Psihološke karakteristike bolesnika sa bolom u grudima bez srčanog uzroka
Sažetak
Apstrakt
Uvod/Cilj. Bol u grudima koji nije srčanog porekla često liči na anginozni i kada se ne pronađu medicinski uzroci, bolesnici se upućuju psihijatru radi dalje procene. Cilj istraživanja bilo je utvrđivanje psiholoških karakteristike bolesnika sa bolom u grudima bez koronarnog uzroka, razlika u poređenju sa koronarnim bolesnicima i prediktivnih vrednosti parametara za bol bez koronarnog uzroka. Metode. Konsekutivno je bilo regrutovano 40 bolesnika bez dijagnoze srčane bolesti (BDSB grupa) sa simptomima bola u grudima, koji su upoređeni sa 45 koronarnih bolesnika (K grupa). Za postavljanje dijagnoze psihijatrijske bolesti korišćen je Mini-internacionalni neuropsihijatrijski intervju (MINI), za procenu psiholoških simptoma Upitnik liste simptoma-90-revidirani (SCL-90R upitnik), za procenu izloženost životnim događajima Holmas Rahe skala, a za procenu nivoa anksioznosti i depresivnosti Bek–ov upitnika za anksioznost i Bek-ov upitnik za depresivnost . Statistička analiza rađena je pomoću SPPS 17, a korišćeni su Student-ov t-test i χ2 test za utvrđivanje razlike između parametara u grupama. ANOVA je upotrebljena radi određivanja parametara koji su povezani sa bolom u grudima bez koronarnog uzroka. Rezultati. Bolesnici u BDSB grupi bili su mlađi (33,40 ± 5,43 vs 48,37 ± 6,43, p < 0,001), anksiozniji (20,47 ± 11,93 vs 9,63 ± 3,86, p < 0,001), više izloženi životnim događajima (102,03 ± 52,22 vs 46,5 ± 55,08, p < 0,001) i imali su viši nivo distresa (41,37 ± 7,70 vs 29,37 ± 5,67, p < 0,001), dok su koronarni bolesnici bili više depresivni i hostilni. Regresiona analiza je pokazala da porast skora anksioznosti za 1 poen, znači 25% veću šansu da subjekt pripada BDSB grupi [odds ratio (OR) = 1,25; 95% interval poverenja (IP): 1,10–1,41] i porast skora životnih događaja znači 2% veću šansu da bolesnik pripada BDSB grupi (OR = 1,02; 95% IP: 1,01–1,03). Mlađi ispitanici imali su veću šansu da pripadaju BDSB grupi (OR = 0,58, 95% CI: 0,42–0,80). Zaključak. Bolesnici BDSB grupe nisu imali udruženi psihijatrijski poremećaj, ali su imali viši nivo distresa, izloženost životnim događajima i umereni nivo anksioznosti. Psihološka pomoć mladim ljudima sa bolom u grudima bez srčanog uzroka, mogla bi biti korisna u cilju prevencije mogućih psihijatrijskih poremećaja.
Reference
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