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