Clinical and Psychopathological Characteristics of Psychotic Disorders of Senile Age, Occurring in the Postoperative Period.

BACKGROUND: The course of the postoperative period in patients who underwent surgical interventions is often complicated by cerebral disorders. The aim of the research was to examine the clinical and psychopathological, pathopsychological, clinical and dynamic features of psychotic disorders, occurring after surgical interventions conducted using general anesthesia in patients of senile age with concomitant psychiatric pathology of the defect and organ register.

SUBJECTS AND METHODS: The study relied on examination of 67 subjects who had psychotic disorders after surgical interventions conducted using inhalation anesthesia. Depending on the etiological factor of cognitive impairment, the examined patients were divided into two groups. Group I included 33 people in whom the vascular component was the leading etiological factor for cognitive impairment. Group II included 34 patients (22 women and 12 men, average age - 75.3 ± 1.8 years), in whom cognitive disorders were due to atrophic processes. The study applied clinical and psychopathological, psychodiagnostic and statistical methods of research.

RESULTS: The concomitant defect and organic symptoms caused by vascular diseases of the brain are a risk factor for psychotic disorders in the postoperative period as compared to atrophic processes (p<0.05). Delirium syndrome, observed in the subjects of Group I, had signs of hyperactive subtype (p<0.05). At the same time, delirium syndrome, which occurred in the postoperative period in patients of Group II, had signs of the hypoactive subtype. Patients were more likely to be drowsy or sedative (p<0.05). Patients of Group II, the recovery time was longer (p<0.05), and the concomitant atrophic pathology of the brain caused a certain therapeutic resistance to psychotic disorders that occurred in the postoperative period.

CONCLUSIONS: The obtained results indicate the heterogeneity of symptoms of postoperative psychotic disorders of senile age, depending on various concomitant psychiatric and neurological pathologies.