actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.12737/article_5a3a0e794aff80.62275471actabiomedica-518Research ArticleПСИХИАТРИЯ, НАРКОЛОГИЯ И ПСИХОЛОГИЯPSYCHOLOGY AND PSYCHIATRYК вопросу о выделении группы риска наличия психических расстройств в практике кардиологического отделенияOn the issue of allocation of a risk group for the presence of mental disorders in the practice of cardiology departmentДорофейковаМ. В.DorofeikovaM. V.mvdorofeykova@mail.ruЗадворьевС. Ф.ZadvoryevS. F.zadvoryexsf@yandex.ruПетроваН. Н.PetrovaN. N.petrova_nn@mail.ruЯковлевА. А.YakovlevA. A.yakotema@gmail.comФГБУ «Санкт-Петербургский научно-исследовательский психоневрологический институт им. В.М. Бехтерева»Bekhterev Psychoneurological Research InstituteСПб ГБУЗ «Городская многопрофильная больница № 2»City Multifield Hospital N 2ФГБОУ ВО «Санкт-Петербургский государственный университет»Saint-Petersburg State UniversityФГБОУ ВО «Санкт-Петербургский государственный университет»; СПб ГБУЗ «Городская многопрофильная больница № 2»Saint-Petersburg State University; City Multifield Hospital N 220172809201725(2)114120Copyright © Дорофейкова М.В., Задворьев С.Ф., Петрова Н.Н., Яковлев А.А., 20172017Дорофейкова М.В., Задворьев С.Ф., Петрова Н.Н., Яковлев А.А.Dorofeikova M.V., Zadvoryev S.F., Petrova N.N., Yakovlev A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/518

В настоящее время остро стоит проблема дифференциальной диагностики соматической и соматоформной патологии в клинике внутренних болезней. Целью исследования явились разработка алгоритма, позволяющего на этапе поступления выявить группу пациентов многопрофильного стационара, имеющих показания для консультации психиатра и психотропной терапии. Материал и методы. Проведен регрессионный анализ данных 1031 пациента кардиологического отделения многопрофильного стационара с целью выявления факторов, определяющих рекомендации приема психотропной терапии при выписке. Результаты. Предложен алгоритм для выделения среди пациентов кардиологического профиля лиц, требующихмультидисциплинарного подхода в лечении с привлечением специалистов в области психического здоровья. В число входящих в формулу факторов вошли лабильная или пароксизмальная артериальная гипертензия (Л), число сопутствующих (некардиологических) диагнозов (Д), женский пол (П) и сердцебиение или нарушения сердечного ритма с дебютом до 55 или 50 лет (С): И = 8 х Л + Д + 3 х П + 3 (6) х С. Выводы. Выявленные закономерности могут быть полезны в клинике внутренних болезней для скрининга пациентов на предмет высокого вклада психоэмоционального фона в тяжесть состояния. Врачам стационаров общесоматического (терапевтического) профиля следует обращать более пристальное внимание на психоэмоциональное состояние больных с лабильной АГ, ранним дебютом нарушений сердечного ритма, большим количеством сопутствующей патологии. Пациенты, соответствующие указанным критериям, с большой вероятностью нуждаются в консультации психотерапевта или психиатра ввиду наличия психосоматических или сопутствующих психических расстройств.

Differential diagnosis of somatic and somatoform pathology is a pressing issue in general practice. The aim of this study was to develop an algorithm for identification of the patients with indications for psychiatrist's consultation and possible psychotropic therapy at the stage of admission to multi-disciplinary hospital. Material and methods. Regression analysis of data of 1031 patient hospitalized in the cardiology department of a multiprofile hospital was done with the aim of identifying factors determining the recommendation for receiving psychotropic therapy at discharge. Results. An algorithm for allocation among patients of cardiological profile individuals that require a multidisciplinary approach to treatment involving experts in the field of mental health is proposed. Factors included in the formula were labile or paroxysmal hypertension, the number of associated (non-cardiological) diagnosis, female gender and heart rate or heart rhythm disorders with the debut at the age below 55 or 50 years: I = 8 х L + D + 3 х F + 3 (6) х H. Conclusion. The revealed pattern may be useful in the clinic of internal diseases for screening of patients with a high contribution of the emotional state the severity of the condition. The doctors of the hospitals of somatic (therapeutic) profile should pay more attention to the psycho-emotional condition of patients with labile hypertension, early onset of cardiac arrhythmias, and large number of comorbidities. Patients that meet the criteria are likely to need a consultation of a psychotherapist or psychiatrist because of the presence of psychosomatic or other mental disorders.

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The authors declare that there are no conflicts of interest present.