ARTICLES ARCHIVE

To establish the peculiarities of cognitive impairment in the structure of vascular dementia, which is accompanied with hallucinatory−paranoid disorders, the patients with this pathology and the ones without psychotic disorders were examined. According to the statistical analysis results, the most informative signs of cognitive impairment in the patients with vascular dementia and hallucinatory−paranoid disorders were as follows: impaired motivational component of thinking (paralogia, disintegration, incoherence); impairment of criticism; disorder of the attention stability (distraction, inertia and attention fatigue); disorders in drawing the conclusions; impairment of orientation in space and personality. Significant cognitive impairment was established in these patients, which increase the level of diagnostic information: disturbance of generalizations in thinking (lack of generalization, its distortion); disordered formal logical operations in thinking; memory impairment (impairments in reproducing associated with encoding disorders); impaired praxis (impaired writing); impaired gnosis (failures of the instructions understanding); disorders of praxis (disorders in visual−constructive skills); disordered dynamics of thinking (slowing−down, inertness, perseveration and inconsistency) and impaired counting (serial subtraction). The data obtained should be taken into account in the diagnosis and treatment of these patients.

Epilepsy is one of the most common neurological disorders, associated with a range of psychopathological disorders, including depressive ones, personality disorders, cognitive dysfunctions and epileptic psychoses. To determine the featured psychological response to illness in the patients with epilepsy in the case of its comorbidity with depression, a study was performed with the involvement of the patients with epilepsy with interictal depression. Methods of the study were as follows: a brief illness perception questionnaire by E. Broadbent (BIPQ), a methodology for the psychological diagnosis of types of attitude to the disease. It was established that the patients having epilepsy with depression were characterized by a high perception of the threat of the disease, its significant negative impact on the emotional state (in all forms of depression), life in general (in psychogenic and endogenous depressions), disbelief in possible treatment (in endogenous depressions) , low level of understanding of the disease (in organic and endogenous depressions) and maladaptive types of attitudes to the disease (dysphoric for all forms of depression; anxious for organic and psychogenic depressions; neurasthenic forendogenous and sensitive for psychogenic depression). The established features of psychological response to the disease stipulate an increased level of psycho−emotional distress, potentiate the development and aggravation of depressive symptoms. The findings should be considered as targets for psychotherapy and psychoeducation.

Despite the advances achieved in recent decades in diagnosis and treatment of mental illness, the prevention, treatment and rehabilitation of the patients with neurotic disorders remains an important medical task. Changes in the clinical picture, origin of disorders in the system of personality relationships, psychological characteristics in such patients are closely related to external social, economic, cultural factors that are constantly evolving and have a great influence on clinical pathomorphosis of neurotic disorders. To study the pathopsychological features of neurotic disorders in rural population, 88 patients were examined. Questionnaire of interpersonal relations by A.A. Rukavishnikov was used as a toolkit; the methods of diagnostics of social and psychological adaptation of K. Rogers and R. Diamond; a scale for the diagnosis of life quality (Mezzich et al.); C. MacAndrew Hidden Alcohol Scale. During the study the peculiarities of life quality, social and psychological adaptation, level of expression of basic interpersonal needs of individual, as well as the features of person−to−person interaction in the patients with various neurotic disorders were studied, the factors of alcoholization in the patients with neurotic disorders were analyzed. There have been revealed the general and certain psychological features, specific for the patients with neurotic disorders, which can be used as possible differential diagnostic criteria during the diagnosis of disorders, as well as during psycho−corrective, rehabilitation and prophylactic measures.

Blue−water sailors are among the professional groups with one of the highest risks of experiencing psychosocial stress, which is known to have a negative impact on mental health. However, all the researchers mutually understand: sailing is related to mental, psychosocial and physical stressors, depending on sailors working conditions, so the stress reduction strategies should be targeted at different categories. To investigate the psychopathological and pathopsychological features of the aggression and hostility phenomena as a destructive response of individual to the occupational extra−stressors, 180 navy merchant representatives, i.e. the team members and workers were surveyed. The study involved the use of clinical psychopathological and psychodiagnostic methods. It revealed that the vast majority of officers and virtually all sailors were characterized by a prevailed aggressiveness, not exceeding its average level, but its average intensity was in the amplitude of the increased range. Staff members were much more likely to be physically and verbally aggressive than workers, indicating that the officers were more responsive to stressful occupational conditions through physical and verbal aggression than sailors. About half of the persons surveyed was characterized with a high and very high tendency for irritation, most of them were of a high severity. The intensity of irritation was high in the Navy representatives. The vast majority of blue−water sailors, regardless of their professional background, experienced hostility above average, and five percent of respondents had high and very high levels. Many sailors, regardless of specific nature of their professional activity, lived with a permanent guilt of increased or greater severity, which undoubtedly adversely affected their mental health. The identified features should be taken into account when designing specific psychotherapy and psychoprophylaxis measures for this contingent of patients.

