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Volume 13, №4' 2018

ABSTRACTS

State Enterprise "Ukrainian State Research Institute for Medical and Social Disability Issues, Ministry of Health of Ukraine", Dnipro, Ukraine
Cardiologic patient in the situation of medical and social expertise
3 - 7
The disability medical examination, where the crucial moment is both the assignment and withdraw of "disability" status, is referred to the important life events with quite a high stress level. This issue is associated with social and economic relationship, personal response and maladaptive strategies of mental adaptation as well. There were examined 72 patients with congenital heart disease. The main maladaptive manifestations in these patients under disability medical examination were modeled. The maladjustment towards the negative spectrum of disability experiences with clinical stress manifestations as a neurotic depression, the leading stressor: a social environmental component (emotional level of internal invalidity picture), stigmatizing behavior and plunging into disease, were determined as inherent to the patients with low resources, assigned with "disability" status. The persons, not assigned with disability status were characterized by maladjustment toward aggression and rejection of situation, clinical stress manifestations, i.e. hysterical reactions with vegetative component, the leading stressor: the socio−economic component (motivation level of internal invalidity picture), behavior with attitudes to be assigned with disability status, disagreement with an expert decision. Thus, the assessment of a life event as a potentially stressful in persons with low physical and mental resources arises when the implementation of needs is mostly focused on external social factors, with a minimal inclination to use internal resources.
Key words: disability dynamics, significant life event, neurotic states, "disabled" status, internal picture of disability.
Zaporizhzhia State Medical University, Ukraine
Functional features of the brain and psychophysiological reactions in patients with the internet gaming addiction
8 - 11
With the boosting role of Internet in daily life of citizens, the number of Internet product consumers is steadily increasing. Many scientists observe an increased number of Internet users to be proportional to the incidence of addiction, implemented through Internet, including gaming addiction. In this context, the timely diagnostics of online gaming disorder gains an importance. Recent studies have demonstrated the bias of diagnostic results of psycho−diagnostic questionnaires of Internet addiction towards hyperdiagnosis, reducing thereby their diagnostic significance. The mentioned above stipulates the search for other markers and diagnostic tools for Internet addiction, including the gaming one. This study was aimed to systematize the morphofunctional, psychophysiological markers and tools for diagnosis of Internet gaming addiction. Here, we analyzed the reported data on the task of determining the morphofunctional and psychophysiological features of patients with internet gaming addiction. These features were systematized and considered as diagnostic markers of Internet gaming addiction. The diagnostic tools were combined, that enabled establishing the morphofunctional and psychophysiological features of patients with Internet gaming addiction. The content analysis of scientific materials demonstrated the presence of morphofunctional and psychophysiological features in the patients with Internet gaming addiction, which were partially similar to other addictions and not inherent to the persons with recreational gaming activities, and therefore could be considered as diagnostic markers for studied pathological state. These features are as follows: neuron activation in the right adjacent nucleus, right orbitofrontal cortex, anterior bone marrow, medial frontal cortex, right dorsolateral prefrontal cortex, right caudate nucleus in response to the presentation of the visual stimulus associated with the Internet games; activation of neurons of striatum, lateral and prefrontal cortex, as well as precuneus during game activity; reduction of functional relationship between the dorsolateral prefrontal cortex and the upper frontal lobe with increased functional relationship between striatum and thalamus during gaming activity; decrease in the amount of gray matter in the postcentral gyrus, the left precental gyrus, the left posterior laceration, the left upper temporal gyrus, the lateral orbitofrontal cortex, the lower parietal lobe, the cuneus, the right temporal lobe, the right supramarginal gyrus; increase in electrical activity of skin, pulse blood flow, peripheral body temperature, decrease in the standard deviation of the heart rate, decreased eye−blink rate and distance of eyes moving during each saccade, increase in average respiratory rate in response to the presentation of Internet games stimulus. Diagnostic tools, enabling to identify these markers are as follows: neuroimaging techniques, including functional ones, as well as psychophysiological methods, i.e. photoplethysmography, electroaculography, measurement of the galvanic skin response, respiratory rate and peripheral body temperature.
Key words: the Internet gaming addiction, additions, morpho-functional features, psychophysiological features, diagnosis, diagnostic markers.
