ARTICLES ARCHIVE

With the purpose of studying personality psychosexual development and its influence on formation of behavior in women with somatization disorder (SD) as well as the role of psychosocial and sociogenic factors, 93 both married and unmarried female patients were investigated. The methods included clinical interview, systematic structural analysis of sexual health. I. Botneva's scale was used to determine the type of sexual constitution in women and G.Vasiltchenko's scale - in men. V. Krishtal's classification was used to determine the type of sexual motivation. The obtained findings allowed formulating the laws of disorders in general and sexual behavior of women with SD: delay in phasing psychosexual development, fragmentary assimilation of sexual roles, disharmonious development of sexuality. Dynamic monitoring of adolescents with inadequate behavior, allowing timely psychocorrecting measures to prevent development of pathocharacteriological personality features and disorders of communication, is recommended.

The authors feature one of the urgent tasks of medical psychooncology, improvement of the physician's knowledge about the psychology of the patient and his/her relatives and communicative competence. It is noted that oncologists work with overload, interaction with psychological and psychiatric services has not been established yet. Impotence of psychoeducational and training programs for medical personnel, including such aspects: the psychological state of cancer patients and their parents, psichodeformity, the impact of cancer treatment on physical and mental development of the child, the role of the family, quality of life, ethical and legal issues, etc. are emphasized. Particular attention is paid to communication training for health professionals to teach effective communication with the patient and his family, which will improve the quality of medical care, psychosocial adaptation of the child and his relatives.

To clarify the role of the phenomenon of social and psychological frustration (SPF) in development of mental adaptation disorders, experimental psychological examination of 1630 employees of Main Branch of Ministry of Home Affair of Ukraine in Donets region was performed. Psychopathological symptoms were studied using a questionnaire SCL-90-R (L.R. Derogates et al.) and method "The level of social frustration" (L. Wasserman, et al.). The results showed that the basic mechanisms of the factors contributing to the SPF on the structure and expression of psychopathology were universal in gender, but in women with psychosomatic disorders their role and polymorphism are higher than those in men. This should be considered when developing specific corrective treatment conducted among the employees of internal affairs departments.

Typological peculiarities of compliance in patients with essential hypertension (EH) as well as the factors influencing its formation were investigated. Psychodiagnostic examination was done in 114 patients with EH using R.B. Cattell's and SCL-90 questionnaires, techniques "TOBOL", "Coping behavior in stress situations", "Level of subjective control", etc. On the basis of correlation and factor analysis typology of compliance, including clinical (EH stage, duration of illness, hospitalization), socio-demographic (gender, age) and psychological (personal characteristics, coping, locus control, internal picture of disease, emotional sphere disorders, communicative sphere, quality of life) factors were distinguished. The obtained findings are important for therapeutic behavior of patients with essential hypertension, timely inclusion in the therapeutic process of psychocorrecting measures to optimize compliance, which can improve the treatment of this group of patients.

Sexual function of 120 men with various types of asynchronous psychosexual development: simple, combined, complicated was investigated. Sexual constitution of the patients was studied by G.Vasilchenko's scale, self-esteem was determined by Dembo - Rubinstein technique, the type of attitude to the disease - using a special technique. The dynamics of sexual manifestations and levels of sexual activity indicated a decline in sexual needs at all age levels, that is most characteristic of simple and combined types. For complicated asynchronias characterized by accelerated puberty and delayed psychosexual development, and vice versa, the level of sexual activity did not differ from the norm. The findings of the research can be used to study the questions of disproportional psychosexual development.

A comprehensive system of psychological management of 55 adolescents with puberty retardation (PR), which aims to stabilize their emotional state by correcting deadaptative types of internal picture of the disease, is presented. It is based on the principle of individuality. The program included 8 - 10 sessions with teenagers 40 - 50 minutes each in the hospital and, 2-3 consultative meetings with the parents. The work was organized in four phases: preparatory, diagnostic, development and implementation of the program, performance evaluation. After completion of the course the patients demonstrated a positive dynamics (increased adaptive capacity, decreased anxiety, frustration, aggression). The positive impact of cooperation with the psychologist was noted in 75% of adolescents. The proposed system showed high efficacy and can be used for psychocorrection work with adolescents with PR.

