Volume 12, №2' 2017


Kharkiv Medical Academy of Postgraduate Education, Ukraine
Disorders of general, interpersonal and sexual communication of women with depressive disorders in conditions of involuntary resettlement
3 - 6
In the 20th century the incidence of anxiety−depressive disorders increased almost in all economically developed countries. Under the conditions of antiterrorist operation in the East of Ukraine and the Crimea annexation, almost 20 % of the population correspond the diagnostic criteria of affective disorders. This investigation was performed to study the features of personality, addictive behavior, psychosexual types, quality of life, family anxiety in women with depression under the conditions of resettlement from the areas of permant residence. Social demographic method was used to analyze the risk factors of forming mental disorders and maladjustment in the investigated group of patients. E. G. Eidemiller technique was used to determine the level of family anxiety. Satisfaction with sexual relations was assessed using W. E. Snell and D. F. Panini's scale. The level of quality of life was evaluated by J. S. Mezzich's technique. State and trait anxiety was assessed by Ch. D. Spilberger−Yu. L. Khanin method. The most prevalent depressive disorder in the investigated women was dysthymia (F.34.1) including depressive neurosis, depressive disorders, anxiety states. The obtained findings demonstrated prevalence of non−functional marriage. The majority of women with depressive disorders had pathology of general and sexual communication; all components of communication were disordered. The persons with medium level of state and trait anxiety prevailed. The findings of investigation of addictive object admiration in the refugees with depressive disorders showed that more dangerous were tobacco smoking, alcohol, and the Internet. Thus, the revealed disorders of general, interpersonal and sexual communication in women with depressive states occur due to combination of psychopathic, pathopsychological and negative sociopsychological agents, namely, at resettlement from the regions of permanent residence.
Key words: personality orientation, dependent behavior, psychosexual types, quality of life, depressive disorders, women.
Institute of Neurology, Psychiatry and Narcology of NAMS of Ukraine, Kharkiv, Ukraine

Danilo Halytskyi Lviv National Medical University, Ukraine
Clinical psychological peculiarities of persons with different forms of post−stress mental disorders
7 - 11
To define the clinical psychological features of post−stress response in persons with different forms of post−stress mental disorders, the army men from the ATO zone and the persons resettled from the zone of the military operation were investigated. The methods of conversation, psychodiagnostic and mathematical−statistical were used. The study shows that in the cobbattants with the signs of post−traumatic stress disorder, the signs of hyperactivation and invasion combined with emotional disorders (lability and alienation, guilt, narrowing the range and depth of social contacts) dominated. It was shown that in the army men directly involved in military actions, severity of post−stress mental disorders was significantly higher. The severity of symptoms correlated with the age and the presence of comorbid pathology. It is emphasized that the combatants without psychopathological disorders also developed some symptoms of avoidance and emotional detachment, which can be regarded as the result of psychological defense mechanisms to overcome stress. The civilians resettled from the ATO zone also had some symptoms of hyperactivity and avoidance, as well as anxiety and phobic experiences, emotional lability, signs of asthenia and alcohol abuse. They formed negative attitude to the environment. The degree of post−stress disorders was more pronounced in individuals who lost their loved ones, as well as in older persons. The obtained findings can be used to develop treatment and rehabilitation measures for various groups of people with post−stress mental disorders.
Key words: post-stress mental disorders, post-traumatic stress disorder, adjustment disorders, combatants, civilians resettled from the ATO zone.
Kharkiv National Medical University, Ukraine

Kharkiv Medical Academy of Postgraduate Education, Ukraine

O. Bogomolets National Medical University, Ukraine
The system of medico−psychological support of families raising a child with a severe disease
12 - 14
A comprehensive survey of families of children with a severe disease was performed with the aim of developing and testing the system of medico−psychological support of the families raising a child with a severe disease. A serious illness of the child became a psychotraumatic situation for all parents, which led to the development of anxiety−depressive reactions and conditions. According to the psychodiagnostic examination, the parents had mild, moderate depressive and anxious episodes on the Hamilton scale; high levels of state and trait anxiety according to C. D. Spielberger, a high level of expression of neuropsychic stress on the scale of T. A. Nemchin. The surveyed couples noted the presence of tensions in family relationships, family conflicts, as related to the treatment of the child and the escalation of pre−existing interpersonal and marital problems that led to the distancing and reducing intrafamily resource. Based on these data, a system of medical−psychological support of the families raising a child with severe disease, which consisted of four consecutive phases and included the use of individual cognitive−behavioral therapy, family therapy, rational therapy and pejoratively programs, was developed. Application of the proposed system of medical−psychological support showed a stable positive dynamics of the psychological state with a total reduction of anxiety−depressive states and harmonization of the marital relationship.
