Cognitive Disorders in Patients of Mental Work with Chronic Cerebral Ischemia, Their Professional Maladjustment and Burnout
Purpose. Detection of professional disadaptation and burnout manifestations, peculiarities of cognitive disorders in intellectual workers on the background of chronic cerebrovascular ischemia (CCI).Materials and methods. There were examined 110 patients with neurological and instrumental signs of CCI. The average age of patients was 60±12 years (from 40 to 77), 58.2% (n=64) females, 41.8% (n=46) males. The study included patients with higher education, who were engaged in active mental activity. All patients underwent a general examination, neurological instrumental and neuropsychological tests with the help of corresponding clinical scores. All patients were distributed into two clinical groups, according to the presence (the 1st group) or absence (the 2nd group) of atherosclerotic changes in brachiocephalic arteries.Results. The signs of anxiety disorders were observed in 39.3% of patients of the 1st group and 35.2% of patients of the 2nd group; they were confirmed according to the Hospital Anxiety and Depression Score (HADS) in 58.9% and 66.7% of the 1st and the 2nd groups respectively, which justifies the relevance of the use of the score.The results of testing with the help of the MoCA test showed the preservation of cognitive functions in the examined patients at the sufficiently high level. Subjective complaints along with normal results of neuropsychological tests were registered in 59.1% of patients. According to the data of the assessment scores, the signs of professional disadaptation were registered in 76.4% of the examined patients. Atherosclerotic changes in brachiocephalic arteries were registered in 60.9% of patients; stenosis did not exceed 70% (according to the ECST protocol).Conclusions. The evidence of professional disadaptation was registered in 76.8% of patients, while the changes in the reduction of personal achievement block (52.7%) prevailed. The professional disadaptation score is worthwhile as an additional instrument for assessment of the functional status of intellectual workers while establishing the CCI diagnosis.