FEATURES OF PRIMARY HYPOTHYROIDISM IN FORCIBLY DISPLACED PERSONS AS A BASIS OF FORMATION COGNITIVE AND ANXIETY-DEPRESSIVE DISORDERS

The purpose of this research is to study the clinical and psychopathological features of the formation and course of anxiety-depressive disorders in forcibly displaced persons suffering from primary hypothyroidism. Materials. In order to achieve this purpose, a comprehensive examination of 144 patients of both sexes aged 30–55 years with primary hypothyroidism of varying severity and etiology, who were diagnosed with anxiety- depressive disorders, was carried out on the basis of Educational and Scientific Medical Complex «University Hospital of Kharkiv National Medical University» in compliance with the principles of bioethics and medical deontology. Results. The main group consisted of 85 patients — forcibly displaced persons, the comparison group included 59 patients permanently residing in the Kharkov region. The following examination methods were used in the work: anamnestic, clinical-neurological, clinical-psychopathological, clinical-biochemical. Conducted clinical-psychopathological analysis allowed us to identify depressive, anxiety-depressive and anxious variants of emotional disorders in the examined patients. It is established that the IDPs affected by primary hypothyroidism more often have depressive syndrome (37.1 % surveyed with mild, 35.1 % with moderate and 22.1 % severe primary hypothyroidism), by contrast to the surveyed persons of the comparison group (22.5 %, 23.6 % and 20.9 % respectively). It is proved that the decrease of thyrotrophic hormone (below 2,0 мМО/l) level in the examined patients led to the activation of anxiety manifestations both in patients of main group (40.7 % surveyed with mild, 45.3 % with medium and 57.5 % severe primary hypothyroidism) and comparison group (41.35 %, 48.9 % and 59.9 % respectively). The free T4 level was in the range of 13.0–15.6 pmol/l, in both groups. Cognitive impairment took the lead in the clinic of dysmetabolic encephalopathy against the background of hypothyroidism and was manifested by a decrease in memory and concentration, distraction, the inability to concentrate on a specific task for a long time, a slowdown in the rate of thinking, and sometimes a decrease in intelligence. Thus, in conditions of deficiency of thyroid hormones in both comparison groups, there was a significant decrease in the ability to concentrate, increased fatigue, decreased exercise tolerance and overall cognitive performance (sometimes there was a significant decrease).