Key words: medico-psychological support, anxiety, depression, family interactions, child with a severe disease.
G. S. Kostiuk Institute of Psychology of the National Academy of Educational Sciences of Ukraine, Kyiv, Ukraine
Investigation of communicative competence in context of university teacher professional self−fulfilment
14 - 21
The work of a university teacher as a representative of a communicative type of professions is very complex due to the number of the tasks it is necessary to solve. This empirical study revealed that communicative competence plays an important role in self−fulfilment of the academics and in development of their professional competence that is carried out in the scientific and pedagogical activity. Reduction in the development of communicative competence in the sphere of business communication was recorded in the lecturers over 40 years of age. This may be the result of communicative professional deformity that causes inertia in pedagogical communication, carelessness, authoritarianism, lack of critical self−appraisal, subjectivism, weakening psychological readiness for professional achievements. The age and probably increase of the teaching load can result in burnout, reduction of the role of reflexive and communicative dominants in the psychological structure of the subjects of culture and education. Branched positive correlations of instrumental criterion of communicative competence of the specialists and the indices of professional self−fulfilment were revealed. The connections of motivation character are more branched and distinct than the characteristics of external professional self−fulfilment. Cognitive criterion positively correlates only with internal professional self−fulfilment. Despite the importance of mature skills to verbalize the thoughts, to listen, perceptive and nonverbal abilities, which are the main components of communicative competence, the results of the research show the opposite −− the insufficiency of development of these skills for permanent solving tasks for the professional self−fulfilment of these employees and need in a constant professional and communicative improvement for the successful realization in the professional field. The findings concerning the connection between communicative competence and the characteristics of professional self−fulfilment testify about the needs of permanent and coherent development of professional self−fulfilment and the improvement of communicative competence.
Key words: professional self-fulfillment, communicative competence, ability to listen, ability to express thoughts, academics.
M. P. Dragomanov National Pedagogical University, Kyiv, Ukraine

V. N. Karazin Kharkiv National University, Ukraine
The features of social cognition in visual impairment
21 - 26
Social cognition allows a person to perceive, remember and interpret social information in the context of understanding the behavior of other people and organize their own behavior in the society. From the neurocognitive perspective, the social cognition includes 3 components: social cognition, action observation, theory of mind. Meta−analysis of the results of investigations suggesting that neuron substrates of the social cognition are similar in visually challenged and sighted people was performed to assess various aspects of social cognition. Deep visual impairments are characterized by the following features of social cognition: domination of diffuse−local type of visual perception of the interlocutor; impossibility to fully compensate for the lack of visual information about the person's emotional state through the auditory, tactile and chemoreceptor sensory input; more effective recognition of those mental states that happened more often in children's life (usually of a negative emotional modality, i.e. fear, anger); the ability to form the adequate ideas about socially significant actions; the theory of mind in adulthood can reach the level of the sighted, but in childhood its delay can be observed. To understand the social cognition development in visual impairment, longitudinal studies involving the four groups of children (those with congenital and acquired blindness, visually challenged and low vision) is necessary. The methodology for diagnosing the development level of social cognition in visually challenged children needs further elaboration.
Key words: visual impairments, social cognition, social perception, action observation, theory of mind.
