ARTICLES ARCHIVE

In order to study the personality characteristics of patients with occupational pathology were examined 85 patients with occupational respiratory pathology and 84 patients with occupational pathology of the peripheral nervous system as compared to 60 practically healthy persons using multivariate shorter questionnaire personality, election method of color and questionnaire The level of subjective control. The presence of occupational pathology in patients with hypochondriac and depressive tendencies, and signs of disintegration and deadaptive manifestations that can be considered the symptoms of neurotization with hypochondriac personality development were revealed. Adverse changes in the psychoemotional sphere included increased anxiety, frustration, emotional lability, suspiciousness in patients with occupational pathology of the respiratory system, in patients with occupational pathology of the peripheral nervous system −− depression, asthenia and sensitive features. The patients with occupational pathology had inherent tendency to increasing externalization of passivity, conformity and focus on external aid. These trends were more pronounced in patients with peripheral nervous system pathology that can be associated not only with clinical manifestations, but also with social features of these patients. Persistent changes in the psychoemotional sphere found in patients with occupational pathology can be considered a specific variant of pathocharacterological transformations resulting from occupational diseases and should be considered when developing corrective measures. Gradual increase of depressive, anxiety−depressive, asthenic−depressive manifestations and aggravations trends was revealed in the dynamics of pathopersonological changes. The patients with respiratory pathology more often complained of emotional lability, instability, fixation on unpleasant somatic sensations, anxiety, while the patients with pathology of the peripheral nervous system on the increase of asthenic, depressive, asthenic−depressive and apathodepressive trends combined with rigidity of passion and predominance of passive−apathetic response.

The article reports the investigation of interaction of hardiness with personality components which mediate the impact of a difficult situation in both neurotic and normal condition. The purpose of the work was to determine the predictors of personality hardiness in both neurotic and normal condition. The basic group in the investigation included the patients with borderline mental disorders. The comparison group consisted of employees from different medical facilities in the city of Grodno. Women dominated in both samples. The following methods were used: Viability test by S. Muddy in adaptation of D. A. Leontyev and E. I. Rasskazova; Multidimensional scale of perceived social support by G. D. Zimet in adaptation of N. A. Sirota, V. M. Yaltonsky, N. V. Matrehina; questionnaire Index of lifestyle by R. Plutchik, G. Kellermann, G. Conte in adaptation of L. Wasserman, O. F. Eryshev, E. B. Klubova; Test of life orientations by D. A. Leontiev (2000), method of studying the level of tolerance to uncertainty Multiple Stimulus Types Ambiguity Tolerance −− I by D. McLain, 1993 in adaptation of E. G. Lukovitskaya. It was found that in the comparison group avoiding responsibility and self−determination destroyed readiness to do away the difficulties. Viability was also increased by the ability to predict the situation and withstand the tension of uncertainty, and the ability to correlate the situation with opportunities, to discover and to show strengths. The personality identified and combined inner tension and anxiety with an external problem in the main group, thus assessed difficulties more negatively. Low tolerance to uncertainty in this group made it difficult to find a solution in a difficult situation and required more compensatory contribution negation. Personality reduced anxiety in a difficult situation by denying the circumstances of its internal contradictions. The person in the basic group conceptualized the difficult situation in the context of past events. A successful experience in solving life difficulties greatly increased viability of the individual. This group had stable relationships helping the person to do away life difficulties.

The purpose of the work was to study the character traits in patients with arterial hypertension (AH) in the remote period after stroke. Open controlled investigation, after obtaining the informed consent, included 39 patients with stage III arterial hypertension in the remote period after stroke. Method of diversified personality study was applied to determine the personal characteristics, Shmishek questionnaire −− to define the accentuations and character traits, and R. Cattell's test to assessment of individual psychological characteristics of personality. Mathematical processing of the results was carried out using the methods of mathematical statistics. The most significant character features of the individuals with the history of stroke were +F (restraint−expressiveness), +L (trustfulness−suspiciousness), +E (subjugation−domination), −Q1 (conservatism−radicalism), −Q3 (low−high self−control), −M (practicality−mature imagination), −A (offishness−communicability), −G (sensitivity−highly normative behavior). The patients with stage III arterial hypertension showed low motivation (−Q4), high level of satisfaction (−O), stiffness in relation to the others (−I), irritability, fatigue (C), irresponsibility, anti−social behavior (−G), indiscipline (−Q3). The patients with stage III arterial hypertension in the remote period after stroke most strongly suffered impairment of emotional and volitional sphere, much less intellectual and communicative features. The study of the character traits is necessary to create individual programs for the rehabilitation of patients, since they can be the basis for formation of compliance in these patients.

