Browsing by Author "Kopchak Oksana"

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COGNITIVE FUNCTIONS IN MULTIPLE SCLEROSIS PATIENTS DEPENDING ON THE DIFFERENT RISK FACTORS PRESENCE
(ALUNA, 2021-10) Kopchak Oksana; Odintsova Tetiana; Pulyk Oleksandr
The aim: To clarify the influence of different risk factors on cognitive impairment (CI) in general and in separate domains and their association with MRI findings in patients with relapsing-remitting (RRMS) and progressive forms of multiple sclerosis (SPMS and PPMS). Materials and methods: One hundred and thirty-seven participants with MS (102 females and 35 males) aged from 22 to 69 years were enrolled into this study. All patients completed the Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A) and undergone MRI. Results: According to MS phenotypes all participants were divided into two groups: patients with RRMS (n= 106) and with progressive phenotypes (n= 31). A significant positive correlation was present between MoCA and BDI scores in all participants (p= 0,0015). Presence of anxiety did not demonstrate any valid influence on cognitive performance, although severe anxiety was significantly more often found in subjects with progressive phenotypes in presence of brain atrophy (p= 0,0028). Patients with higher education had no CI more frequently compare to those without it (p= 0,0019), whereas, participants smoking cigarettes had higher prevalence of severe CI than non-smokers (p= 0,0061). Conclusions: Among cognitive domains memory, visual-spatial and executive functions, abstract thinking were impaired the most in MS patients, though abstract thinking was more often affected in progressive forms. The results demonstrated that physical disability, depression and smoking negatively impacted cognitive performance, meanwhile presence of higher education demonstrated a favorable influence on cognition in MS patients.
Cognitive impairment and depression in patients with relapsing–remitting multiple sclerosis depending on age and neuroimaging findings
(Springer Nature, 2021-09-08) Kopchak Oksana; Odintsova Tetiana
Background: Multiple sclerosis is an insidious, disabling, both physically and mentally, demyelinating disease of the central nervous system. This work aims to evaluate relationships between cognitive impairment in separate domains, depression and their correspondence with MRI-fndings, as well as the infuence on each other’s manifestations, in patients with relapsing–remitting multiple sclerosis. Results: Visual–spatial/executive functions and memory domains sufered more frequently than others in the study subjects under 40 years; in patients over 40 years old memory, visual–spatial/executive functions and abstract thinking impairment prevailed the most. Such cognitive domains as memory, language, abstract thinking, visual–spatial and executive functions were impacted in both groups of patients even without the apparent cognitive decline according to MoCA scale. Presence of depression impacted language and attention more prominently than the rest of the domains only in participants younger 40 years. According to the MRI, frontal lobe, corpus callosum and periventricular area were afected more often compared to other brain regions in case of cognitive impairment; meanwhile, combined lesions of frontal lobe and corpus callosum, fronto-temporal region were associated with depression. Conclusion: Cognitive impairment and depression are one of the common, yet disabling and socially disrupting manifestations of MS. Quite frequently such complaints are neglected or considered as parts of comorbidities. At the same time cognitive impairment can be amplifed by depression, especially in patients under 40 years.
