ORGANIZATION OF PSYCHOSOMATIC CARE FOR PATIENTS WITH CARDIAC PATHOLOGY

Introduction. The prevalence of mental disorders, especially anxious and depressive calculi, among cardiac patients is significant. There is no doubt that it affects the cardiovascular system. The objective of the study was to analyze the prevalence of anxiety and depressive disorders among patients with cardiac pathology in the large hospital; and also to assess the provision of patients with this pathology with psychosomatic beds. Material and methods. In the course of the study, a questionnaire was conducted among 264 patients in the large cardiology department in St. Petersburg. The respondents were asked general and specialized (HADS questionnaire – screening for anxiety and / or depression) questions. With the help of special formulas on the basis of the received data, the required number of psychosomatic beds and regular positions of psychotherapists for the treatment of psychosomatic pathology for the city of St. Petersburg was calculated. Results. The findings confirmed the presence of a significant proportion of anxiety and / or depressive disorders among patients with diseases of the circulatory system. In addition to objective data, a significant percentage of interviewed patients associate the development of the underlying disease with emotional stress. Special attention is required by the age group of 60–75 years and older; men and women equally. It is important to note that the specific weight of clinically expressed forms is significant. This group of patients needs psychotherapeutic treatment in addition to the therapy of cardiac disease, which the respondents admit. Conclusions. Despite such a significant relevance, the organization of medical care for these patients in St. Petersburg is not enough. The perspectives of solving the problem were determined: an increase of stuff psychotherapists in multidisciplinary hospitals, integration of psychotherapeutic care into the outpatient stage of treatment.

1. Vorob’eva O.V., Ryabokon’ I.V. Stress and anti-stress therapy. Lechashchiy vrach. 2011;5:85-87. (In Russ.)

2. Balukova E.V., Uspenskiy Yu.P. Clinical psychopharmacotherapeutic possibilities of antidepressant trazodone in the complex treatment of patients with irritable bowel syndrome Uchenye zapiski Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta imeni akademika I. P. Pavlova. 2006;13(1):26-28. (In Russ.)

3. Krasnov V.N. Nonpsychotic mental disorders in general medical practice Psikhicheskie rasstroystva v obshchey meditsine. 2009;2:76-78. (In Russ.)

4. Pogosova G.V. Depression a Risk factor for Coronary Heart Disease and a predictor of Coronary Death: 10 Years of scientific Research. Cardiology. 2012;52(12):4-11. (In Russ.)

5. Dorozhenok I.Yu., Medvedev V.E., Shofigullin M.R. Mental disorders in general medicine (report about the symposium). Psikhicheskie rasstroystva v obshchey meditsine. 2009;2:78-80. (In Russ.)

6. Lapina N.A., Vanchakova N.P., Fedorov B.B. The nature of the consultative and diagnostic work of the outpatient consultative psychosomatic center of the Alexander Hospital. Uchenye zapiski Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta imeni akademika I. P. Pavlova. 2006;13(1):83-85. (In Russ.)

7. Gelazoniya G.R., Vanchakova N.P., Popov A.P. Dynamics and structure of outpatient admission at the Center for Psychosomatic Medicine, CMSC 122.. Uchenye zapiski Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta imeni akademika I. P. Pavlova. 2006;13(1):85-88. (In Russ.)

8. Sofronov A.G., Zinov’ev S.V., Tyavokin D.V., Veselova M.V. Questions of providing psychiatric care in a multidisciplinary hospital. Uchenye zapiski Sankt- Peterburgskogo gosudarstvennogo meditsinskogo universiteta imeni akademika I. P. Pavlova. 2006;13(1):88-89. (In Russ.)

9. Tokarev N.G., Zheleznova E.V. Epilepcy: clinical and psychological aspekts. Elektronnyy nauchno-obrazovatel’nyy vestnik «Zdorov’e i obrazovanie v XXI veke». 2016;8:128- 131. (In Russ.)

10. Andryushchenko A.V., Drobizhev M.Yu., Dobrovol’skiy A.V. The comparence of the scales CES-D, BDI i HADS(D) in general medicine. Zhurnal nevrologii i psikhiatrii im.S.S.Korsakova. 2003;5:11-18. (In Russ.)

11. Kochorova L.V., Skripov V.S., Ivanova G.A., Zakharova E.B. Medico-social characteristics of patients at the psycho-somatic department. The Scientific Notes of the I. P. Pavlov St. Petersburg State Medical University. 2016;23(4):25- 28. (In Russ.)

12. Bliznyuk A.I. Psychosomatic patology, classical theories and modern conceptions. Meditsinskie novosti. 2014;10:10-15. (In Russ.)

13. Troshina D.V. Report on the scientific and practical conference «Mental disorders in general medicine». Psikhicheskie rasstroystva v obshchey meditsine. 2017;1:43-49. (In Russ.)