The Role of Heredity in the Development of Anxiety Disorders among Patients with a Difficult Family History of Dementia

Abstract

Dementia has a physical, psychological, social and economic impact not only on the sick person, but also on the people who care for him / her, on family members and society as a whole. Family members are prone to the development of anxiety and depressive disorders, and are often in "anxious anticipation" of the development of dementia in themselves, since the role of genetic burden in the etiology of this pathological process is undeniable. The purpose of the study was to analyze the degree of depth of anxiety disorders in first-line descendants of patients with dementia. Materials and methods. The study used clinical and anamnestic, clinical and psychopathological research methods, the syndromic approach to establishing a diagnosis and the genealogical method with the construction and analysis of a family tree. After obtaining informed consent, 26 patients (all female patients) who sought medical help from a psychiatrist during 2021-2022 with symptoms of anxiety disorder were examined. Results and discussion. Clinical and anamnestic analysis revealed a 100% hereditary susceptibility to dementia. In the genealogical analysis of pedigrees, in 65.4% of cases, the hereditary burden was traced in two previous generations, in 11.5% ‒ in three previous generations. Analyzing the results of the clinical-psychopathological examination of the level of anxiety according to the General Anxiety Disorder-7 scale, it was found that all patients had signs of generalized anxiety disorder (medium – 10–14 points and high level – 15–21 points). The results of anxiety analysis according to the Hamilton Anxiety Rating Scale confirmed the clinical results. The anxiety indicators of all patients reached from 20 to 25 points, which corresponds to an anxious state. At the same time, a clear correlation was found between the hereditary burden and the level of anxiety: patients with a hereditary burden for dementia in three generations had the highest level of anxiety, patients with a hereditary burden in two generations had a slightly lower level of anxiety, a moderate level of anxiety was detected in patients with a family history of dementia no more than in one of the previous generations. Conclusion. Considering the polygenic nature of dementia, it can be concluded that not only the genetic component plays a role in the development of certain multifactorial diseases, in particular dementia. Given the presence of an environmental component, a patient with a hereditary predisposition and genealogical burden of this disease must make efforts to minimize environmental influences. The identification of a clear correlation between the hereditary burden of dementia in generations and the severity of an anxiety disorder makes it possible to understand the approaches to pharmaco- and psychotherapeutic interventions in this contingent of individuals