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CNAA / Theses / 2007 / June /

Rheumatoid Arthritis: psychosomatic relationships


Author: Larisa Rotaru
Degree:doctor of medicine
Speciality: 14.00.06 - Cardiology and Rheumatology
Year:2007
Scientific adviser: Liliana Groppa
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Mircea Revenco
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 6 June, 2007
Approved by NCAA on the 20 September, 2007

Abstract

Adobe PDF document0.32 Mb / in romanian

Thesis

CZU 616.72-002.77:616.89

Adobe PDF document 1.06 Mb / in romanian
138 pages


Keywords

rheumatoid arthritis, psychosomatic disorders, Hamilton scale, depressive symptoms, antidepressant Mianserin hidroclorid, types of attitude to the disease

Summary

There were investigated 120 of female patients with confirmed Rheumatoid Arthritis (RA) at different stages of the disease. Besides standard general clinical and laboratory tests all the patients were examined according to a special program: psychological testing on Hamilton scale, as well as determination of the type of attitude to the disease by the method of psychological diagnostics of the types of the attitude to the disease.

Among the causes leading to the onset of joint syndrome the most frequent causes as acute and chronic psycho-emotional stress was determined (χ2=4,52, р<0,05). There were found changes of psychical status at the onset and in the developed stage of the disease; as well as veridical changes of relationship between somatic and psychical disorders.

The patients were randomized, divided into two groups. All the patients received basic treatment: Metotrexate and Diclofenac. The first group included 50 of the patients that received basic treatment and also administered antidepressant Mianserin hydrochloride in the dosage of 30 mg in 24 hours (in the evening time) during 3 month. The second group included 50 patients that received only basic treatment (control group). The volume of investigations was equal in both groups. All the patients were examined 4 times: at the entrance into the study, in a month, in 3 months and in 6 months from the beginning of the observation.

Received data allowed performing a comparative analysis between abovementioned groups, on the following parameters: the number of inflamed and painful joints, duration of morning stiffness, indexes Lee, HAQ, DAS, VASH; laboratory tests: ESR, CRP, as well as Hamilton scale and by the method of determination of the type of psychological attitude to the disease. Psychological testing by Hamilton scale showed the presence of depression and dependence of depressive symptoms intensity on the dynamics of the main disease. The first group showed better results.

There was found correlation between psychological statute of the patient and the activity of the main disease; certain types of attitude to the disease and their dynamics were established.

There was found positive dynamics of the main disease and improvement of psychical statute of the patients on the background of introduction of antidepressant Mianserin hydrochloride into complex therapy of Rheumatoid Arthritis.