ARTICLES ARCHIVE

The purpose of the work was to develop approaches to the diagnosis of cognitive functions in patients with a history of stroke. After obtaining informed consent, open controlled study included 39 patients with AH III in the remote period after cerebral stroke (CS). The following tests were used to study psychological features: G. Shmishek's test, R. Cattell's test, Mini−mult, PQBI, Benton table, Schulte tables, a technique of M?nsterberg, memorizing 10 words of Luria, figurative, visual and semantic memory. Mathematical processing of the results was performed using the methods of mathematical statistics. Mild cognitive impairments were identified in 74.2 % of cases, moderate in 25.8 % of patients with CS. Monofunctional anamnestic type and polyfunctional type with memory disorders occurred in 13.5 % and 83.8 %, polyfunctional type without memory disorders in 2.7 % of cases. Significant cognitive disorders in patients with AH III were observed in memory (97.3 %), attention (90.6 %), intelligence (75.6 %), and thinking (64.9 %). The developed algorithm for diagnosis of the nature and extent of cognitive dysfunction at hypertension comprise, according to the FCI, assessment of the functions of consciousness and orientation, temperament and personality functions, intellectual, volitional and incentive functions, global psychosocial functions, memory, thinking and attention. The algorithm for the diagnosis of cognitive functions in AH is one of the elements of the developed information technology for assessment of cognitive functions in the practice of medical and social expertise that can help to reduce disability and improve the quality of life of the patients and their integration into society.

Atopic dermatitis is a chronic relapsing disease of the skin, medico−social significance of which is determined by the duration and area of the affected skin, as well as a number of subjectively uncomfortable symptoms caused by the lesions of the skin. In the context of psychology and psychiatry, in addition to the known anatomical and morphological problems, the skin perform the functions of nonverbal communication of the individual and formation of a model of self. In case of skin lesions, these features may not be fully realized, which leads to emotional distress of the individual. This circumstance is especially important in adolescence, when the personality of the individual develops, including through the establishment of a scale of self−acceptance and self−denial. The article emphasizes the impact of atopic dermatitis on medico−psychological and psychopathological features of adolescents with atopic dermatitis; multitask functions of the skin are stressed in the context of psychology and psychiatry and features of their disturbances in atopic dermatitis. The study involved 34 adolescents with atopic dermatitis, the average age of the patients was 16±1.32 years; duration of the disease 4−10 years. These patients formed the main group research. The comparison group included 30 apparently healthy adolescents with mean age 16±1.33 years. History taking, clinical−psychopathological, psychodiagnostic methods were used. Assessment of the symptoms severity was conducted according to the international system SCORAD (Scoring of Atopic Dermatitis). The features of the emotional sphere were defined through the use of State−Trait Anxiety Inventory, STAI (Ch. Spielberger) modified by Y. L. Hanin (2001). The study allowed distinguishing dermatitis−dependent variants of the attitude of adolescents with atopic dermatitis to their own skin. The comorbid psychopathology, including obsessive−compulsive spectrum, was discussed. The levels of state and trait anxiety in adolescents with atopic dermatitis were determined.

The work analyzes the ways of studying sexual problems and their influence on psychosomatic health. The importance of studying such problems of women at crisis state and necessity of carrying out research and definition of connections of orientations to sex with the actual psychoemotional state (psychopathological signs, psychosocial stress, anxiety and depression) in the investigated 350 women aged 29−56 are substantiated. The study sample consisted of 224 women from crisis families and 126 women from ordinary families. The analysis proved that both groups of women had meaningful connections of orientations to sex with scales of actual psychoemotional state. Total quantity of interconnections in groups was the same but these connections differed qualitatively. It was determined that the group of women from ordinary families had more orientations to sex, which do not have any meaningful interconnections with the actual psychoemotional state, than the group of women from the crisis families. But by the total level of correlations, the women from ordinary families overtook the women from the crisis families due to the large number of interconnections at separate scales. Both groups did not have any connections of psychoemotional state with scales of impersonal sex, pornography and sexual disgust. The group of women from ordinary families also did not have any connection with scales of sexual excitement, physical and aggressive sex. It was determined that the women from crisis families have the least number of correlations with psychopathological signs as to scales of neurotic sex, sexual excitement and libido. The women from ordinary families had the least number of correlations by the scale of sexual satisfaction. The largest number of interconnections of orientations to sex with psychopathological signs was determined in the both groups of women by the scales of permissiveness, sexual shyness and sexual satisfaction, but the group of women from ordinary families had more connections of this type. Direct connections with psychopathological signs were detected in the both groups by the scales of sexual shyness, prudishness and neurotic sex; the group of women from crisis families had such connections by the scale of aggressive sex; in the group of women from ordinary families sexual satisfaction directly correlated with the scale of psychosocial stress. High level of sexual permissiveness, satisfaction, neurotic sex, shyness, prudishness, libido, satisfaction, and demonstration of masculine style of behavior in women from both groups decreased the level of psychopathological signs. In the group of women from crisis families the same interdependence with the scales of excitability, physical and aggressive sex should be added to this list. The received results demonstrate the necessity to conduct psychopreventive actions, corrections of psychoemotional state and orientations to sex as factors of risk of psychosomatic diseases.

