THE EFFECT OF COGNITIVE-BEHAVIORAL THERAPY ON INDICATORS OF LIPID AND CARBOHYDRATE METABOLISM IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE ON THE BACKGROUND OF ABDOMINAL OBESITY.

OBJECTIVE: The aim: Analyse the impact and effectiveness of cognitive-behavioural therapy in patients with NAFLD on the background of AO on indicators of lipid and carbohydrate metabolism. PATIENTS AND METHODS: Materials and methods: 85 patients with NAFLD and obesity of the 1st degree (42 women, 43 men) were examined. All patients were divided into two clinical groups: 1st group (research) - 48 people, who underwent a course of CBT for 6 months; the control group - 37 people, who followed only diet therapy, recommended physical activity, without involvement in CBT. The general clinical examination of patients consisted of the measurement of anthropometric and physiological indicators, the study of lipid and carbohydrate profile indicators. RESULTS: Results: After a 6-month course of CBT, a decrease in the atherogenic coefficient (AC) was recorded in the patients of the 1st group in 2.29 times (p=0.037<0.05), the number of patients with hypertension of the 1st degree decreased in 1.8 times (p=0.0047<0.05) in comparison with the initial indicators (on the 1st day) and amount of patients with normal blood pressure of the 1st group increased by 2.4 times (p=0.0115<0.05) compared to the control group. CONCLUSION: Conclusions: The course of CBT should be an integral component in the program for the management of obese patients to optimize not only the psycho-emo¬tional condition, but also to correct lipid and carbohydrate metabolism indicators, reduce the risk of developing cardiovascular and neurological complications.

EATING BEHAVIOUR AND OBESITY: GENDER-AGE FEATURES.

OBJECTIVE: The aim: Identify the types of eating behaviour in overweight and obesity depending on gender and age. PATIENTS AND METHODS: Materials and methods: A survey of 210 people (men -105, women -105) was conducted. The age of women ranged from 19 to 60 years, the average age was 41.5 ± 11.2 years. The age of men ranged from 22 to 60 years, the average age was 42.3 ± 12.3 years. The examined patients were divided into two clinical groups: group I - 70 people (women - 35, men - 35) with overweight. BMI of persons of the I group from 25.8 kg / m2 to 29,3 kg / m2 (BMTmid. = 27,5 ± 1,31 kg / m2); Group II - 72 people with 1st degree obesity (women -36, men - 36). Evaluation of eating disorders was carried out using the DEBQ questionnaire (Nederland) adapted to the purpose of the study. RESULTS: Results: In patients of groups I and II healthy type of eating behaviour was recorded less often than in control groups, 5.38 times (D = 13.561, p = 0.002 <0.05) and 10.45 times (D = 21.043, p = 0.022 <0.05), respectively. In group I, the restrictive type of EB among women occurred 1.7 times more often than in men (D = 0.852, p = 0.001). In group II, the restrictive type of EB among women was observed 1.3 times more often than in men (D = 0.382, p = 0.005). CONCLUSION: Conclusions: Restrictive eating behaviour disorders are one of the leading factors in the development of overweight and obesity. Correction of eating disorders in obese people must be carried out taking into account the gender and age characteristics of the patient, to obtain positive results for a shorter course of treatment.

Pain as leading syndrome of the somatoform disorders at the pediatrics.

OBJECTIVE: The aim: Study of somatoform vegetative dysfunction' clinical features at adolescent age with a chronic pain (HA syndrome and AP syndrome), and also socially-psychological factors of its formation too. PATIENTS AND METHODS: Materials and methods: There are 82 teenagers have been examined in this research: 48 girls (58,5 %) and 34 young men (41,5 %) at the age of 16 - 17 years. Research will be done according to diagnostic criteria of ICD-10. RESULTS: Results: An aetiological basis of HAS and APS are various somatoform disorder mostly at teenage age (70,8 % cases at girls and in 58,8 % - at young men). 32,2 % of the patients had various neurotic disturbances with anxiety-depressive symptoms in a genesis of HAS and APS. Somatoform vegetative dysfunction - the most widespread reason of HAS and APS development among teenagers. Among teenagers HAS cases (68,8 % - at girls, 58,8 % - at young men) essentially prevail over APS (31,2 and 41,2 % cases accordingly). All adolescents had combine negative life events in their life. Girls felt psychotraumatic experience more strongly than young man. The greatest combine negative life experience has been revealed in a subgroup of girls with HAS. The least influence of psychotraumatic factors was observed at young men with APS. Consequently, SVD, accompanied by severe pain in adolescence - is pathogenic complex and combined mental disorders, requiring adequate psychopharmacological and psychotherapeutic intervention. CONCLUSION: Conclusions: Chronic stressful situations were experienced by each of the examined patients. Each of the teens noted combination of stress problems in their lives. The widespread common problem among the examined adolescents was a sense of being overprotected by parents. Consequently, SVD, accompanied by severe pain in adolescence -is pathogenic complex and combined mental disorders, requiring adequate psychopharmacological and psychotherapeutic intervention.