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0Central Asian Journal of
Education and Innovation
SPECIFIC ASPECTS OF PSYCHOEMOTIONAL DISTURBANCES IN FUNCTIONAL DISORDERS OF GASTROINTESTINAL FUNCTION. Rustamov U.T.
Bukhara state medical institute https://doi.org/10.5281/zenodo.11398710
ARTICLE INFO
ABSTRACT
Qabul qilindi: 20-May 2024 yil Ma'qullandi: 25- May 2024 yil Nashr qilindi: 31- May 2024 yil
KEY WORDS
functional disorders of the gastrointestinal tract, depressive disorders, psychodadaptation, melancholic depression.
The study presents information on the prevalence of depressive disorders in patients with functional pathology of the gastrointestinal tract, structural characteristics, nosological relationship and levels of depression depending on the severity of the disease. The prevalence of depression or psychopathological disorders determines the polymorphism of this disease. In our study, severity levels of depression were studied using the HADS-scale.
Sweetness: One of the current problems of gastroenterology is functional disorders of the gastrointestinal tract (GI). The high prevalence of this pathology is associated with the difficulty of differential diagnosis and the insufficient effectiveness of treatment for this category of patients [1, 2]. Research results show that from 30% to 70% of patients referred to gastroenterologists suffer from functional disorders, and almost half of them have mental disorders. It has been determined that there are types [3, 4]. A number of studies have been conducted to study the psychopathological characteristics of patients with gastrointestinal tract pathology, and the types of mental disorders vary in each person according to the severity of the disease and are also related to the number of factors that cause the disease [5], however, the clinical manifestations and structure of comorbid relationships are still not well studied [6, 7]. Increasing patients' enthusiasm for treatment is one of the topical directions of modern medicine [7]. Currently, about 250 factors are known for the treatment of patients with gastric and duodenal diseases, which indicates the complexity of identifying the mental and emotional state of patients with this disease[8]. In our study, there are functional disorders of the gastric and duodenal tract. It consists of monitoring and identifying psychoemotional disorders in our patients according to the severity of the disease. The purpose of the study:
Analyzing the structure and distribution of depressive disorders in functional disorders of the gastrointestinal tract, and studying the effect of matching them.
Materials and methods: An interview was conducted with 89 inpatients treated in the gastroenterology department of the multidisciplinary hospital of Bukhara region. A survey was conducted using sociodemographic data, anamnesis data and a clinical part, which had characteristics of psychopathological syndromes according to the criteria of MKB-10 and DSM-IV. , 34 were men and 55 were women (mean age 42.9 ± 12.9 years). In our study, the
HADS scale created by Hamilton was used to diagnose depression. Results and their discussion
Among the controlled patients, 38.2% were men, 61.8% were women. The group of patients with gastroenterological pathology was dominated by working people (77.5%). Non-working patients made up 22.5%. In 49.3% of employed people, a decrease in adaptation to work (inability to keep pace and rhythm of work, work in different shifts, violation of work discipline) was found.
The origin of social conflicts, for example, loss of previous interests, apathy, lack of initiative, disruption of family relations or conflict, was found in 38.2% of the control subjects. Psychodisadaptive episodes in childhood were identified in 52.8% of patients: organic disorders (headaches, night terrors, sleepwalking, etc.), overestimates (body dysmorphic disorder, neurosis, anorexia), affective disorders (fear, depressive reactions , excitability).59.6% of patients indicated stress as a contributing factor to the occurrence or recurrence of the main disease. Almost all patients had non-specific somatic complaints (loss of appetite, weight loss, weakness, nausea, etc.), which means that they are a serious disease, Most of the time, they were worried about stomach cancer. Multiple types of psycho-emotional disorders were found in 88.4% of patients and double diseases were found in 75.4%. Among the examined patients, symptoms of depressive disorder were found in 78.7% of cases. Severe depression was found in 43.8% of patients, the predominance of severe depression (23.6%) and mild depressive form was found in (11.3%) patients. Patients complained of insomnia (61.8%) and a feeling of suffering. 59.6% of patients indicated stress as a contributing factor to the emergence or recurrence of the main disease. In 52.8% of the observations, complaints of fatigue or loss of energy were found almost every day, and 47.2% of the subjects showed a depressed mood that lasted most of the day and almost every day. 42 of depressed patients, 7% reported weight loss unrelated to the diet. Cognitive disorders were found in 38.2% of patients (decreased ability to think and reason, repeated thoughts about death). In 35.9% of patients with depression, a significant decrease in interest or loss of pleasure in all types of activities was found. In one third of respondents (14.6%), depressive disorders are combined with a sense of their worthlessness and unreasonable guilt. Manifestations of anxiety as part of depression, patients complained of excessive anxiety and worry, anticipation of bad things, restlessness, impatience, irritability, sleep disturbances in the form of frequent awakenings, difficulty falling asleep, obsessive thoughts related to the feeling of impending death. Fear panic disorder increased muscle