At present mental health is a prominent problem of the health system. The patients with mental disorders caused by diagnosis, course and treatment of physical illness, are a separate category of persons with psychological needs. For clinical practice it is necessary to develop specific diagnostic tools and psychological algorithms that can optimize and improve the quality of care for patients. One of tools is the Psychological Passport of the Disease, developed by experience of providing psychological help for patients with physical illness. This form includes statistical, descriptive and interventional parts describing the main characteristics of the disease, critical for understanding its psychological patterns. A significant number of patients with somatic diseases accompanied by psychological maladjustment require reorientation of the health system capacity to support somatic patients, especially for development of psychological services. The Psychological Passport of the Disease is one of the steps that systematizes psychological knowledge in a brief and clear form for the doctor of any specialty, describes the psychological characteristics of the disease and interventional measures.

Modern studies of the prevalence of mental health pathology are characterized by a shift of the emphasis to more universal ones based on the concept of mental health as a set of mental, social, and psychological well−being of the individual and the state of equilibrium with the environment. All this is embedded in the concept of mental ecology which is wider than the concept of mental health. It includes assessment of not only the presence or absence of mental disorders, but also the impact of factors affecting the mental health, such as environmental, cultural, political, informational, social, etc., as well as psychological, social and somatic components of the quality of life. In modern literature, great attention is paid to occupational health of persons whose activity is associated with increased risk, high responsibility and is carried out under conditions of constant intellectual, emotional stress. This article presents the results of investigation of mental health in workers of the industry on the basis of synergistic approach. Subjective significance, the proportion and the degree of influence of biopsychosocial factors in the mental ecology of people working in the industry were studied. An expanded characteristics of stressful circumstances is presented in biogenesis, psychogenesis and sociogenesis. On the basis of the qualitative evaluation of the data the groups of workers at high risk of formation of mental disorders were determined, which allows for a forecast of their dynamics, as well as development of the most productive methods of intervention of mental health and psychoprevention.

At present chronic pancreatitis is a significant health problem because of the increasing incidence and prevalence of the disease, presence of threatening consequences of illness and reduction of psychosocial functioning. The aim of the work was to study the features of deviant behavior in patients with chronic pancreatitis with biliary and alcoholic etiology. To study the deviant behavior we used Assessment of Deviant Behavior by A. Orel, modified for adults. The study involved 147 patients with chronic pancreatitis, group 1 −− 98 females and 49 males, and group 2 −− 44 females and 96 males. 7−22 % of patients with biliary pancreatitis and 20−38 % with alcoholic chronic pancreatitis develop trends to different forms of deviant behavior. Higher levels of preparedness to tackle standards and rules, addictive, self−destructive behavior, tendency to aggression and violence, reduced control on emotional reactions of respondents with chronic pancreatitis of alcoholic etiology were detected. Predisposition to addictive behavior prevailed in women, chiefly in patients with biliary pancreatitis, and self−destructive −− in respondents with alcoholic chronic pancreatitis, while in males predisposition to violations of rules and addictive behavior was revealed. All deviations influenced the treatment process: violation of compliance for behavior with violations of rules; alcohol use, jamming stress, work−addiction for addictive behavior; frivolous attitude to their health and impairment of their lives, self−destruction for susceptibility to self−destructive behavior, aggressive disposition to the environment for readiness for violence; negative emotions for low volitional control. The tendencies to different forms of deviation in patients with chronic pancreatitis and their effect on the behavior during treatment indicate the need for inclusion of psychodiagnostic assessment and psychological treatment of maladaptive patterns in the program of psychological help.