EMOTIONAL IMPACT OF THE COVID-19 PANDEMIC ON HEALTHCARE WORKERS IN UKRAINE
(Aluna Publishing, 2022-05) Pinchuk Irina; Pishel Vitaliy; Polyvіanaia Marina; Kopchak Oksana; Chumak Stanislav; Filimonova Natalia; Yachnik Yuliaya
Objective: The aim: To study the emotional impact of the COVID-19 pandemic on healthcare workers in Ukraine. Patients and methods: Materials and methods: 1087 healthcare workers across all regions of Ukraine completed an online questionnaire. Respondents were divided into two groups: A - 863 (79.4%), В - 224 (20.6%), according to whether or not they experienced anxiety/fear related to COVID-19. Results: Results: Such factors as risk of contracting COVID-19, news of new cases, insufficient staff in healthcare facilities, risk of transmission of COVID-19 to family or friends, risk of death from COVID-19, the threat of the spread of the COVID-19 pandemic were associated with high level of anxiety/fear among healthcare workers. Factors that facilitate coping with stress included absence of Covid-19 cases among staff, recovering patients, availability of gear and protective equipment and absence of COVID-19 infected among loved ones, relieving stress (relaxation, going info sports and so on), communication with family and friends to relieve stress and get support, avoidance of COVID-19 media reports in particular on deaths connected cases, getting information about the spread of Covid-19 only from legitimate sources. Conclusion: Conclusions: The data obtained in this study indicate an urgent need for the development and implementation of preventive and rehabilitation measures aimed at stabilizing the psycho-emotional state of health workers and improving the quality of care in the special conditions of the COVID-19 pandemic. Achieving these goals will be facilitated by taking into account the specifics of the response to COVID-19 and measures to reduce the effects of stress while enhancing the effects of stressors among health care workers.
Improvement of treatment guidelines for patients with gingival fi bromatosis considering interdisciplinary approach
(Stomatologia Współczesna, 2021-04) Kopchak Oksana; Azarov Oleksii; Cherniak Svetlana; Asharenkova Olha; Airapetian Karolina
Our paperwork is the result of medical literature, life science journals, menegment protocols analysis, and our own practical experience of managing a patient with gingival fi bromatosis and observations of doctors’ work and medical errors in the course of the treatment. In the fi rst part the work is a highlight of basic theoretical knowledge on gin gival fi bromatosis. The next part was analysis of scientifi c works with respect to an interdisciplinary approach in the treatment of this pa thology. As a result of the analysis, we found a lack of communication between internists and dentists at the stage of dental treatment right before surgery, which is a common medical mistake. We want to fo cus doctors' attention to early therapeutic treatment before surgery, an important part for preventing particular complications in the course of gingivectomy and infl ammatory responses exacerbation. This paper proposes improved treatment guidelines for patients with gingival fi - bromatosis for prevention of possible medical errors and emphasis on doctors communication in the course of treatment.
Influence of an epigenetic diet on migraine patients
(AMPH, 2022-11-09) Kopchak Oksana; Hrytsenko Olena
Objective. Migraine is a common type of primary headache disorder, distinguished by recurrent attacks of moderate to severe unilateral throbbing pain. The goal of this study is to analyze the epigenetic influences of diet and their effects on patients with migraine headaches. Materials and methods. 130 patients with migraine headaches were analyzed (13.7% male and 86.3% female). The subjects were divided into two groups; Group A patients subsequently followed an epigenetic diet enriched with 5 mg of folic acid. Group B patients didn’t follow any type of diet. Results. When analyzing the data before the start of the study, it was found that the average concentration of folic acid in Group A was 2.8+3.6 ng/ml, which was significantly lower than in Group B (p=0.003). The average level of homocysteine was significantly different in both groups (р=0.04). Furthermore, a significant decrease in the intensity and frequency of headache was found (р = 0.02; р = 0.04), and a decrease in the average level of anxiety according to the Hamilton Anxiety Scale was found (from 15.0+3.5 points to 9+2 points) (p=0.03). Conclusion. A significant effect from homocysteine and folic acid levels in migraine patients on headache severity and quality of life was observed.