Institute of Neurology, Psychiatry and Narcology of NAMS of Ukraine, Kharkiv, Ukraine
Copying behavior and copying resources in formation of addictive behavior in neurotic disorders
27 - 30
In recent years the variety of addictions has significantly expanded due to socially acceptable addictions. Many authors draw parallels between the nature of addictions development, especially of non−chemical origin, and neuroses; both these psychopathologies have similar etiology −− psychoemotional overstrain, obsessive compulsive component and similarity in the mechanisms of occurrence. With the purpose to determine the characteristics of coping behavior and coping resources of patients with neurotic disorders, comorbid with addictive behavior we investigated the patients with neurotic disorders (anxiety−phobic, dissociative and neurasthenia) with and without addictions. AUDIT−like tests, MSPSS technique, CISS scale and SACS inventory. (adapted by N. Vodopyanova and A. Starchenko) to study strategies and models of coping behavior were used. The findings of the work demonstrate that prosocial variants of coping joining social contact and seeking social support dominated, which were equal to the average and above average level of expressiveness. Among the features of coping behavior of patients with anxiety and phobic disorders with addiction, a high level of expression of emotionally oriented coping style and coping models of avoidance and impulsive actions. The patients with addictions at dissociated disorders demonstrated a high level of emotionally oriented style of coping and coping oriented to avoidance, marked asocial strategies of overcoming in the form of aggressive and antisocial behavior, decrease in the level of satisfaction with social support in everything in their lives, and in particular, the level of support of public organizations. The obtained findings in patients with neurotic disorders with addiction should be taken into account in corrective and preventive work with these patients.
Key words: neurotic disorders, addictive behavior, comorbidity, coping behavior, environmental coping resources.
I. I. Mechnikov Odessa National University, Ukraine
The role of parental involvement in forming psychological well−being of senior schoolchildren
31 - 34
This empirical study was conducted to investigate the relationship between the factor of parental involvement and socio−demographic indicators and the parameters of the psychological well−being of senior schoolchildren. The literature analysis showed that the issue of parental involvement is poorly investigated in Ukraine in spite of its urgency and active investigation in other European countries. The study was conducted in 10 secondary schools of Odessa as a part of the Swedish−Ukrainian project SEYLE investigating mental health of adolescents in collaboration with Swedish National Center for Suicide Investigation supported by Swedish Institute. The methodological base of the study was Comprehensive Questionnaire on Mental Health and Personality Life Style, developed to reach the objectives of the European research SEYLE (Saving and Empowering Young Lives in Europe). The following parameters were investigated using SEYLE inventory: sociodemographic indices (age, gender, the number of siblings, the order of birth), history of chronic diseases; subjective assessment of well−being, depression point according to Beck, smoking and alcohol consumption by the parents, psychosomatic disorders, risky behavior. The interrelation of these parameters with the factor of parent involvement was investigated. It was discovered that the expression of parental involvement does not depend on the sex of the child, as adolescence grow, they become more self−sufficient and the need for parental involvement in their lives gradually decreases. It was found that the parental involvement had a protective effect on chronic diseases, psychosomatic disorders, depression and risk behavior of adolescents. It was determined that alcohol consumption by the parents is reversely proportional to the parent involvement. The results of this study can be used in educational and psychological practice for the promotion of healthy behavior among adolescents.
Key words: adolescents, mental health, psychological well-being, parental involvement.
Zaporozhzhia State Medical University, Ukraine
Psychocorrection and psychoprevention principles of organic anxiety−depressive disorders exacerbation in patients with impaired compliance to therapy
35 - 38
A significant prevalence of affective disorders among patients with organic brain damage distinguishes this group among other patients in the neurological clinic. Specific is a high frequency of combinations of neurological deficiency and non−psychotic disorders of the hypothymic spectrum, namely, anxiety−depressive signs, which necessitates an integrated and multidisciplinary approach to the diagnosis and therapy. Compliance disorders in this group of patients leads to unsystematic administration of psychopharmacotherapeutic agents, which is accompanied by a decrease in their effectiveness. The development and implementation of the principles of psychocorrection and psychoprevention, which have a polyfocal, multimodal and hierarchically organized nature, focused on the components of the psychopathogenesis of organic anxiety−depressive disorders and aimed at establishing and maintaining high−compliance relationships in therapeutic care, are relevant. Clinical history and follow−up results investigation, clinical−psychopathological, and statistical methods were used in the study. The follow−up results investigation was used to determine the effectiveness of the developed principles of psychocorrection and psychoprevention measures, and was implemented by comparing the indicators obtained by Behtereyev Institute Personality Questionnaire, which is used to determine the type of attitude to the disease; Medical Compliance Scales −− to determine the patient's commitment to long−term administration of pharmacotherapeutic agents; Global Assessment of Functioning Scale −− to assess the ability of patients to social functioning. As a result of the study, the principles of compliance−oriented psychocorrection and psychoprevention were formulated: cognitive stabilization, normative appeal, semantic congruence, paraverbal preferences, evolutionary intensification, microsocial integration. Practical application of these principles made it possible to eliminate the number of patients with significant and severe disorders of global functioning as well as the patients with discompliance arrangement of the attitude to the disease.