The findings of recent decades indicate that functional deficits (a disorder that involves and uses neurocognitive connections) in endogenous episodes with episodic flow are one of the leading factors in social maladaptation formation. To comparatively analyze the neuropsychological disorders in the patients with endogenous psychoses with episodic flow in remission/intermission the ones with diagnoses were examined: bipolar affective disorder, recurrent depressive disorder, schizophrenic disorder, schizophrenic disorder. The main methods of the study were clinical and psychopathological, psychodiagnostic, clinical− anamnestic and clinical−follow−up, as well as medical and statistical analysis. In schizophrenia, the most significant neuropsychological disorders in terms of prevalence and severity were revealed: reduced short−term auditory memory, impaired understanding of logical−grammatical structures and phonotematic analysis, gnosis of persons, constructive and dynamic praxis. Disturbances in understanding of situational speech and words, gnosis of persons, recognition of sounds, melodies and reproduction of rhythms in the patients with schizoaffective disorder were more frequent than at affective disorders. The study of a patient's behavior during testing revealed noso−specific differences in motivational component of cognitive activity and social interaction modes. In endogenous psychoses, there was a decrease in the quality of the report between patient and researcher in the direction of: affective disorder−schizoaffective disorder−schizophrenia. Herewith, the main mechanisms for reducing the report of affective and schizoaffective disorders were the passive−aggressive behavior of the examination procedure impairment, and in schizophrenia these were emotional poverty and symptoms of autism. The findings can be used for differential diagnosis, as well as for determining the scope and evaluation of the effectiveness of individually needed therapeutic psychosocial interventions and targeted neurocognitive training in the patients having endogenous psychoses with episodic flow.

This article covers the findings of peculiarities of mental state of internally displaced persons for timely diagnosis and prevention of the formation of mental disorders in these persons, the use of psycho−educational work was substantiated and the author's version of the psycho−educational program was proposed. To study the mental peculiarities of internally displaced persons and to determine the range of psychopathological disorders they had, 155 internally displaced persons were examined. The following methods were used: a semi−structured questionnaire for screening assessment of mental state; questionnaire on the severity of symptoms of post−traumatic stress disorder; PHQ−SADS questionnaire for the assessment of depressive, anxiety and somatic symptoms. According to the findings, the mental state of internally displaced persons was characterized by a wide range of different intensity of psychopathological disorders, i.e. from psychologically clear emotional responses to clearly defined psychopathological symptoms of different severity. Thus, the vast majority of the internally displaced persons surveyed were found to be characterized with the signs of depressive symptoms (73,55 %), anxiety symptoms (69,68 %), somatic symptoms (67,74 %), and symptoms of post−traumatic stress disorder (32,9 %). Among them, the presence of clinically pronounced symptomatology requiring inpatient treatment was noted in 7,74 % of interviewed internally displaced persons on the scale of depressive symptoms, in 5,8 % on the scale of anxiety, in 3,87 % on the scale of somatoform symptoms, and in 5,8 % on the scale of post−traumatic stress disorder. The findings strongly suggest that the diagnosis and prevention of mental disorders in internally displaced persons require a close attention. For timely diagnosis, the prevention of formation and chronicity of mental disorders in internally displaced persons, use of psychoeducation have been proposed. The author's version of psycho−educational program for internally displaced persons was developed and tested. The proposed program is a group work and consists of a series of thematic sessions (sessions) with elements of social and psychological training. Thematically proposed program includes the following blocks: features of functioning of the psyche in stressful conditions; options and manifestations of the most common mental disorders of internally displaced persons (post−traumatic stress disorder, depressive and anxiety disorders); opportunities for regulatory behavior; reducing stress in relationships; resources to overcome psycho−emotional stress. The testing results of the proposed program showed that at the end of psycho−educational program its participants were characterized by higher mental adaptation, as evidenced by lower level of their neuro−psychic tension and situational anxiety, compared to internally displaced persons, not receiving the psycho−education.