PECULIARITIES OF THE GUT MICROBIOTA IN PATIENTS WITH MIGRAINE COMPARING TO HEALTHY INDIVIDUALS
(Aluna Publishing, 2022-09) Kopchak Oksana; Hrytsenko Olena; Pulyk Oleksandr
The aim: Analyze the gut microbiome state in patients with migraine (M) and healthy individuals, to assess possible correlations between the detected changes in patients with migraine and the frequency, intensity of headaches, psycho-emotional state of the patients, and their quality of life. Materials and methods: 100 objects were enrolled, divided into 2 groups: main – patients with M and control – healthy volunteers. Investigation of the intestinal microbiome was performed by chromato-mass spectrometry. For M patients the following scales were used: Visual Analogue Scale (VAS), Migraine Disability Assessment (MIDAS), Back Depression Inventory (BDI). Results: In main group increased amount of Alcaligenes spp (p = 0.0061), Clostridium coccoides (p = 0.0021), Clostridium propionicum (p = 0.0287), Eggerthella lenta (p = 0.0138), Pseudonocardiaspp (p = 0.0210),Rhodococcus spp (p = 0.0164), Candidaspp (p = 0.0079), Micromycetes spp(campesterol) (p = 0.0011) were found. Patients with M had a raised amount of Herpes simplex (p = 0.0305) and endotoxin level (p = 0.0459). Differences in gut microorganisms in both groups were significant. In patients with M negative correlations were observed between Alcaligenes spp ammount and BDI score (r = -0.6226, p =0.007), VAS score (r = -0.489, p = 0.046), headache frequency (r = -0.487, p = 0.046); between the levels of Clostridium coccoides and MIDAS score (r =-0.51, p = 0.035), BDI score (r = -0.54, p = 0.025) and positive correlation between Eggerthellalenta level and VAS score (r =0.4830, p=0.049). Conclusions: Correlations between changes of gut microbiome and M are promising for further research.
Predicting cognitive impairment and psycho-emotional disorders in Multiple Sclerosis patients according to MRI findings
(AMPH, 2022-12-30) Odintsova Tetiana; Kopchak Oksana
Objectives. The aim of our study was to assess the probability of cognitive impairment (CI) in general and in separate domains, depression, anxiety and sleep disorders onset depending on their association with MRI findings in patients with multiple sclerosis (MS). Materials and methods. 137 patients with MS were enrolled into the study. All participants were divided into two groups: group A included study subjects with relapsing remitting multiple sclerosis (RRMS) and B consisted of patients with secondary progressive multiple sclerosis (SPMS). Results. Participants with progressive forms of MS had a higher risk of CI development compare to the patients with RRMS (p=0,0361). Memory decline onset depended on the presence of the brain atrophy in combination with lesions of the parietal lobe (OR=2.74 (0.85-8.77), p <0.0001) in RRMS cases, furthermore, on presence of combined demyelination in temporal lobe with corpus callosum (OR=17.33 (2.92-103.02), p=0.0006) and parietal lobe separately (OR=7.5 (1.14-49.26), p=0.0239) in patients with SPMS. Conclusions. CI and psycho-emotional disorders can be predicted by means of MRI findings and potentially prevented.
PROGNOSTIC ASSESSMENT OF STRESS-RELATED FACTORS IN HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC
(Medicinska naklada, 2022) Pinchuk Irina; Pishel Vitaliy; Chumak Stanislav; Ilnytska Tetiana; Stepanova Nataliia; Filimonova Natalia; Kopchak Oksana; Yachnik Yulia; Kolodezhny Oleksiy; Solonskyi Andrii
Introduction: The COVID-19 pandemic is an extraordinary challenge for all countries and affects the psychological wellbeing of healthcare professionals working with people suffering from COVID-19 and puts them at a high risk of mental health problems. The aim of the study was to identify stress-related factors that affect the mental health of healthcare workers during the COVID-19 pandemic in Ukraine. Subjects and methods: A total of 1098 Ukrainian healthcare workers were surveyed using an online questionnaire consisting of questions relating to a) socio-demographic characteristics; b) perceptions of the COVID-19 related situation; and c) stress and protective factors. Respondents were divided into two groups, depending on whether they provided care to the patients with COVID-19 or not. Results: Of the 1087 healthcare workers, 863 (79.4%) were found to have anxiety / fear caused by the COVID-19. No significant difference was detected between professionals who did and did not provide personal assistance to patients with COVID-19 concerning anxiety / fear related to COVID-19 the most significant predictive factors for anxiety / fear caused by the COVID-19 were factors related to safety and risk perception (the risk of getting infected, dying, infecting loved ones, perception of the threat of the epidemic spread), information factors (constant news about COVID-19), as well as factors related to the organisation of care (lack of staff in health care facilities). Conclusions: Negative risk perception, high consumption of COVID-19 news, and shortage of staff in health care facilities were significant predictors of anxiety / fear caused by the COVID-19.