Hormone production disorder is one of the main features of endocrine diseases. Thyroid disorders manifest in various physical and mental symptoms. The aim of the study was to investigate the coping mechanisms in women with thyroid pathology. The study involved 113 females with thyroid pathology (TG): 59 patients with hyperthyroidism (G1), 54 with hypothyroidism (G2) and 50 somatically healthy women (CG). Questionnaires for diagnosis of psychological coping mechanisms by E. Heim were used. The dominant coping mechanisms in patients with thyroid disorders were emotional adaptive, i.e. mindset of self−esteem (G1) and preservation of control (G2), middle adaptive, i.e. finding sense, relativity, non−adaptive, i.e. confusion (both groups); in cognitive sphere, adaptive, i.e. protest (G1), optimism (TG), middle adaptive, i.e. emotional discharge (TG), passive cooperation (G2); in behavioral sphere, adaptive such as search for help, middle adaptive, i.e. compensation, regardless the distraction dysfunction. In healthy women such features as higher proportion of persons with self−control, low representation of confusion, higher rates of optimism, protest, cooperation, altruism were found. Intragroup differences depending on the type of hormonal dysfunction manifested by high performance of self−esteem, problem analysis, search for meaning, protest, aggression, search for help, constructive activity in women with hyperthyroidism, and preservation of self−control, relativity, confusion, and passive cooperation, suppression of emotions, humility, retreat, and active avoidance in patients with hypothyroidism. The number of persons with adaptive variants was less and that with middle adaptive and non−adaptive mechanisms of coping was higher compared with somatically healthy women. middle−adaptive coping options prevailed in females with thyroid pathology. Women with hypothyroidism showed greater problems in cognitive and behavior coping dimensions, the patients with hyperthyroidism had tendency to transformation of adaptive types to opportunistic adaptive and non−adaptive emotional coping types. Differences in the ways of coping require differentiated approach to correction and measures of psychological help in patients with this type of endocrine pathology.

The purpose of the work was to study the effectiveness of dolphin assisted therapy on the emotional state of children with psychophysical disabilities. The study involved 97 children aged 3−12 years with cerebral palsy (32), retardations of mental development (33) and autism spectrum disorders (32) were examined before and after the course of dolphin assisted therapy at dolphinarium «Nemo» (Odessa, Ukraine). A set of psychodiagnostic methods was developed to assess the emotional state of the children, which included Differential scale of emotions by K. Izard and Self−assessment of emotional states (A. Wessman and D. Ricks). Mathematical processing of the results was performed using the methods of mathematical statistics. Analysis of the results of our study showed that prior to the course of dolphin assisted therapy the leading emotions of children with psychophysical disabilities were fear (5.71), surprise (4.85), shame (4.72); and the emotional state of the children was characterized by concern, fear, disturbance or uncertainty, nervousness, agitation, irritability (3.81); easy fatigue, laziness and lack of energy (4.71); dispiritedness (4.74), the inability to do anything (4.27). After the course of dolphin assisted therapy the most relevant emotions of those children were joy (9.17), surprise (6.16, and interest (5.07). Positive emotions significantly increased, i.e. interest (by 17.9 %), pleasure (by 111.3 %), surprise (by 27.0 %); negative emotions decreased, i.e. sorrow (by 15.3 %), anger (by 15.9 %), disgust (by 11.6 %), contempt (by 7.0 %), fear (by 43.8 %), shame (by 67.4 %), guilt (by 7.5 %). General coefficient of being of children with psychophysical disabilities after the course of dolphin assisted therapy increased by 53.6 %. At the same time the emotional state of children improved; they became more relaxed (by 101.0 %), energetic (by 71.8 %), felt a sense of elation (by 70.0 %) and self−confidence (by 87.4 %). Their total emotional state index increased by 81.4 %. As a result of using dolphin assisted therapy as a method of rehabilitation for children with psychophysical disabilities their interest to life grew, joy appeared, and feelings of grief, anger, contempt, fear, shame, and guilt decreased; the emotional background normalized and became more adaptive; great vigor and confidence appeared. Inclusion of 10−day dolphin assisted therapy into the rehabilitation program contributes to the overall children being and the increase of the coefficient of general emotional state of children with psychophysical disabilities.

