P0274 - Stress and psychosocial determinants of formation of neurotic and affective disorders in patients with peptic ulcer

Abstract

Objective:

To study the role of psychosocial stressor factors in formation of neurotic and affective disorders in patients with PU of duodenum and stomach.

Material and Methods:

In Borderline States Department of MHRI TSC SB RAMSci we examined 245 patients (male - 111; female – 134; mean age 43,28±8,86 years) with peptic ulcer and mental disorders (MD) of neurotic and affective level appearing to be causes of seeking by patients for a psychiatrist. In 24,9% of them PU was diagnosed for the first time under conditions of a psychiatric hospital.

Results:

Method of logistic regression along with convenient for PU factors of “aggression” and “defense” predictors of psychosocial disadaptation and prognosis of PU development have been revealed in men (Concordant=84,6%, Somers'D=0.693), in women (Concordant=82,8%, Somers'D=0.660). From the first step sign “heredity” according to PU has constituted 24% (p=0.0001). Of significance were somatic factors: gastroduodenitis infected HP (p=0.0015), duodenogastric reflux (p=0.0015), gallstones (р=0.003), indices of immune status (р=0.0174). Significant psychosocial (stressor factors) predictors have been revealed: life events (p=0.0021), medical (p=0.0002), working, everyday ones (p=0.037). Mental disorders of depressive, anxious, asthenic spectrum (р=0.0001), duration (р=0.001) and age of onset of mental disorders (р=0.001), psychopathological syndrome (р=0.0009). Non-specific symptoms of PU are represented by psychovegetative paroxysms of fear of death (p=0.0006), cardialgias (p=0.008), abdomenalgias (p=0.005), hypochondriac fixation (p=0.001), hypothymia (р=0.0003), demonstrativeness (р=0.004). Perspective is assessment of interrelationship of somatic and mental factors in development of schemata of complex somatic and psychopharmacotherapy, psychotherapy of PU patients.