Pros and cons of remote medical education in Ukraine in terms of COVID-19 pandemics
(Elsevier Ltd., 2022-08-24) Kopchak Oksana; Odintsova Tetiana; Bachinskaya Nataliya; Ivniev Borys; Pokanevych Oleksandr
Introduction: COVID-19 is an ongoing pandemic, which forced countries across the globe to adapt all daily activities to the new reality in order to stop the disease from spreading. The educational process was not an exception, it caused a sudden shift towards the exceptional introduction of online teaching and Kyiv Medical University was one of the first universities in Ukraine to assess the quality of education under the restrictive measures Objectives: The aim was to analyze the advantages and disadvantages of online education during the COVID-19 pandemic in the learning of neurology at the Department of Neurology, Psychiatry and Physical Rehabilitation, Kyiv Medical University. Methods: 169 students were interviewed using an online questionnaire consisting of 18 items focused on different angles of educational process. Results: According to the obtained results, the biggest pros of online teaching included: flexibility of learning schedule, learning at your own pace; ability to develop deeper problem-solving and clinical thinking skills. Social distancing, family distractions, and internet connection issues negatively affected most students’ feelings during online learning. One of the most prominent cons of online learning of neurology pointed out by the majority of medical students was a lack of practical component of training and contact with patients. Conclusions: Online teaching, along with a number of advantages, has significant disadvantages, especially in medical education in case of studying clinical disciplines
Psychological well-being of Ukrainian students three months after the emerge of full-scale war
(Polish Psychiatric Association Editorial/Publishing Commitee, 2024) Pinchuk Irina; Solonskyi Andrii; Yachnik Yuliia; Kopchak Oksana; Klasa Katarzyna; Sobański Jerzy; Odintsova Tetiana
Aim. To depict overall psychological well-being of a large group of students of different universities in Ukraine three months after the emerge of the full-scale war. Material and methods. A total of 1,142 participants were asked to measure their psychological well-being on a 0–10 scale before and after the onset of full-scale war. Mental health symptoms were measured with questionnaires targeting depression (PHQ-9), anxiety (GAD-7), sleep problems (ISI), eating disorders (SCOFF), alcohol abuse (CAGE), and PTSD symptoms (PC-PTSD-5). To evaluate the connection between variables a χ2 was conducted. Phi and Cramer’s V coefficient were stated to demonstrate the power of the relationships. Additionally, machine learning (the XGBoost regression model) was used to build a predictive model for depressive symptoms. Results. Of all respondents, 66% screened positive for PTSD symptoms, 45% – moderate and severe anxiety symptoms, 47% – moderate and severe depressive symptoms. Regarding sleep, alcohol use and eating behavior, 19% of surveyed students had signs of moderate and severe insomnia, 15% reported alcohol abuse and 31% disordered eating. The severity of the aforementioned disorders varied depending on gender, year of study, social status, etc. According to the predictive model, lower initial psychological well-being, female gender, younger age, first years of study and any traumatic experience, including multiple trauma, predicted increases in depression score. Return to home after relocation was a protective factor. Conclusions. The study demonstrated the high prevalence of mental health symptoms among university students in Ukraine during the first months of the full-scale war. The psychological well-being pre-war was the strongest predictor of depressive symptoms in the model.