Annually 6−8 children out of 1000 are born with congenital heart defects. Of this group 2−3 infants usually have critical defects which imply the emergency heart surgery. Big proportion of patients will further need repeated surgery at different age stages of their life. Numerous scientific works testified to effectiveness of preoperative psychological preparation on children while the implementation of such measures still remains a complicated process due to the lack of medical psychologists. As a rule before the heart surgery the children are concerned in relation to fear of pain and discomfort, with the fear to be taken from their parents and the need to communicate with the unknown people, as well as with a fear of unknown, of awakening during the operation, of limitations in their behavior and the feeling of losing control of the situation, as well as ugly scar on the chest. The preoperative preparation should involve the child as well as his/her parents and include the following tasks: 1) reducing patients' and parents' anxiety, 2) improving patients' cooperation with the team of specialists during the diagnosis and treatment, 3) improving the postoperative rehabilitation process, 4) to raise the confidence of the patient and parents in the medical stuff, 5) improving the long term postoperative emotional and behavioral reactions of patients and other family members. The preoperative preparation should usually start with the assessment of children's' and parents' perception of the procedures awaited. While consulting families the psychologist should take into account the patient's cultural and religious traditions as long as the belief remains the powerful resource. The mothers often say that it is the prayer that helped them pass through the period of operation and rehabilitation. Thus, numerous studies noted an active involvement of psychologists into the preoperative preparation of patients. Taking into consideration the key features the psychological assistance in pediatrics, depending on the age, working out of the individual child medical psychological profile card seems to be quite urgent. In such cards the medical psychologist could note the factual psychomotor development of the child as well as temperamental features of coping strategies with specific instruction for parents, nurses and doctors. The complex medical and psychological follow up will help the child to adequately prepare for surgery and create confidential relationship with the medical staff while improving the general child's impression of the hospital and a reduce his/her fear of the possible surgery in future.

The article presents the results of the study, the aim of which was to investigate the structure of comorbid mental and behavioral pathology in schizophrenia as well as to develop criteria for diagnosis of schizophrenia comorbid with other mental and behavioral disorders on the base of research of their clinical−psychopathological and pathopsychological peculiarities. The main group of the study consisted of 160 patients with schizophrenia and comorbid mental and behavioral disorders, including 36 patients with schizophrenia and depressive disorders (F32−F33); 70 patients with schizophrenia and various dependences (36 with substance dependence (F10.20; F12.21; F17.21 etc.), 34 with non−substance dependences (F63.0; F50.9 etc.); 33 patients with schizophrenia and anxious−phobic and obsessive−compulsive disorders (F40, F41, F42), and 21 patients with schizophrenia and personality disorders. The control group consisted of 35 patients with schizophrenia selected randomly among general population of patients without comorbid mental and behavioral pathologies. The structure of mental comorbidity in patients with schizophrenia was investigated, the variants of mental and behavioral disorders in schizophrenia were defined and their possible multimorbid combinations were analyzed. Clinical−psychopathological and pathopsychological peculiarities of schizophrenia with comorbid mental and behavioral disorders were determined. Diagnostic criteria and factors of prognosis were detected as well as regularities of formation of schizophrenia with specific variants of comorbid mental disorders were described.

Eighty−five wives were observed with the aim of investigation of communicative coping resources and their impact on the family adaptation level in families, where a husband has schizophrenia. As a result of the observation, the low level of empathy and affiliation was confirmed, as well as the increasing sensitivity to the rejection in women whose husbands are schizophrenics, which causes the inter communicative disturbance and self−isolation. The existence of positive statistic link between the level of the investigated coping resources and family adaptation was found. The level of empathy, which was not developed to the full extent, influences egoistic motivation formation, which is directed above all to self−wellbeing protection and self−emotional tension reduction. The egoistic behavior of women whose husbands are schizophrenic, their desire to impose their point of view, wish to direct the interests of the people who surround them to the personal one, influence the communicative component in their relationship with the husband. Such women do not show emotional warmness, empathy and compassion, are not able to perceive and understand the ill husband to full extent, improve the effective collaboration with him, especially in time of the next exacerbation. This could be observed as absence of the ability for the contact making in time of interpersonal collaboration, absence of the possibility to receive the necessary support if such problem exists, emotional loneliness. The low affiliation level testifies for the ability to provide shallow contacts with the associates and disability to feel deep emotional empathy. As a result, the problem of cohesive descending level appears and family adaptation, one of the main resources for overcoming the crises situations both for the ill one and his wife. The following results suggest the necessity of development of psychocorrecting techniques directed to emphatic abilities development, communicative skills improvement, increased levels of family cohesion and adaptation.

