In everyday practice, the doctor rarely encounters only one specific disease, more often a patient with comorbid pathology comes to him. Such a group of concomitant diseases are mental disorders. Their prevalence in cardiology practice reaches 80%. Mood affective, anxiety and somatization disorders, as well as cognitive impairment are observed most often. The review looked at mental disorders that occur in cardiac diseases with the highest number of deaths, such as coronary heart disease, including myocardial infarction and cardiac arrhythmias, arterial hypertension and cerebrovascular diseases. Including attention is paid to the senile asthenia syndrome, which is accompanied by cognitive impairment, loss of previous vital interests and depression. The review highlights the questions of regular and adequate psychopharmacotherapy of cardiovascular diseases, which leads to a statistically significant decrease in the frequency of their exacerbations, which reduces the number of doctors who come to see for somatogenic symptoms, and also allows to improve the prognosis of the underlying disease and significantly reduce mortality. It was observed that the doctor should take into account the fact that modern cardiological preparations have effects that can cause side effects in the form of mental disorders when choosing a therapy. Understanding the processes of formation and occurrence of mental diseases in a patient with cardiovascular pathology, as well as methods for their correction, can increase the effectiveness of the therapy and improve the prognosis of the underlying disease.

Aim. To assess the effects of acquired social status, neurotic conditions, type D personality, cognitive functions, quality of life and adherence to treatment on psychosocial adaptation of patients with coronary heart disease (IHD) to chronic heart failure (CHF), depending on the severity of decompensation. Methods. 87 patients with coronary artery disease and chronic heart failure aged between 55 and 72 years were examined. All patients were divided into two groups depending on the functional class of chronic heart failure [New York Heart Association (NYHA) class IIV]. The first group included 41 patients with NYHA functional class III, the second group 46 patients with NYHA functional class IIIIV. For a comprehensive study of the psychosocial adaptation of patients, a set of standardized questionnaires was used: the abridged variant of the Minnesota Multiphasic Personality Inventory (SMOL), a clinical questionnaire for identifying and assessing neurotic condition, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 36-Item Short Form Health Survey Questionnaire (SF-36), the Mini Mental State Examination (MMSE), 14-question test Type D Scale-14 (DS14), MoriskyGreen test, the short version of the AUDIT questionnaire (AUDIT-C). We collected data on the patient's social status: gender, education, income level. The results obtained were analyzed. Results. Based on the SMOL personality profiles, patients of the second group were classified as neurotic an increase was noted in three neurotic scales: hypochondria (U=541; p=0.030), hysteria (U=579; p=0.048), and autism/schizoid (U=577.5; p=0.047) compared with patients of the first group. According to the results of the clinical questionnaire for the identification and assessment of neurotic condition, the greatest differences were found between patients of first and second groups on the scale of autonomic disorders (U=571; p=0.039) and neurotic depression (U=576; p=0.046). Comparing the groups according to the MLHFQ score, quality of life in patients of the second group was markedly reduced (U=447.5; p 0.001). According to the SF-36 questionnaire, a decrease in the quality of life was also found in patients of the second group on the scale Physical functioning (U=554; p=0.032) and Physical component of health (U=573.5; p=0.044). The cognitive status in patients of the second group was significantly decreased compared with the first group (U=427; p 0.001). No significant differences were found in adherence to treatment between the two groups (U=757; p=0.666). Also, there were no patients with type D personality on both subscales (U=717.5; p=0.483, U=784; p=0.933) and according to the AUDIT-C scores, there are no significant differences between men (U=681.5; p=0.257) and women (U=728.5; p=0.425) in both groups of patients. Conclusion. Signs of social maladjustment in patients with more severe NYHA functional class of the disease are expressed by significantly more pronounced social isolation (autism), a tendency to avoid communicating with others, isolation on their own problems and hypochondriacal attention to the somatic manifestations of chronic heart failure; probably, the main reason that reduces the level of social adaptation is a high score in neuroticism, which leads to a functional decrease in cognitive abilities and a significant deterioration in quality of life.