Mental disorders in polycythemia vera (review of clinical cases according to literature data)

Introduction. In the literature, mental disorders (MD) occurring in patients with polycythemia vera (PV) as secondary manifestations have not been sufficiently studied. Objective: to study MD in association with PV based on the analysis of clin-ical cases, mainly described in the English-language scientific literature, in order to establish the relationship between symp-toms, risk factors, and outcomes. Materials and Methods. Search, selection, and systematic analysis of clinical cases (PV with MD) retrieved from the PubMed database to compare treatment outcomes. Keywords for information search were: “polycy-themia vera”, “mental disorders”. Results. The review is devoted to the analysis of literature data on the materials of published clinical case studies of MD in PV in English. Organic MD is a characteristic mental manifestation of PV. Somatogenic psycho-pathological symptoms in PV are very diverse. In clinical practice, nonpsychotic MD and psychoses, such as delirium and par-anoid, are highly common in patients with PV. Cognitive and anxiety disorders, depressive and manic syndromes are de-scribed. The appearance of signs of MD (anxiety, depression, restlessness, irritability, depression, cognitive decline) in patients with PV in the development of the disease indicates disease progression. Elder patients are at risk for developing MD in PV. Although it is difficult to state the cause-and-effect relationship between MD and PV with certainty, their common risk factors, however, the improvement in the condition of patients within a short time after phlebotomy and normalization of the hemoglo-bin level allow assuming that in these cases PV led to the development of secondary mental disorders. Positive dynamics (im-provement of the physical and psychological state, pain reduction, improved prognosis) after cytoreduction indicated the pres-ence of a reversible pathogenetic mechanism causing MD. Conclusion. The identification of secondary, potentially correctable or eliminable factors causing the development of MD is extremely important for preventing iatrogenic harm from unjustified pharmacological treatment with psychotropic drugs and minimizing the risk of delay in diagnosis and treatment. Timely diag-nosis and therapy of MD at early stages in patients with PV contribute to the optimization of treatment and rehabilitation measures, prevention of complications, reduction of adverse effects of the disease and disability.