Depressive disorders in the modern structure of psychiatric morbidity occupy a considerable place with a constant stable trend towards further growth. More than a third of cases of depressive disorders are considered resistant to treatment. The focus of constant attention of the leading specialists in the field of depression is pathogenesis of treatment resistant depression (TRD), their clinical characteristics, effective therapy. It has been determined that reduced metabolism in the prefrontal cortex of the brain, reduced level of cerebral circulation in the hippocampus, posterior cingulate cortex, increased neuronal activity in the amygdala, pallidum / striatum and medial thalamus play the role in development of TRD. These phenomena lead to violations of bioelectrical brain activity. Our investigation found that the clinical presentation of TRD is polymorphic with prevalence of complex syndromologic structures with apathy and obsessive components. EEG found that the patients with TRD are characterized by mild to moderate general changes against a background of low−amplitude EEG, without the signs of local pathology, reduced integrative processes in the frontal areas with reduction of the coherence factor for alpha, beta 1 and beta 2 rhythms with increased synchronization of bioelectrical activity in the temporal and occipital areas due to delta and theta ranges. Right−hemisphere functional asymmetry (in all frequency bands) was also typical for patient with TRD.

The aim of this study was to examine the nature of the relationship between negative symptoms and neurocognitive deficiencies as key clusters of manifestations of schizophrenia in remission. The emphasis in the selection of the patients for this study was put on the attempt to separate accurately the primary negative symptoms (actually deficiency syndrome) and secondary negative symptoms caused by the factors not related to the actual schizophrenic disorder (depression, extrapyramidal disorders, anxiety, pharmacological side effects, sedation). Psychometric scales PANSS, SAS, SDSS were used for selection of the patients in the study. Seventy−nine patients with diagnosed schizophrenia in remission with primary negative symptoms were chosen. Neurocognitive functioning of patients was assessed using psychodiagnostic tests TMT A (Trial Making Test A) for speed of processing and attention, WMS−III Spatial Span for visual−spatial working memory; Letter−Number Span for verbal working memory; BACS Symbol Coding for speed of procession, attention and working memory; HVLT−R for verbal learning; Category Fluency for speed of processing. Statistically significant correlation between severity of negative symptoms and quality of tests performance were found: Trial Making Test A (r = 0.335, p = 0.001), BACS Symbol Coding (r = 0.267, p = 0.010), WMS−III Spatial Span (r = 0.330, p = 0.002), HVLT−R (r = 0.217, p = 0.029), Category Fluency (r = 0.191, p = 0.048). Correlation between severity of negative symptoms and Letter−Number Span performance did not reach statistical significance (r = 0.129, p = 0.131). Thus, in this study more prominent negative symptoms in patients with schizophrenia were associated with poorer performance by tests on processing speed, verbal learning, visual spatial memory, attention. At the same time taking into account the criteria defined by Cohen (1977) the small range of correlation of severity of negative symptoms and performance by tests BACS Symbol Coding (r = 0.267), HVLT−R (r = 0.217), Category Fluency (r = 0.191), and the medium range of correlation of severity of negative symptoms and performance by tests Trial Making Test A (r = 0.335), and WMS−III Spatial Span (r = 0.330) were established. Given the degree of correlation of negative symptoms severity and neurocognitive tests performance indicators, which generally do not exceed small degree of correlation, it can be concluded that in the case of negative symptoms and neurocognitive deficiency, we deal with a variety of neurophysiological mechanisms, which to a certain extent may be linked to each other and cause two sets of related but distinct impairments. They cause various manifestations of psychopathological phenomena.

The aim of the research was to study the characteristics of the subjective picture of life (SPoL) and its relation to the structure and the degree of anxiety and depressive symptoms in patients with various forms of neurotic pathology. We applied the methods of observation, psychodiagnostic and mathematical−statistical ones. The most prominent components of SpoL in patients with neurotic disorders were life structuring and activity factors that show a certain mental stress, irritation, lack of feeling for the implementation of the current goals, high dynamics of reality compared to internal static painful situation. These figures, in spite of their severity in the main group, were significantly lower than in the control group. This situation is typical for the subjective perception of the life as insufficiently ordered, uncontrolled, with the lack of clear understanding of the patterns of events, contradictory impulses. At neurotic disorders the indicators of fatigue, tearfulness, health concerns manifested most prominently in the structure of depressive symptoms. The level of depression was significantly higher in patients with neurasthenia than in other types of neurotic pathology. In dissociative disorders the level of depression corresponded to the control group.

