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Abstract
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The article presents the leading pathoanatomical, clinical-anamnestic, and pathophysiological factors that influence the formation of suicidal behavior in patients with mixed dementia. The research included 60 patients; 30 of them made the main group with suicidal behavior (SB) in the clinical picture, 30 patients made the control group without SB.
METHODS of research: neuroimaging, clinical-anamnestic, psychodiagnostic (MMSE scale, Clinical Dementia Scale (CDR), Suicidal Risk Assessment Scale, The Self-Consciousness Death Scale, Hamilton's Depression Rating Scale, Barthel Index, Bass-Darky Questionnaire, Method of Statistical Processing of the Results). It was revealed that the main structural characteristics of patients with high risk of suicide in mixed form of dementia were the signs of expansion of subarachnoid spaces, deepening of the cerebrum fissures, periventricular leukoaraiosis, expansion of the cisterns of bases of the brain, reduction of brain matter density in the projection of basal nuclei, aneurysm of ACA, post-stroke cysts, infarction in the middle and posterior cerebral artery. The clinical-psychopathological predictors of SB in this category of patients include the following: expressed cognitive deficit, severity and predominance of inhibited or agitated depression; suicidal intentions, difficulties in falling asleep, paranoid symptoms, presence and severity of daily fluctuations in mood; feeling of hopelessness and helplessness, anxiety, irritability and suspicion, guilt, verbal aggression, and the presence of chronic diseases. Among the factors of psychological trauma, there are the following: loss of a beloved person in connection with death or divorce, changes in life or in the environment, which caused the SB formation. The anamnestic correlates of SB were revealed: the presence of previous suicidal attempts in the case history and depressive episodes in the past. The lack of emotional and financial support, as well as negative attitude towards the environment were mostly expressed in patients with high suicidal risk. The pronounced degree of dependence on others is a factor of anti-risk of SB. © 2018, UE Professional Editions.
Language: ru |