Clinical features of asthenic disorders in chronic heart failure

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OBJECTIVE

The aim of the study is to study the clinical features of asthenic disorders in chronic heart failure (CHF) considering the reaction to the disease.

MATERIAL AND METHODS

62 inpatients with CHF II—IV functional class (FC) according to NYHA were examined. Research methods included somatic, psychopathological and pathopsychological examination using psychometric scales.

RESULTS

According to a pathopsychological study using the Multidimensional Fatigue Inventory (MFI-20), asthenic disorders were discovered in all examined patients, realized mainly by «general fatigue» (75.8%) and «physical fatigue» (72.6%), more rarely «mental fatigue» was observed (32.2%). Correlations of «general fatigue» with the age of patients were revealed (p=0.018). There was a relationship between the severity of asthenic disorders and the severity of CHF, as evidenced by the correlation between «general fatigue» and reduced ejection fraction (EF) of the left ventricle (p=0.005), as well as «physical fatigue» and FC according to NYHA (p=0.022). The negative impact of all components of the dimensions of asthenic disorders on the quality of life was determined (p<0.05). According to the concept of the formation of different perceptions of the manifestations of a somatic disease, two types of reactions to asthenic disorders were identified: 1. Dissociative reactions, manifested by a discrepancy between the severity of CHF and a subjective assessment of the condition with an underestimation of the asthenic symptoms denial of its influence on the usual lifestyle and associated with an unfavorable course of CHF and 2. Adaptive reactions, realized by a harmonious perception of asthenia, awareness of the need to change lifestyle considering the presence of CHF symptoms.

CONCLUSION

In accordance with the results, the described clinical features of asthenic disorders allow to distinguish asthenia in CHF and other pathology, and the identified types of reactions can contribute to the timely verification of asthenia, prevention of further progression of CHF, and the development of appropriate treatment approaches.

Keywords:

chronic heart failure

asthenic disorders

dissociative disorders

denial

Authors:

Fomicheva A.V.

Mental Health Research Center

Volel’ B.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University);
Mental Health Research Center

ORCID: 0000-0003-1667-5355

Troshina D.V.

Sechenov First Moscow State Medical University

Andreev D.A.

Research Institute for Healthcare Organization and Medical Management of Moscow Health Department

ORCID: 0000-0003-0745-9474

Simonov A.N.

Mental Health Research Centre

Zozulya S.A.

Mental Health Research Center

ORCID: 0000-0001-5390-6007

Klyushnik T.P.

Mental Health Research Center

ORCID: 0000-0001-5148-3864

Received:

09.08.2022

Accepted:

25.09.2022

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