Specific measures of psychosocial rehabilitation of patients were developed based on investigation of the clinical features and specific psychopathological manifestations of social functioning of patients with paranoid schizophrenia with comorbid bone tuberculosis. Application of the developed measures to psychosocial rehabilitation demonstrated significant reduction in the severity of positive and general psychopathological symptoms of paranoid schizophrenia, which directly affect the psychosocial functioning of the patients with restoration of social ties and contacts with the world around (p < 0.001), the ability to live in a normal social environment and to use their social experience (p < 0.001). The patients from the intervention group (according to their subjective evaluation) demonstrated significant achievements in all areas of quality of life, namely the physical well−being (p < 0.05), psychological/emotional well−being (p < 0.05), self−service and independence in the actions (p < 0.05), interpersonal interaction (p < 0.05), socio−emotional support (p < 0.05), public and official support (p < 0.05), self−actualization (p < 0.05), spiritual realization (p < 0.05), the overall perception of quality of life (p < 0.05). Similar situation with considerable achievements was observed according to the objective measure of social functioning, namely behavioral dysfunction (p < 0.05) and dysfunction of the patients in hospital (p < 0.05). Furthermore, significant (p < 0.05) positive trend was diagnosed in the field of disability and interpersonal relations. Significant improvement (p < 0.05) was noted in compliance maintenance: the number of patients keeping drug therapy was significantly higher among the patients in the intervention group versus the controls. Thus, the investigation of the effectiveness of the proposed measures of psychosocial rehabilitation of patients with paranoid schizophrenia comorbid with bone tuberculosis, revealed their positive impact on the ability of the patients to minimize the effects of comorbid diseases, to create the conditions for individual growth of the patient, improve the quality of supporting psychopharmacotherapy.

To study pathopersonological features and key patterns of behavioral response of patients with anxiety disorders (AD) of different origin, to take into account the differences in their vulnerability when creating differentiated therapeutic approaches in the treatment of these patients. Two hundred patients with AD were investigated using the principles of bioethics and ethics at Poltava Regional Neuropsychiatric Hospital within the period of 2011−2015. The patients were divided into two groups: group 1 included 100 patients with AD of neurotic origin, group 2 included 100 patients with AD of organic origin. Pathopersonological properties were determined using questionnaire of K. Leonhard −− G. Shmishek. The leading behavioral patterns were diagnosed using the methods of psychological diagnosis of coping behavior by E. Heim. Comparative analysis showed significant differences between the distribution and structure of accentuation in different groups of patients (r ? 0.01). Thus, for the patients of group 1 a typical trend was prevalence of anxious and emotive (65.0 %) combinations of accentuations. Besides, this group showed demonstrative (16.0 %), dysthymic (7.0 %), and cyclothymic (6.0 %) and exalted (6.0 %) accentuations In this group, nonadaptive emotional (85.0 %) and behavioral (62.0 %) coping strategies prevailed against a background of relatively adaptive cognitive ones (59.0 %). Unlike neurotic patients, in patients with organic AD, accentuated features were distributed more evenly; the leading one was agitative−pedantic combination of accentuated features (60 %); anxiety (13.0 %), demonstrative (10.0 %) and cyclothymic (9.0 %) accentuation were also present. This group demonstrated absolute prevalence of nonadaptive coping strategies of all type, among the cognitive copings nonadaptive made 82.0 %, emotional 66.0 %, behavioral 73.0 %. Thus, in patients with AD of different origins, various options of mosaic destructive combination of pathopersonological and behavioral patterns were revealed. The patients with neurotic AD were characterized by combination of anxiety and emotional pathopersonological features, combined with distortion of emotional and behavioral coping strategies, which played a leading role in development of AD in this group. The patients with AD were characterized by combination of agitative−pedantic pathopersonological features and deformity of all modalities of coping behavior, which, not being the pathogenic factor in development of AD, promoted the features of fable−specific clinical manifestations of pathological anxiety. The revealed differences in pathopersolonological and behavioral patterns in patients with AD were used to develop differentiated measures of psychocorrection and psychoprevention of AD in patients with neurotic or organic disorders.

