Lyashchenko Y. Differentiated approach to the correction of sleep disorders in anxiety-depressive disorders

The aim of the study: to develop a comprehensive phased differentiated treatment and correction program for sleep disorders in anxiety-depressive disorders of neurotic and organic genesis. The thesis establishes the clinical, psychopathological and pathopsychometric features of patients with anxiety-depressive disorders of neurotic and organic origin associated with sleep disorders, and conducts a comparative analysis of the latter. The relationships between sleep disorders and anxiety-depressive symptoms were revealed and the impact of dissomnia on the quality of life of patients and their social functioning was assessed. The study was based on the data of a comprehensive examination of 120 patients aged 18 to 65 years, who were diagnosed with anxiety-depressive disorders of various genesis, accompanied by sleep disorders. Patients were divided into 4 groups depending on the genesis of the disease and the method of its medical correction. Representatives of the 1st and 3rd (main) groups were treated according to the program developed by the researchers, and in patients of the 2nd and 4th (comparison groups) the standard therapy algorithm was used. Clinical-anamnestic, clinical-psychopathological, psychodiagnostic (supplemented with psychometric scales) and statistical methods of research were applied. Taking into account the obtained data, the leading psychopathological syndromes were established and differential diagnostic criteria for patients with anxiety-depressive disorders of various genesis associated with sleep disorders were created. In addition, in order to more correctly identify psychotherapeutic targets and optimize psychotherapeutic intervention, cognitive models of leading psychopathological syndromes were formed. Scientific novelty: for the first time the clinical features and comparative analysis of sleep disorders in patients with anxiety-depressive disorders of organic and neurotic genesis were studied. The significance of sleep disorders influence on the course of anxiety-depressive disorders of organic and neurotic genesis was assessed and proved, and their impact on the quality of life of patients was investigated. Based on the established clinical and psychopathological features, the main patterns of anxiety-depressive disorders with sleep disorders depending on the genesis of the disease were formed and differential diagnostic criteria were determined. An evaluation of the effectiveness of a comprehensive phased differentiated treatment and correction program for patients with anxiety-depressive disorders of organic and neurotic genesis with dyssomnias was developed and conducted. A set of factors that determine the rate of the positive effect of treatment development in patients with anxiety-depressive disorders of various genesis associated with sleep disorders has been established. The clinical significance is based on the development of a comprehensive step-by-step differentiated treatment and correction program for patients with anxiety-depressive disorders of organic and neurotic genesis with sleep disorders and the determination of criteria for predicting the effectiveness of treatment. In addition, differential diagnostic criteria for anxiety-depressive disorders with sleep disorders depending on the genesis were determined. Cognitive models of the leading psychopathological syndromes were formed in order to identify psychotherapeutic targets and optimize the therapeutic effect. Key words: sleep disorders, anxiety, depression, mental disorders, melatonin, cognitive deficit, endothelial dysfunction, complex treatment, psychotherapy, quality of life.