IntroductionUnder contemporary social circumstances, there is a tendency to increasing of amount of persons disposed to addictive behavior (AB) as a mean to remove psychoemotional tension and to solve their significant problems. This tendency raises in patients with neurotic disorders (ND) that influences on clinical manifestations of the pathology and impedes diagnosis and timely care for this category of patients.AimTo investigate AB in the structure of neurotic disorders (F44.7, F40.8, F48.0).MethodsAssessment of personal addictive status with AUDIT-like tests to detect disorders related to substance and non-substance abuse; 109 patients with ND (main group) and 52 persons without ND (control group) were examined.ResultsIt was revealed that patients with ND had significantly higher risk of AB formation (59.73% compared with 21.15% in healthy persons; P < 0.0001). According to the group comparison, in patients with ND levels of AB expression on parameters of “Job” (12.06 points), “Food” (11.98 points), “Internet” (11.10 points), “TV” (8.82 points), “Shopping” (6.59 points) were significantly higher than in healthy persons (9.73; 9.23; 9.00; 7.38; 4.25 points, respectively; P < 0.05). However, levels of keenness on computer were significantly higher in healthy persons (3.48 points) than in patients with ND (2.34 points; P < 0.05). AB connected with substance abuse was not registered in the groups.ConclusionsThe results suggest that the patients use AB in forms of food, Internet, job, TV, shopping dependencies as a subconscious mechanism substituting unsatisfied needs and decreasing motivation-emotional tension under conditions of a frustration conflict.Disclosure of interestThe authors have not supplied their declaration of competing interest.
доктор юридичних наук, доцент Міжвідомчого науково-дослідного центру з проблем боротьби з організованою злочинністю при Раді національної безпеки і оборони України М. М. Денисенко orcid.org/0000-0002-8212-8264 ка ндидат юридичних наук, докторант відділу аспірантури і докторантури Національної академії Служби безпеки України
Мета: визначити клінічні особливості та закономірність формування неврастенії з підвищеним ризиком адиктивної поведінки.Матеріали та методи: клініко-психопатологічне дослідження; система AUDIT–подібних тестів для комплексної оцінки адиктивного статусу; клінічний опитувальник для виявлення та оцінки невротичних станів.Результати. Таким чином, за результатами проведеного дослідження пацієнтів з неврастенією що поєднана з адитивними порушеннями, характеризує затяжний тип формування невротичного розладу, наявність емоційно-ізоляційних психотравмуючих факторів, широкий спектр клініко-психопатологічних симптомів, з домінуванням сомато-вегетативних та депресивних проявів, а також представленість в синдромальной структурі провідного астенічного синдрому на тлі сомато-вегетативного, дисфоричного або депресивного синдромів. В якості найбільш інформативних маркерів наявності адикцій у хворих на неврастенію виділено наявність затяжного початку хвороби (МІ=0,83) та дисфоричного синдрому (МІ=0,8).В формуванні невротичних розладів з адикціями були задіяні переважно поєднання гострих та хронічних психотравмуючих чинників з різних сфер життєдіяльності людини; окрім цього значна доля в формуванні неврозів з адикціями належала емоційно-ізоляційним психотравмуючим чинникам, що пов’язані з переживанням відчуття самотності та відчуженості.Висновок. Отримані дані можуть бути використані для удосконалення програм діагностики, профілактики та терапії хворих на невростенію.
Objectives: A substantial obstacle to carry out a timely diagnosis and an effective therapy of depressive disorders (DD) is their combination with other forms of pathologies. Specific difficulties occur in diagnosis and treatment of DD with comorbid other mental disorders. Aim: The aim of the study was to investigate typologies of DD with comorbid anxious disorders, alcohol dependence, and personality disorders. Methods: A complex of methods included clinical-psychopathological and psychometric methods with application of the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. In the study 189 patients with DD (F32.0-F32.1) accompanied by anxious disorders (F41.0 and F41.1), personality disorders (F60.3 and F60.0), and alcohol dependence (F10.20) were examined. The control group consisted of 52 patients with DD without comorbid pathology. Results: It was demonstrated that patients with comorbid anxious disorders predominantly had senesthopathic-hypochondriac depression (42.9%, p<0.05) with an expressed somatization, somatic anxiety, and hypochondriac equivalents. For DD with comorbid personality disorders a clinical picture of depression was determined by a predominance of mournful (41.8%) and obsessive (32.7%) variants with anhedonia and obsessive-compulsive symptoms. Depression with comorbid alcohol dependence was characterized with a presence of asthenic-anergic (24.0%) and apathic-adynamical (21.3%) variants with expressed somatic-vegetative manifestations. Conclusions: These results stipulate a necessity of using of differentiated approaches to pharmacotherapy and psychotherapy in patients with comorbid DD.
IntroductionAt the present stage of psychiatry development, the problem of co-morbidity, which is an important factor determining the effectiveness of treatment. One of such tendencies is the combination of neurotic pathology and addictive behavior (AB).ObjectivesTo research AB features in neurotic disorders.MethodologyOne hundred and forty-eight patients with neurotic disorders: neurasthenia (F48.0), dissociative disorder (F44.7), anxiety-phobic disorder (F40.8), according to ICD-10 criteria. Clinical-psychopathological, psychodiagnostic (AUDIT-like tests), statistical methods were used.ResultsIt was found out that the patients with neurotic disorders had a high risk of AB formation (59.73%). The most prominent among AB were: the use of psychoactive substances (tea/coffee [11,682], tobacco [8,091], sedatives [6,964], food addiction [14,036]), as well as socio-acceptable AB, such as Internet (13,527), watching television (9,982), computer games (2,909), shopping (7,264), workaholism (15,018). Socio-demographic characteristics of the generation of neurotic disorders with AB were determined: young age (50.46%), AB presence among the surrounding people (91.64%), a short interval of time between the psychogenic factor exposure and the first signs of neurotic disorder (50.46%). The clinical pattern of neurotic disorders with AB was characterized by a predominance of anxiety-obsessive (35.78%), as well as anxiety-phobic (45.95%) syndromes associated with AB: “Shopping” (−0.32; −0.51, respectively), “Sleeping pills, sedatives” (−0.37; −0.42), “Sex” (−0.41; −0.37) and “Tea/coffee” (−0.34; −0.39).ConclusionsThe data obtained determine AB specificity and should be taken into account in pharmaco – and psychotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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