CHRONIC WARTIME STRESS AS A FACTOR IN ANXIETY AND DEPRESSIVE DISORDERS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ARTERIAL HYPERTENSION
DOI:
https://doi.org/10.21856/j-PEP.2023.3.06Keywords:
arterial hypertension, type 2 diabetes mellitus, chronic wartime stress, anxiety and depressive disordersAbstract
The aim: to study the frequency and severity of anxiety and depressive disorders in patients with arterial hypertension (AH) and type 2 diabetes mellitus (T2DM) who experienced chronic wartime stress.
Materials and methods. We examined 56 patients (civilians) with AH and T2DM, who were in the war zone in the Kharkov region and experienced chronic wartime stress. The examination was carried out using standard clinical, laboratory and instrumental methods. Anxiety and depressive disorders were identified using specialized questionnaires: the Hospital Anxiety and Depression Scale (HADS), the Spielberger-Khanin Personality and Reactive Anxiety Scale, and the Mississippi scale for the study of post-traumatic stress disorder (PTSD) (civil version). The analysis of the data obtained was carried out using the SPSS 19.0 for Windows XP.
Results. Most of the examined AH patients with T2DM had symptoms of anxiety (80%) and depression (69%) according to the HADS. When analyzing using the Spielberger-Khanin Personal and Reactive Anxiety Scale, a high frequency of both personal and reactive anxiety was established. Chronic wartime stress leads to the formation of a clinical variant of PTSD in 13% of patients and individual symptoms of PTSD in 63%. The most vulnerable in terms of the development of anxiety and depressive disorders after wartime stress were women, as well as patients with more severe hypertension and especially with decompensated T2DM.
Conclusions. Chronic wartime stress leads to the development of severe anxiety and depressive disorders in the majority of hypertensive patients with type 2 diabetes, which must be taken into account during their examination and treatment. Gender differences in the development of anxiety and depressive disorders in the examined patients were revealed, with a predominance in women of the frequency of clinically expressed anxiety and depression, a high level of personal anxiety and individual symptoms of post-traumatic stress disorder. A significant direct relationship between the severity of anxiety and depressive disorders and symptoms of post-traumatic stress disorder with the severity of arterial hypertension and, especially, type 2 diabetes was established.
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