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Biomedical subjects

M Iu Drobizhev

Publications and source records attributed to M Iu Drobizhev.

At least 19 recordsLinked to original sources
PubMed2003

[A comparative validation of the scale CES-D, BDI, and HADS(d) in diagnosis of depressive disorders in general practice].

To determine a most precise instrument for diagnostics of depression and a level of its severity, a comparative study of 3 questionnaires: Hospital Anxiety and Depression Scale (d) (HADS(d)), Beck Depression Inventory (BDI) and Center for Epidemiological Studies Depression scale (CED-D) was conducted in 148 patients (91 women, 57 men), aged 46.5 +/- 9.34 years. An analysis of sensitivity, specificity and predictive values of positive and negative results allowed to detect optimal cut off points, distinguishing depressive patients, as follows: = 18 for CES-D, = 12 for BDI, = 0.89 for HADS(d). For all scales, areas under receiver-operator characteristic (ROC) curve (0.97 +/- 0.02, 0.96 +/- 0.02 and 0.94 +/- 0.02, respectively) proved to be comparable. The optimal cut off points for distinct separation between patients with mild and severe depression were detected as = 26 for CES-D, = 20 for BDI, = 10 for HADS(d). The area under ROC curve for CES-D was higher (0.99 +/- 0.01) than those for BDI (0.86 +/- 0.04) and for HADS(d) (0.83 +/- 0.05). The data obtained reveal that the cut off points ascertained in the study reduce a chance of depression under diagnosis. All the scales could be recommended to interns for primary (screening) diagnostics of depression in routine medical care.

Adolescent↗
PubMed2002

[Visceral neuroses: clinical approaches to the problem].

Visceral neuroses are regarded as psychosomatic pathology represented by functional symptom complexes common for both psychic (personality, psychopathologic disorders of anxietyphobic, affective, hypochondriac spectrum) and somatic pathology. Two hundreds fourteen patients: 67 with hyperventilation syndrome (HVS), 77 with Da Costa syndrome (DCS), 70 with irritable bowl syndrome (IBS) have been studied. The study suggest that visceral neuroses represent a group of independent diseases. In contrast to converse neuroses, a topical projection (respiratory, cardiovascular system, gastrointestinal tract, etc.) of visceral neuroses reflects not only a psychosomatic disorder's specificity but also the course and prognosis regularities inherent to them. HVS course is wavy with periodic exacerbations and incomplete remissions, DCS one is phased (remissive), IBS is chronic without distinct phases and intervals. HVS and DCS are comorbid to milder psychic (personality and anxiety phobic disorders) and somatic pathology. IBS is associated with not only more severe mental disorders (overvalued, hypochondriac, affective) but also with chronic somatic diseases (alimentary system).

Adult↗
PubMed2001

[Clinical course, internal picture of the disease and pathogenic reactions in patients with bronchial asthma].

AIM: To study clinical features of bronchial asthma (BA) associated with internal picture and nosogenic reactions. MATERIAL AND METHODS: Clinical features of BA were studied in 108 patients (38 males and 70 females, mean age 44.7 +/- 1.4 years, mean BA duration 6.6 +/- 0.76 years) treated in the clinic of the I. M. Sechenov Moscow Medical Academy in 1995-1998. RESULTS: Clinical and statistical analysis of BA clinical course allowed to single out three leading variants of BA course: persistently obstructive (stable and definite respiratory disturbances with progressive deterioration of bronchial permeability), moist (associated chronic bronchitis, allergic rhinosinusopathy, chronic maxillary sinusitis, intestinal dysbacteriosis, repulsive symptoms, e.g. discharge of much sputum et cet), paroxysmal (short-term episodes of asphyxia arrested by inhalations of beta 2-agonists, absence of stable respiratory disorders). The above variants of BA course significantly correlated with types of the internal picture (IP) and types of nosogenies. Persistently obstructive, moist and paroxysmal BA variants were characterized with vital, defensive and coping IP, respectively, neurotic reactions with hypochondria, hypochondriac depressions; pathocharacterological sensitive reactions; neurotic and affective reactions with "la belle indifference" and "euphoric pseudodementia", respectively. CONCLUSION: The above correlations can be used for planning and conduction of psychocorrective measures aimed at optimisation of patient-doctor compliance.

Adult↗
PubMed2001

[Anxious-phobic disorders in patients with dyspnea].

The examination included 35 patients (21 women, 14 men, mean age 47.2 +/- 2.4 years) with anxious-phobic disorders (APD) and dyspnea phenomena combined bronchial asthma (BA) and hyperventilation syndrome (HVS). There was established that APD in these cases develops more frequently similarly to the panic attacks (PA) and HVS was PA component. Three PA types with dyspnea phenomena were recognized: cognitive ones (with prevalence of cognitive anxiety--8 cases); somatized PA (with prevalence of somatized anxiety--18 cases) and PA with both cognitive and somatized anxiety (9 cases). PA of the first type amplifies BA attack (psychopathologic structure of PA was integrated with manifestations of the acute bronchial obstruction). PA of the second type duplicates (because of the pronounced somatized anxiety associated with asphyxia) an acute bronchial obstruction between BA paroxysms. PA of the third type imitates somatic pathology forming without its participation (polymorphic conversion disorders were found first of all). The link of severity of the anxious-phobic and pulmonary pathology can be interpreted in the ranges of psychosomatic conception of the "reciprocal correlations".

Anxiety Disorders↗
PubMed2001

[Obliterating arteriosclerosis of lower limb arteries and ischemic heart disease clinico-pathogenetic correlations].