The results of many years (2006−2009/2010−2015) empirical research were used to psychological present individual (introverted) and factor−comparative analysis of psychosomatic health of students from Kyiv National Taras Shevchenko University. Differentiated analysis of the sample of male students (n = 311) taking into account the allocation of three groups: introverts (n = 122), ambiverts (n = 118), extroverts (n = 71) was performed. All stages of complex study were performed: general statistical, correlative, factor analysis for the sample of male introverts (n = 122) and female introverts (n = 79) taking into account the complex dynamics of total 45 indicators of four blocks of psychodiagnostic methods. The results confirmed our assumption of a leading role and effects of H. Eysenk two−factor theory of personality (introversion / extraversion, emotional stability / instability) on psychosomatic health of the investigated students of both genders. Individual psychological study was performed in a group of male introverts (n = 122) in order to reveal indirect factors of mental and physical health. The empirical results confirm the prospects of further theoretical and applied screening in the structure of the teaching process among students. The combination of individual psychological diagnostic and psychosomatic−based screening techniques made it possible to get a complete structure of complex correlations, factors, borderline disorders of psychosomatic health in male introverts. Obvious differences in manifestations and course of the first signs of deterioration in the psychosomatic health of female introverts (n = 79) were obtained as opposed to male introverts (n = 122). The following factors of borderline state were revealed in female introverts: Age −− Likelihood of neurosis (0, 225*), Depressions (0.275*), Dysthymic (0.246*), Exhaustion (0.246*), Heart complaints (0.242*), Intensity complaints (0.231*).

The aim of the study was to determine the relationship of antitcipation solvency and coping strategies of the individual with various forms of neurotic disorders. Such methods as observation, psychodiagnostic and mathematical−statistical were used. The results of the study indicate that in patients with various forms of neurotic disorders anticipation capabilities decreased for all parameters (temporal, spatial, personal, and situational), there was a tendency to monovariant type prediction, expectations of mostly favorable results. The study of coping strategies in patients with neurotic disorders showed the highest orientation of the coping behavior, including setting tasks. At the same time coping associated with emotions, which indicates that solution of problems for these patients is closely linked to emotional response, when emotional response blocks behavioral strategies, significantly predominated in these patients. It was found that low predictive competence in patients with neurotic disorders was accompanied by the use of coping strategies with predominance of emotions, avoidance and distraction. Anticipation inconsistency in neurasthenia correlated with coping in the form of distraction, while dissociative disorders − in the form of emotions, with anxiety and phobic disorders −− in the form of avoidance.

General principles and preconditions of necessary medical and psychological support for cancer patients were considered. It is emphasized that provision of medical care to patients with severe medical conditions must include medical and psychological support to the patient and his family throughout treatment. It is also noted that cancer not only leads to functional and organic disorders, their important feature is that it created a set of complex psychological problems for the patient. The presence of mental reactions to cancer at different stages of the diagnosis, treatment and rehabilitation demonstrates the need for systematic monitoring of the mental status in cancer patients and timely psychological help aimed at prevention and correction of psychological, mental and behavioral disorders.