Reforming Undergraduate Psychiatry Training in Ukraine
(SAGE Publications, 2020-06-22) Kopchak Oksana; Pinchuk Irina; Ivnev Boris; Skokauskas Norbert
In Ukraine, mental health problems are common yet the mental health services available are still old fashioned and based on healthcare approaches used in the Soviet Union, providing mainly inpatient services and rudimentary community services. The World Health Organization (WHO) introduced the Mental Health Gap Action Programme (mhGAP) to reduce the mental health treatment gap all over the world and 2 years later introduced the WHO mhGAP-Intervention Guide (mhGAP-IG), version 2.0 (2016) as not only an educational tool, but also an evidence based guideline to scale up services for mental, neurological and substance use (MNS) conditions with an objective to reduce gap between available health systems capacity and resources for mental health. The main aim of this paper is to describe reforms of undergraduate psychiatry training in Ukraine using Kyiv Medical University as a case example. Kyiv Medical University (KMU) is the first university in Ukraine to introduce the mhGAP-IG in Ukraine. The revised psychiatry curricula in KMU aims to strengthens the evidence based teaching practices, to put emphasis on community orientated mental health care, and to use interactive teaching methods that the university hopes will attract more future doctors to psychiatry and ideally contribute towards the reduction of the mental health treatment-gap in Ukraine.
SLEEP DISORDERS IN RELAPSING-REMITTING MULTIPLE SCLEROSIS PATIENTS
(Aluna Publishing, 2021) Kopchak Oksana; Odintsova Tetiana
The aim: Our study aimed at evaluating the relationships between sleep disorders (SD), cognitive impairment (CI), anxiety and depression in patients with relapsing-remitting multiple sclerosis (RRMS). Materials and methods: One hundred and five patients with RRMS (80 females and 25 males) aged from 22 to 67 years (mean age: 41,8±10,7; EDSS:3,5±1,6; disease duration (DD): 10,3±8,5 years) were enrolled into the study. All participants completed questionnaires on sleep (the Pittsburgh Sleep Quality Index /PSQI), cognitive functions (The Montreal Cognitive Assessment /MoCA), anxiety (Hamilton Anxiety Rating Scale /HAM-A), depression (Beck Depression Inventory/ BDI). Results: According to PSQI score the patients were divided into two groups: with (n=42) and without SD (n=63). The patients with SD were older (45,36±1,66 vs 39,41±1,27, p=0.005), had higher EDSS score (3,98±0,26 vs 3,14±0,19, p=0,008), BDI (13,79±1,14 vs 8,96±0,86, p=0,0009) and HAM-A (24,52±1,42 vs 16,56±0,99, p<0,0001) scales compared with patients without SD. The frequency of anxiety (p=0,0034) and depression (p=0,038) was significantly higher in RRMS patients with compared to those without SD. No significant difference was found in gender, DD and MoCA score. In patients with SD significant negative correlation between MoCA and BDI score (r = -0,42, p<0,005) was found. In the group of patients without SD significant negative correlation between MoCA and EDSS (r = -0,27, p=0,03), MoCA and BDI (r = -0,26, p=0,043),) MoCA and HAM-A (r = -0,25, p=0,041) score was detected. Conclusions: Insomnia type SD in RRMS patients were associated with older age, higher EDSS score and presence of anxiety and depression.
The impact of the COVID-19 pandemic on patients with migraine
(SAGE Publications, 2023-04-28) Hrytsenko Olena; Kopchak Oksana; Kozyk Marko; Strubchevska Kateryna
Objectives:The aim of our work was to assess the impact of the COVID-19 pandemic and quarantine measures on migraine patients in regards to the activity of the disease, the psycho-emotional background of the patients and their quality of life. Methods:his study included 133 patients with established diagnosis of migraine. All study participants were divided into two clinical groups: A—patients with chronic and episodic forms of migraine, who had a history of positive PCR test for COVID-19, and B—patients with chronic and episodic forms of migraine who did not have a history of coronavirus disease. Results:We detected increase in the number of antimigraine medication (p = 0.04), frequency of headache attacks (p = 0.01), and the psycho-emotional state deterioration (increase in the Hamilton anxiety scale score) (p = 0.002) in patients after recovery from the coronavirus disease. There was no significant difference in the headache’s intensity according to the VAS scale (p = 0.51) as well as in the dynamics of the Beck depression scale score (p = 0.09) before and after the COVID-19 infection. Conclusion:Patients with a history of migraine who recovered from COVID-19 showed increased frequency of migraine headache attacks and anxiety.