To understand the possible targets of complex therapeutic and rehabilitation work with this group with the purpose to determine the content of codependence as a pathological state, we examined 160 wives of men with alcohol addiction (AA) and 50 women whose husbands did not have alcohol problems at Kyiv City Narcological Hospital «Sociotherapy» within the period of 2012−2015. Depending on the type of AA diagnosed with the use of classification of T. F. Babor in the patients, their wives were divided into two groups: group A, included 80 wives of patients with type A alcohol addiction (group of relatives A, GRA) and group B, which amounted to 80 wives of patients with AA of type B according to T. F. Babor (group of relatives B, GRB). The comparison group (CG) were 50 married women whose husbands ddid not have AA. The criterion for inclusion in the study was absence of clinically outlines AA in the women. The survey included a comprehensive clinical and psychopathological and psychodiagnostic investigation using AUDIT tests developed by a group of authors headed by Linsky I. V. The women from GRA and GRB showed significantly higher levels of susceptibility to involvement / dependence than the women from CG, almost by all objects of consumption. Thus, the average propensity to abuse of food and tea / coffee as addictive objects in GRA was increased 1.9 times compared with CG. In the respondents from GRB −− 2 times; sex, respectively, 2.6 and 5.4 times; work, respectively, 2.1 and 2.3 times; shopping, respectively, 2.2 and 2.4 times; computer, respectively, 3.7 and 7.1 times; Internet, respectively, 2.1 and 2.2 times. In addition, the women from GRB demonstrated significantly higher levels of severity of propensity to watching television (2.4 times, p < 0.01), gambling (3.5 times) and tobacco (1.6 times), cannabinoids (2.9 times) and sedative−hypnotic drugs (4.2 times) when compared with those from CG. Comparative analysis of the indicators in women from GRA and GRB allowed to allocate significantly higher levels of severity of sexual (2.08 times), computer (1.91 times), games (2.20 times) addiction as well as use of cannabinoids (1.23 times) and sedative−hypnotic drugs (2.39 times) in women from GRB. A special trend was established as to certain chemical addictions, including alcohol and psychostimulants. Alcohol and psychostimulants appeared addictive objects with mean score of severity was higher in women from GRA compared with the persons from GRB and CG: to alcohol −− 1.1 and 1.3 times, respectively; to psychostimulants −− 1.3 and 1.5 times, respectively. Thus, the study of the addictive status in the wives of men with AA proved its strength compared to the wives of ordinary men. Among the objects of addiction in the structure of addictive status of the wives, the types of behavioral addictions prevailed compared to its chemical types. Among the objects of chemical dependence, the factor that aggravates the addictive status in wives of men with AA, regardless of its origin, is tobacco, but among the objects of non−chemical addiction such factors are more numerous, namely food, tea / coffee, work, shopping. In wives of men with genetically determined AA, variability of clinical manifestations and severity of pathological phenomena is greater than in wives of men with socio−environmental type of AA. These data suggest the need to include therapeutic interventions aimed at reducing the tension and normalizing addictive status in treatment and psychotherapeutic support of codependent wives of men s with AA.

Сannabis use ranks the first place in the structure of substance abuse. Mental pathology not related to substance is observed in 58.9 % of the consumers of marijuana. The interest of researchers to the problem of paranoid schizophrenia combined with the cannabinoids use is therefore natural. The aim of this study was to investigate the motives of the use of cannabinoids by patients with paranoid schizophrenia. To achieve the purpose of the study we used the method to determine the motivation of the cannabinoids use by V. Zavyalov, designed to study the motivation of alcohol, adapted to cannabis use and contemporary realities. Statistical analysis of the data revealed that the patients with paranoid schizophrenia rarely use cannabis for physical and psychological pleasure, feelings of cannabinoid euphoria (p ? 0,01). The patients with paranoid schizophrenia more often use cannabis to neutralize the negative emotional experiences ? stress, anxiety, fear (p ? 0,01). The patients with paranoid schizophrenia more often use cannabis because of the desire to emerge from boredom, so−called psychological vacuum, unemployment, mental inactivity, the desire to enhance the effectiveness of their behavior (p ? 0,01). They more often use cannabis through a real desire for cannabinoids, so−called thirst for cannabis (p ? 0,01). The average total score in all scales in patients of the main group was significantly (p ? 0,01) higher than in patients from the control group. The obtained results suggest greater motivational tension in search of cannabinoids among the patients with paranoid schizophrenia than among mentally healthy cannabis consumers, as well as higher motivation of consumption.