Clinical psychological mechanisms underlying the process of somatization, variants of its clinical implementation in out-patient mental disorders in patients with pneumoconiosis were identified. The study included 493 patients KLPU "OKBPZ" of Donetsk. The mental state of patients was assessed according to the criteria of ICD-10. Somatization is an intermediate form that incorporates a variety of clinical variants of neurotic and affective disorders, including diseases of the lungs. It was noted that its mechanisms (guilt, nosophysiological symptom complex, autoaggression, denial syndrome) could be considered as targets for purposeful psychocorrection intervention, the effectiveness of which depended on the conceptual substantiation, pathogenetic relationship, specific targeting. The findings of the research may be useful in formation of new diagnostic and therapeutic models in summarization disorders.

To study the problem of burn out, clinical-psychological study of 22 oncologists was performed using the questionnaire to identify the socio-demographic characteristics, Henning's test "Motivation of medical profession choice", "Diagnosis of emotional burn out level" according to Boyko, temperament evaluation according to Belov were used. Emotional burn out syndrome (EBOS) is a type of professional deformation of the personality, which has several aspects, emotional, intellectual, social, psychosomatic. It was found out that EBOS was closely related to the processes of personality self-actualization, life choices, professional motivation and adaptation features. It is emphasized that physical and spiritual strength of doctors are inadequate to the conditions of payment for their work, but their main motive is still a good job. The prospect of further research is development of measures of EBOS psychoprophylaxis in oncologists.

The influence of hopelessness phenomenon (HP) on suicide behavior (SB) motivation was investigated in a group of 650 persons. The examination was conducted in a hospital in view of their somatic and psychological state on day 3-5 day after the suicide attempt. Questionnaires NEO-PR, BDI, TAS, GAF, the WHO scale of well-being, PFAV and other were used. Statistical study consisted of 3 phases: 1) construction of the initial regression model reflecting causal relationship between HP and expressiveness of desire of death, 2) evaluation by ordinal regression analysis of the role of moderators, 3) evaluation of the possibility of prediction of suicidents attribution to the groups of moderation. The obtained data allow identification of two risk groups under the influence of HP: men suffering from anxiety disorder and women with chemical addiction. The proposed gender typology deepens understanding of the relevant issues of suicidology, which is important both for SB prevention and in working with people who have already tried to commit suicide.

The differences of personality characteristics, behavioral patterns, emotional expressiveness were analyzed in 41 healthy women and 108 mothers in the state of prolonged stress whose children were treated at the Center of Psychological Rehabilitation for Disabled Children named after Ya.Korchak for autism, cerebral palsy, Down's syndrome. Taylor's tests, tests of "life orientations" by Leontiev, "self-esteem" and "degree of emotional codependence" by Weinholds were used. This study demonstrates the importance of reducing the level of anxiety, the importance of constructivity in overcoming frustrating situations, high self-esteem, the need for an adequate response to negative emotions, vision of the future to maintain mental and physical health, prevention of psychosomatic and neurotic pathology.

Psychological problems associated with obesity in adolescents are analyzed on the material of foreign scientific publications. The researchers state that the problem of overweight in children as a global epidemic. The main factors contributing the features of the mental state of obese adolescents, determining their quality of life, affecting the effectiveness of the treatment of the physical illness are featured. An important socio-psychological aspect of obesity is risk of patients victimization. The role of the family, parental psychopathology is important. The measures for active involvement of the parents as exclusive mediators in the program of behavioral therapy are developed. In order to prevent and treat obesity in children motivational interview is used. Psychotherapeutic interventions in the system of rehabilitation of adolescents with obesity may focus on patients and family systems, which can be used in our medical practice.

Disruption in the system "mother - child" in the postnatal period results in a traumatic situation causing poor adaptation, delayed psychomotor development. To study this problem on the basis of the Kharkiv City Hospital No.9, 154 women after a normal delivery, and their children with typical development of early age were investigated. The study consisted of 5 stages and included clinical interview, the use of techniques self-esteem diagnosis by Spielberg - Hanin, Edinburgh postnatal depression scale, readiness to motherhood by Mescheriakova, child psychomotor development assessment by Zhurba-Mastyukova. The results showed that the level of psychological development children of psychologically well-to-do mothers was higher than in babies of women with psychoemotional sphere disorders (unavailability of women for motherhood and presence of maternal anxiety-depressive symptoms). Protective factors (high readiness for motherhood and family support) contribute to the optimal level of cooperation in "mother - child" system.

