ASSESSMENT OF THE COGNITIVE STATUS AND PSYCHO-EMOTIONAL SPHERE OF WOMEN WITH A DIFFUSE THYROID GLAND ENLARGEMENT
- Authors: Glavatskikh Y.O.1, Deryaeva A.G.1, Deryaeva O.G.1, Pertsev A.V.1
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Affiliations:
- Voronezh State Medical University named after N. N. Burdenko
- Issue: Vol 12 (2023): MATERIALS OF THE XIX INTERNATIONAL BURDENKOVO SCIENTIFIC CONFERENCE APRIL 20-22, 2023
- Pages: 644-646
- Section: Medicine without frontiers
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/8366
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Abstract
Relevance In the structure of endocrine diseases, one of the main places is occupied by the pathology of the thyroid gland. The development of the intellectual and personal sphere is represented by the priority of the social level of the organization of the individual, which can change in case of violations of the somatic sphere. The role of thyroid pathologies remains one of the leading disorders of the psycho-emotional and cognitive spheres in the clinical picture, which leads to a decrease in the quality of life of these patients.
Objective The purpose of the study is to identify a violation of the psycho-emotional sphere and the cognitive status of women with ultrasound signs of an increase in the volume of the thyroid gland compared to women who have its normal volume.
Materials and methods 122 women were examined at an outpatient appointment with a district general practitioner with further determination of the thyroid gland volume using ultrasound examination on the Vivid brand. The cognitive status of patients was assessed using the Schulte test. The severity of depression was diagnosed according to the Hamilton Depression Scale (HDRS). Quality of life was assessed according to the subjective asthenia rating scale (MFI-20).
Results According to the results of the diagnosis, 54% of the surveyed women showed an increase in the volume of the thyroid gland (19.01 ± 0.64 cm3) When analyzing the data obtained, there was a deterioration in the results of questionnaires to assess cognitive status, quality of life, as well as depression scale indicators in women with an identified increase in thyroid volume.
Conclusion Detection of ultrasound disorders - indicators of the thyroid gland correlates with a decrease in indicators of psycho-emotional, cognitive spheres, as well as an increase in asthenic manifestations according to questionnaires. Among the surveyed patients, 54% showed an increase in the volume of the thyroid gland. In these patients, non-specific complaints about the deterioration of the general condition and the psycho-emotional sphere were confirmed by the data of the questionnaires used. All women who took part in the study were further examined, referred to the appropriate specialists and received the necessary treatment.
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Relevance: The prevalence of chronic noncommunicable diseases is steadily increasing every year. In the structure of endocrine diseases, one of the main places is occupied by the pathology of the thyroid gland. In goiter-endemic areas, in which about a third of the total population of the Earth lives, the prevalence of thyroid pathology reaches 50%. The development of the intellectual-personal sphere is represented by the priority of the social level of the organization of the individual, which can change with violations of the somatic sphere[1, 2]. The role of thyroid pathologies, often not confirmed by laboratory research methods, remains one of the leading in the clinical picture of disorders of the psycho-emotional and cognitive spheres, which leads to a decrease in the quality of life of these patients[3, 4].
Objective: to identify violations of the psycho-emotional sphere and the cognitive status of women with ultrasound signs of an increase in the volume of the thyroid gland in comparison with women with a normal volume of the thyroid gland according to ultrasound diagnostics. .
Materials and methods: 122 women were examined, the average age of patients was 52.5±1.65 at an outpatient appointment with a general practitioner with further determination of the thyroid gland volume using ultrasound examination on the vivid brand device. The cognitive status of the patients was assessed using the Schulte test. The severity of depression was diagnosed according to the Hamilton Depression Scale (HDRS). The quality of life assessment was carried out according to the subjective asthenia assessment scale (MFI-20). Statistical processing of the obtained data was carried out on a personal computer using the STATISTICA 12.0 software package. A comparison of quantitative indicators was carried out using the Kolmogorov – Smirnov criterion. Differences at p < 0.01 were considered reliable. The nonparametric Spearman method was used to analyze correlations.
