Clinical and Psychopathological Aspects of Nosogenic Reactions in Chronic Heart Failure

OBJECTIVE:To study the typology of nosogenic reactions in chronic heart failure (CHF) with the determination of the contribution of cardiological and personality factors in their formation.MATERIAL AND METHODS:One hundred and twenty-one patients with nosogenic reactions associated with CHF were examined. Somatic, clinical-psychopathological and psychometric examinations were used.RESULTS:Three types of nosogenic reactions in CHF have been identifiedSignificantly more frequent were dissociative reactions (76 (62.8%) patients, 40 men, 36 women, mean age 64.4±12.7) with an underestimation of the severity of the somatic condition, which formed in CHF with a short (3.2±3.8 years, p<0.05), but the most severe course. They were associated with hyperthymic, hysterical and schizoid personality radical. Hypochondriacal reactions (28 (23.1%) patients, 18 men, 20 women, mean age 63.4±15.2), due to anxiety about health and excessive fixation on the functioning of the heart, were characteristic of CHF, regardless of the severity of cardiological conditions, with an average duration of the course (4.1±4.2 years). They were observed in patients with anxious and hysterical radicals. Depressive reactions (17 (14%) patients, 8 men, 9 women, mean age 64.3±13.5), had the most protracted character (6.1±3.2 years), formed in patients with anankastic and schizoid radicals, and were noted in chronic heart failure with a long course and moderate severity. Heterogeneous nosogenic reactions in CHF were associated with low adherence to treatment due to maladaptive behavior of the patient, determined by the characteristics of the psychopathological structure.CONCLUSION:The study demonstrates the influence of the characteristics of a cardiac disease and personality on the clinical and psychopathological features of nosogenic reactions associated with maladaptive behavior of the patient.