遗传在痴呆家族史困难患者焦虑障碍发展中的作用

К. V. Hryn
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After obtaining informed consent, 26 patients (all female patients) who sought medical help from a psychiatrist during 2021-2022 with symptoms of anxiety disorder were examined. Results and discussion. Clinical and anamnestic analysis revealed a 100% hereditary susceptibility to dementia. In the genealogical analysis of pedigrees, in 65.4% of cases, the hereditary burden was traced in two previous generations, in 11.5% ‒ in three previous generations. Analyzing the results of the clinical-psychopathological examination of the level of anxiety according to the General Anxiety Disorder-7 scale, it was found that all patients had signs of generalized anxiety disorder (medium – 10–14 points and high level – 15–21 points). The results of anxiety analysis according to the Hamilton Anxiety Rating Scale confirmed the clinical results. The anxiety indicators of all patients reached from 20 to 25 points, which corresponds to an anxious state. 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引用次数: 0

摘要

痴呆症不仅对病人,而且对照顾他/她的人、家庭成员和整个社会产生身体、心理、社会和经济影响。家庭成员容易发展为焦虑和抑郁障碍,并且往往对自身发展为痴呆处于“焦虑预期”中,因为遗传负担在这一病理过程的病因学中的作用是不可否认的。本研究的目的是分析痴呆患者一线后代的焦虑障碍深度程度。材料和方法。本研究采用临床与记忆学、临床与精神病理学的研究方法,采用证候法进行诊断,采用系谱法进行家谱的构建与分析。在获得知情同意后,对26名在2021-2022年期间因焦虑障碍症状向精神科医生寻求医疗帮助的患者(均为女性)进行了检查。结果和讨论。临床和记忆分析显示100%的遗传性痴呆易感性。在系谱分析中,65.4%的病例的遗传负担可追溯到前两代,11.5%的病例可追溯到前三代。根据广泛性焦虑障碍-7量表对患者的焦虑水平进行临床-精神病理检查,发现所有患者均有广泛性焦虑障碍的症状(中重度- 10-14分,重度- 15-21分)。根据汉密尔顿焦虑评定量表进行的焦虑分析结果证实了临床结果。所有患者的焦虑指标均达到20 ~ 25分,属于焦虑状态。同时,发现遗传负担与焦虑水平之间存在明显的相关性:三代有痴呆遗传负担的患者焦虑水平最高,两代有痴呆遗传负担的患者焦虑水平略低,痴呆家族史不超过前一代的患者焦虑水平中等。结论。考虑到痴呆症的多基因性质,可以得出结论,不仅遗传成分在某些多因素疾病,特别是痴呆症的发展中起作用。考虑到环境因素的存在,具有这种疾病的遗传易感性和家谱负担的患者必须努力减少环境影响。确定痴呆的遗传负担与焦虑症的严重程度之间的明确相关性,使理解这类个体的药物和心理治疗干预方法成为可能
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Role of Heredity in the Development of Anxiety Disorders among Patients with a Difficult Family History of Dementia
Dementia has a physical, psychological, social and economic impact not only on the sick person, but also on the people who care for him / her, on family members and society as a whole. Family members are prone to the development of anxiety and depressive disorders, and are often in "anxious anticipation" of the development of dementia in themselves, since the role of genetic burden in the etiology of this pathological process is undeniable. The purpose of the study was to analyze the degree of depth of anxiety disorders in first-line descendants of patients with dementia. Materials and methods. The study used clinical and anamnestic, clinical and psychopathological research methods, the syndromic approach to establishing a diagnosis and the genealogical method with the construction and analysis of a family tree. After obtaining informed consent, 26 patients (all female patients) who sought medical help from a psychiatrist during 2021-2022 with symptoms of anxiety disorder were examined. Results and discussion. Clinical and anamnestic analysis revealed a 100% hereditary susceptibility to dementia. In the genealogical analysis of pedigrees, in 65.4% of cases, the hereditary burden was traced in two previous generations, in 11.5% ‒ in three previous generations. Analyzing the results of the clinical-psychopathological examination of the level of anxiety according to the General Anxiety Disorder-7 scale, it was found that all patients had signs of generalized anxiety disorder (medium – 10–14 points and high level – 15–21 points). The results of anxiety analysis according to the Hamilton Anxiety Rating Scale confirmed the clinical results. The anxiety indicators of all patients reached from 20 to 25 points, which corresponds to an anxious state. At the same time, a clear correlation was found between the hereditary burden and the level of anxiety: patients with a hereditary burden for dementia in three generations had the highest level of anxiety, patients with a hereditary burden in two generations had a slightly lower level of anxiety, a moderate level of anxiety was detected in patients with a family history of dementia no more than in one of the previous generations. Conclusion. Considering the polygenic nature of dementia, it can be concluded that not only the genetic component plays a role in the development of certain multifactorial diseases, in particular dementia. Given the presence of an environmental component, a patient with a hereditary predisposition and genealogical burden of this disease must make efforts to minimize environmental influences. The identification of a clear correlation between the hereditary burden of dementia in generations and the severity of an anxiety disorder makes it possible to understand the approaches to pharmaco- and psychotherapeutic interventions in this contingent of individuals
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