Thyroid disorders are accompanied by hormonal dysfunction. Hypo− and hyperthyroidism cause the changes in not only somatic sphere, but also in mental functioning. The changes in mental state in diseases of the thyroid gland are obligate symptoms of the disease, making the study of psychological aspects no less important than somatic therapy. The aim of the study was to find the features of depressive and asthenic disorders in women with hypo− and hyperfunction of the thyroid gland. The study involved 59 patients with hyperthyroidism, 54 with hypothyroidism and 50 somatically healthy women. Thyroid pathology was accompanied by changes of psychoemotional state with growing negative emotions, depressive and anxious disorders, incidence and structure of which depended on the type of hormonal dysfunction. For women with hypothyroidism, high level of depression was typical, in patients with hyperthyroidism anxious−depressive syndrome dominated. The women with thyroid hyperfunction experienced negative emotions of anxious spectrum, the patients with hypofunction were characterized by amplitude decrease and intensification of anxiety and depressive emotions. Depressive symptoms in patients with hypo− and hyperthyroidism had differences: in hypothyroidism depressive mood, low level of activity, hypochondria, general somatic symptoms, sleep disturbance prevailed, while in hyperthyroidism −− depressed mood, mental and somatic anxiety, agitation, gastrointestinal symptoms, insomnia. Anxiety in women with hyperthyroidism was formed mainly by anxious mood, vegetative symptoms, tension, and anxiety somatization with gastrointestinal and cardiovascular symptoms accompanied by depressive mood, sleep disorders. In patients with hypothyroidism intellectual changes, vegetative, sensory, gastrointestinal symptoms, insomnia on background anxiety−depressive mood were leading. Anxious and depressive disorders in patients with endocrine disorders are formed under the influence of psychobiological and secondary psychogenic factors, which was taken into account when providing medical and psychological assistance to this category of patients. Hormone therapy prescribed by the endocrinologist normalized thyroid function, and therefore improved mental function. Participation of a psychologist improved the motivation of patients to therapy, enhanced partnership with medical personnel, strengthened the adherence to treatment. The main tasks of the mental health specialist were targeted psychological correction aimed at mental changes caused by the disease, which caused tensions in the family, at work, in society.

The author analyzed the concepts of self−realization and self−actualization, proved the necessity of systemic approach to studying self−realization phenomena and necessity of carrying out the research and determining the connections of self−actualization with the psychoemotional state (psychopathological symptomatology, psychosocial stress, anxiety and depression) in 454 women aged of 29−56. The sample included 224 women from crisis families, 104 divorced women. The group of comparison included 126 women from ordinary families. The analysis of the findings showed existence of meaningful connections of self−actualization with the scales of the psychoemotional state in all three groups. It was determined that in women from the crisis families and divorced women, self−actualization was connected with the scales of their psychoemotional state by all scales but most of all it was typical for the group of divorced women. In the group of women from ordinary families such interconnections were found considerably less frequently than in the two crisis groups. Difference in connections of self−actualization and psychosocial stress in women from ordinary families and two crisis groups was revealed. Direct connections of self−actualization with psychosocial stress were established in the group of women from ordinary families. On the one hand, aspirations to personal self−realization of women from the crisis groups provoked crisis situations in the families, but on the other hand, crisis states of women increased personal self−realization, decreasing factors of psychosocial stress. Self−actualization of all three groups of women is characterized by interconditionality with psychopathological signs. Thus, the obtained results demonstrate the necessity of psychopreventive measures, correction of psychoemotional state and increasing the level of self−actualization as risk factors of psychosomatic diseases.

Anxiety is an integral part of the clinical presentation of neurotic disorders. It influences significantly the course and outcomes of the disease, however, the studies dealing with pathopsychological peculiarities of anxiety in neurotic disorders are not numerous. This fact caused the necessity to carry out an integrated investigation to reveal regularities of anxiety formation in neurotic disorders. In view of this, 89 patients with neurotic disorders and symptoms of anxiety (the main group) and 32 patients with neurotic disorders and without anxious symptoms in their clinical pictures (the group of comparison) were examined. The following methods were used: Symptom Checklist−90 (SCL−90), Zung Self−Rating Anxiety Scale, and Integrative Anxiety Test, as well as statistical methods for data processing. It was found out that a general anxiety in patients of the main group had a multicomponent and heterogeneous structure, including emotional discomfort, phobic and asthenic manifestations, an anxious evaluation of perspectives, and a tendency to avoid interpersonal relations. In the investigation it was defined that patients with neurotic disorders and symptoms of anxiety had a high level of personal anxiety, which was expressed not only as anxious and depressed emotional conditions but also in their attitude to different life aspects: decreased general motivation, formation and preservation of various fears and apprehensions especially regarding the future. The data obtained might be used to expand the ideas about anxiety in the structure of neurotic disorders and should be taken into account at pharmacological and psychotherapeutic interventions.

