Some Pathogenic Mechanisms of the Development of Mental Disorders in Patients with Cardiology Pathology

Introduction. The issue of mental disorders in patients with cardiovascular diseases is currently highly relevant. Developing mental disorders significantly worsen the course and prognosis of cardiovascular disease. These conditions substantially reduce patients' quality of life, delay rehabilitation, and increase the risk of repeated hospitalizations. The aim of this review is to analyze current data on the pathogenetic mechanisms of mental disorders in patients with cardiovascular pathology and to assess their impact on disease progression and outcomes. Materials and methods. Russian and international publications on comorbid mental and cardiovascular pathology from 2003 to 2025 were analyzed. The following resources were used for literature search: ScienceDirect, CyberLeninka, JournalDoctor.Ru, Springer. Results. Depression is diagnosed in 15–20% of patients with cardiovascular diseases, while preoperative anxiety is observed in 55% of patients undergoing cardiac surgery. Younger women, as well as individuals with unstable angina and myocardial infarction, are at a higher risk of developing depressive disorders. The dysfunction of the frontal brain regions plays the most significant role in the development of anxiety-depressive syndrome. Postoperative delirium occurs in 26–52% of patients, depending on the type of surgery, and results from hypoxia, hypercapnia, and inflammatory processes. The key pathogenetic mechanisms include neurohormonal changes, endothelial dysfunction, neurotransmitter system disruptions, and systemic inflammatory responses. The incidence of various clinical types of postoperative cerebral dysfunction in cardiac surgery varies: perioperative stroke is detected in 1–9% of surgical cases; symptomatic delirium in the early postoperative period is observed in 7–52% of patients; and delayed cognitive impairments are recorded in 10–80% of patients. Discussion and conclusion. Of particular interest is the relationship between mental disorders and the pathophysiological processes accompanying cardiovascular pathology. Neurohormonal changes, inflammatory responses, blood-brain barrier disruption, and neurotransmitter system dysfunction exacerbate the progression of both psychiatric and cardiovascular diseases. These mechanisms create a vicious cycle in which mental disorders increase the severity of cardiovascular diseases, while somatic pathology, in turn, worsens mental health. Investigating the pathogenetic mechanisms of mental disorders in patients with cardiovascular disease holds not only theoretical but also practical significance for the development of novel personalized treatment approaches, early diagnosis, and correction of identified disorders.