Key words: anxiety-depressive disorders, organic psychopathology, principles of compliance-oriented psychocorrection.
Kharkiv Medical Academy of Postgraduate Education, Ukraine

Clinical Sanatorium «Berezovskiye Vody Resort», Ukraine

International Charity Foundation «Alexander Feldman Foundation», Ukraine
The use of animal assisted therapy in the system of ato participants psycho−rehabilitation in sanatorium conditions
39 - 43
At present, when military operations and forced migration take place in Ukraine, new groups of people exposed to stress factors appear every day. They are risk groups of mental and behavioral disorders of psychogenic origin. Comprehensive psychosocial rehabilitation of 375 combatants was performed during the joined program of Feldman Ecopark Center of psychosocial rehabilitation for children and adolescents, Psychotherapy Department of Kharkiv Medical Academy of Postgraduate Education and clinical sanatorium «Berezovskiye Vody Resort» in 2015−2016. From a clinical perspective, post−traumatic stress disorder is associated with personal and reactive states developing as a result of the previous emergency, which was of the psychogenic nature for the individual. Therefore, medical and psychological rehabilitation should be a mandatory part of complex rehabilitation of demobilized participants of the antiterrorist operation, which will lead to active and gradual restoration of the affected by participation in the antiterrorist operation. The rehabilitation program was implemented in three stages: initial stage (building therapeutic rapport) −− 2−3 days; main (rehabilitation) stage −− 14−18 days; supporting stage −− 2−3 days. Psychocorrection of the experienced trauma was carried out by the experts of clinical sanatorium «Berezovskiye Vody Resort», supporting stage −− at the Center using equine assisted psychotherapy. Addressing the problem of treating post−traumatic stress disorder in the combatants requires innovative approaches, equine assisted psychotherapy being one of them. The horse is an integral part of the process in which they provide valuable emotional feedback.
Key words: post-traumatic stress disorder, maladjustment, demobilized members of Antiterrorist Operation, program of medico-psychological rehabilitation, sanatorium resort conditions, equine assisted psychotherapy.
Family Consultancy Clinic, Makhachkala, Dagestan, Ukraine

Kharkiv Medical Academy of Postgraduate Education, Ukraine
Psychocorrection of pathological masturbation and anorgasmia in women with marital maladjustment
43 - 47
The most relevant in female sexology are the problems of anorgasmia. Specialists often face a situation where orgasm in a woman occurs during masturbation, but is not available at sexual contact with a partner. Most often it is a question of maladjustment variants of anorgasmia as a result of inadequate forms of masturbation, practiced by the woman in adolescence or premarital period. To study the effect of the factor of pathological masturbation in women on the formation of anorgasmia, marital maladjustment, as well as neurotic disorders, an experimental psychological examination of patients with the history of myotonic masturbation and disorders of marital adaptation was carried out. A test of differential self−evaluation of the functional state; test for determining the level of state and trait anxiety by C. D. Spielberger −− Yu. L. Khanin; the level of neuroticism with personality questionnaire by H. J. Eysenck, depression scale by A. Beck were used. In addition, the patients and their spouses were examined using a special card. It was found that the final result of the influence of myotonic masturbation was a disorder of psychosexual development in the form of an inadequately achieved orgasm, retardation of sexual development, or absence of mature erogenic zones, which led to anorgasmia. The speed and ease of obtaining orgasm by the myotonic method made it difficult to form motivation of patients to psychocorrection, psychotherapy and treatment. The methods of sex therapy, various methods of cognitive−behavioral psychotherapy, homework, diaries of sexual feelings with subsequent discussion of the results at sessions were applied. An important component was the confidence between the spouses, the ability to share feelings with each other, and with the psychotherapist or sexologist. Explanations, suggestions for effective psychocorrection and adaptation in pairs were performed. In some cases, erotic training was recommended. The results of the research showed that the use of combined methods of psychocorrection of a married couple and rational, suggestive psychotherapy, sexual−behavioral and sexual−erotic partner trainings, taking into account the pathogenic influence of pathological masturbation on a woman's sexual health, distortion of her psychosexual development, and formation of neurotic disorders is very effective.