For the successful use of family rehabilitation resources the studies aimed at identifying the specific characteristics of family functioning in families of mentally ill patients are necessary to develop tactics of their psychosocial rehabilitation. The aim of the study was to investigate the characteristics of functioning families in which one parent suffers from paranoid schizophrenia, and the impact of changes in mental activity of individuals on the quality of relationships in the family and the possibility of traumatic situation affecting the children. The study involved 124 married couples, of them in 68 (54.84 %) the women were ill with paranoid schizophrenia, and in 56 (45.16 %) mental illness was present in the men. The families were divided into 3 groups: group 1 (main) included 56 couples where the man had paranoid schizophrenia, group 2 (main) 68 couples in which the mental illness was diagnosed in the mother, group 3 (the controls) included 30 families without mental disorders. The study also involved 168 children who were brought up in 124 families. A survey of children and parents with paranoid schizophrenia was performed using clinical and clinical psychopathological methods. The data showed abuse of almost all components of family health in the presence of mental illness (paranoid schizophrenia) in one parent. It was found out that 70.16 % of them were disharmonious, and 29.84 % pseudogarmonious. In all studied families combined dysfunction of the family was observed, educational one was broken in 100 % of cases, emotional in 89.55 %. As a result of disorders in the quality of emotional contacts and inconsistencies of family−role positions in all families, emotional and educational functions wereaffected as a factor of emotional deprivation, constant conflicts and created conditions of permanent traumatic situation. Neurotization of children deepened due to inadequate perception of mental health of children by the parents. Thus, the traits of parents who suffer from paranoid schizophrenia, are defined by psychopathological phenomenology of the underlying disease and have a negative impact on their family roles, addressing one of the major factors in the formation of family disharmony. The analysis reveals a role of psychogenic and social factors in the genesis of family maladjustment and opens the possibility of differentiated psychotherapeutic influence.

Leading research centers and institutions studying the problems of depression have noted that on an average 40−60 % of patients with depressions do not exhibit significant clinical improvement in response to the psychiatric care. Such depression is qualified as treatment resistant. The course of treatment−resistant depressions (TRD) in most cases is long with a significant stress load on the patient and his environment and family. This leads to development of severe social deadaptation and becomes a significant socio−economic burden. A look at the solution of the problem of resistance to treatment of depressive disorders lies mainly in the understanding of biological and psychosocial mechanisms of the origin as well as the course of the problem. Along with this solution to the task of overcoming the resistance of depressive disorders is impossible without the use of a family support resource. This study investigates clinical and psychopathological features of TRD, identify the type of family interaction and analyzes the capabilities of family support resource in this group of patients. To solve the tasks of the study we examined 52 patients who met standard criteria for TRD (when the treatment for two consecutive courses (3−4 weeks) by monotherapy with adequate dosage of pharmacologically different drugs resulted in lack or insufficiency of the clinical efficacy (reduction of symptoms by Hamilton scale is less than 50 %) in the structure of bipolar disorder and recurrent depressive disorder with clinical−psychopathological, psychometric, pathopsychological, statistical methods. The results of this study showed that TRD in the structure of bipolar disorder and recurrent depressive disorder by severity in most cases were severe (46.7 % and 54.1 %, respectively). The study of family type of TRD patients showed low rate of harmonic types in the studied patients. Symbiotic families prevailed in patients with bipolar disorder (26.8 %). Families of patients with recurrent depressive disorder were attributed to emotionally alienated and dissociative−stressful types (21.6 % in equal shares). Adequate attitude of family members to the disease in patients with TRD was predominant in the studied patients (53.3 % of patients with bipolar affective disorder and 64.9 % of patients with recurrent depressive disorder). The data on the attitude of family members to the disease were directly proportional to the level of family support for patients with TRD. Sufficient level of family resource was detected in 53.4 % of patients with bipolar affective disorder and in 67.6 % of patients with recurrent depressive disorder. Thus, the study of the patterns of family interaction in patients with TRD opened new perspectives in establishing the role of the family and the possibilities of its involvement in development and maintaining the adaptive resources of the patients with TRD, improvement of their social activity and quality of life.