To study clinical and pathogenetic correlations between different stages of arterial deficiency in obliterating atherosclerosis of lower limbs arteries (OALLA) and various clinical forms of ischemic heart disease (IHD) as well as the influence of different risk factors on OALLA clinical course in different arterial territories. The study included 76 OALLA patients (73 men and 3 women, mean age 56 years). The diagnosis was made on the basis of typical complaints, physical and device examinations. IHD was diagnosed on the basis of typical clinical symptoms and/or findings of the device examinations. OALLA and IHD differ by some risk factors. One of them--chronic alcoholism--is responsible for OALLA progression. This was shown by the analysis of chronic alcoholism prevalence in two groups of patients: with OALLA alone and OALLA in combination with IHD. In the former group alcoholics prevailed (61 vs 24.1%). Chronic alcoholism may be considered as an independent risk factor of OALLA development.

Alcoholism↗
PubMed2000

[Psychopharmacotherapy and management of psychiatric care in somatic hospital].

A clinical trial was made of 1994 patients admitted to a large general hospital in Moscow during a day in two seasons (spring, autumn). The aim of the study was to detect patients of a general hospital in need of psychotropic drugs, to assess their psychic condition and to develop recommendations for optimization of psychiatrist's consulting. It was found that 49.3% of the examinees need psychotropic drugs (at least one). 37.5% need tranquilizers, 20.7%--nootropic drugs, 21.2%--antidepressants, 5.9%--neuroleptics.

Antidepressive Agents↗
PubMed1999

[Therapy of cardio-neurotic diseases in general practice: clinical experience with atarax].

An open study of efficiency and safety of atarax (hydroxisine) enrolled 55 outpatients (23 males and 32 females, mean age 45.91 +/- 1.91) with generalized anxious and somatoform disorders running as cardioneurosis as well as nosogenic reactions (maladaptation), manifestations of cardiovascular pathology (acute myocardial infarction, angina of effort functional class II-III, postinfarction cardiosclerosis, essential hypertension in 5, 13, 2 and 5 patients, respectively). The patients received atarax for 28 days (daily dose 50 mg). The course was completed in 54 patients. In 47 of them, the overall score value by Hamilton Anxiety Scale dropped by 10 scores, the reduction being more obvious in patients with somatic anxiety. Hydroxysine is well tolerated and safe both in patients with somatic pathology and those with cardiovascular disorders.

Adult↗
PubMed1999

[Clinical aspects of somatic disease and internal course of the disease (heart ischemia and bronchial asthma model)].

Criteria of subjective severity (SS) and subjective control of the condition (SC) associated with establishment of the disease internal picture (DIP) were determined in 67 patients with verified coronary heart disease (CHD) and 68 with verified bronchial asthma (BA). Essential for SS were: severity of the subjective symptoms, features of the somatic condition debut, the speed of the disease progression. Essential for SC were the following components: effectiveness of self-care, severity of noticeable or ugly symptoms, features of the triggers (attack provokers). SS and SC criteria can be used for differentiation of the interventions to change the patient's attitude to their disease and therapy in the direction of more compliance with the doctor.

Asthma↗
PubMed1999

[Litigious nosogenic reaction].

In general somatic hospital the prevalence of litigious nosogenic reactions (LNR) was 4,3 pro mille. It was examined 52 cases of LNR. Paranoic (overvalued and delirious) disorders were the main ones in clinical picture of LNR. Two forms of motivation were noted: rental disorders (demand of money compensation of the loss resultant from somatic disease) and equitable ones (revelation of the damage due to actions of medical personnel). Among the patients with rental LNR (43 persons) the individuals with hysteric disorders of personality (hysterical psychopathy) were mainly found. Meanwhile among the patients with equitable LNR (9) there were patients with slow-progredient psychopathic-like schizophrenia inclined to the development of paranoic reactions and with litigious-paranoic tendencies. The development of rental LNR was seen in comparatively favourable course of somatic diseases which was not connected with invalidism or considerable loss of ability to work. In somatic diseases, when equitable LNR were formed, it was not possible to reveal a preference in severity of the course of somatic disease.

Adult↗
PubMed1997

[The clinical and psychological aspects of the reaction to disease (the problem of nosogenias)].

"Nosogenias" is the term describing some reactive states. They account for 15-90% of all the patients of somatic hospital. They are due to constellation of some psychotraumatic events related to somatic disease. A total of 166 patients were examined, among them 55 patients with ischemic heart disease, 56 cases with hypertension and 56 ones with bronchial asthma. The results evidence for the existence of two independent vectors which characterise "extremal" points of continuum of disease perception. The importance of somatic trouble (hyper- or hyponosognomia) was the basis of the first vector while the degree of completeness of independent and the whole image of disease as something which differed from "self" (ego-dystonic and ego-syntonic perception of disease) was the basis of the second vector. Combination of the above vectors with clinical and psychological characteristics in the whole clinical pattern of disease was recorded.

Analysis of Variance↗
PubMed1994

[Protracted hypochondriacal reactions (based on the type of hypochondriacal development) in myocardial infarct patients].

Clinical follow-up, MPT, clinical and instrumental cardiological evidence is available for 30 postmyocardial infarction patients. They exhibited hypochondriac reactions which persisted for more than 6 months. Three types of such reactions were recognized: somatization (I), cenesthetic (II), overvalued (III). I reactions were associated with homonomous body sensations, anxious and conversion disorders, avoidance behavior. II reactions cover heteronomous sensations with attendant autoaggressive behavior. Patients with reactions III had dominant ideas of complete health recovery, delirium-like fantasies. It is established that I reactions arise in personalities with neurotism radical, reactions II in those with rigidity and eccentric behavior, reactions III in patients with rigidity and conformity.

Angina Pectoris↗