Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье (Nov 2020)
PSYCHOLOGICAL ASPECTS OF QUALITY OF LIFE AND PROGNOSIS OF REHABILITATION IN PATIENTS WITH ULCERATIVE COLITIS
Abstract
This study aims to analyze the role and impact of psychological aspects of quality of life in patients with ulcerative colitis (UC) on the disease course.We have recruited 61 patients (39 women and 22 men aged 18–60 years) diagnosed with UC (according to the requirements of the Helsinki Declaration of 1975). Study participants were divided into two groups. Group 1 included 32 patients with a slowly progressing disease. Group 2 comprised 29 patients with frequent UC relapses and rapid development of complications. We analyzed the data from the MOS SF-36 questionnaire, levels of and personal and reactive anxiety (PA and RA respectively) assessed using the Spielberger-Khanin's test, stress tolerance, and social adaptation evaluated using the Holmes and Rahe scale.We also analyzed the frequency and main clinical manifestations of anxiety and depression in UC patients that affected their quality of life, as well as the state of psychosomatic mental health. UC patients are characterized by a significant decrease in physical and emotional functioning. The analysis of personal and situational anxiety demonstrated an association between psychological health and social functioning. Reactive anxiety was negatively correlated with psychological health, while personal anxiety was positively correlated pain syndrome and negatively correlated with social functioning (r = -0.48) and psychological health (r = –0.34). The level of depression increased with patient age (r = 0.49, р < 0.0001). Situational anxiety increased when patients had troubles in their family (r = 0.33, p = 0.04) and at work (r = 0.49, p = 0.008) or received negative information from the media (r = 0.57, p = 0.003).The psychoemotional state and quality of life directly depend on the degree of compensation and psychosocial adaptation of the patient, as well as on the compliance of the doctor, patient, and family members. Assessment of quality of life in UC patients is necessary to develop individual treatment strategies that will improve the disease control and increase compliance.