The Implementation of the WHO Mental Health Gap Intervention Guide (mhGAP-IG) in Ukraine, Armenia, Georgia and Kyrgyz Republic
(MDPI, 2021-04-21) Pinchuk Irina; Yachnik Yulia; Kopchak Oksana; Avetisyan Kristine; Gasparyan Khachatur; Ghazaryan Gayane; Chkonia Eka; Panteleeva Lilya; Guerrero Anthony; Skokauskas Norbert
Despite the increasing burden of mental disorders, a lot of people worldwide suffer a gap in receiving necessary care in these countries. To close this gap, the WHO has developed mhGAP training modules aimed at scaling up mental health and substance use disorders services, especially in low- and middle-income countries. This article presents the experience of implementing the Mental Health Gap Action Programme (mhGAP) in Ukraine, Armenia, Georgia, and Kyrgyz Republic. Data were gathered from an electronic questionnaire administered to representatives from higher educational institutions where the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) was implemented in existing curricula for medical students, interns, and residents in family medicine and neurology, practicing physicians, and master’s program in mental health students. More than 700 students went through the programs that provided the feedback. Evaluations of program effectiveness mainly involved standard discipline tests or pre- and post-tests proposed in the mhGAP trainer manual. This finding suggested that mhGAP-IG can be successfully adapted and implemented both on undergraduate and on postgraduate education levels and among medical and nonmedical specialists. Future evaluations need to more definitively assess the clinical effectiveness of mhGAP-IG implementation.
VASCULAR RISK FACTORS AND COGNITIVE FUNCTIONS IN THE PATIENTS WITH CEREBROVASCULAR DISEASE
(Aluna, 2020) Kopchak Oksana; Bachinskaya Natalia; Pulyk Oleksandr
The aim: To assess the severity of cognitive impairment (CI) in patients with cerebrovascular disease (CVD) depending on the number of vascular risk factors (VRF). Materials and methods: The study consisted of five hundred and eighty patients with CVD (247 females and 333 males) aged from 45 to 89 years (mean age: 64,1±8,9 years). The patients were divided into 6 groups (I, II, III, IV, V, VI) depending on the number of VRF. The examination consisted of a standard clinical evaluation, neurological examination, the application of neuropsychological tests (the MMSE; the PALT/The Paired Associates Learning Test; clock drawing test), laboratory tests, MRI of brain. Results: According to ANOVA, the greater the number of VRF the patients had, the lower was their total MMSE score corresponding to more pronounced cognitive decline (F=2,97, p=0,012). A significant negative correlation between patients’ age and their MMSE score was detected regardless of their VRF count. The patients of the V and VI groups had substantially lower parameters of immediate, delayed memory and clock drawing test score comparing to the patients of the I group. Conclusions: The presence of 4 and more VRF was related to more pronounced CI in the patients with CVD. Decline of different aspects of memory, attention, spatial orientation, abstract thinking, planning, concentration, executive and visuospatial skills in groups of patients with 4,5 and 6 vascular risk factors was established. Age was substantially associated with cognitive decline in all the group of patients
WHO Mental Health Gap Action Programme Intervention Guide (mhGAP-IG): the first pre-service training study
(Springer Nature, 2020-06-29) Kopchak Oksana; Chaulagain Ashmita; Pacione Laura; Abdulmalik Jibril; Hughes Peter; Chumak Stanislav; Mendoza José; Avetisyan Kristine; Ghazaryan Gayane; Gasparyan Khachatur; Chkonia Eka; Servili Chiara; Chowdhury Neerja; Pinchuk Iryna; Belfar Myron; Guerrero Anthony; Panteleeva Lilya; Skokauskas Norbert
