PSYCHO-EMOTIONAL CHANGES IN PATIENTS WITH MYASTHENIA GRAVIS

Kalbus O. I.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The aim of the study is to study the level of anxiety and depression in patients with myasthenia gravis, depending on the clinical form and class of the disease. Research materials and methods. 182 patients with myasthenia gravis were included into the study. The Beck Depression Inventory was used to assess depression; the Spielberg-Khanin Anxiety Score was used to assess anxiety. Antibodies to acetylcholine receptors (AchR), to muscle-specific tyrosine kinase (MuSK), to titin, to SOX1 were evaluated. Results. AchR antibodies were detected in 124 (68.1%) patients in the general sample (including 108 (73.5%) patients with generalized and 16 (45.7%) with ocular form). The mean titer was 4.05 (1.55; 6.55) nmol/l in the total sample, 0.8 (0.6; 1.2) nmol/l in patients with ocular myasthenia gravis, 4.8 (2.4; 7.05) nmol/l in patients with generalized myasthenia gravis. Antibodies to MuSK were detected in 16 (8.8%) patients in the general sample, all of these patients had a generalized form of myasthenia gravis. The mean titer was 6.0 (1.45; 6.95) nmol/l. Titin antibodies were detected in almost one-third of all surveyed patients – 53 (29.1%) of the total sample (all of them had generalized form of myasthenia gravis). Antibodies to SOX1 were detected in 10 (5.5%) of the total sample (all with generalized form). The mean level of depression, determined on the Beck depression inventory, was 6.0 (3.0; 11.0) points in patients with ocular form, whereas 19.0 (12.0; 29.0) points in patients with generalized form (p <0.001). An assessment of anxiety level showed that in most patients (75.3%) the level of PA was high (more than 45 points), mean 52.0 (45.0; 60.0) points. RA was in most cases moderate (73.1%), mean 50.0 (44.0; 59.0). The level of both PA and RA. As well as depression increased with increasing disease class, ie with increasing disease severity (p<0.001). Depression level correlates with RA scores (ρ = 0.73; p <0.001), and with PA (ρ = 0.75; p <0.001). PA correlates with RA (ρ = 0.89; p <0.001). The level of depression correlates with the clinical form of myasthenia (generalized) (ρ = -0.52; p <0.001), with class (ρ = -0.30; p <0.001) and the disease subclass (ρ = -0.36; p <0.001)). PA score correlates with the clinical form of myasthenia (generalized) (ρ = -0.44; p <0.001), class (ρ = -0.20; p = 0.007) and the disease subclass (ρ = -0.23; p = 0.002). RA score correlates only with the clinical form of myasthenia gravis (generalized) (ρ = -0.35; p <0.001), with no correlation with class or subclass of myasthenia (p>0.05). The depression score correlates with the presence (ρ = 0.15; p = 0.040) and the AchR antibody titer (ρ = 0.42; p <0.001), with the presence (ρ = 0.18; p = 0.016) and the MuSK antibody titer (ρ = 0.19; p = 0.011). RA and PA scores correlate with the presence (ρ = 0.24; p = 0.001 and ρ = 0.25; p = 0.001, respectively) and the AchR antibody titer (ρ = 0.43; p <0.001 and ρ = 0.47; p <0.001, respectively). Conclusions. The development of depression and increased anxiety are mainly typical for patients with generalized myasthenia gravis. The level of depression and the level of anxiety increase with increasing of the severity of myasthenia gravis. Anxiety in patients with myasthenia gravis correlates with the presence and titre of antibodies to AchR, and depression correlates with the presence and titer of antibodies to AchR and MuSK.

myasthenia, depression, anxiety, antibodies, class, subclass, generalized form, ocular form.

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«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 97-101 pages, index UDK 616.74+616.8]-009.17-036.8

10.29254/2077-4214-2019-4-2-154-97-101