К вопросу о тревожно-фобических расстройствах у больных с пародонтитом

Abstract

Під нашим спостереженням знаходилися 22 пацієнта з пародонтитом легкого та середнього ступеня тяжкості. Огляд і лікування хворих проводилися на базі Клінічної лікарні № 1. Для оцінки психосоматичного статусу реактивної і особистісної тривожності нами була використана шкала Спілбергера-Ханіна (Spielberger Ch.D., 1970) і були створені 4 групи пацієнтів: 1-а група – (n=6) – низька тривожність – 5-8 балів, 2-а група (n=6) – середня тривожність – 9-11 балів, 3-тя група (n=5) – висока тривожність – 12-17 балів, 4-та група – (n=5) – дуже висока тривожність – 18-20 балів. Метод мотиваційного інтерв’ювання чинив позитивний ефект на мотивацію хворих до лікування і в більшості випадків був успішним; Под нашим наблюдением находились 22 пациента с пародонтитом легкой и средней степени тяжести. Осмотр и лечение больных проводились на базе Клинической больницы № 1. Для оценки психосоматического статуса реактивной и личностной тревожности нами была использована шкала Спилбергера-Ханина (Spielberger Ch.D., 1970) и были созданы 4 группы пациентов: 1-ая группа – (n=6) – низкая тревожность – 5-8 баллов, 2-ая группа (n=6) – средняя тревожность – 9-11 баллов, 3-я группа (n=5) – высокая тревожность – 12-17 баллов, 4-ая группа – (n=5) – очень высокая тревожность – 18-20 баллов. Метод мотивационного интервьюирования оказывал положительный эффект на мотивацию больных к лечению и в большинстве случаев был успешным; Goal. The use of a method aimed at generating a commitment with dental treatment, to overcome unnecessary anxiety and fear and determination of the protein component of saliva in patients with periodontitis. Methods. Were examined in 22 patients with periodontitis mild and moderate severity. For the assessment of psychosomatic status was used the Scale of reactive and personal anxiety Spielberger-Khanin: 1st group (n=6) – low anxiety – 5-8 points, the 2nd group (n=6) – average anxiety – 9-11 points, group 3 (n=5) – high anxiety – 12-17 points, 4th group (n=5) – very high anxiety – 18-20 points. The control group consisted of practically healthy persons (n=10). Average age of examined patients was 35.5±6.4 years – minimum 20 years, maximum 66 years. As material for researches was samples of unstimulated mixed saliva. Saliva collection was performed in the morning by spitting in test tubes, unpeeled teeth, on an empty stomach. Usually get 3-5 ml of saliva. The determination of inflammatory proteins in saliva, total protein (REV), albumin (A) globulin (G), the ratio A/G were carried out on the biochemical analyzer BioScreenMS-200 using Human kits (Germany). Level interlaminar-1β, the main proinflammatory cytokine in the saliva was determined by enzyme immunoassay (ELISA method) on the analyzer BioscreenMS- 500 using sets of company Vector-best (Novosibirsk). Results. To dental procedures, we obtained the following data on personal and situational anxiety of patients according to the scale Spielberger-Khanin: very high anxiety was observed in 5 (22.7%) patients, high in 5 (22.7%), moderate – in 6 (27.2%), low in 6 (27.2%). Revealed that the causes of phobias in our patients are: a negative response during previous visits to the dentist, someone else’s negative experience, the transfer of negative experience of treatment in other areas of medicine in dentistry, a sense of helplessness, vulnerability, despair, which in turn causes fear. Conducting psychological research in patients with periodontitis using test Spielberger-Khanin has shown that most patients showed elevated levels of anxiety, chronic stress, caused by different types of reasons. The level of total protein in the group of healthy individuals averaged 1.14±0.1 g/l, albumin – 0.54±0.05 g/l, globulins – 0.6±0.06 g/l, the ratio A/G – 0.93±0.08, IL-1β – 42.2±6.4 PG/ml had significantly higher values of total protein, albumin, IL-1β and significantly lower values for the level of globulin in patients with high and very high level of anxiety. Correlation analysis indicates an increase in the level of total protein, albumin and IL-1β with an increase of anxiety level on a scale Spielberger-Khanin. Biochemical studies of oral fluid (total protein, albumin, IL-1β) can serve as indicators of anxiety level in patients with periodontitis in stage of aggravation of the process. Conclusion. The motivational interviewing method had a positive effect on the motivation of patients to treatment and in most cases were successful.