CC BY
2
УДК 616-036.21.89-008.19
Mirzaev A.A.
Agranovsky M.L.
Kozimzhonova I.F.
Muminov R.K. department of psychiatry and narcology Andijan State Medical Institute
THE COURSE OF MENTAL COMPLICATIONS IN THE CORONAVIRUS PANDEMIC AND A MODERN APPROACH TO
THEIR PREVENTION
Resume: In recent decades, there has been a lot of talk in the health sector about non-communicable diseases, obesity, nicotine addiction, the swine flu pandemic, which went unnoticed by the public 10 years ago. In this regard, such a large-scale pandemic of viral infection, which often leads to death, has become unlikely to cause much concern among the population, and in some cases reaches the level of panic About people are inextricably linked with socioeconomic deficits with diseases with a high burden, so those countries that you know from a high standard of living in studies of a socio-cultural society with diseases with a high burden, that the degree of negative infection is considered historical. This article discusses the mental complications of coronavirus infection and the specifics of their rejection characteristics.
Keywords: pandemic, coronavirus, prevention, complications.
Relevance. Mental disorders and complications in the coronavirus pandemic are the most vulnerable group of the population to isolation. The conditions of such a pandemic can lead to their recurrence in the form of an enhanced mental disorder [4].
In the context of the coronavirus pandemic, this is especially relevant for patients with affective complications, personality pathology, anxiety and neurotic disorders (obsessive-compulsive, panic and general anxiety, somatoform, dissociative and phobic disorders) and chronic psychoses, including schizophrenia [2]. During the pandemic period, which began in December 2019, it is obvious that many patients are experiencing difficulties in obtaining timely advice due to restrictive travel measures and a high risk of infection. Patients receiving inpatient treatment have a much higher risk of infection because they are in a confined space where the virus spreads quite quickly. This fact is confirmed by the experience of psychiatric clinics in China and Italy [1,5]. Low compliance, poor-quality self-isolation regime of hygiene rules [3,6] causes violations and neglect of less critical attitude towards mentally ill patients, increases the risk of infection with the virus and can worsen the course of the disease.
It should be noted separately that the authors of domestic [7] and foreign [2,7] note difficulties in the treatment of patients with mental disorders with COVID-19. A sufficient number of psychotropic drugs, in addition to their main action, can cause various side effects and complications. The range of effects on the somatic state is very wide: from orthostatic hypotension, intestinal and bladder atony to cardiotoxic effects and sudden coronary death. As can be seen, when prescribing / continuing treatment of a mental disorder in patients with coronavirus, it is necessary to take into account the full range of possible effects on the somatic state, as well as interactions (and their consequences) between psychotropic drugs and drugs used for the treatment of COVID-19.
The purpose of the study. The aim of the study is to study the features of COVID-19 infection and identify factors associated with mental complications, the course and unfavorable prognosis of covid-19 in this category of patients.
Materials and methods of research. To complete the task, we selected 80 patients with COVID-19 infection who had mental complications as a result, and conducted examinations on them.
The results of the study. The study of the psychological consequences of the coronavirus epidemic in our examined patients showed that more than half of the respondents, that is, 53.8%, rated them as moderate or severe, in the group of patients who examined this condition, practice strengthened confidence in the qualifications of doctors, and reports of successful recovery can be identified as protective factors.
As a result of our survey, it is worth noting one of the mental complications during the pandemic - the adaptive function of anxiety, the experience of this threat makes a person look for ways to solve problems, change their habitual behavior.
Based on literature data, in a large Internet survey conducted at the beginning of the pandemic, an increase in the level of psychological stress was associated with self-isolation, social remote use and the use of antiseptics. Psychotherapy in this contingent should be aimed at accepting its limitations and understanding that compliance with restrictions can significantly reduce the risk of infection, even if our chances of preventing mental disorders and complications with them in patients who have passed the examination do not eliminate it completely,
As a result of our treatment of these cases, gradually, as the incidence decreased, the experience of anxiety shifted to the pressing problems of post-quarantine life. Thus, a study conducted in the USA, Great Britain and Israel [6] compared the intensity of anxiety experiences associated with health problems, economic well-being, changes in the usual rhythm of life and social isolation, showing a significant predominance of material well-being and health problems compared to other experiments, despite the fact that the study was conducted in relatively economically developed countries. If moderate anxiety has a
mobilizing effect on a person, then excessive anxiety significantly worsens cognitive activity and problem-solving behavior [1,7].
In the case of increased anxiety tension in patients of our main group, the balance in the interaction of the stress-tolerant and stress-limiting systems of the body was disturbed, anxiety became a source of adaptive disorders, and we found that such patients need soothing therapy. To help our patients in this group quickly overcome cases of anxiosis, the first series of drugs were tranquilizers, the action of which was aimed at GABAergic transmission. Considering that Gamma-aminobutyric acid (GABA) is the main mediator of the stress-limiting system, they can be considered agents with a pathogenetic mechanism of action. They enhance the inhibitory effect of gabaergic attachment neurons to the structures of the amygdala of the brain (produce a response signal) and prevent the release of glutamate.
Conclusions. Increased stress as a mental complication during the coronavirus pandemic is a factor contributing to a decrease in immunity, which makes a person more susceptible to COVID-19 infection. In our examined patients, we can observe the development of various psychopathological conditions that arise due to stress associated with a new coronavirus infection.
In this regard, in the prevention and treatment of these conditions, it is necessary to avoid prescribing psychotropic drugs without supervision and, first of all, seek psychiatric and psychotherapeutic help aimed at reducing stress and normalizing the patient's condition, as well as conduct public campaigns aimed at raising public awareness and reducing the overall stress level.
References:
1. Melnikova E.V., Ivanova G.E. // Bulletin of restorative medicine. 2020. No. 97 (3). pp. 105-109.
2. Solovyova N.V., Makarova E.V., Kichuk I.V. "Coronavirus syndrome": prevention of psychotrauma caused by COVID-19 // RMZH. 2020. No. 9. pp. 18-22.
3. Opekina T.P., Shipova N.S. Family during self-isolation: stresses, risks and opportunities coping // Bulletin of Kostroma State University. Series: Pedagogy. Psychology. Sociokinetics. 2020. Vol. 26. No. 3. pp. 121-128.
4. Consequences of COVID-19 for the mental health of society: problem statement, main directions of interdisciplinary research / A.I. Tsvetkov [et al.] // Ural Medical Journal. 2020. No. 6 (189). pp. 95-101.
5. Bavel J.J., Baicker K., Boggio P.S., et al. Using social and behavioural science to support COVID-19 pandemic response. Nat. Hum. Behav, 2020, vol. 4, pp. 460-471.
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7. Zhang J., Lu H., Zeng H., et al. The differential psychological distress of populations affected by the COVID-19 pandemic. Brain Behav Immun, 2020, vol. 87, pp. 49-50.