H. S. Skovoroda Kharkiv National Pedagogical University, Ukraine
The features of smoking influence on family functioning at different stages of the family life cycle
12 - 18
The specific character of notions about the impact of smoking on some family functions and general family functioning depending on the life cycle stage has been investigated. There were interviewed 356 complete nuclear families (846 respondents) with at least one smoker in it, in order to determine the peculiarities of notions about the tobacco smoking impact on family functions at various stages of its life cycle. The families under study belonged to three categories, corresponding to the family life cycle stages, i.e. 109 young families prior to firstborn child (218 respondents), 134 families with adolescents (402) and 113 mature families (226), who fulfilled their parental role ("empty nest").Here, we applied the author�s psychodiagnostic technique entitled as "The Impact of Smoking on Family Functioning", enabling to determine the variants of impact of smoking on the primary functions of the family. The notions of impact of smoking on both separate family functions and general family functioning as well, were established to have a specific character depending on the family�s life cycle stage. The most negative impacts of smoking on household and educational functions, spiritual communication, emotional and primary social control functions was recorded in the notions of families with adolescents, and least one was noted in the mature families, which fulfilled their parental function. The prevalence of notions about the neutral impact of smoking on general family functioning was recorded in young families and with adolescents, and in the mature families the notions of neutral effect and positive senses of smoking dominated. The highest variation of typological profiles of notions about the impact of smoking on family functioning was found in the families with adolescents, and the lowest one was done in the mature ones. In young families, the typological profiles had a uniform distribution. In those with adolescents, the "The negative impact of smoking on educational function in family with adolescents" profile prevailed; that of "Favorable impact of smoking on family functioning in family with adolescents" was the least represented. In mature families the profile "Negative impact of smoking on mature family functioning" prevailed, the least represented was the "Favorable impact of smoking on mature family functioning" profile.
Key words: family life cycle, family functions, representations about the influence of smoking, typological profiles.
Kharkiv Medical Academy of Postgraduate Education, Ukraine
The use of e. berne’s script positions to characterize the narcissistic component and the attitude to objects of attraction in different types of personality
18 - 21
The well−known concept of script programming and game theory, developed by the distinguished American psychiatrist and psychotherapist Eric Berne is based on the transactional analysis. This method of psychotherapy includes the structural analysis, i.e. the analysis of the individual psyche; analysis of transactions, i.e. verbal and non−verbal communicative interactions between people; analysis of psychological games, i.e. hidden transactions, resulting in the desired outcome (gain) and, finally, the script analysis, i.e. the analysis of the individual life plan a person follows. The main attention was paid to some aspects of the life script analysis, namely, to the script positions. The initial script programming begins during child feeding and, over the next years, the child develops a feeling of well−being and distress, convictions about himself and the people around him, especially the parents. These beliefs persist in a person for all life, becoming the basis for making a certain life decision. The convictions, that presuppose a person�s attitude to the world as a whole and to all those around him, E. Berne defines a position. The author proposed the characteristics for the following positions: depressive, masochistic, narcissistic, hypomanic, paranoid, schizoid ones. Our findings showed the narcissistic (associated with self−esteem) components of idealization and depreciation processes to be manifested differently in various personality types. Both in inner personal space, and in any external affections, alliances, the positions might be changed after medical and psychological correction.
Key words: E. Byrne’s transactional analysis, life script, script positions.
Ukrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kyiv, Ukraine
Clinical and psychological characteristics of psychoendocrine syndrome in hypogonadism
22 - 25
The goal was to establish the clinical and psychological characteristics of psych�endocrine syndrome in patients with primary hypogonadism. In compliance with the principles of bioethics and deontology, 100 patients with primary hypogonadism were examined at the Ukrainian Scientific and Practical Center of Endocrine Surgery, Endocrine Organs Transplantation and Tissues of the Ministry of Health of Ukraine. The study was carried out in two stages. At the first stage, the psychoanalystic stage, there were compared the psychodynotonergic and other clinical and anamnestic features of patients from different groups. At the second stage, clinical−psychopathological one, a clinical and psychopathological typing of psychoendocrine syndrome was implemented and the manifestations of the latter were compared in the groups of patients. Here, we used the SCL−90 scale to determine the clinical and psychopathological characteristics under medicated compensation and decompensation. The hospital anxiety and depression scale (HADS) was used to analyze the pathoaffective component of the psychoendocrine syndrome. The manic forms in the structure of this component were determined using the YMRS scale. In this research using the HADS scale we examined the groups of patients in order to analyze the pathoaffective component of psychoendocrine syndrome. According to the results of HADS subclass A, the indices were within the norm in 55.0 % of patients; in 29 % the indices corresponded to the subclinically expressed anxiety; 16.0 % of patients showed the level, corresponding to clinically expressed anxiety. By the HADS subclass D data, the indices within the norm were in 31.0 % of patients; in 47.0 % the indices corresponded to the subclinically expressed depression; the level of clinically expressed depression was in 22.0 % of patients. The maniac form manifestations within the structure of the pathoaffective component of psychendocrine syndrome were analyzed with YMRS. In patients with hypogonadism, the irritability prevailed, an overall assessment showed no manioformal condition, while the available semiotic evidence indicated a deeply subclinical nature of pathoaffective disorder. Clinical and psychopathological characteristics in patients with hypogonadism were compared in the states of medical compensation and decompensation using the questionnaire SCL−90−R. It was established that in case of hypogonadism there were the differences in manifestation of psychopathological symptoms in compensation and decompensation states. A reliable clinical reduction of the severity of somatization forms, violations of intrapersonal sensitivity, moderately severe forms of depressive disorders, and severe and moderately severe forms of anxiety was found. It should be noted that in addition to pathophysiological phenomena and violations of intrapersonal sensitivity in this group, the symptoms, which were at the level of average intensity and above, were almost absent. According to our findings, the clinical and psychopathological characteristics of psychodenocrine syndrome with hypogonadism were established to be as follows: the depressive symptoms and anxiety were significantly expressed in 34 and 50 % of patients, respectively. The irritability had a total expressiveness. Severe forms of intrapersonal sensory impairment occur in 55 % of the contingent.
Key words: psychoendocrine syndrome, hypogonadism, pathoaffective component, depression.
Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
The individual model of psychological health in patients with adaptation disorders and the efficacy of the emotional state psychological correction
25 - 29
The purpose of this work was to study the characteristics of the individual model of psychological health, the complex of basic psychological and socio−psychological factors, associated with its formation in patients with adjustment disorders and their sensitivity to psychological correction. It was shown that in adjustment disorders, the deformation of an individual model of psychological health occurred. This was manifested in the negative dynamics of humanistic, creative and spiritual factors, the decline in strategic planning, along with the growing need for social and family support, as well as the increased severity of individualism. A significant decrease in the level of happiness was also found in patients with adaptation disorders. As well, the psychological indices of psychological well−being such as Environmental Management, Human Being as an Open System, Affect Balance, and Positive Relationships were referred to the diagnostic criteria for pathopsychological signs of patients with adjustment disorders. The use of the psychological technique for emotional state correction in case of disorders enabled to increase the level of happiness in these patients. Their individual psychological health model was also harmonized, that was manifested in increased indices of the Strategic Vector and Creative Vector scales, but the indices of Prosocial Vector scale decreased. The most sensitive to psychological correction components of mental well−being were the scales Affective Balance, Control of the Environment, and the Positive Relations scale was improved.
Key words: adaptation disorders, happiness level, individual model of psychological health, psychological well-being, psychocorrection, emotional states.
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Analysis of psychoemotional and personological spheres in representatives of youth subcultures of adolescent age depending on their socio−psychological adaptation
30 - 37
There were examined 143 adolescents in order to reveal the psycho−emotional and the features inherent to the representatives of youth adolescent subcultures, depending on their social and psychological adaptation, and for further determining the targets for psychoprophylaxis with maladjusted individuals. The extreme adolescents with manifested social and psychological maladjustment were established as characterized by the prevalence of hyperthymic and cyclotamine pathocharacterological tendencies, and in the neurotic profile of personality response they showed the presence of an unhealthy hysterical reaction and autonomic disorders. The representatives of an extreme subculture with normal indices of social and psychological adaptation among the accented signs showed the predominance of hysterical and unstable traits and a healthy course of anxiety and asthenia experience in neurotic profile. The socially−maladjusted teenagers−gamers had a tendency to dominate the melancholic and schizoid pathocharacterological properties, being the background for the formation of a personal neurotic profile with an unhealthy anxiety and healthy hysterical response. Among the accented trait in socially−adapted gamers the most frequent were schizoid and unstable types, and the state of psychoemotional sphere was characterized by healthy indices of neurotic depression and obsessive−phobic disorders. In the adolescents, not involved into youth subcultures and having the normative indices of social and psychological adaptation, the melancholic and sensational traits prevailed among the characteristic features, and the state of psychoemotional sphere determined the unhealthy nature of neurotic depression, while the emotional−labile and cyclothymic pathocharacterological tendencies and tendency to asthenization as a leading feature of the psycho−emotional state were inherent to socially maladjusted adolescents. Our findings should be taken into account when determining the strategy of psychoprophylaxis for these individuals.
