Nonpsychotic mental disorders in patients with benign hypersplasia of the prostate gland (clinic and therapy)
Background: Benign prostatic hyperplasia (BPH) is the most common disease of the genitourinary system in elderly men. It hampers social functioning and reduces the quality of life. The aim of the study: To develop approaches to the provision of psychotherapeutic care of elderly patients with BPH based on the verification of the clinical picture of nonpsychotic psychiatric disorders. Materials and methods: 120 patients with BPH and nonpsychotic psychiatric disorders were examined: 60 patients treated conservatively and 60 patients at the stage of preparation for surgical intervention. The following research methods were used: clinical-psychopathological, psychometric and statistical (descriptive statistics, criterion c2 for conjugation tables 2x2, coefficient of rank correlation of Spearman). Results: It has been established that borderline mental disorders are observed in patients with BPH in 84.5%–89.5% of cases. The most representative were prolonged anxious and anxious-depressive reactions (18.3%–27.5%), apathic depressive and hypochondriacal (8.3%–15.0%), anxious-phobic reaction (16.7%) and anxiety-subdepressive and anxious reactions with conversion symptoms (13.3% and 11.7%). In patients with conservative therapy, the symptomatology was moderately expressed (17.5±0.09 points) and they assessed the quality of life as "unsatisfactory" (3.8±0.09 points), but those patients subject to surgical treatment were detected (t> 33.2 p<0.0001) to have more severe symptoms (31.1±0.4 points), and the quality of life was assessed (t>10.8 p<0.0001) as poor (5.2±0.1 points). Anxious, egocentric and ergopathic types of response to the disease were prevalent. Conclusion: Differentiated psychotherapy in the structure of complex treatment of patients with BPH with nonpsychotic psychiatric disorders should be built taking into account the basic approach to the therapy of somatic disease. This approach allows to reduce the degree of intensity of affective tension and fear of surgical intervention at the hospital stage, to reduce the main psychopathological symptoms and to teach skills of self-regulation.