The use of antidepressants in the complex therapy of patients with breast cancer
The problem of mental health and subjective perception of quality of life by cancer patients is currently specifically relevant. Most patients with breast cancer (BC) in the process of adaptation to their disease experience some mental disorders: depressive, anxiety-phobic and psychosomatic disorders. Objective: to study the severity of anxiety-depressive tendencies in the clinical picture of the disease and to evaluate the effectiveness of psychopharmacotherapy with the use of antidepressants in breast cancer patients with identified disorders of the anxiety-depressive spectrum. Material and Methods. The study included 30 patients with newly diagnosed breast cancer (on average 6.8±1.2 months from the date of diagnosis) and 52 patients with a follow-up period of 3-17 years. Basic methods: clinical-psychopathological and clinical-dynamic. The psycho-pathological assessment was carried out in the framework of clinical analyzes using an interdisciplinary approach. To assess the severity of anxiety-depressive syndrome in the clinical picture and the effectiveness of treatment, special standard scales were used: hospital anxiety and depression scale (HADS), clinical global impression scale (CGI) for assessing the severity of the disease (CGI-S “severity”) and improvement of mental state (CGI-I “improvement”). To assess the effectiveness of psychopharmacotherapy, psychometric data were processed statistically using the Statistica 10 program (method using the Chi-square test). Results. High rates of effectiveness of antidepressant therapy in combination with benzodiazepine drugs and hypnotics were obtained in the group of patients with anxiety-depressive nosogeny (88% of responders with a reduction in the starting points of anxiety and depression on the HADS scale more than 50%, on the CGI scale 85%), in the group of patients with chronic hypochondriac dysthymia and cyclothymic endoform depression (respectively 93.7% and 90.6%). The data obtained in this study confirm the effectiveness of psychopharmacotherapy with antidepressants in breast cancer patients with identified disorders of the anxiety-depressive spectrum. Conclusion. The presented clinical results can significantly contribute to the creation of new forms of optimization of psychiatric and psychological care for cancer patients when treating and diagnosing in an oncological hospital