Psychometric parameters in patients with trigeminal neuralgia: changes in result of surgical treatment (report 2)
Abstract
Objective – to investigate the changes of psychometric indicators in patients with trigeminal neuralgia in the immediate postoperative period as a result of microvascular decompression of the trigeminal nerve root. Materials and Methods. 56 patients (32 women) underwent surgery for trigeminal neuralgia were included in the study. The patient’s age ranged from 26 to 80 years. For the study we used pain scales, HADS, «catastrophizing pain scale», scale «Subjective evaluation of the treatment effectiveness», and clarified the presence of suicidal ideation, aggravation and extraction of secondary gain from illness. Results. None of the patients appreciated the interference of «excellent» via scale «subjective assessment of treatment effectiveness» despite the complete absence of pain in the majority of patients (78.6 %). The evaluation «good» was delivered by 16.1 % of patients, «satisfactory» – 69.6 %, «no change» – 8.9 %, «got worse» – 5.6 %. In the evaluation of the intervention effectiveness a significant impact has exaggeration of symptoms (p = 0.01). In a study in the early postoperative period anxiety increased in 48.2 % of patients and depression – in 26.8 %. According to the results of clinical and psychological examination 40 % patients showed secondary gain from illness after surgery. Conclusion. Psychological characteristics of patients with trigeminal neuralgia affect the assessment of the dynamics of pain resulting from surgery, while patients are more focused on their overall condition after the intervention, regardless of the original state. After the intervention due to changes in the social status of patients they need time and psychological assistance for social adaptation, regardless of the results of operations.
Key words
Rzaev J.A. – neurosurgeon, e-mail:d_rzaev@neuronsk.ru
Moysak G.I. – neurologist, e-mail: g_moisak@neuronsk.ru
Zubok N.A. – clinical psychologist, e-mail: n_zubok@neuronsk.ru
Amelina E.V. – senior researcher, e-mail: amelina.evgenia@gmail.com
Kulikova E.V. – neurosurgeon, «Federal Neurosurgical Center», e-mail: e_kulikova@neuronsk.ru
Aftanas L.I. – academician of RAS, doctor of medical sciences, professor, psychiatrist, director
Krylov V.V. – academician of RAS, doctor of medical sciences, professor, neurosurgeon, head of neurosurgery and neuroreanimation department