Psycho−oncology is the science and section of clinical practice on the junction of medicine and psychology, which deals with the study of psychosocial and psychobiological aspects of cancer, namely: psycho−emotional responses of patients at all the stages of the disease, as well as members of their families and caregivers (psychosocial); psychological, behavioral and social factors that can affect morbidity and mortality due to cancer (psychobiological factor). The untimely detection and inadequate correction of maladaptive mental states and disorders in oncological patients leads to a longer period of examination, reduced predisposition to anti−tumor therapy of patients and, consequently, the effectiveness of anti−tumor measures. Important aspects of clinical practice in the field of psycho−oncology include the phenomenon of "delayed treatment", a high risk of suicidal intent. Various psychotherapeutic areas, as well as psychopharmacotherapy, are effective in the psychological assistance to cancer patients. Psycho−oncology is an example of a successful implementation of the principle of interdisciplinarity and integrativeness in treatment, which allows to see the patient and his/her life situation holistically and accordingly to build a comprehensive and effective system of medical, medico−psychological and psychosocial care.

The life prospects of young people are always colored by personal meanings. Formation of personality in special conditions imposes its imprint on the attitude to the world, where there is a high probability of forming the identity of ?disabled? as a social phenomenon. Young people aged 18?29 years with the status of "disabled child" without mental pathology were examined. The structure of personal meanings of the disease was studied: personality characteristics, parental attitude, alexithymia, life plans, values, treatment setting was the basis of the structure; self−reports of activity and participation. The following personal meanings have been identified: conflict, positive, barrier. A three−stage model of psychological rehabilitation, based on the personal meanings of illness and alexithymia, has been proposed. It was concluded that diseases of young people with the status of "disabled child" wree formed by the parental attitude, there was alexithymia in their structure, there were complexities in building a life prospect against the background of life dissatisfaction, uncertainty of resources, supported by personality traits, striving to make his/her state heavier during self−reporting, which should be taken into account both in examination and when preparing the rehabilitation programs.

Today, dorsalgia is referred to as musculoskeletal (myofascial) pain, the syndromes of which can occur, regardless of degenerative vertebrogenic pathology, and complicate virtually any vertebrogenic pain. Patients of young age with vertebrogenic pain syndromes were examined for the evaluation of psycho−emotional status and quality of life of the patients suffering from vertebrogenic pain, depending on the severity and duration of pain. The study design included a clinical−neurological investigation evaluating the severity of pain using a visual−analogue scale, as well as assessing psycho−emotional status using the HADS. Patients quality of life was assessed using the SF−36 (brief version) and GHQ−28 questionnaires. Research has shown a decline in the overall health, which is associated with the negative impact of patients emotional state on their daily activity and subjective pain, as evidenced by an increase in pain intensity. Patients had a low viability, indicating that they had asthenic syndrome. The results of the study confirmed the assumption of a close relationship between general health, social functioning and psychological health in the patients suffering from vertebrogenic pain syndromes, which confirmed the relationship between the perception of pain and the severity of emotional and personality disorders and their impact on the life quality. Pain in patients with vertebrogenic dorsalgia was found to strongly affect the quality of life, which was dependent on the duration and severity of the pain syndrome, as well as psychological health and emotional and personality disorders in the form of anxiety and depression.

Among the plastic surgery patients, there are three groups of those who dissatisfied with their natural defects of appearance, age−related changes in appearance, changes in the appearance of a traumatic origin. There are several basic types of acute psychological responses in the patients with acquired cosmetic short−comings and defects: the normal state of mind in general, hyperbolized type, passive, masochism−like, depressive, indecisive, imperative. Generally there are distinguished the most common behavioral strategies of people with visual defects: defective masking, hypercompensation, rent behavior. All patients who seek the help of plastic surgeons can be divided into three main groups according to the features of their aesthetic sphere: with a lowered, normal, distorted or incorrectly developed aesthetic feeling. The premise of emerging the reactive states is the premorbid "neurotic personality structure". The long−term consequences of skull injuries, neuroinfections, physical and mental fatigue can also play an important role. It has been concluded that dissatisfaction with their appearance is most often a consequence of the psychiatric pathology of the non−psychotic registry and requires, above all, psycho−corrective rather than surgical assistance.