Key words: pathological myotonic masturbation, anograsmia, psychocorrection of married couple.
Ukrainian State Research Institute of Medico−social Problems of Disability, Dnipro, Ukraine
Evaluation of cognitive dysfunction in arterial hypertension in practice of medical social expertise
48 - 54
Arterial hypertension is one of the most important medical and social problems due to its high prevalence and frequent cardiovascular complications and cognitive deficiency, which determine high levels of morbidity, life−activity limitation and mortality. This disease results in cognitive dysfunction −− disorder of one or more cognitive functions (memory, praxis, gnosis, language, regulation of arbitrary activities). In order to develop approaches to the evaluation of cognitive dysfunction in arterial hypertension in the practice of medical and social examination, patients aged 30 to 59 years with grade 2 and 3 essential arterial hypertension were examined (in the recovery period or the consequences of the stroke). Cognitive functions were studied in accordance with existing approaches within the International Classification of Functioning, Limitations of Life and Health. In evaluating the cognitive functions of patients the most informative were: in attention −− effectiveness of work, the volume of dynamic attention and its index of fatigue; in memory −− short−lived memory and its volume, meaningful and image memory; in thinking −− understanding of the logical connections between concepts and the ability to distinguish their heterogeneity, productivity and level of logical thinking; in the emotional intelligence −− understanding of the own and others' emotions, interpersonal and intrapersonal emotional intelligence. Their disorders led to significant restrictions in patients with hypertension in the following spheres of life: interpersonal interaction and relationships, main areas of life, education and use of knowledge, self−service, everyday life and mobility. The study of the structure of the personality (personality and characterological features, internal picture of the disease) and cognitive functions (attention, memory, thinking, intelligence) is a promising direction in objectification of psychoemotional disorders in patients with arterial hypertension, therefore they should become a compulsory study in the practice of medical and social expertise in this pathology.
Key words: arterial hypertension, cerebral stroke, cognitive functions, personality features, medical social expertise.
Danilo Halytskyi Lviv National Medical University, Ukraine
Structure, semiotics and complex therapy of anxiety in cardiological patients
55 - 59
Today it is proved that anxiety symptoms negatively influence the course of cardiac disease, which becomes the main cause of temporary disability, increases mortality in cardiologic patients. This investigation was conducted to study the structure of anxiety disorders in such patients, as well as to develop a comprehensive system for the provision of medical care in comorbid anxiety manifestations. The design of the study envisaged screening of a sample of patients regarding the presence of clinically significant anxiety, establishment of clinical and psychopathological features of anxiety syndrome, application and evaluation of the effectiveness of the proposed program of medical correction of anxiety disorder. The mental state of the patients was evaluated based on the analysis of patient complaints, their disease history, the study of symptoms, syndromes, their psychopathological interpretation. The Hospital Anxiety and Depression Scale (HADS), J. E. Mezzich et al. technique were used to obtain the quality of life indicators. Anxiety−depressive affect was determined by the patients as a negative emotion, aimed at the future, with a sense of undetermined threat, internal anxiety. The peculiarity of this variant is the polymodality of the leading affection with the presence of disturbing manifestations. The strategy of integrated medical care for cardiologic patients was based on a combination of medical and psychotherapeutic interventions and was aimed at maximal restoration of their health, disability, personal and social status, achieving material and social independence, integration and reintegration into normal living conditions. The psychotherapeutic component in treatment of anxiety disorders in patients with a heart disease lasted for 6 weeks and consisted of 10 sessions, 3 of which were psychoeducational, the rest −− of the type of short−term focused therapy. The psychotherapeutic sessions were aimed at working out coping strategies, identifying feelings and finding the way out of the negative experiences. Early cognitive strategies, including technology of distraction, and later techniques of work with negative automatic thoughts and conducting behavioral experiments appeared to be the most effective strategies for improving the patient's condition in the early stages. Such an integrated approach to treatment anxiety disorders in patients with cardiac pathology showed a significant reduction in the level of anxiety and a significant improvement in the quality of life of the examined group of patients.
