Neuropsychological and psychometric parameters in the patients with duodenal ulcer depending on Helicobacter pylori presence

Abstract

Background. The purpose was to study the effect of Helicobacter pylori (H.pylori) in duodenal ulcer on the neuropsychological and psychometric scores. Materials and methods. We conducted a comprehensive clinical, neurological, neuropsychological, and psychometric examination of 60 patients with duodenal ulcer aged 25–60 (the mean of 39.80 ± 1.29) years. All of them were divided into two groups considering whether H.pylori infection was detected (group 1) or not (group 2). The control group included 30 apparently healthy individuals with no somatic abnormalities. To study psychometric and neuropsychological characteristics, the patients were comprehensively tested, in particular using the Beck Depression Inventory for evaluating the severity of depression, the State-Trait Anxiety Inventory for assessing separate dimensions of state and trait anxiety, the Well-being, Activity, Mood (WAM) questionnaire, the Mini-Mental Health Examination for screening cognitive function, the Schulte tables for evaluating the refocusing speeds and performance distribution. Results. The level of depression in H.pylori-positive duodenal ulcer was significantly higher than with H.pylori-negative duodenal ulcer (p < 0.05). The patients from the group 1 had higher scores of state and trait anxiety and the lower ones of the functional state. The concentration of attention detected by means of the Schulte tables was lower in these patients. A direct correlation was found between the degree of depressive disorders and the number of complaints associated with psycho-emotional disorders in the patients with duodenal ulcer (r = 0.61). We found an inverse correlation (p < 0.05) between the anxiety level and the WAM indices, on the one hand, and between depressive disorders and the WAM indices, on the other hand, in the patients with duodenal ulcer. Depression and anxiety were comorbid in 73.3 % of cases in the group 1 and in 30 % of cases in the group 2. Conclusions. The complaints associated with psycho-emotional disorders occurred in the patients with both H.pylori-positive and H.pylori-negative duodenal ulcer; however, they were more frequent in the group 1. The clinical presentations of depression were observed in both groups, but the depression level was significantly higher in the patients with H.pylori-positive duodenal ulcer (p < 0.05). An increase in anxiety was also found in both groups; however, the rates of state and trait anxiety were higher in the group 1. At duodenal ulcer exacerbation, no matter if H.pylori infection was present or not, the patients had unsatisfactory well-being, low activity, and poor mood. The decreased indices of the functional state self-assessment were detected in the group with H.pylori-positive duodenal ulcer. Using the Schulte tables, we found that a decrease in attention concentration was more evident in the group 1 that in the patients with H.pylori-negative duodenal ulcer. Thus, having conducted the neuropsychological and psychometric testing, we conclude that H.pylori infection has not been the main cause of psycho-emotional disorders in duodenal ulcer, but if the patients were infected, the dysfunction was more severe. It was subject to the increased frequency of psycho-emotional complaints, the deterioration in the patients’ sense of well-being, the increased levels of anxiety and depressive disorders.