Key words: youth subcultures, socio-psychological adaptation/maladjustment, gamers, thrill-seekers, neurotic profile, character accentuation.
Odessa National Medical University, Odessa, Ukraine
The features of mental and somatic disorder representation in the awareness of patients with schizofrenia and cardiovascular comorbidity
38 - 41
This research was aimed to investigate the peculiarities of the perception of the psychic and somatic state in schizophrenic patients with cardiovascular comorbidity. We examined 100 patients with schizophrenia (F20), the half of which had chronic cardiovascular diseases. The research methods were as follows: a modified Dembo−Rubinstein method to determine the peculiarities of self−esteem of general health state and individual mental and physical health; an adapted SUMD (Scale to Assess Unawareness of Mental Disorder) technique to evaluate the level of "insight" of mental disease; and a brief illness perception questionnaire (BIPQ) adapted by V. �. Yaltonsky. The data were processed with the statistical methods for comparative studies (t−test and Fisher�s exact test). The schizophrenic patients with cardiovascular disorders were established as characterized by low self−esteem of their health in general and additionally by the mental and physical health states; preserved criticism as for the mental disorder and its perception as having much higher risk to life than a somatic disease. Our findings reflected the high level of psychological distress in schizophrenic patients with cardiovascular disorders, stipulated by the awareness of the presence and consequences of mental disorder.
Key words: schizophrenia, cardiovascular disorders, comorbidity, disease perception.
Ukrainian Medical Stomatological Academy, Poltava, Ukraine
Dysmorphophobias in esthetic surgery
42 - 46
Here, we reviewed the reported data on dysmorphophobia in patients, wishing to change their appearance. A typical patient with dysmorphophobia is convinced that one of his/her body parts is too large, too small or distorted. The other people consider the appearance of the patient either to be absolutely normal or find insignificant, unobtrusive abnormalities in some cases. As a rule, the patients point out to either a distorted form or abnormal size of nose, ears, mouth. They are constantly immersed into thoughts about their abnormalities and suffer deeply. They believe everybody pays attention to their facial deformity and often discusses it in−between. The "disadvantage" is admitted as the cause of all life difficulties. Patients argue stubbornly that if they had more beautiful nose, they could be more successful in work, social life, sexual relationships. Recently, the characteristics of the patients, who applied to aesthetic surgery, have been actively studied. The dysmorphophobia was proven to be a common disease among the people who wanted to change their appearance. According to the different publications, the incidence of dysmorphophobia ranges from 5 to 25 %. These patients demonstrated mostly the symptoms of subclinical and mild forms of dysmorphophobia, wherein the confidence in presented defect in the appearance did not reach the intensity of delusion. Some researchers found out the mental state in some patients with dysmorphophobia to meet the diagnostic criteria for other psychiatric disorders such as personality disorder, schizophrenia, depressive disorder. The reported data analysis also showed no efficiency of surgery in dysmorphophobia defect and even the exacerbation of symptoms of dysmorphophobic disorder. In contrast, a high efficiency of psychotherapeutic and pharmacological correction was proven.
Key words: dysmorphophobia, esthetic surgery, psychotherapy, pharmacological correction.