Clinical psychopathological investigation of 352 children aged 3 months - 10 years with perinatal damage of the nervous system, in whom in 11.36% of cases autistic spectrum disorder (ASD) was diagnosed, was performed. To qualify nerve disorders CARS scale was used. The results show a significant prevalence of ASD in children with perinatal brain injury, and their clinical symptoms related to medical, psychological and educational issues. Uniform basic principle of autism is training determined by primary representation (ABA, FLOOR TIME, TEACCH). The need for a multidisciplinary approach to autism, when each member of the team can show psychiatrist driven activity is emphasized. Care should be provided at specialized centers for children with ASD.

Comparative characteristics of the level of compliance was done in women with paranoid schizophrenia, according to abdominal obesity. The factors that adversely affect compliance were analyzed. The study involved 93 patients of KhCPH No. 3 using techniques PANSS, TSQM. The women were divided into 3 groups depending on the body weight. The results showed that the level of compliance in patients with overweight is highest, which allows better therapeutic alliance with them and improvement of the prognosis of antipsychotic therapy. However, the patients who are overweight and obese have lower levels of physical functioning, discomfort, which may adversely affect the compliance. These studies must be considered when treating these patients.

Based on a comprehensive interdisciplinary study the authors identified the marker targets and the principles of psychocorrection of patients with various forms of anxiety disorders (AD). The study included 144 patients with the diagnosis of neurotic, stress-related and somatic disorders according to ICD-10. Questionnaire SCL-90-R, IES-R scale, etc. were used. The leading role of the personal radical (internal representation of self, perception system) in the formation, clinical manifestations, dynamics of AD was proven. Common and differentiated principles of psychocorrection in patients with AD were worked out on the basis of identification of the mechanisms of occurrence, pathological features individual psychological identity deformity . Implementation of psychocorrective measures into clinical practice can help to eliminate deviations in the outlook of patients with AD.

Based on clinical psychopathological and psychodiagnostic investigation of 400 patients with partial loss of vision of traumatic origin the author determined the peculiarities of objective assessment of presence and degree of depressive and anxiety manifestations in this group of the patients. All patients had symptoms of acute stress response. The study included clinical interview using the criteria of ICD-10, depression and anxiety scale by Hamilton HDRS and HARS. The analysis of patients revealed the overall picture of depressive disorders with signs of mood disorders, mental and motor retardation. Limited ability of visual perception led to excessive stress of mechanisms of mental self-regulation of the personality, which contributed to the emergence of subclinical anxiety. Main figures on the scale of HDRS and HARS, which were addressed in development of psychotherapeutic measures and evaluation of their effectiveness over time were distinguished.

The findings of longstanding research of pathopsychological foundation of the diagnosis of depressive states of various nosological forms are presented in age-dependent aspect. Particular attention is paid to the peculiarities of disorders of the spheres of mental activity that are subjected to greatest changes at this condition. Various methods for determining these disorders (icon method, Luscher's color test, self-esteem study according to Dembo - Rubinstein, etc) were used.. The results of the study of premorbid personality of adolescents with endogenous diseases that complement the clinical picture are presented. The importance of the problem of school deadaptation is emphasized. The literature data suggests the need for further study of pathopsychological peculiarities of various nosological nature in connection with polymorphism of disorders manifestations.

An analytical review of the literature about psychological peculiarities of patients with schizophrenia is presented in age-related aspect. . One of the most important trends in psychiatry and pathopsychology is the study of the problem of schizophrenic defects, the common feature of which is reducing motivational components of social regulation of mental activity. Several studies highlighted uneven disorders of intellectual activity in children and adolescents with schizophrenia (hypertrophic development of abstract concepts and lack of their influence on formation of perceptual generalizations, helplessness in simple situations, inadequate generalizations. The literature data reflect the state of the problem, much attention is paid to various aspects of mental activities, analysis of the mechanisms of formation of deficiency disorders in childhood, which in the future can determine the rational ways of correction of the revealed disorders.

