Early affective disorders in patients who underwent thrombectomy for thrombotic occlusion: comparison of objective and subjective assessments

Background. The work is devoted to the comparison of subjective and objective assessment of early affective disorders in patients who underwent thrombectomy of thrombotic occlusion. Purpose – to determine the features of self-perception of existing affective disorders in patients who underwent thrombectomy of thrombotic occlusion in the early postoperative period, and to compare them with objective examination data. Materials and methods. During 2023–2024, a prospective study of 96 patients who underwent thrombectomy for thrombotic occlusion was conducted at the Center for Roentgen Endovascular Neurosurgery of the Kyiv City Clinical Hospital № 1 (Kyiv, Ukraine). The study of early psychiatric consequences took place in the early postoperative period – on the 7–8th day after surgery using clinical-anamnestic, clinical-psychopathological and psychodiagnostic research methods. An objective assessment of the affective sphere of patients was carried out using the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS). The Hospital Anxiety and Depression Scale (HADS) and the Altman Self-Rating Mania Scale (ASRM) were also used – diagnostic tools that are based on a subjective assessment of the severity of existing affective disorders. Results. The features of self-perception of existing affective disorders in patients who underwent thrombectomy of thrombotic occlusion in the early postoperative period were determined. In particular, a dissociation was revealed between the indicators of objective and subjective assessment of the severity of depression and anxiety: a wide range of manifestations remained without attention of patients or were perceived by them as neurological consequences of a suffered cerebral catastrophe and/or performed surgical intervention; isolated cases of manic symptoms, identified by objective assessment by a specialist, did not correlate with the data of self-reports of patients, which also indicates the absence of criticism of patients on psychopathological manifestations of this spectrum. Conclusion. The obtained data on the peculiarities of self-perception of affective disorders in patients who underwent thrombectomy for thrombotic occlusion form the basis for a personalized system of comprehensive rehabilitation of these patients.