THE MECHANISMS OF PSYCHOLOGICAL DEFENSE IN THE FORMATION OF COMORBIDITY IN CARDIOVASCULAR DISORDERS

The relevance of research on cardiovascular diseases (CVD) stems from their high mortality rate. The comorbidity of CVD with other disorders exacerbates disease chronification and therapeutic resistance. To study clinical and psychological shifts, taking into account the mechanisms of psychological protection (MPD), in patients with CVD and comorbid disorders in order to develop the most effective therapeutic, diagnostic, preventive approaches and improve the quality of life of patients. A total of 84 respondents were examined at the M.M. Mirrakhimov National Center of Cardiology and Internal Medicine of the Ministry of Health of the Kyrgyz Republic, as well as at several medical centers in Bishkek. Participants were aged between 30 and 70 years; 51 were women (60.7 %) and 33 were men (39.3 %). The respondents were divided into two groups: 48 (57.1 %) patients with hypertension and 36 (42.9 %) with comorbid disorders. Materials and research methods: A semi-structured interview, anxiety and depression scales, the Plutchik – Kellerman – Conte scale of psychological defenses, SPSS 16.0 for Windows, and Microsoft Excel were used for data collection and analysis. Assessment of anxiety levels revealed clinically significant anxiety in 25 participants (29.8 %) and subclinical anxiety in 33 (39.3 %). Clinically significant depression was observed in 13 respondents (15.5 %), while 24 (28.6 %) demonstrated subclinical depression. In both groups, the most prominent defense mechanisms were denial, compensation, and regression. However, these mechanisms were significantly more pronounced in the group with comorbid disorders (p < 0.05). Statistically significant correlations were found between anxiety and depression (p < 0.01), duration of illness and frequency of medical visits (p < 0.01), as well as among various psychological defense mechanisms. Conclusion: Subclinical levels of anxiety and depression, along with increased use of defense mechanisms such as denial, compensation, and regression, and their significant correlations, contribute to the development of stable comorbid relationships. These psychological factors play a substantial role in the chronification of both cardiovascular and comorbid disorders.