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Abstract
The study involved comprehensive clinical-anamnestic, neuroimaging and pathopsychological examination of 75 patients with dementia in Alzheimer's disease. The patients were divided into main group with a high risk of suicide (36 patients), group without signs of suicidal behavior (SB) and control group (39 patients). Patients with SB were found to have the damage of basal nuclei and alba; expansion of the cerebral fissures; subcortical damage in insular, frontal, occipital, parietal regions; hippocampal atrophy. The following factors of suicide risk in patients with Alzheimer's disease were determined: psychic trauma (life-threatening condition, loss of work or money); communicative (lack of emotional, financial and communicative support); anamnestic (suicidal attempts and depressive episodes in past); personal (physical, verbal and indirect aggression, irritability, susceptibility, negativism, suspicion and feeling of guilt); clinical (hallucinatory-paranoid syndrome). Specified predictors serve as target symptoms for psychoprophylaxis.
Key words: dementia in Alzheimer's disease, suicidal risk, predictors of suicide, clinical and psychopathological peculiarities.
КЛІНІКО-ПСИХОПАТОЛОГІЧНІ ОСОБЛИВОСТІ ХВОРИХ НА ДЕМЕНЦІЮ ПРИ ХВОРОБІ АЛЬЦГЕЙМЕРА З ВИСОКИМ РИЗИКОМ СУЇЦИДУ
Мудренко І.Г.
Проведено комплексне клініко-анамнестичне, нейровізуалізаційне та патопсихологічне обстеження, обстежено 75 хворих з деменцією при хворобі Альцгеймера. Серед них виділено основну групу з високим ризиком суїциду (36 хворих) та без ознак суїцидальної поведінки (СП), контрольну (39 хворих). У хворих з СП частіше виявлялись враження базальних ядер та білої речовини півкуль мозку; розширення щілин мозку; субкортикальне враження в інсулярній, лобній, потиличній, тім’яній ділянках; атрофія гіппокампу. Встановлені наступні фактори ризику суїциду у хворих на хворобу Альцгеймера: психотравмуючі (небезпечна для життя хвороба, втрата роботи чи грошей); комунікативні (відсутність емоційної, фінансової та комунікативної підтримки); анамнестичні (суїцидальні спроби та депресивні епізоди в минулому); особистісні (фізична, вербальна та непряма агресія, роздратованість, образливість, негативізм та підозрілість та почуття провини); клінічні (галюцинаторно-параноїдний синдром). Виділені предиктори будуть слугувати симптомами-мішенями для формування психопрофілактичних заходів.
Ключові слова: деменція при хворобі Альцгеймера, суїцидальний ризик, предиктори суїциду, клініко-психопатологічні особливості.
КЛИНИКО-ПСИХОПАТОЛОГИЧЕСКИЕ ОСОБЕННОСТИ БОЛЬНЫХ С ДЕМЕНЦИЕЙ ПРИ БОЛЕЗНИ АЛЬЦГЕЙМЕРА С ВЫСОКИМ РИСКОМ СУИЦИДА
Мудренко И.Г.
Проведено комплексное клинико-анамнестическое, нейровизуализационное и патопсихологическое обследование 75 больных с деменцией при болезни Альцгеймера. Среди них выделено основную группу с высоким риском суицида (36 больных) и без признаков суицидального поведения (СП) контрольную (39 больных). У больных с СП чаще выявлялось поражение базальных ядер и белого вещества полушарий мезга, расширение щелей мезга, субкортикальное поражение в инсулярной, лобной, затылочной, теменной одластях; атрофия гиппокампа. Установлены следующие факторы риска суицида у больных болезнью Альцгеймера: психотравмирующие (опасная для жизни болезнь, потеря работы или денег); коммуникативные (отсутствие эмоциональной, финансовой и коммуникативной поддержки) анамнестические (суицидальные попытки и депрессивные эпизоды в прошлом) личностные (физическая, вербальная и косвенная агрессия, раздражительность, обидчивость, негативизм и подозрительность и чувство вины); клинические (галлюцинаторно-параноидный синдром). В
Ключевые слова: деменция при болезни Альцгеймера, суицидальный риск, предикторы суицида, клинико-психопатологические особенности.
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