Experience in the Use of Psychocorrection Therapy in the Comprehensive Treatment of Patients with Gastroesophageal Reflux Disease Combined with Dysfunction of the Biliary System
Nowadays, due to the rapid increase in the number of stress factors, it is especially important to use psychotherapy and psychopharmacotherapy in the combination treatment of patients with diseases of the gastrointestinal tract. Psychogenic overlaying plays a leading role in the clinical picture of the disease and determines the decreased performance in patients. Objective. To evaluate the effectiveness of therapy with psychocorrective agents in patients with gastroesophageal reflux disease (GERD) associated with dysfunction of the biliary system, if they have depressive and anxiety symptoms. Materials and methods. All patients were divided into 2 groups: group I consisted of 27 patients, who received only basic combination treatment, group II — of 25 patients, who in addition to the basic treatment received thioridazine, which is a piperidine derivative of phenothiazine and belongs to the group of neuroleptics. Both groups were representative by the age, duration and course of the disease. All patients demonstrate anxiety and depressive symptoms on the HADS scale. Questionnaire SF‑36 was used to analyze the quality of life. Treatment efficacy was assessed 14 days after. Results. As a result of the treatment, an improvement in overall well-being was observed in both groups against the background of reduction in the pain and dyspeptic syndromes. Additional prescription of psychocorrectives (thioridazine) to the basic therapy results in greater positive changes in the intensity of anxiety and depressive symptoms. The distribution of patients by the level of anxiety and depression after treatment showed that these indicators were absent more often in group II (by 2.6 and 1.5 times, respectively). However, cases of clinically significant anxiety and depression were 4.6 and 3.7 times more often in patients, who did not receive thioridazine. The difference in points between the level of anxiety and depression before and after the treatment was 4 times higher in patients, who additionally received psychocorrection. Also, comparing scores before and after the treatment, we have found significant improvement in the quality of life in group II. Conclusion. The inclusion of thioridazine into the basic therapy in the presence of depressive and anxiety disorders in patients with GERD associated with dysfunction of the biliary system improves the clinical effectiveness of pharmacotherapy of this comorbid pathology.
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Nojkov B. The influence of co-morbid IBS and psychological distress on outcomes and quality of life following PPI therapy in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther, 2008, no. 27, pp. 473-482.
Odintsova V.V. Features of emotional sphere of patients gastroenterological profile. Vestnik St. Petersburg State University, 2012, vol. 12, no. 9, pp. 36-39. (In Russ.).
Mizyed I., Fass S.S., Fass R. Review article: gastro-oesophageal reflux disease and psychological comorbidity. Aliment. Pharmacol. Ther, 2009, no. 29, pp. 351-358.
Sidorov P.I. Novikov I.A. Psychosomatic diseases: concept, prevalence, quality of life, medical and social assistance to patients. [electronic resource] Medical psychology in Russia: the electron. scientific. zh. 2010; 1. URL: http: // medpsy.ru (reference date: 30.08.2016). (In Russ.).
Plotnikov E.Y., Seledtsov A.M., Shamrai M.A. Psychosomatic aspects of gastroenterology. Therapist, 2012, no. 10, pp. 44–49. (In Russ.).
Zimmerman Y.S. Gastroenterologiya. depressivniy syndrome v gastroenterologii [Gastroenterology. Depressive syndrome in gastroenterology]. Moscow, GEOTAR-Media, 2012, 799 p.
Kosinskaya S.V. Objectification of anxiety and depressive disorders and rationale destination of their correction in patients with gastrointestinal profile. Gastroenterology: zbіrnik of naukova articles, no. 4(50), pp. 13-17. (In Ukraine).
Abilov K.U. Clinical features of psychogenic disorders in patients with gastroesophageal reflux disease. Neurosurgery and neurology of Kazakhstan, 2010, no. 2, 3 (15, 16), pp. 182-183. (In Kazakhstan)
Zigmond A.S., Snaith R.P. HADS Scale. Available at: http://paracels55.ru/_ld/0/2_HADS_SR_Scale.pdf (accessed 05.09.2015).
Ware J.E. The SF-36 Health Survey. Available at: http://www.rand.org/health/surveys_tools/mos/36-item-short-form/survey-instrument.html (accessed 15.08.2015).
Cheganov A.V. Shevchenko V.V. Experience with the drug Polisorb MP in patients with viral liver cirrhosis. Doctor, 2010, no. 2, pp. 54-56.
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