One of the important factors that affect the overall effectiveness of treatment of patients with schizophrenia is the patient's family support resource through which allows determining willingness of the relatives to provide assistance and support to the patient. Providing informed consent we examined 168 reference families (RF) of patients with paranoid schizophrenia. The control group consisted of 55 families that do not live with the mentally ill (MI). In order to clarify the features of formation of contemporary life for patients with schizophrenia in a chronological sense, all RF were divided into 3 groups. Group 1 (MG1) amounted to RF, lived in families where patients with disease duration of up to 4 years, groups 2 and 3 (MG2 and MG3) were RF with patients with disease duration from 4 to 8 years and 8 years and more, respectively. It was established that the presence of a mentally ill individual always led to violation of emotional responses to all family members that generated some negative consequences in interpersonal interactions and influences the effectiveness of therapy. Three variants of family resource support (low, limited, sufficient) were revealed. It was determined that in patients with schizophrenia RR leveled empathic−affiliative trends in interpersonal interaction, formed new relationships with emotionally distant, rigid components of negative content and lacked care. In 48.2 % of patients with schizophrenia RF demonstrated depressive state, mostly hidden (somatization) dysphoric−dysthymic depression, along with high levels of neurotization reaching its maximum when the duration of the disease in the patient exceeded 4 years. Positive correlation was revealed between neurotization, depressive reaction and limited resources and low family support (r = 0.663 and r = 0.561), low levels of neurotization and sufficient family support resource (r = 0.632); slightly reduced correlation was determined between mild depressive reaction and limited resource of family support (r = 0.245). The peculiarities should be considered when developing psychoeducation and psychocorrection programs for RF of patients with schizophrenia.

Modern views on the quality of life for residents of industrial areas are often limited by not quite complete data. Most of the modern research does not consider the delicate gradation associated with mental health. This applies to both the general population and participants of labor directly involved in production, i.e. industrial workers. Working conditions lead to formation of psychoorganic background leading to development of persistent pathoplastic personality changes, and. as a consequence, mental maladjustment. In connection with the above mention, a spectrum of clinical−psychopathological, clinical and epidemiological studies, designed to determine the basic properties of the quality of life and social functioning of the above population group was performed. In the process of professional preventive examinations by a psychiatrist, the most effective ways of evaluation, clinical questionnaires aimed at the diagnosis of psychosocial characteristics were introduced. The data obtained fully reflect the peculiarities of social inclusion of persons with organic non−psychotic mental disorders in comparison with the relatively healthy industrial workers. The most significant in terms of psychosocial deficiency was collapse of indicators of quality of life in the area of interaction with the environment, in the physical, biological spheres, social care and support. Risk factors for adaptive capabilities in the structure of social functioning in individuals with non−psychotic organic changes are decreased overall health, fatigue, fall in activity, dyssomnia, inability to obtain quality medical and social support as well as limited capacity in terms of financial resources, transport; problems with others at work, at home, in the family.

Problems of somatogenic exacerbation of psychopathological disorders in elderly and senile patients with various forms of cardiovascular pathology, in particular coronary artery disease and hypertension, is one of the central problems of clinical psychiatry and general therapy of somatic disorders. Identification of the optimal targets of psychotherapeutic influence to the links of psychogenetic mechanisms of somatogenic exacerbation of psychopathological disorders, gives the prospect of successful prevention of exacerbations by congruent psychotherapeutic influence. In order to form the models of psychogenetic interaction of the most common forms of cardiovascular diseases (hypertension, coronary artery disease) and depressive−paranoid disorders, 100 patients of elderly and senile age having a dominant depressive−paranoid syndrome in the structure of psychopathological disorders were studied. It was revealed that cardiogenic exacerbation of depressive−paranoid syndrome, occurs under the combined effects of following pathogenic mechanisms: factors of psychogenic influence; anxious−hypochondriac modus of personal response; background of negative psychopathology presented within a continuum psychasthenic syndrome ? psychoorganic syndrome.

