Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Influence of emotional status and quality of life in patients with cervical disc herniation on the accuracy of topical diagnosis

https://doi.org/10.14412/2074-2711-2018-4-30-35

Full Text:

Abstract

What factors negatively influence the accuracy of topical diagnosis of spinal nerve root lesion during neurological examination has not been solved until now.

Objective: to identify the nature of the relationship between the accuracy of topical diagnosis of spinal nerve lesion from neurological symptoms in patients with cervical disk herniation and the peculiarities of their emotional status and quality of life.

Patients and methods. Forty-eight patients with cervical disc herniation were examined. At first, the level of spinal nerve root lesion established during neurological examination was compared with the results of magnetic resonance imaging or computed tomography and surgical intervention. Thereafter, the importance of emotional factors in determining the accuracy of topical diagnosis is studied in these patients.

Results and discussion. If there was a divergence between preliminary neurological and final diagnoses, personality traits, such as hysteria, psy-chasthenia, alexithymia, and trait anxiety were most significant. The most substantial differences were found in the index of alexithymia. The accuracy of topical diagnosis was influenced not only by the psychological profile of patients with cervical disc herniation, but also by their qualty-of-life indicators. These are persons who are anxious and suspicious and are characterized by anxiety, fearfulness, indecision, and constant doubt. They use the symptoms of a somatic disease as a means to avoid responsibility. These patients solve all their problems, by escaping into disease, which causes social maladjustment.

Conclusion. The features of an individual's psychological profile as increased anxiety, hysteria, and psychasthenia reduce the accuracy of topical diagnosis of the lesion by 25.6%. Patients with cervical disk herniation, low quality-of-life indicators, and high scale scores for hypochondria, depression, psychasthenia, and trait anxiety need their emotional status to be corrected.

About the Authors

A. A. Chekhonatsky
V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia
Russian Federation

Andrey Anatolyevich Chekhonatsky

Moscow, 412, Bolshaya Kazachiya St., Saratov 410012



V. N. Nikolenko
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; M.V. Lomonosov Moscow State University
Russian Federation

28, Trubetskaya St., Build. 2, Moscow 119991; 331, Lomonosov Prospect, Build. 5, Moscow 



I. I. Sholomov
V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia
Russian Federation

Moscow, 412, Bolshaya Kazachiya St., Saratov 410012



V. A. Chekhonatsky
Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation

119192; 42/1, Barrikadnaya St., Build. 1, Moscow 125993



L. A. Gridin
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

28, Trubetskaya St., Build. 2, Moscow 119991



References

1. Mitskevich VA. Pathology of the cervical spine. Instability of the cervical spine. Praktikuyushchemu nevrologu. 2005;(2):18-20. (In Russ.).

2. Baptiste DC, Fehlings MG. Pathophysiology of cervical myelopathy. Spine J. 2006 Nov-Dec; 6(6 Suppl):190S-197S.

3. Young S, Aprill C, Laslett M. Correlation of clinical examination characteristics with three sources of chronic low back pain. Spine J. 2003 Nov-Dec;3(6):460-5.

4. Zaitsev VP, Tyurina OG, Aivazyan TA, et al. Features of pain perception and psychological status of patients with spinal osteochondrosis with pain syndrome. Voprosy kurortologii, fizioterapii i lechebnoi fizkul'tury. 2002;(6):30-3. (In Russ.).

5. Parfenov VA, Gerasimova ON. Management of patients with back pain in outpatient practice. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2010;2(4):65—71. (In Russ.). doi: 10.14412/ 2074-2711-2010-120

6. Bruehl S. Chung OY. Psychological and behavioral aspects of complex regional pain syndrome management. Clin J Pain. 2006 Jun; 22(5):430-7.

7. Foster N, Hartvigsen J, Croft P. Taking responsibility for the early assessment and treatment of patients with musculoskeletal pain: a review and critical analysis. Arthritis Res Ther. 2012 Feb 29;14(1):205. doi: 10.1186/ar3743.

8. Novikov AV, Yakh-no NN. Neuropathic pain. Pathophysiological mechanisms and principles of therapy. Russkii med-itsinskiizhurnal. 2001;(7-8):318-21. (In Russ.).

9. Parfenov VA, Gerasimova ON. Nonspecific back pain in outpatient practice, the use of Airtal and Midocalm. Spravochnik poliklinicheskogo vracha. 2013;(1):34—7. (In Russ.).

10. Casey E. Natural history of radiculopathy. Phys MedRehabil Clin N Am. 2011 Feb;22(1): 1-5. doi: 10.1016/j.pmr.2010.10.001. Epub 2010 Dec 3.

11. Steffens D, Hancock MJ, Maher CG, et al. Does magnetic resonance imaging predict future low back pain? A systematic review. Eur J Pain. 2014 Jul;18(6):755-65. doi: 10.1002/j.1532-2149.2013.00427.x. Epub 2013 Nov 26.

12. Tabeeva GR. Comorbidity of chronic pain and depression in neurological patients. Nevrologiya, neiropsikhia-triya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2013;5(3): 4-12. (In Russ.). doi: 10.14412/2074-2711-2013-2332

13. Яхно НН. Неврология боли. Российский журнал боли. 2014;(2):3—5. [Yakhno NN. Neurology of pain. Rossiiskii zhurnal boli. 2014;(2):3—5. (In Russ.)].

14. Yakhno NN, Preobrazhenskaya IS, Zakharov VV, et al. Prevalence of cognitive impairments in neurological diseases: Analysis of the activities of a specialized outpatient reception office. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2):30-5. (In Russ.). doi: 10.14412/2074-2711-2012-378

15. Golovacheva VA, Parfenov VA. Depression in neurological practice: prevalence, diagnosis, treatment standards and new opportunities of pharmacotherapy. Meditsinskii sovet. 2015;(5):55-61. (In Russ.).

16. Yakhno NN, Kukushkin ML. Chronic pain: medical-biological and socioeconomic aspects. Vestnik RAMN. 2012;(9):54—8. (In Russ.).

17. DePalma MJ, Ketchum JM, Saullo T. What is the source of chronic low back pain and does age play a role? Pain Med. 2011 Feb; 12(2):224-33. doi: 10.1111/j.1526-4637.2010.01045.x. Epub 2011 Jan 25.

18. Yakhno NN, Kukushkin ML. Dysfunctional mechanism of chronic pain. Rossiiskii zhurnal boli. 2014;(1):23—4. (In Russ.).

19. Cagnie B, Castelein B, Pollie F, et al. Evidence for the use of ischemic compression and dry needling in the management of trigger points of the upper trapezius in patients with neck pain: a systematic review. Am J Phys Med Rehabil. 2015 Jul;94(7):573-83. doi: 10.1097/PHM.0000000000000266.

20. Schneiderhan J, Orizondo C. Chronic pain: How to approach these 3 common conditions. JFam Pract. 2017 Mar;66(3):145-157.

21. Avdulova TP, Ter-Ovanesov MD, Yagudina OP. Features of alexithymia and subjective evaluation of interpersonal relationships in cancer patients. Kinicheskaya ispetsial'naya psikhologiya. 2016;5(3):24—39. (In Russ.).


For citation:


Chekhonatsky A.A., Nikolenko V.N., Sholomov I.I., Chekhonatsky V.A., Gridin L.A. Influence of emotional status and quality of life in patients with cervical disc herniation on the accuracy of topical diagnosis. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(4):30-35. (In Russ.) https://doi.org/10.14412/2074-2711-2018-4-30-35

Views: 202


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)