To study the characteristics of individual psycho- and somatosexual development, motivational sphere at neurasthenia in women, 77 couples who referred to department of psychiatry and medical psychology of UMDA were investigated. All women were diagnosed neurasthenia. Disharmonious puberty is the basis of formation of accentuated character traits, deadaptative behaviors, sexual behavior and sexual psychological deadaptation, the health of family members. The obtained data of analysis of psychosexual development deviations, motivational sphere at psychogenic disorders in women confirmed the need of psychocorrecting measures for children and adolescents, preventing enhancement or exacerbations of pathopsychological features, development of social, interpersonal and partner deadaptation.

At present affective disorders are the most common mental illness. The purpose of the work was to study the structure and emotional disorders in patients with bipolar affective disorder (BAD) (depressive episode). Twenty patients were investigated using technique of BDI, scale of differentiated emotions by K. Izad, questionnaire SCL-90-R. The findings of the study allowed to determine symptom complex of depressive affect in patients with BAD (the level of depressive feelings, fear, grief, anger and guilt). Differences depending on gender (somatic manifestations of depression dominated in men and psychasthenic were more common in women) were noted. These studies allow for increased representation about emotional reactions of BAD patients and can be used in formation of other psychocorrective measures for this category.

The problem of rehabilitation of epilepsy patients is analyzed based on literature data. The variety of manifestations of the disease determines its relevance to public health. Importance of not only of attacks prevention but also of optimization of the quality of life, psychosocial adaptation of the patients is stressed. The recommendations of researchers in epilepsy treatment are reported (psychoanalysis, "organism" methods of therapy, hypnotherapy, labor education, rational and reassuring conversation). In Ukraine, social aspect of epilepsy enhances at present. The analysis of the literature showed development of psychotherapeutic methodology aimed at overcoming the attacks, the study of the period between the attacks, mental condition of the patient as a whole. The need to develop customized correction and rehabilitation programs for these patients is emphasized.

Comparative analysis of spontaneous oxidation of proteins by the level of carbonyl derivatives in the blood plasma of 18 patients with depressive signs of various pathogenesis (somatogenic, endogenic, psychogenic) is presented. The method of oxidative modification of proteins (OMP), the extent of which was established by the method of E. Dubinena was used as the main one. Considering the presence of oxidative stress in patients with depression, it is advisable to administer antioxidants, and definition of OMP may be an estimate of effectiveness of this therapy. The role of OMP in dynamics to determine the course of the disease was emphasized. In the future development of methods for determining oxidative modification of specific functional proteins of neurotransmitter systems in different parts of the brain with understanding of the mechanisms of mental disorders and access to new treatment are possible.

In connection with the study of effectiveness of Gestalt therapy in psychological rehabilitation of people who survived myocardial infarction, comprehensive survey of 40 patients who received treatment in cardiology department was performed. The following protocol of work was suggested: 1) history taking, physical examination, 2) diagnostic phase, 3) psychocorrection stage with the use of Gestalt therapy. SAN, LOBBY, Spielberger - Hanin anxiety level were used Participation of patients in Gestalt groups allows to solve psychocorrection tasks: to assist in the emotional response to traumatic experience, overcome intrapersonal conflicts, increase self-esteem, etc. The prospect of the research is the use of Gestalt therapy along with other psychocorrection techniques to study the dynamics of personality development in patients after myocardial infarction.

The problem of studying the quality of life (QL) of patients with opium addiction (OA) is extremely urgent considering high prevalence and social health significance of this addiction. The study included 54 patients who were treated at Kharkiv Regional Narcology Clinic. In order to control withdrawal symptoms the patients underwent membrane plasmapheresis (MP). The technique of the quality of life, consisting of 10 scales was used. The findings of the research suggest different dynamics of QL depending on treatment method. In patients who received MP, positive dynamics was more pronounced. The need to improve psychological support for patients with OA, which will facilitate adaptation of these patients in the community and increase their social status is emphasized.

Clinical-psychopathological examination of 70 men with mental and behavioral disorders due to alcohol use was done. Protein spontaneous oxidation was analyzed by the level of carbonyl derivatives in the blood plasma of patients. Statistical processing of the data included non-parametric methods: Kolmogorov - Smirnov, Spearman correlation, ANOVA, Kruskal-Wallis. Significant correlation of the level of carbonyl derivatives in blood plasma with unfavorable factors of the psychopathological process course, as well as its significant differences from the control group and between the major syndromes with increase in the following sequence: acute intoxication, addiction syndrome, withdrawal syndrome with delirium, were established which allows to consider this method as an additional differential diagnostic marker for these syndromes.