Issue №3-91, 2019

Psychological diagnosis and rehabilitation of patients with gastroesophageal reflux disease

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1 Odarushchenko O.I., 1 Shakula A.V., 2 Pavlov A.I.

1 National Medical Research Center of Rehabilitation and Balneology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
2 3rd Central Military Clinical Hospital A.A. Vishnevsky of the Ministry of Defense of Russia, Moscow, Russia


ABSTRACT

The atypical clinical manifestations that occur in GERD make it difficult to diagnose gastroesophageal reflux disease andlead to overdiagnosis of some diseases, such as IHD. Numerous studies have established the role of certain psychologicalvariables in the occurrence of nausea, vomiting and heartburn in patients with GERD. Meanwhile, the identification of sucha relationship does not explain a number of cases of GERD morbidity, especially in young people.The paper describes a diagnostic computer program developed by the authors for studying the current emotional stateof patients with GERD and presents the results of a study that allow determining the directions of psychocorrectional andrehabilitation work. The computer program includes techniques: 1) the “State Scale” method (Russian-language adaptationby A. B. Leonova, 1984), 2) the “Scale of Differential Emotions” methodology (Russian-language adaptation by A. B. Leonovaand M. S. Kapitsa, 2003), 3) the method “The degree of chronic fatigue” A. B. Leonova and I.V. Shishkina; modification – 2003,4) a test assessing the level of situational and personal anxiety by C. Spielberger. According to the results of the examinationof patients and groups of healthy individuals, it was determined that patients with GERD experience subjective discomfortand often feel bad (p≤0.01). In these patients, a relatively stable individual experience of the anxious-depressive complex isexpressed in the “profile of emotions”. Они испытывают беспокойство, подвержены страхам и чувству вины (p≤0,01). Atthe psychophysiological level, in patients with GERD, symptoms of physiological discomfort are expressed, including signsof disturbances in the sleep-wake cycle; decreased overall health and pronounced cognitive discomfort; there are violationsin the emotional-affective sphere and a decrease in motivation and changes in the sphere of social communication (p≤0.01).Patients are distinguished by psycho-emotional tension (p≤0.01) and an alarming mental state, sufficiently stable and longlasting,turning into a personality trait that becomes a factor in its change (p≤0.01). Examination of patients with the help ofthis computer program allows you to personalize rehabilitation treatment and rehabilitation.


KEYWORDS: gastroesophageal reflux disease, emotional-personal sphere, anxiety, emotional states, psychological correction, psychological rehabilitation.



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