Results: The women surveyed complained of weakness (100%), sweating (44%), weight loss over the past 6 months (23%), stool disorders (51%), mood swings (94%), memory impairment (60%), trembling sensation (45%), palpitations (87%), difficulty swallowing (35%), menstrual irregularities among women of reproductive age (40%). Diseases of the thyroid gland in the anamnesis were observed in 34% of cases. All patients were referred to the ultrasound diagnostic room to determine the standard parameters of the thyroid gland. According to the results of the diagnosis, 54% of the examined women showed an increase in the volume of the thyroid gland. The average volume was 19.01 ± 0.64cm3, the normal values for women are no more than 18 cm3. When analyzing the data obtained from the questionnaire of patients, there was a deterioration in the results of questionnaires for assessing cognitive status, quality of life, as well as indicators of the depression scale in women with an identified increase in the volume of the thyroid gland. The average value of the Schulte test was 69.15 ± 2.21 seconds, the normal cognitive status indicators according to this test ranged from 30-50 seconds. In women with normal thyroid volume, the test values were 49.2 ± 1.52 seconds, in patients with increased thyroid volume - 86.1 ± 2.34 seconds (p < 0.001). Patients surveyed with ultrasound signs of increased thyroid volume also had higher scores on the Hamilton Depression Scale compared to women with thyroid volume within normal limits, and were 25.54 ± 1.07 and 17.02 ± 1.33 points (p < 0.001). The average values of this questionnaire in the questionnaires are 21.6 ± 0.92, which indicates moderate depression. When analyzing the subjective scale for assessing asthenia (MFI-20), reflecting the quality of life and general well-being of patients, a tendency to deterioration of values in women with an enlarged thyroid gland was revealed according to the ultrasound study. The average values were 36.05 ± 1.02 points in patients with an increased thyroid volume, 14.8 ± 0.66 - with normal values of thyroid volume (p < 0.001). Thus, the average indicator is 26.3 ± 1.15 points, which is regarded as a normal value (N = 20-30 points). When analyzing correlations, the following data were revealed: a strong positive correlation was noted between the values of the thyroid gland volume and the Schulte test (r = 0.71; p < 0.001), as well as the volume of the thyroid gland and the indicators of the subjective scale for assessing asthenia (r = 0.77; p<0.001), which characterizes a decrease in the values of the cognitive sphere and a deterioration in general well-being with an increase in the volume of the thyroid gland. A moderate positive correlation was found between the Schulte test and the asthenia scale (r = 0.63; p < 0.01), as well as between the values of thyroid volume and the Hamilton depression scale (r = 0.53; p < 0.01). A similar relationship was observed in the analysis of the Hamilton scale and the Schulte test (r = 0.5; p < 0.01).
Discussion: the number of patients turning to primary care with non-specific complaints is steadily increasing, women are increasingly turning to such complaints. A thorough questioning and examination of the patient, as well as conducting the necessary diagnostic studies should lead to a clear diagnosis and immediate start of the necessary therapy.
Conclusion: The detectability of ultrasound disorders - indicators of the thyroid gland correlates with a decrease in indicators of the psycho-emotional, cognitive spheres, as well as an increase in asthenic manifestations according to questionnaires. Among the surveyed patients, 54% showed an increase in the volume of the thyroid gland. In these patients, non-specific complaints about the deterioration of the general condition and the psycho-emotional sphere were confirmed by the data of the questionnaires used. All women who took part in the study were further examined, referred to the appropriate specialists and received the necessary treatment.
About the authors
Yuliya O. Glavatskikh
Voronezh State Medical University named after N. N. Burdenko
Email: Yuliyag36@gmail.com
ORCID iD: 0000-0002-2398-5987
SPIN-code: 9762-6156
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia
Alena G. Deryaeva
Voronezh State Medical University named after N. N. Burdenko
Author for correspondence.
Email: centaurea_cyanus@mail.ru
ORCID iD: 0009-0001-7672-0982
SPIN-code: 1981-2495
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia
Olga G. Deryaeva
Voronezh State Medical University named after N. N. Burdenko
Email: centaurea_cyanus@mail.ru
ORCID iD: 0000-0002-4562-6416
SPIN-code: 2786-0295
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia
Alexander V. Pertsev
Voronezh State Medical University named after N. N. Burdenko
Email: pertsev.vrn@yandex.ru
ORCID iD: 0000-0001-8984-1831
SPIN-code: 1432-9076
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia
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