Essential hypertension: neuro formous and affective abnormality (clinical investigation and treatment strategy)
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StatusThe thesis was presented on the 11 December, 2007Approved by NCAA on the 24 January, 2008 Abstract – 0.69 Mb / in romanianThesisCZU 616.12-008.331.1+616.8-009
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Keywords
essential hypertension, neuro formous syndrome, affective syndrome, anxious syndrome, asthenic syndrome, obsessive syndrome, depressive syndrome, psychological testing, psychotropic treatmentSummary
Secondary psychical abnormalities occur more often and often together with cardiovascular diseases.
This work has the aim to determine the intercommunication between the somatic and psychic (neuro formous and affective) abnormalities at 518 patients with essential hypertension and to determine indications to combines antihypertensive and psychotropic treatment. The carried out results gave us the possibilities to determine the following abnormalities of personality type – anancastic, dependent, impulsive, hypertonic that can be often observed at patients with essential hypertension, they have polymorphous, unsteady character and influence on the beginning, peculiarities of clinical presentation, disease’s development and prognosis. Clinical investigations have defected the following neuro formous syndromes – anxious, asthenic, obsessive, and from the affective – depressive. Thanks to the symptomatic diversity these syndromes constitute the core that associates other neuro formous, affective, somatic and vegetal conditions, which in their turn lead to different forms formation in their composition.
Anxious syndrome is one of the most typical for essential hypertension. It manifests in different types, such as anxious – depressive, anxious – hypohondriac, anxious – obsessive, anxious – phobious, anxious – hysterical.
Asthenic syndrome gas three stages – I – compensated, II – subcompensated and III – decompemsated. Two clinical variants are defined - hyper and hyposthenic.
The obsessive syndrome at patient with essential hypertension has some peculiarities. It is manifested in some cases as a syndrome with predominantly obsessive ideas, in other cases – it is combined with other neuro formous and affective syndromes. At these patients we can often observe obsessive, obsessive – phobious and especially obsessive – anxious syndrome.
If we examine affective state at essential hypertension we can single-out depression combined with other clinical variants. The depressive, depressive-hypohondriac, depressive – anxious, adynamic – depressive, depressive – hypohondriac, depressive – phobious syndromes are often defined. We can mention that depressive – apathic, depressive – hysterical formed variants are rarely defined.
A range of psychological tests – level of anxiety’s investigation (Spilsberger Test) and depressions (Hamilton test), alexitimic (Toronto), CMIL, quality level determination (SF-36).
A morphological investigation of noradrenergic and GOMK receptors.
Taking into consideration general pathogenetic mechanisms of essential hypertension and some neuro formous and affective conditions, pharmacokinetic and pharmacodynamic mechanisms of the used preparations, schemes of the combined treatment were proposed depending on the evidenced clinical syndromes. The proposed treatment had a positive effect on clinical course, and this was subjectively and objectively mentioned (at psychological testing).
Oficial Reviewers
- Liliana Groppa
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova - Aurel Grosu
doctor habilitat, professor, Medical-Sanitary Public Institution Institute of Cardiology
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