A comprehensive survey of 120 patients with paranoid schizophrenia, of them 60 with bone tuberculosis in addition to schizophrenia, identified the features of clinical psychopathology and psychosocial functioning of respondents determining development of a specific condition of exclusion, characteristic of patients with dual mental and somatic pathology, indicating the need to develop specific measures of psychosocial rehabilitation for this category of patients. It was formulated that comprehensive treatment of this group should include consideration of the clinical presentation of both diseases, individual susceptibility to psychopharmacotherapy and TB treatment, a combination of action and side effects as well as separation of 3 stages of drug therapy (acute treatment, stability treatment, maintenance therapy). Psychosocial rehabilitation measures should take into account deterioration of subjective well−being, which limits functionality of the patients and leads to severe social exclusion, aggravating the quality of life in general. It is also necessary to consider the clinical manifestations of syndrome of psychomotor indifference of varying degrees of severity. When carrying out psychosocial rehabilitation it is necessary to apply four cognitive−behavioral strategies, namely: cognitive−behavioral therapy; training programs to fill neurocognitive deficiency; formation of psychological protection of patients; training social skills. The recommendations for improving the quality of life of these patients include overcoming existing and preventing new problems in the fields of public support necessary to increase the motivation of patients to achieve important social objectives; psychorehabilitation aimed at negative consequences of basic psychological / emotional feeling of dissatisfaction, which in the majority of patients is the background for the problems in all areas of operation; focuses on treatment of tuberculosis as well and mental disorders, their consequences and related conditions in order to restore sense of physical well−being; recovery and self−dependence in actions, which is generally more difficult for therapeutic intervention, since they depend on the total objective conditions caused by micro− and macrosocial environment; psychosocial rehabilitation activities are planned based on the measures of overall quality of life, not only assessment of individual areas of operation.

A considerable growth of anxiety disorders with paroxysmal phenomena is observed at present. Panic disorder (PD) is dominant in their structure. Emotional disturbances of 40 PD and 20 agoraphobia (A) patients were investigated with the clinical and pathopsychological methods. The high level of anxiety was shown. A high level of personality anxiety and low level of neurotism and depression of PD patients were identified. All patients were investigated using Hamilton depression scale, Spilberberg−Khanin state and trait anxiety scale, Isenk inventory, Leongard−Shmishek personality accentuation inventory. The main syndromes in PD patients were asthenic (20 % of patients), anxiety−depressive (33.5 % of patients) and hypohondric (46.5 % of patients). The medium level of trait anxiety by Spilberberg−Khanin scale made 39 points. Ostentation (mean 17 points), torpidity (mean 19 points), dysthymia (mean 18 points), anxiety (mean 21 points) prevailed. The system of psychotherapy correction was worked out, which showed its efficacy in 68 % of cases.

In order to increase the effectiveness of treatment and improve the quality of life of patients with urolithiasis, the work on the study and development of the measures of medical and psychological support to these patients was performed at the first stage of care. We examined 120 patients who presented with symptoms and signs of acute kidney pain. After pain control and diagnostic procedures before performing extracorporeal lithotripsy all patients were provided psychoeducation aid under minor psychotherapy according to I. Z. Velvovsky et al. Minor psychotherapy is nosoinspecific, easy to implement and effective medical and psychological technology that allows in a short time and with minimal costs to facilitate the patient, decrease anxiety−phobic manifestations of emotional stress and fear, deactualize traumatic experiences and prepare the patient to a complex diagnostic and therapeutic procedure. Experience in the use of medical and psychological technologies at department of X−ray shock−wave lithotripsy and endourology and urology outpatient department of Donetsk Regional Clinical Medical Association proved its high efficiency and the need for broad implementation in the clinic of internal diseases.