contractions, the inability to relax, pain and discomfort along the epigastric tract and intestines, a feeling of tension in the abdomen, as well as symptoms from the gastrointestinal system are often the first among the patient's complaints, significantly reducing the quality of life of patients, and the ineffectiveness of treatment with drugs prescribed by the gastroenterologist, positive in the treatment the effect was additionally achieved with the introduction of psychopharmacotherapy. Depressive conditions were combined with phobic (specific, social and agrophobia) and panic disorders in 76.9% of cases. It is worth noting that the reason why the patient was in the hospital for frequent panic attacks was unpleasant sensations from the gastrointestinal tract: (pain or burning sensation behind the sternum, feeling of fullness, swelling in the epigastric area). In patients with functional disorders of the gastrointestinal tract, melancholic or melancholic depression (12.4%) is characterized by depression,
melancholy and feelings of hopelessness. Patients with melancholic depression are indifferent, they are not interested in prescriptions, the results of diagnostic studies, they are not interested in information about their disease. (5.6%) was diagnosed when complaints of unpleasant, painful sensations from internal organs prevailed against the background of vaguely expressed depressive mood. Senestopathic feelings are sometimes focused on a specific content in nature. Patients felt "sudden swelling" in the stomach area, "tremor in the hands", "pain in the throat", "pain in the intestines", often moving along the intestine. International classification characterized by feelings of melancholy and hopelessness. Patients suffering from melancholic depression are indifferent, they are not interested in prescriptions, the results of diagnostic studies, and they are not interested in information about their diseases. Senestoipochondric depression (5.6%) is characterized by the presence of complaints of unpleasant, painful sensations from internal organs against the background of vaguely expressed depressive mood. diagnosed. Senestopathic feelings are sometimes focused on a specific content in nature. Patients felt "sudden swelling" in the stomach area, "tremor in the hands", "pain in the throat", "pain in the intestines", often moving along the intestine. International classification characterized by feelings of melancholy and hopelessness. Patients suffering from melancholic depression are indifferent, they are not interested in prescriptions, the results of diagnostic studies, and they are not interested in information about their diseases. Senestoipochondric depression (5.6%) is characterized by the presence of complaints of unpleasant, painful sensations from internal organs against the background of vaguely expressed depressive mood. diagnosed. Senestopathic feelings are sometimes focused on a specific content in nature. Patients felt "sudden swelling" in the stomach area, "tremor in the hands", "pain in the throat", "pain in the intestines", often moving along the intestine. International classification were not interested in information about their diseases. Senestoipochondriac depression (5.6%) was diagnosed when the complaint of unpleasant, painful sensations from internal organs prevailed against the background of vaguely expressed depressive mood. Senestopathic feelings are sometimes focused on a specific content in nature. Patients felt "sudden swelling" in the stomach area, "tremor in the hands", "pain in the throat", "pain in the intestines", often moving along the intestine. International classification were not interested in information about their diseases. Senestoipochondriac depression (5.6%) was diagnosed when the complaint of unpleasant, painful sensations from internal organs prevailed against the background of vaguely expressed depressive mood. Senestopathic feelings are sometimes focused on a specific content in nature. Patients felt "sudden swelling" in the stomach area, "tremor in the hands", "pain in the throat", "pain in the intestines", often moving along the intestine. International classification According to MKB-10, depressive syndrome occurred within the framework of repeated depression dysthymia (20.5%), depressive episode (7.7%), bipolar affective disorder (5.1%), in 38.5% of cases depressive syndrome with neurotic state, occurred within the framework of stress-related and somatoform disorders (somatized disorder, adjustment disorder, post-traumatic stress disorder). In 7.7% of the studied people, it was found within the framework of organic non-affective psychotic depression disorder. During the study, it was found that despite the prevalence and severity of psychopathological disorders, 62.9% of the respondents never consulted a psychiatrist during their lifetime. 37.1% of patients who consulted a psychiatrist, psychotherapist or psychologist, as a rule, received one consultation
without long-term follow-up. Individuals with low adherence to therapy predominated among the respondents. According to the results of the test, 62.9% of those examined did not meet the requirements, 23.6% of patients were in the risk group, and only 13.5% met the requirements. Summary
Most of the patients with functional disorders of the gastrointestinal tract developed mental health problems during the examination and throughout their lives, and we witnessed neglect and indifference in receiving the necessary recommendations and treatment from psychiatrists and psychotherapists. Most of the respondents suffered from mental disorders. The wide spread and polymorphism of mental disorders in patients with functional gastrointestinal pathology emphasizes the need for long-term observation. helps to improve the quality.
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