CLINICAL SIGNIFICANS OF ANXIETY AND DEPRESSIVE DISORDERS IN PATIENTS WITH METABOLIC SYNDROME

Abstract

Currently, depression is increasingly considered as one of the triggers in the development of metabolic syndrome. This is due to the fact that affective disorders contribute to the formation of risk factors, which, according to the recommendations of the All-Russian Scientific Society of Cardiology for the diagnosis and treatment of metabolic syndrome, lead to the development of metabolic disorders. The main risk factors are: overeating, physical inactivity and hypertension.

And indeed, in a state of depression, the physical activity decreases, appetite increases, and hyperreactivity of the sympathetic nervous system (sympathicotonic syndrome) is a trigger factor

for increased blood pressure. The fact that the association between depression and metabolic syndrome is a "two–way street" is confirmed by the results of a prospective cohort study of Whitehall II in 2009, which was performed by T.N. Akbaralya et al. Epidemiological studies are currently represented by data from samples of patients with metabolic syndrome quite large volumes. The most representative are the studies published in 2004 by L.S. Kinder et al. The authors of the work, which analyzed the material collected over 6 years, indicate that in a group of 3003 examined people aged 17 to 39 years, the proportion of people with metabolic syndrome is 2 times higher in cases where there is a history of an episode of depressive disorder. L. Witterberg et al. proposed the concept of "low melatonin syndrome" in patients with depressive disorders. According to this model, low melatonin levels may be the main reason for a decrease in the levels of norepinephrine and serotonin in the brain and indirectly affect the dysfunction of the hypothalamic-pituitary system, which in turn can be used as a marker of predisposition to the development of depressive disorders. At the same time, there are works discussing the role of melatonin in the development of dysmetabolism. In recent years, there has been an increase in patients with metabolic syndrome, which is a  significant medical problem. The severity of clinical manifestations of metabolic syndrome affects the quality of life of patients, while physical and mental health indicators decrease. Obesity leads to anxiety disorders, neurosis-like conditions and depression, which contributes to the deterioration of the underlying disease. The available clinical and experimental data convincingly show the presence of multiple pathophysiological links that explain the high probability of the formation of metabolic syndrome in people with anxiety and depressive disorders.