Background: Despite the increasing burden of mental, neurological, and substance use (MNS) disorders, a signifcant treatment gap for these disorders continues to exist across the world, and especially in low- and middle-income countries. To bridge the treatment gap, the World Health Organization developed and launched the Mental Health Gap Action Programme (mhGAP) and the mhGAP Intervention Guide (mhGAP-IG) to help train non-specialists to deliver care. Although the mhGAP-IG has been used in more than 100 countries for in-service training, its implementation in pre-service training, that is, training prior to entering caregiver roles, is very limited. Aim of the study: The aim of this study was to collect and present information about the global experience of academic institutions that have integrated WHO’s mhGAP-IG into pre-service training. Methods: A descriptive cross-sectional study was conducted using an electronic questionnaire, from December 2018 to June 2019. Results: Altogether, eleven academic institutions across nine countries (Mexico, Nigeria, Liberia, Sierra Leone, Somaliland, Armenia, Georgia, Ukraine and Kyrgyzstan) participated in this study. Five of the institutions have introduced the mhGAP-IG by revising existing curricula, three by developing new training programmes, and three have used both approaches. A lack of fnancial resources, a lack of support from institutional leadership, and resistance from some faculty members were the main obstacles to introducing this programme. Most of the institutions have used the mhGAP-IG to train medical students, while some have used it to train medical interns and residents (in neurology or family medicine) and nursing students. Use of the mhGAP-IG in pre-service training has led to improved knowledge and skills to manage mental health conditions. A majority of students and teaching instructors were highly satisfed with the mhGAP-IG. Conclusions: This study, for the frst time, has collected evidence about the use of WHO’s mhGAP-IG in pre-service training in several countries. It demonstrates that the mhGAP-IG can be successfully implemented to train a future cadre of medical doctors and health nurses.
Лікування порушень сну, що асоційовані з тривогою, у пацієнтів з розсіяним склерозом
(Харківський національний університет імені В. Н. Каразіна, 2020-06-23) Odintsova Tetiana; Kopchak Oksana; Kobys Tetiana
Порушення сну (ПС) відіграють значну роль у поглибленні інвалідизації та зниженні якості життя пацієнтів з розсіяним склерозом (РС) поряд з моторними, когнітивними та психоемоційними розладами. Метою нашого дослідження було визначення ефективності терапії порушень сну, асоційованих з тривогою, у хворих на РС та оцінка можливого впливу препарату на вираженість втоми, когнітивних розладів та проявів астенії у обстежених пацієнтів. У дослідженні прийняли участь пацієнти з РС ремітуючо-рецидивуючим та вторинно-прогресуючим типами перебігу (середній вік 43,7 ± 8,9 років; тривалість захворювання 11,3 ± 7,6 років), що мали порушення сну різного ступеня тяжкості, асоці-йованих з тривогою. Для дослідження були використані наступні шкали: Піттсбурзький опитувальник на визначення індексу якості сну (PSQI), шкала тривоги Гамільтона (HAM-A), Монреальська шкала оцінки когнітивного статусу (MоCA), модифікована шкала впливу втоми (MFIS) та шкала астенічного стану (ШАС). Відповідно до результатів Піттсбурзького опитувальника якості сну, легкі порушення виявлено до лікування у 10% пацієнтів, помірні – у 35%, тяжкі – у 55% хво-рих. За даними шкали Гамільтона, легку тривожність спостерігали у 30% пацієнтів, помірну – у 25%, тяжку – у 45% па-цієнтів до лікування. З метою лікування було застосовано препарат Валео-Дорм Дуо (кризин, мелатонін). Оцінювались динаміка показників якості сну, тривоги, когнітивних розладів, втоми та астенії із використанням відповідних шкал на тлі лікування. У 70% пацієнтів було виявлено достовірне покращення якості сну у вигляді зменшення частоти ви-ражених розладів сну та зниження рівня тривожності до легкого ступеню у 45% та помірного у 55% згідно результатів шкали тривожності Гамільтона. Застосування препарату Валео-Дорм Дуо виявилося ефективним у лікуванні пацієнтів з РС за умови поєднання порушення сну та тривоги, сприяло нормалізації сну та зменшенню проявів тривоги та астенії, а відтак покращувало якість життя хворих.