ASSESSMENT OF PSYCHOLOGICAL ADAPTATION LEVEL IN HIV INFECTED WITH NON-PSYCHOTIC MENTAL DISORDERS

Spirina I. D., Fauzy E. S., Gnenna O. M., Kovalenko T. U., Shirokov O. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

There was revealed a lack of research on mechanisms for the formation of behavioural abnormalities in HIV-infected people after the preliminary survey of scientific literature. The purpose of the study. Assessment of the level of psychological adaptation in HIV infected with non-psychotic mental disorders, depending on the presence of self-destructive (auto-aggressive) behaviour. The object and methods of research. The comprehensive clinical and psychodiagnostic survey of 43 HIVinfected patients with non-psychotic mental disorders was conducted, which included analysis of primary medical documentation, clinical and diagnostic interview, M. Luscher’s “Color Test” (eight-color version), Montreal Cognitive Assessment (MoCA) and the methodology of psychological diagnostics of types of attitude to the disease (TAD). The examined patients were divided into 2 groups of observation, depending on the presence/absence of selfdestructive (auto-aggressive) behaviour. The statistical processing of the results was carried out using the STATISTICA 6.1 software (StatSoftInc., Serial No. AGAR909E415822FA) using the corresponding tasks of the descriptive and analytical biostatistics methods. Results and discussion. The age of the examined patients ranged from 21 to 58 years and amounted to an average of 38.53 (8.10) years – M (SD). Among the examined patients, infected males (62.79%) with secondary education (48.84%), unemployed (69.77%), and single (69.77%) heterosexual orientation (83.72%) prevailed. The duration of HIV infection in them ranged from 1 month to 20 years and amounted to an average of 4.0 (0.5, 7.0) years – Me (25%, 75%). The leading place in people without symptoms of self-destructive behaviour is asteno-depressive disorder, in patients with autoaggression is anxiety-depressive disorder (29.41% and 19.23% respectively, p <0.05). Cognitive impairment (less than 26 points for MoCA) was detected in 34 patients (79.07%). The choice of purple color was in the first place along with the main colors at 20.93% when the Lusher test was the total deviation from the autogenous norm of color selection was observed in almost half of the cases of HIV infected patients. Types of relations with the disease characterized by violations of personal and psychosocial adaptation were 58.14% (the main type of response – sensitively ergotaptic) with the predominance of interpersonal maladaptation over intrapsychiatric. Conclusion. In spite of a certain proportion of HIV-infected persons adapted to the disease, in most patients there is an interpersonal and, to a lesser extent, intrapsychiatric disadaptation. The examined patients react to the disease mainly by the sensitively ergopathic type. In general, those infected with HIV who have a self-destructive behaviour have discovered a greater degree of adaptation disorders compared to the group without auto-aggressive behaviour.

HIV infected, non-psychotic mental disorders, psychological adaptation, Luscher test

1. Global AIDS Monitoring 2018: Ukraine. Summary n.d. Available from: http://www.unaids.org/sites/default/files/country/documents/ UKR_2018_countryreport.pdf (accessed December 4, 2018).
2. Baingana F, Thomas R, Comblain C. HIV/AIDS and mental health. The World Bank; 2005.
3. Nedelcovych MT, Manning AA, Semenova S, Gamaldo C, Haughey NJ, Slusher BS. The Psychiatric Impact of HIV. ACS Chem Neurosci. 2017;8:1432-4.
4. Del Guerra FB, Fonseca JLI, Figueiredo VM, Ziff EB, Konkiewitz EC. Human immunodeficiency virus-associated depression: contributions of immuno-inflammatory, monoaminergic, neurodegenerative, and neurotrophic pathways. J Neurovirol. 2013;19:314-27.
5. Neigh GN, Rhodes ST, Valdez A, Jovanovic T. PTSD co-morbid with HIV: Separate but equal, or two parts of a whole? Neurobiol Dis. 2016;92:116-23.
6. Schadé A, van Grootheest G, Smit JH. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients. BMC Psychiatry. 2013;13:35-45.
7. Chibanda D, Benjamin L, Weiss HA, Abas M. Mental, Neurological, and Substance Use Disorders in People Living With HIV/AIDS in Low- and Middle-Income Countries: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2014;67:54-67.
8. Rybalko VO, Yasnikova EE, Aitov KA. Rasprostranennost’ i osobennosti nepsihoticheskih psihicheskih rasstrojstv u VICH-inficirovannyh, poluchayushchih vysokoaktivnuyu antiretrovirusnuyu terapiyu v stacionarnyh usloviyah. Social’naya i klinicheskaya psihiatriya. 2015;2:40-4. [in Russiаn].
9. Valieva TV, Eltsova AV. Psihologicheskaya adaptatsiya VICh-infitsirovannyih i zdorovyih lyudey. Vestnik Uralskogo instituta ekonomiki, upravleniya i prava. 2016;3(36):59-69. [in Russiаn].
10. Valeeva AM, Muhametova RN, Sinyushina NN. Patopsihologicheskoe issledovanie i sravnenie sostoyaniya affektivnoy sferyi v dvuh gendernyih gruppah VICh infitsirovannyih bolnyih. VICh infektsiya i immunosupressii. 2010;2(3):82-7. [in Russiаn].
11. Stan’ko EHP. Social’noe funkcionirovanie VICH-inficirovannyh potrebitelej narkotikov. GrGMU. 2018. 316 s. [in Russiаn].
12. Pohorilko OV, Skrypnikov AM, Herasymenko LO, Isakov RI. Autoahresyvna povedinka pidlitkiv. Poltava: TOV «ASMI»; 2017. 141 s. [in Ukrainian].
13. Pshuk NH, Kyryliuk NP, Stukan LV. Kliniko-psykhopatolohichni osoblyvosti VIL-infikovanykh patsiientiv. Arkhiv psykhiatrii. 2012;18:29-33. [in Ukrainian].
14. Sannikova OE, Solov’ev AG, Sidorov PI. Social’no-psihologicheskie aspekty dezadaptacii VICH-inficirovannyh lic v penitenciarnoj srede. Ehkologiya cheloveka. 2009;4:20-4. [in Russiаn].
15. Vovk VI. Psychoemotional state in HIV infected male patients at early and late stages of HIV disease. Psykhiatriia, nevrolohiia ta medychna psykholohiia. 2014;1:72-6.
16. Spirina ID, Rokutov SV, Hnenna OM, Lazarenko AM. Kliniko-psykhopatolohichni ta psykholohichni osoblyvosti povedinky pry nepsykhotychnykh psykhichnykh rozladakh u khvorykh na VIL (ohliad literatury). Dermatovenerolohyia. Kosmetolohyia. Seksopatolohyia. 2017;1(4):87-93. [in Ukrainian].
17. Sobchik LN. MCV – metod cvetovyh vyborov. Modificirovannyj vos’micvetovoj test Lyushera. Prakticheskoe rukovodstvo. SPb.: Izd-vo «Rech’»; 2001. 112 s. [in Russiаn].
18. Timofeev VI, Filimonenko YuI. Cvetovoj test M. Lyushera. SPb.: Imon; 2001. 47 s. [in Russiаn].
19. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-9.
20. Vasserman LY, Yovlev BV, Karpova EB, Vuks AIa. Psykholohycheskaia dyahnostyka otnoshenyia k bolezny: posobye dlia vrachei. SPb.: SPb NYPNY ym. V.M. Bekhtereva; 2005. 32 s. [in Russiаn]. 

«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 167-173 pages, index UDK 6616.89-008-036-07-08:616.98:578.828

10.29254/2077-4214-2019-1-1-148-167-173