Sumy State University, Medical Institute, Ukraine
Aggressiveness as a suicide risk marker in patients with dementia
47 - 50
Dementia is a progressive disorder with an impaired cognitive function, loss of self−care skills, accompanied with a wide range of comorbid psychiatric disorders such as agitation, depression, anxiety, sleep disorders, irritability, tearfulness, psychosis. To study the level of aggressiveness and its relationship with suicide risk, 213 patients with vascular, mixed dementia and dementia as a result of Alzheimer�s disease were examined. Clinical anamnestic, pathosychological (Buss−Durkey Inventory) and psychodiagnostic methods (a method for determining suicide risk) were used. The findings of the aggressiveness features in the patients with various types of high−risk suicide dementia demonstrated that ones with vascular dementia differed from those with a mixed type of dementia and Alzheimer�s disease with a higher degree of retardation and irritability; the rates of verbal and indirect aggression were higher in the patients with vascular and mixed dementias if compared with those surveyed with Alzheimer�s disease. Physical aggression predominated in the patients with vascular dementia versus the ones with Alzheimer�s disease, the negativism predominated in patients with Alzheimer�s disease and in vascular dementia as compared to the patients with mixed dementia who had a greater sense of guilt than those with vascular dementia. Patients at high suicide risk had significantly higher rates of aggressiveness, regardless of the dementia form, it had a self−directed vector. The aggressive manifestations in dementia with suicidal behavior were the predominance of negatively sensed feelings −− guilty, resentment, hostility, indirect and verbal aggression, whereas manifestations of the physical response of negatively stained emotions were not inherent in dementia patients. The data obtained explain the predominance of ideational forms of suicidal behavior over external phenomena in the mentioned patients.
Key words: dementia, Alzheimer’s disease, physical aggression, suicide risk.
Kharkiv Medical Academy of Postgraduate Education, Ukraine
The features of affective disorders in the structure of alcohol addiction in persons with different psychotraumatic experience and level of psychosocial stress
51 - 57
Ukraine is ranked 2nd internationally by the wasted time because of inability to work or premature alcohol−related death. The research aim was to analyze the peculiarities of the correlation between severity of affective disorders in alcohol addiction, existing psychological traumatic experiences and severity of psychosocial stress, to understand the ways of modifying the available therapeutic and rehabilitation strategies, taking into account the aggravating effect of stress on the formation and course of alcohol addiction. Within 2014−2018, 312 alcohol addicted individuals were examined: 107 combatants were the persons who were involved into military activities in the East of Ukraine as the participants in the Anti−Terror Operation and the Joint Forces Operation; 89 internally displaced persons from temporarily occupied territory of Donetsk and Luhansk Regions; as well as 116 residents of Kharkiv and Kharkiv Region, not being the combatants or internally displaced persons. Both the severity and clinical variability of depressive and anxious phenomena in the individuals with an alcohol addiction were established to reveal a strong association with the level of psychosocial stress. In this case, the factor of participation in military operations or forced displacement played a minor role. At the same time, the combatants and internally displaced persons expressed higher levels of depression and anxiety in compared with local residents; for the combatants this was confirmed by integral indices of depression and anxiety, most indices of adynamic depression, depression with fear, undifferentiated depression and mental anxiety, and for internally displaced persons that was evidenced according to individual indices of agitated depression and somatic anxiety. The revealed patterns should be considered when developing the treatment and rehabilitation, as well as preventive measures for the individuals, who suffer from alcohol addiction.
Key words: alcohol addiction, affective disorders, depression, anxiety, psychosocial stress, psycho-traumatic experience.
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Cognitive disorders in elderly and old patients with proximal femur fractures
58 - 62
The problem of increasing manifestations of cognitive post−surgery disorders in elderly and senile patients with proximal femoral fractures stipulates a profound consideration of this issue. In addition, the problem of mental health impairments of various genesis is gaining an importance for older people, among those a significant share of existing cognitive impairments is revealed as a combination with emotional disorders of anxiety−depression spectrum, therefore the surgery requires a special pharmacological correction at pre− and early post−surgical stages. During surgery such individuals are characterized with the following psychological changes: increased vulnerability, annoyance, irritability, "affective" attention fixation on certain perceptions, frequent loss of auto− or allo−mental orientation, major loss of mood, un−satisfaction with others, signs of anxiety and fear, agitation. The study has found a prevalence in women (versus men) of cognitive impairments, as well as there was revealed quite a high proportion of individuals with simultaneous cognitive and emotional disorders. The following psycho−neurological disorders were identified in the examined individuals: dyscirculatory encephalopathy of 2 and 3 grades, most of them were complicated with cerebral atherosclerosis; dementia, severe cognitive decline and cerebral atherosclerosis.
Key words: cognitive disorders, cognitive disturbances, cognitive functions, emotional disorders of anxious-depressive spectrum, proximal femur fractures.
