The structure of non-psychotic mental disorders, alexithymia and anxiety in patients with aseptic necrosis of the femoral head

Abstract

Aseptic necrosis of the femoral head (ANFH) is a severe chronic poliaethiologic disease of the hip joint which is prevalent mainly in young people with a loss of professional and social skills. It is known that the non-psychotic mental disorders appearance in patients with ANFH can lead to the increasing disability, the decreasing in the quality of life, and difficulties in organizing the rehabilitation period. Current researches prove that the preoperative mental state assessment in patients can lead to the statistically significant decrease of the pain intensity in the postoperative period, an improvement in the quality of life related to health, a decrease in anxiety, depression and behavioural problems in the postoperative period. The aim of this research was to study the syndromic features of non-psychotic mental disorders, alexithymia and anxiety levels in patients with ANFH at the preoperative stage. The study involved 137 people aged 25 to 75 years, who were diagnosed with ANFH and identified non-psychotic mental disorders. Clinical-psychopathological and psychodiagnostic methods of examination were used (AUDIT test, Toronto alexithymia scale-20, Taylor manifest anxiety scale). The patients were divided into two groups depending on the ANFH duration. The results of the study revealed the main leading syndromes: asthenic-depressive – in 35.8%, depressive-hypochondriac – in 18.2%, anxious-phobic – in 16.1%, anxious-depressive - in 15.3% and astheno-apathetic – in 14.6% of cases. The average anxiety score was 26 (19; 37), which indicates the presence of a medium-high level of anxiety in the examined, while 52.5 percent of patients had high and very high levels of anxiety. A multivariate logistic regression analysis was performed and as a result, the duration of the disease (OR: 2.23; 95% [CI]: 1.11-4.47; p<0.05), estimates of alexithymia (OR: 2.52; 95% [CI]: 1.00-6.36; p<0.05) and female sex (OR: 2.16; 95% [CI]: 1.03-4.50; p<0.05) were found to be independent risk factors associated with the level of anxiety in persons with ANFH at the preoperative stage.