Comprehensive therapy of gastroesophageal reflux disease combined with anxiety-depressive states in antiterrorist operation participants

G.V. Osyodlo, M.V. Radushynska, V.G. Gurianov

Abstract


Background. The purpose was to establish the incidence and severity of anxiety-depressive disorders in antiterrorist operation (ATO) participants with different clinical endoscopic forms of gastroesophageal reflux disease (GERD) and to evaluate the effect of psychocorrecting drugs in their additional prescription. Materials and methods. To evaluate mental state of 108 militaries, male participants of АТО, on the first day of the general clinical examination, the Hospital Anxiety and Depression Scale was used for grading anxiety and depression. As a psychocorrecting agent, sulpiride and fluoxetine were chosen. Results. Psychoemotional disorders were detected in 108 (100 %) militaries, АТО participants. The asthenoneurotic syndrome was diagnosed in 14 (35 %) patients with non-erosive reflux disease and in 28 (41.2 %) — with erosive form of GERD, anxiety-depressive syndrome was diagnosed in 26 (65 %) servicemen with non-erosive reflux disease and 40 (58.8 %) patients with erosive GERD. The analysis did not reveal a correlation between treatment efficacy in patients with GERD when ­using both sulpiride (p = 0.87) and fluoxetine (p = 0.40). It has been found that the use of fluoxetine reduces (p = 0.02) the risk of not achieving the effect: from 38.2 % (95% confidence interval (CI) 22.3–55.6 %) in the treatment with sulpiride to 9.1 % (95% CI 1.7–21.6 %) when using fluoxetine. Conclusions. Comprehensive standard therapy with correction of psychoemotional manifestations allows improving the treatment of GERD, contributes to a more rapid regression of clinical manifestations. Comparison of the clinical efficacy of the additional use of psychotropic drugs showed the advantages of fluoxetine (risk ratio = 0.24 (95% CI 0.07–0.76)) compared with sulpiride.


Keywords


gastroesophageal reflux disease; militaries; structure; clinical course

References


Zygalo EV, Demeshkina LV, Starykova LM, et al. Features of psychosomatic disorders depending on the state of autonomic homeostasis in patients with gastroesophageal reflux disease. Aktual'ni pytannja medychnoi' nauky ta praktyky: zbirnyk naukovyh prac' Zaporiz'koi' medychnoi' akakdemii' pisljadyplomnoi' osvity MOZ Ukrai'ny. 2015;82(1.2):207-210. (in Ukrainian).

Kosinskaya SV. Objectification of anxiety and depressive disorders and substantiation of their correction in gastroenterological patients. Gastroenterologìa. 2013;(50):13-17. (in Ukrainian).

Liakh IuE, Gur'ianov VG, Khomenko VN, Panchenko OA. Osnovy komp'iuternoi biostatistiki: analiz informatsii v biologii, meditsine i farmatsii statisticheskim paketom Medstat [Fundamentals of computer biostatistics: analysis of information in biology, medicine and pharmacy by statistical package Medstat]. Donetsk: Papakitsa EK; 2006. 214 p. (in Russian).

Mosiichuk LM, Demeshkina LV, Kushnirenko IV, Zavialova IYu. Psychological dysadaptation in patients with gastroesophageal reflux disease: review and own researches. Gastroenterologìa. 2014;(54):23-29. doi: 10.22141/2308-2097.4.54.2014.82000. (in Ukrainian).

Os'odlo GV, Kalashnikov MA, Radushyns'ka MV. Possibilities of rapid assessment of the mental state of patients with gastroenterological profile using the hospital scale of anxiety and depression (HADS). In: Proceeding of the International Congress on Man and Drugs. 2015 September 10-11; Kyiv, Ukraine. Kyiv; 2015. 43-44 pp. (in Ukrainian).

Radushyns'ka MV. Interrelation of gastroesophageal reflux disease and anxious-depressive states among participants in antiterrorist operation. Problemy vijs'kovoi' ohorony zdorov'ja : zbirnyk naukovyh prac' Ukrai'ns'koi' vijs'kovo-medychnoi' akademii' Ministerstva oborony Ukrai'ny. 2016;45(1):240-243. (in Ukrainian).

Stepanov JuM, Mosijchuk LM, Demeshkina LV. Likuvannja pacijentiv z gastroezofageal'noju refljuksnoju hvoroboju ta hronichnym gastrytom z urahuvannjam psyhoemocijnyh rozladiv: metodychni rekomendacii' [Treatment of patients with gastroesophageal reflux disease and chronic gastritis with regard to psychoemotional disorders: methodological recommendations]. Dnipro, 2017. 8-23 pp. (in Ukrainian).

Syropjatov OG , Dzeruzhinskaja NA. Tehniki psihoterapii pri posttravmaticheskih stressovyh rasstrojstvah: prakticheskoe posobie [Techniques of psychotherapy for post-traumatic stress disorders: a practical guide]. Odessa; 2015. 278 p. (in Russian).

Syropjatov OG , Dzeruzhinskaja NA. Klinicheskaja fenomenologija psihosomatiki: posobie dlja vrachej i psihologov [Clinical phenomenology of psychosomatics: a manual for doctors and psychologists]. Kyiv: Poligraf pljus; 2016. 96 p. (in Russian).

Cimmerman JaS. Depressive syndrome in gastroenterology. In: Cimmerman JaS. Gastrojenterologija: rukovodstvo [Gastroenterology: a guide]. Moscow: GEOTAR-Media; 2012. p. (in Russian).

Kim JY, Kim N, Seo PJ, et al. Association of sleep dysfunction and emotional status with gastroesophageal reflux disease in Korea. J Neurogastroenterol Motil. 2013 Jul;19(3):344-54. doi: 10.5056/jnm.2013.19.3.344.

Chou PH, Lin CC, Lin CH, et al. Prevalence of gastroesophageal reflux disease in major depressive disorder: a population-based study. Psychosomatics. 2014 Mar-Apr;55(2):155-62. doi: 10.1016/j.psym.2013.06.003.




DOI: https://doi.org/10.22141/2308-2097.52.2.2018.132610

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