Kharkiv National Medical University, Ukraine
Borderline disorder manifestations in patients with sexual dysfunctions
62 - 65
Among the possible categories of sexual dysfunctions in men, the ejaculatory dysfunctions are most commonly encountered, most of which form the so−called premature ejaculation, early ejaculation and short sexual intercourse. The development of these disorders is due to the "formed" specific complex of various "fears" before the forthcoming sexual intercourse, which is generally stressful for the man before the intercourse itself. In this case, the existing sexual dysfunction acts as a trigger factor for a permanent psycho−emotional strain, which further "deepens" the stress−loading on a person and can lead to the development of neuropsychiatric genesis disorder. Borderline disorders are commonly encountered in combination with other psycho−neurological disorders (panic disorder, generalized anxiety disorder, depression, obsessive−compulsive neurosis, manic−depressive psychosis, paranoid disorder, etc.), alcoholism and drug abuse, suicidal and auto−destructive behaviour. To determine the peculiarities of manifestations of borderline disorders in patients with sexual frustrations, the patients with premature ejaculation, erectile dysfunction, persons with weak erection and low libido were examined. As a result of a study of the patients with borderline disorders and / or sexual dysfunctions (premature ejaculation and erectile dysfunction), the possible influence of age characteristics on the development of sexual and borderline y disorders was established; the primary character of development and probability effect of borderline disorders on the appearance of sexual dysfunctions was revealed; the presence of a pronounced moderate depressive episode was noted, as well there was observed a significant quantitative prevalence of the manifestations of psychopathological symptoms in the patients with borderline disorders if compared with the patients with premature ejaculation and erectile dysfunction.
Key words: sexual dysfunctions, borderline disorders, premature ejaculation, erectile dysfunction.
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Psychoemotional and addictive status of demobilized combatants and their wives with different health conditions of the family
66 - 71
A special place in the society social structure is held by the families of discharged combatants, because during their life they face numerous problems, which the family members are not prepared for. To investigate the psycho−emotional and addictive status of spouses in the families of discharged combatants, 100 couples were examined in a comprehensive way to establish their relationship with the family health issues and to identify the targets for further psycho−correction. The study was performed using clinical psychopathological and psychodiagnostic methods. According to the marital success criterion, the families examined were divided into groups: with an impaired family health and successful couples. It has been established that the clinically defined psychopathological anxiety−depressive manifestations were recorded in spouses of both groups, but among those surveyed with successful family relationships they were less common and slightly expressed. The activity of the addictive status was significantly higher among the respondents with impaired family health. In both groups, the character of the detected behavioural and chemical addictions is established. So, the food, television, Internet, computer games, tea and coffee, as well as alcohol addiction was combined in the respondents with tobacco smoking addiction. The obtained data confirm the author�s hypothesis about the existence not only of person−to−person psychological, but also biological resources of family support and maintaining the family�s health of the combatants. The findings will be the basis for developing a complex of the measures for psycho−correction and psychological support to the combatants families.
Key words: family health, combatants, wives of combatants, anxiety, depression, addictive status.
Odessa National Maritime University, Ukraine
Pathogenic factors in labor conditions of employees of sea and river transport
71 - 75
An increase in morbidity, social and professional maladaptation and disability of the patients with either complete or partial loss of the opportunity to participate in the production sphere as a result of mental impairment, developing in individuals, working in the sea, is one of the most urgent medical, social and psychological problems. Disorders of clinical polymorphism are observed, and their social consequences attract the attention of many specialists. The scientific novelty of the problem is that mental disorders develop in individuals, not having physical or mental functioning disorders. Many authors consider the problem of mental disorders in those working in marine conditions within the framework of neurotic and neurosis−like disorders. At the same time, there is reason to believe that the important scientific and practical issues, the prevalence of neurotic, psychotic and psychosomatic disorders of their classifications, remain unexplored. As well it is of further relevance to expand the data on the classification of determinative factors, epidemiology, and the dynamics of mental disorders forming in sea conditions. The features of the syndrome structure of such disorders, correlation dependence of exogenous, including psychogenic and premorbid−constitutional aggravating factors in their development, remain unstudied. Thus, to date, certainty of organizational and methodological approaches in treatment, prevention, rehabilitation of this category of patients is the most relevant. Marine professional activity dictates the need to develop non−traditional therapeutic and recreational measures of therapy, that is, medical and psychological support and prevention at the industrial enterprises of this profile. All of the above led to the study of pathogenic factors of the employees of sea and river transport.