Key words: anxiety, cardiological pathology, complex therapy.
Kharkiv National Medical University, Ukraine
Pathogenetically substantiated system of psychoprevention of suicidal behavior in depressive disorders in internally displaced persons
59 - 61
Mental health of refugees, who were forced to leave the place of their permanent residence is a social, medical psychosocial, and psychiatric problem. In Ukraine, increased incidence and prevalence of depressive disorders, mainly non−psychotic, has been recorded. One of the most dramatic medical and social consequences of depressive disorders is suicide. On the basis of the study of the peculiarities of formation of suicidal behavior in internally displaced persons with depressive disorders, a pathogenetically grounded system of their psychoprevention was developed. For this purpose, a comprehensive clinical−anamnestic, clinical−psychopathological, psychodiagnostic and biochemical examination of such patients was conducted. The patients' low level of self−realization of death, high level of anhedonia, clinical manifestations of anxiety and depression by the hospital scale, severe anxiety and depression by Hamilton scale, a large depressive episode by Montgomery−Iceberg scale were determined to be the markers of suicide risk. The basis for formation of a suicidal danger is the high level of anhedonia, internal stress with inability to relax, impulsiveness, problems of interpersonal communication, lack of a metabolic resource to overcome the traumatic situation. The triggers of suicidal behavior are frustration of significant basic needs, coverage of the experiences of acute grief with narrowed cognitive functions and domination of the content of mental trauma in the consciousness, the assessment of the current situation as hopelessness, the loss of target settings of personality, alcohol consumption, possible imbalance in the system ACP 1−gene/product. Based on the received data, a program of differentiated prevention of suicidal behavior in patients with depressive disorders, which included conducting complex diagnostic and therapeutic measures to assess the presence of markers of suicidal risk, consideration of the clinical dynamics of depressive disorders, mitigating or eliminating trigger factors that lead to adaptation failure, was developed and tested. The system included pharmacotherapy, psychotherapy and psychoeducation. Pharmacotherapy presupposed differentiated administration of antidepressants −− selective serotonin reuptake inhibitors, melatonin, serotonin and norepinephrine. According to the results of a 1.5−year follow−up, over 83 % of the surveyed patients did not repeat suicide attempts, which indicates the effectiveness of the proposed system.
Key words: depressive disorders, suicidal behavior, neurohormones, psychological prophylaxis, psychotherapy, psychoeducation.