Phobic and anxiety disorders are non−psychotic disorders often associated with long periods of emotionally severe psychoemotional stress. They include phobic disorders, panic disorder, generalized anxiety disorder, mixed anxiety and depressive disorder, obsessive compulsive disorder. Contributing factors of anxiety and phobic disorders include mental illnesses (primarily neurotic and depressive disorders); heredity; presence of organic predisposition as perinatal, intrapartum (birth asphyxia) and postnatal (cerebrocranial injury, neurological infection, acute and chronic intoxication) kinds of brain damage; personality features: anxious−hypochondriac, anancastic features; a history of neurotic and depressive disorders; psychoemotional stress in the period preceding the disease. Clinical characteristics of various disorders are the most common for them; however, they are often shown in varying degrees of severity and may occur combined or at different stages of the disease, acquiring clinical or subsyndromal forms. In clinical cases, a combination of various symptomatic complexes in the stage of independent disorders means comorbidity disorders. The main directions in treatment of anxiety disorders at the present stage are combination of pharmacotherapy and psychotherapy.

Comprehensive survey of 50 unmarried men with mental retardation and 47 married couples (MC) in which the men were diagnosed the presence of childhood and adolescence signs of mental development retardation allowed to allocate the following forms of sexual dysfunction (SD): communicative form (24.6 %), sexual disorders (76±6 %) including constitutional (42±7 %) and anticipation of sexual failure (14±5 %), pathoreflexive form (14±5 %), coitophobia (sexual phobic neurosis) 4±3 %. The identified causes, conditions and mechanisms of disorders of SF and SD in men with mental retardation, clinical manifestations, personality characteristics and peculiarities of interpersonal relations in men with mental retardation were the basis for development of differential psychotherapeutic correction. Implementation of the system of psychotherapeutic correction in unmarried men with mental retardation and sexual dysfunction made it possible to obtain a sufficiently high and long−lasting therapeutic effect. the symptoms of neurotic disorders were eliminated in the majority of unmarried men with mental retardation (89±4 %). Vast majority of patients who were treated and for a long time did not have sexual contact, restored their sexual life (45±7%), or established partnership with a potential sexual partner.

To determine the characteristics of clinical manifestations of codependency as a model of health problems associated with stress 160 wives of men with alcohol addiction (AA) and 50 women whose husbands did not have alcohol problems were examined. Depending on the type of AA diagnosed by classification of T.F. Babor, the patients and their spouses were divided into two groups: group A included 80 patients with AA type A and 80 their wives; group B totaled 80 people with type B AA, and their 80 wives. Comparison group included 50 married women whose husbands were not alcohol addicted. Psychopathological symptoms did not reach the designated clinical depression and were found in the group A −− 40.0 % and group B −− 12.5 %, controls −− 90.0 %. Small depressive episode was diagnosed in group A −− 50.0 %, group B −− 65.5 %, controls −− 10.0 %; severe depressive episode made 10.0 % in group A, 22.5 % in group B. Psychopathological symptoms reaching subclinical anxiety were found in group A −− 42.5 %, group B −− 10.0 %, controls −− 96.0 %. Anxiety was diagnosed in 55.0 % of group A patients, 70.0 % of group B, 4,0% of the controls (p ? 0.001); Anxiety disorder was found in 2.5 % of group A patients, 20.0 % of group B patients. Objective assessment demonstrated that in group B anxiety prevailed in points and in percentage (p < 0.05). In the majority of patients from group A and group B anxiety reached its average severity, while anxiety disorder corresponded severe degree. The degree of severity of symptoms of mental radical dominated over the symptoms of physical radical. Similar indicators of psychosocial stress were revealed in group A and group B, emphasizing universality and emotional significance of emerging issues for the wives of patients suffering from AA. Low levels of stress in the investigated patients with the danger of psychosomatic illness (in some cases at the stage of nervous exhaustion) were 67.5 % (310 points) in group A and 80.0 % (355 points) in group B. The obtained findings suggest of uniform mechanisms of family experience of a stressful situation (p < 0.05), but with varying intensity depending on the characteristics of family history of substance abuse in men; they were used as the basis for developing a comprehensive treatment measures and psychotherapeutic support for codependent wives of patients with AA.