Resume: Depression affects virtually all spheres - emotional, intellectual, strong-willed and necessarily motivational, which is manifested as subjective in the patient's complaints, and objectively - in behavior change. A persistent decline in mood during depression is combined with a loss of interest in what was previously perceived by the patient as attractive, satisfying or joyful - various forms of leisure, communication, reading books, hobbies, professional activities, sex life, etc.
Key words: depression, endocrine disorders, intellect, behavior, patient.
Relevance. With depression, virtually all areas are affected - emotional, intellectual, strong-willed and necessarily motivational, which is manifested as subjective in the patient's complaints, and objectively - in changing behavior [3,5,7]. A persistent decline in mood during depression is combined with a loss of interest in what was previously perceived by the patient as attractive, bringing satisfaction or joy - various forms of leisure, communication, reading books, hobbies, professional activities, sex life, etc. Not only does the feeling of satisfaction result such activities. A patient suffering from depression has no motivation, no desire to start this activity, and interest in activity itself is replaced by indifference and irritation [1,2,4,9]. In all types of depressive state, primary biological motivations -food, disturbed appetite, sexual function, disturbed sleep. The degree of these disorders depends, as a rule, on the severity of the depressive state [6,8].
The purpose of the study: to study endocrine dysfunction in depressive states.
Materials and methods. To solve the tasks, 39 people with depression were examined at the inpatient examination and treatment in the psychosomatic department of the Andijan Regional Psychoneurological Dispensary. Criteria for inclusion in the study: patients (men and women over 18 years) with depressive diseases with endocrine dysfunctions.
Results of the study: As shown, analysis with depression, more often a decrease in appetite, which is accompanied by a decrease in body weight. In 5 (12.8%) patients anorexia and malnutrition were noted, these disorders so often accompany depression that are considered one of its obligatory signs and are
included as criteria for diagnosing depression and practically in all known questionnaires. Anorexic reactions in depressed patients had a number of distinctive features. As a rule, there was not only a decrease in appetite or lack of it, but often the food became tasteless or disgusted. Anorexia led to a sharp reduction in the amount of food and weight loss. Anorectic manifestations are closely related to the intensification of other manifestations of depression and are most pronounced in the morning.
Anorexia nervosa mostly affected the girl. The peak incidence fell on adolescence and adolescence. The main signs of the disease were a decrease in body weight of more than 15% of the original, a painful conviction in its own fullness, even despite a low mass, amenorrhea. With depression, there was rarely a significant deficit in body weight, as in anorexia nervosa, and concomitant metabolic, expressed endocrine, cardiovascular and other disorders requiring special correction. In 8 (20.5%) patients, there was an increase in appetite and bulimia. As a rule, bulimia was combined with a lack or decrease in satiety and leads to an increase in body weight and obesity.
The study showed that the sexual function has an important biological and social significance, since it not only ensures the continuation of the genus and the receipt of specific sexual sensations, but also opens the possibility of creating a family, eliminating loneliness.
In 14 (36%) young women, depression led to various violations of the menstrual cycle: dysmenorrhea, amenorrhea, the emergence of anovulatory cycles and, ultimately, even infertility. With a detailed gynecological and endocrinological examination, such women, as a rule, did not find convincing reasons for the violation of menstrual function. In these cases, you need to think about the possibility of depression and conduct an appropriate study. These violations are obligatory accompanied by a violation of sexual desire and frigidity.
The syndrome of affective disorders with dysfunction of the gonads is a syndrome of premenstrual tension. It was found in severe form in about 10% of women and had a number of synonyms - premenstrual dysphoric disease or late luteal dysphoric phase. Clinical symptoms usually appear 7-10 days before the onset of another menstruation and disappears with its onset. There is a depressed mood, irritability, fatigue, reduced efficiency, resentment, aggressiveness, hostility. The main role in the pathogenesis of the premenstrual tension syndrome is played by sex hormones: estrogens, progesterone, and serotonin. They have a modulating effect on the functioning of the central nervous system; it is with serotonin deficiency and the violation of the ratio of estrogens and progesterone to the luteal phase of the cycle that the appearance of clinical symptoms in the premenstrual tension syndrome is associated.
It should be noted that the depressive state has a close relationship with the menopause, and other signs of depression may appear or worsen against the background of hormonal restructuring of the female body and successfully carried out hormonal therapy can lead to a decrease in the severity of mental disorders. Among the studied depression was observed in 5 (12.8%) climacteric patients. In
the climacteric period, a significant role in the deterioration of the emotional state, have changes in the hormonal status of women, as hormones affect mental processes, the functional state of the brain, alter interhemispheric relationships. These women showed affective disorders in the form of decreased mood, anxiety, tearfulness and vegetative disorders: sweating, a feeling of heat, palpitations, a quickening of the pulse. It is the depressive state that can cause the pathological course of menopause.
In 7 (17.9%) patients with depression, sleep disturbances are observed. In some patients, they were the leading complaint, while in others they were noted, among other clinical symptoms characteristic of depression. The relationship between sleep disorders and depression is extremely close: the presence of persistent sleep disorders always serves as the basis for excluding the latent, larval depression that manifests itself under the guise of these disorders. Clinical manifestations of sleep disorders in depression have a number of characteristic features.
Conclusion: In depressive states, alongside obligate symptoms of depression, there are symptoms of endocrine dysfunctions, which also have important diagnostic value.
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