Institute of Neurology, Psychiatry and Narcology of National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

Dr. Artemchuk Health Center, Kharkiv, Ukraine
Expression and course of state and trait anxiety in alcohol−dependent patients as integral prognostic indicators of forming therapeutic remission
62 - 68
The main principle in the study of adaptation reactions is based on the ideas of integrity of the psyche, personality and behavior, as well as other system−structure levels of the organism. The purpose of this study is to highlight the psychopathological features of modern forms of alcohol addiction, which have a prognostic value in formation of therapeutic remission. The study used the scale of state and trait anxiety by Ch. D. Spielberger−Khanin, according to which anxiety severity and course in time and in different life situations can be regarded as an integral indicator of the adaptive capacity, stability of the psyche, personality, and behavior. This can be used to predict the quality of therapeutic remissions. The materials of long−term research of patients with alcohol addiction at the stage of controlled alcohol withdrawal syndrome, as well as after stress−psychotherapy according to. O. R. Dovzhenko, were analyzed. Each study involved two measurements without additional stress−load, and the third one with additional stress−provocation. The clinical−statistical analysis covered six professional groups: motor vehicle drivers, electric gas welders, patients engaged in cold metal processing, builders, and office workers. The established changes in the average indicators of state and trait anxiety, as well as the overall frequency of their high and low values in patients at the stages before and after adaptation−metabolic therapy, before and after stress−psychotherapy, can serve as integral indicators of the effectiveness of treatment in alcoholic disease in general, and in particular, in each professional group. The use of dosed electrostress loading at the stages before stress−psychotherapy provides an early prognosis of its results in each professional group of patients with alcohol addiction. The conducted study of objective (biological −− communication 1) and psychopathological, subjective characteristics (communication 2) in patients with alcohol addiction indicates higher predictive value of the biological, objective, evaluation criteria for therapeutic remission, especially after stress−provocation.
Key words: alcohol addiction, state and trait anxiety, stages of treatment, stress-loading, prognosis.
Kharkiv Medical Academy of Postgraduate Education, Ukraine
The features of psychosexual dysontogenesis in patients with bipolar affective disorder
69 - 72
Systemic approach is the most productive model of mental disorders investihation because it is mental adaptation that completes the structure of homeostatic processes. This circumstance as well as absence of the data about manifestations of bipolar affective disorder in adolescents determined the purpose of the work. The study involved 47 couples in which one of the members was diagnosed bipolar affective disorder using sociodemographic, psychoanamnestic, clinical socio−psychological methods as well as investigation of special sexological state of the family health (according to V.V. Kryshtal). The presence of accelerated and more often retarded (delayed), especially in men, psychosexual development in the prepubertal and pubertal age, made disharmonious the whole process of psychosexual development and resulted in failure of the process of communication with the opposite sex, formation and consolidation in the further substitution and surrogate forms of sexual activity and could be a factor of development of bipolar affective disorder in adulthood. Pathological types of family relations in the parent family were a factor in formation of the primary socio−psychological maladjustment in their own families at forming the disease. Thus, disharmonious parent families with distorted relations between the parents, impaired parent−child interaction, consistency in the rate of somatosexual and psychosexual development, pathological general and improper sexual education influenced the personality formation and gender communication of the examined persons and were a precondition for development of sexual disorders in the majority of the investigated women and men at bipolar affective disorder.
Key words: bipolar affective disorder, somatosexual and psychosexual, development, adolescent depression, women, men.
Ukrainian Medical Dental Academy, Poltava, Ukraine
Efficacy of atypical antipsychotics combined with antidepressants during depressive type schizoaffective disorder treatment
73 - 76
Recently, the question of diagnosis and pharmacotherapy of schizoaffective disorder has been an important medical problem. To study the therapeutic efficacy of atypical antipsychotics in combination with antidepressant for the therapy of depressive type of schizoaffective disorder, we investigated 60 patients with depressive type of schizoaffective disorder. Depending on the administered atypical antipsychotic three groups were formed: the patients of group 1 were administered Eridon (5.38±1.2 mg/day), group 2 −− Quetiron (462.6±102 mg/day), group 3 −− Soleron (564.8±204.3 mg/day). Simultaneously with the antipsychotic antidepressant, Stimuloton (82.4±12.23 mg/day) was administered. The observation period was 6 weeks. Assessment of mental status was conducted using PANSS, HAMD−21 the CGI−I scales before the study and on week 2, 4, 6. The combined administration of atypical antipsychotics (risperidone, quetiapine, amisulpride) with antidepressants of SSRI group is an effective psichopharmacotherapy tactics in the treatment of patients with depressive type of schizoaffective disorder. Eridon with Stimuloton contribute to more rapid and deeper reduction of depressive signs but is more slowly in deceleration of hallucination symptom−complex. Quetiron in combination with Stimulonton contribute more rapid and deeper reduction of hallucination syndrome. Soleron with Stimuloton also influenced significantly the paranoid signs, which manifested by more rapid and even deceleration of positive syndromes.