One of the most important aspects of a pediatric cerebral palsy clinic is cognitive, speech, emotional−volitional and communicative disorders. They, not just motor deficits, determine for most patients their social prognosis and the possibility of adaptation in society. In order to study the clinical and psychological features of adolescents with pediatric cerebral palsy and their dynamics in the course of rehabilitation by the Kozyavkin?s method, the patients with various clinical forms of pediatric cerebral palsy and diagnosed non−psychotic psychiatric disorders of residual organic genesis: slight cognitive disorder (F06.7) and organic emotionally−labile disorder (F06.6) were examined. The study used clinical−anamnestic, clinical−psychological, mathematical and statistical methods. All the adolescents underwent a course of rehabilitation using the Kozyavkin method at the Kozyavkin International Rehabilitation Clinic and were examined twice: during the first two days of stay and before discharge. The effectiveness of the method in the context of the correction of psychopathological symptoms in the patients with pediatric cerebral palsy was largely determined by the nature of the dominant psychiatric disorders. The highest clinical effect of the developed method was observed in adolescents with unexplained forms of mental pathology. Thus, the results of the study has indicated a positive change in the mental status of adolescents with childhood cerebral palsy, which will help to prevent their maladaptation, improve school achievement and socialization.

In conditions of rapidly occurring socio−economic changes in society, the manifestations of anxiety, emotional instability, and tension are increasingly observed among the adult population. To study the features of sanogenic thinking in women predisposed to psychosomatics and physical ailments, a study was performed. The main features of the manifestation of sanogenic thinking in women, their non−adaptive cognitions and dominant (destructive) judgments about themselves have been described, the results of a survey to identify possible psychosomatic disorders, a tendency to depression and the presence of somatic symptoms have been presented. Based on the results of interaction with respondents and empirical research, dominant negative judgments were identified, in particular, judgments that a woman "should": "I must be a good mother", "It will be terrible if I do not get a job after a long maternity leave", "I can't control myself, I'm a living person", etc. Diagnosed pronounced pathogenic thinking in women with heart complaints, dizziness, pain in the stomach and back, exhaustion and frequent pain symptoms in various parts of the body, but it was established low degree of their manifestations. It was determined that in women with psychosomatic complaints there were dominated the emotions of anger, fear and sadness, they had low levels of rigidity and reflexivity, an ambivalent response to negative environmental stimuli, increased anxiety, pronounced negative motivation, negative self−perception, a low manifestation of volitional characteristics, a high probability of nervous−mental breakdowns, threshold level of resistance to stress. In patients with severe psychosomatic manifestations, a tendency to depression was found. Conclusions were drawn about the need for the formation of sanogenic thinking in women with psychosomatic complaints in order to correct a negative attitude towards themselves, to eliminate frequent neuropsychic breakdowns, and to acquire skills for deep reflection of relevant emotions.

Among the variety of current psychopathology, the depressive disorders hold a special place, as they are one of the most common diseases with a tendency for a steady growth. Against the background of the traditional attention to the role of biological factors in the emergence and course of depression, the problem of clinical−constitutional and personological preconditions for depressive disorders of both reactive and endogenous origins is being actively studied, among which the strategies of stress−coping behavior, especially copious behavior, occupy a leading place. To investigate the features of the current coping repertoire in women with depressive disorders of different genesis, with different expressions of psychosocial maladaptation, to understand further specific targets of differential psychosocial rehabilitation of these patients with psychiatric disorders: adaptation), endogenous (depressive episode; recurrent−depressive disorder; bipolar affective disorder; current episode of depression), organic depression (organic affective disorder). The study was conducted using clinical psychopathological and psychodiagnostic methods. The coping repertoire was studied using the ways of coping questionnaire by S. Folkman et R. Lazarus. The study found that women with depression had a deformed coping repertoire, but the qualitative characteristics of this deformity depended on the presence / absence of the signs of psychosocial maladaptation and, in part, on the disease genesis. Among the women with the signs of psychosocial maladaptation, regardless of the genesis of depression, the leading coping mechanism is escape, i.e. avoidance, which is characterized by a general decrease in activity due to depressive inhibition and slow mental processes, the desire to avoid anything that can enhance depressive experiences; these trends are exacerbated from psychogenic depression through endogenous to organic. The data obtained should take into account the differences in the development of treatment and rehabilitation measures for these patients.

Psychological and physical health disorders of the combatants were investigated within 3?5 months after their coming back from the area of anti−terrorist operation in the East of Ukraine within the period of 2015−2016. In the research the following methods were used: traumatic event, Personal Crisis Questionnaire, and Beck Depression Inventory. During individual interviews with the respondents, it was found that, in average, a combatant in the area of an anti−terrorist operation receives sufficient combat experience to complete the assigned tasks for a period of 2 to 8 months. They were investigated for the symptoms of invasion, avoidance, physiological excitation, which had different levels of manifestation. The results of the Beck Depression Inventory showed that the most unfavorable indices of affective−cognitive scale wereas follows: sadness, pessimism, guilt, sense of punishment, self−blame. On the subscale of somatic manifestations of depression should be noted the indices of insomnia, fatigue, loss of sexual desire, dysmorphophobia, which are the signs of this condition. According to the correlation analysis the following was found: disorders of cardiac activity, breathing, cycle "sleep −− insomnia"; increased anxiety, generalized emotional reactions, memory impairment. The results of the study confirmed the presence of symptoms of post−traumatic stress disorder, depression, emotional distress and impaired physical health of combatants.