Key words: psychoemotional state of the workers of sea and river transport, pathogenetic factors, extreme working conditions, limited space, occupational hazards.
SI "Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
Clinical psychopathological characteristics of combatants with established diagnosis of post−stress personality disorder
76 - 79
With relation to political situation in Ukraine, an increasing number of modern scientists in the field of medicine, psychology, psychiatry and military psychology is directing the vector of their research towards identifying the methods for comprehensive diagnostics and developing the algorithms for medical and psychological assistance, support and rehabilitation for the individuals who were the participants in hostilities. The author presents the results of his own continuous study (2014−2018) on the identification of clinical and psychopathological features of military personnel with an established diagnosis of post−stress personality disorder (PSPD). At the first stage of the study, it was revealed that some soldiers, in addition to the PSPD signs, also demonstrated pronounced tendencies of pathological chemical addictions, which became the basis for conducting further research to determine the targets of clinical and psychopathological characteristics of the soldiers with addictive behavior. The mentioned above will further allow the development of an algorithm for rendering medical, psychological and pharmacological assistance to this group of combatants.
Key words: post-stress personality disorder, clinical psychopathological features, addiction, addictive behavior, participants in combat operations.
SI "Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
The features of time perception in the course of depressive disorders
80 - 85
The purpose of the work was to determine the peculiarities of time perception in the patients with depressive disorders, as well as to consider their dynamics. We examined 79 people, 44 of them made the patients with depressive recurrent disorder (main group), 35 persons without mental disorder (comparison group). During the study the clinical−psychopathological method was used, it included a thorough analysis of the disease history in patients of the main group, as well as the psycho−diagnostic method "Semantic Different Time" (SDR) to determine the cognitive and emotional components of subjective perception of time. The patients with recurrent depressive disorder have been established to be characterized with a negative assessment of the present and future, with a rather positive assessment of the past. In addition, it was noted that patients with recurrent depressive disorder considerably more negatively perceived all time categories of their lives versus the comparison group. The presence and nature of the relationship between the peculiarities of time perception and dynamics of recurrent depressive disorder have been studied. It was discovered that with the accumulation of depressive experience, the negative perception of reality and future was deepened, and was complemented by the formation of negativization of the past, that was manifested by a general depreciation of its own life path and narrowing its prospects.
Key words: recurrent depressive disorders, time perception, depressive disorder course dynamics.
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Efficiency of sanatorium resort treatment of adaptation disorders inparticipants of military actions
86 - 89
Within the period of 2014−2018 according to the recent data, more than 320 thousand individuals participated in hostilities. The medical−psychological rehabilitation in the combatants is vital as a result of these hostilities; many of the combatants were physically and mentally injured. To restore the mental health of combatants, the Department of Psychotherapy of Kharkiv Medical Academy of Postgraduate Education has developed a program of medical and psychological rehabilitation using a resort therapy conditions. Sanatorium−and−health resort treatment is purposefully intended to effectively prevent the relapses, as well as provides a restorative treatment of patients and their rehabilitation. The organization of sanatorium and resort assistance is based on the principles of prophylactic and rehabilitation orientation, stage−by−stage activity and relationship between out−patient and inpatient as well as sanatorium−resort institutions. The purpose of our study was to investigate the phenomenology of mental disorders in the patients with adaptation disorders (AD), pathopsychological mechanisms, determining their occurrence and assessment of the effectiveness of medical and psychological rehabilitation of the combatants during the spa treatment. The study was performed using clinical psychological, socio−demographic and psycho−diagnostic methods. During medical−psychological rehabilitation, the following psychotherapy is recommended. First is the individual psychotherapy, conducted as the consultation using the methods of rational, cognitive−behavioural psychotherapy, and in case of strong somato−vegetative manifestations the hypnosis−suggestive one is applied. Second is the group psychotherapy, which is conducted as the open therapy groups. Assessment of the results of psycho−correction of the patients with AD in the sanatorium conditions the positive dynamics in stabilizing the psychoemotional background and activity of the surveyed individuals (in 89.76 %) was observed.
Key words: adjustment disorders, demobilized participants of combat operations, program of medico-psychological rehabilitation, sanatorium facilities.
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