Diabetic retinopathy is one of the most severe vascular complications of diabetes. This is a specific disease of the retina, characterized with the development of vascular and extra−vascular changes, leads to a reduced vision, even to a complete blindness. The study aim was to investigate the intellectual, emotional, volitional and communicative features of the patients with proliferative and non−proliferative diabetic retinopathy. An open−label controlled study enrolled 30 patients with diabetic retinopathy, their characteristics were determined by the R. Cattell's 16 personal factor test. It has been found out that all the patients with diabetic retinopathy had independence, suspicion, anxiety, uncertainty, fear, lack of motivation, self−confidence, conservatism. The intellectual characteristics of the persons with a non−proliferative stage of the disease included: a high level of general culture, erudition, ability to operate abstractions, developed imagination; to emotional−volitional−self−confidence and self−efficacy, calm adequate perception of reality, ability to control their emotions and behavior, balance; to communicative ones−restraint in establishing both interpersonal and social contacts, expressiveness, impulsiveness, introversion. The intellectual features of the patients with proliferative stage included: specific thinking, low general culture and erudition, conservatism and criticality in the perception of new intellectual knowledge; to emotional−volitional ones−inability to control their emotions and behavior, mood dependence, impulsiveness, affectiveness, low motivation, inner relaxation; to communicative ones−restraint in interpersonal contacts, difficulties of direct and social communication, propensity to work individually, seclusion, orientation to one's inner world, introversion. The prospect of further research is the need to determine the impact of communicative, emotional−volitional and intellectual characteristics of the patients with diabetic retinopathy on their quality of life and the formation of their compliance.

People who are addicted to psychoactive substances, like other citizens, are increasingly involved in using the Internet. Therefore, it is expected that the behavioral patterns of the patients with addiction may modify and transform into new forms under the Internet influence. Now hallucinogens are the most common substance among adolescents and young adults being the Internet users. Internet is well known to negatively affect the behavioral patterns, on the other hand, there is also opposite positive trend, manifested in patients' access to resources for curative and preventive purposes. To determine the Internet behavior characteristics during intoxication in patients with hallucinogen dependence, a study was conducted involving 18 people with psychiatric and behavioral disorders that developed as a result of psychoactive substance use. For comparative analysis of the obtained data, a group of 16 patients with alcohol dependence was formed. Clinical−anamnestic, clinical−psychopathological, psychodiagnostic, statistical methods of research were used. The survey identified the following differences in Internet behaviors during intoxication among the people with substance abuse and alcohol addiction. The latter has turned out to be a much narrower range of Internet behavioral patterns, which was limited to the use of Internet content for euphoric hedonic purposes and Internet−communicative behavior, whereas in the patients dependent on hallucinogens, the Internet behavior also included reorientation of addictive activity from off−line to online, Internet−supportive, creative, and autocurative online behavior. Therefore, we can conclude that the last three components of Internet behavior during alcohol intoxication are inherent in persons with hallucinogen dependence and may act as diagnostic markers of anesthesia. It was noted that the most common Internet behavior of patients during hallucinogenic intoxication was the use of euphoric−hedonistic Internet content, and alcohol−dependent behavior was characterized by Internet−communicative behavior.

Comparative analysis of the indices of three groups of adolescents aged 15−19 years and a group of young people diagnosed with alcohol dependence was performed to identify the main early psychosocial factors that influence the formation of alcohol−related disorders. It has been found that the living of teenagers in dormitories, destructive relationships in their parent families, etc are more likely related to use alcohol. There is a clear link between the nature of alcohol consumption by the father and the teenage son. Leisure features, hobby structure and interests are an important component. An adverse factor is gambling addiction. Poor school behavior, absenteeism, and police motives are also common in alcohol groups. Thus, there is an abstinence or alcohol microsociety that begins with the parental family and results in the early formation of alcohol−induced disorders as early as adolescence. The early prevention system for alcohol−related disorders should include a developed and accessible leisure culture, be multidisciplinary and interagency, involve the families and administration of educational institutions. The positive effects of early intervention are likely to have a positive transgenerational effect.