Key words: schizoaffective disorder, depressive type, eridon, quetiron, soleron, stimuloton.
V. N. Karazin Kharkiv National University, Ukraine
Clinical predictors of parasuicidal behavior in women with depressive disorders and history of fetal loss syndrome
77 - 84
The urgency of investigation of parasuicidal behavior in women is due to the high level of its prevalence in the population. In order to determine the clinical predictors of parasuicide behavior we investigated female patients with depressive disorders of affective register, miscarriage and intentional non−suicide self−harm history. As potential clinical predictors of parasuicide behavior in this cohort the incidence of the following characteristics: age; family history of mental and behavioral disorders; the presence and frequency of deliberate self−harm in the immediate family; pathology of pregnancy in the mother; pathology of births in the mother; psychoemotional development of the childhood period; previous diseases and head injuries in the childhood; the age of onset of sexual activity; normativity of menstrual function; the number of pregnancies; predominant type of perinatal loss; premorbid personality traits were investigated. The analysis of clinical and statistical data within the framework of consistent procedure by A. Wald revealed the signs with informativity values allowing to conclude about their relation to the group of clinical predictors of parasuicide behavior in the studied cohort. The clinical predictors of parasuicide behavior include the following signs: emotionally unstable type of premorbid personality characteristics; hysterical type of premorbid personality characteristics; non−deliberate self−harm in the immediate family; deliberate self−harm in the immediate family; affective disorders in the immediate family. The obtained findings can be used to prevent parasuicide behavior in the potentially suicide−dangerous group of women with depressive disorders and a history of miscarriage syndrome.
Key words: women, depressive disorders, history of fetal loss, parasuicide, clinical predictors.
I. I. Mechnikov Odessa National University, Ukraine
Three−factor model of risky behavior in adolescents with suicidal ideation and intentions
85 - 93
Risky behavior of adolescents is a biopsychosocial phenomenon. Since the severity of puberty course and the level of involvement of the adolescent in risky behavior directly and to a greater extent depend on the psychological characteristics of his personality, various psychological parameters were compared in three groups of adolescents: non−practitioners of risky behavior, regularly practicing 2−3 types of risky behavior, adolescents involved in 4 or more types of risky behavior (clustered risk behavior). The revealed differences made it possible to conclude that even an irregular passion for risky behavior causes statistically significant changes in the emotional, cognitive, psychological, personal, and social levels. Factor analysis by the method of the main components identified three factors that can be considered psychological peculiarities of adolescents involved in risk behavior. Factor 1 «Negative assessment» includes dissatisfaction with life, loss of interest to the environment, irritability, sadness, loneliness, difficulty in decision making, sensation of uselessness, anxiety, subjectively perceived stress, self−criticism, perception of himself/herself a loser. Negative emotional experiences (dissatisfaction with life, loss of interest, irritability, sadness, loneliness) in adolescents with risky behaviors correlate with the levels of depression and anxiety. Factor 2 «Perception of difficulties» includes an emotionally negative reaction to difficulties, recognition of difficulties, duration of difficulties, recognition that difficulties affect relationships with other people. The structure of the third factor «Problems with behavior» includes hyperactivity, feeling of punishment, problems with behavior. The main emerging problems with behavioral disorders in adolescents are somehow related to the social situation of this teenager. Under the influence of problems with the behavior the ability of integration into society is disturbed or excluded. The results of the study show that initially, risky behavior can be perceived by the adolescent as an opportunity to expand their personal experience, but with time requires a constant increase in sensitivity, which leads to an increase in the number of types and the frequency of their practical implementation. Prolonged practice of risky behavior inevitably leads to an increase in the intensity of negative emotional experiences, anxiety and depression, a decrease in stress tolerance, increase in the amount and intensity of difficulties, which in turn provokes suicidal thoughts that can eventually transform into suicidal intentions and attempts.
Key words: risky behavior, adolescents, three-factor model.
Zaporizhzhia Medical Academy of Postgraduate Education, Ukraine
Compliance−oriented integrated system of psychological prevention and treatment of mental disorders in patients with type 2 diabetes mellitus
94 - 97
The prevalence of type 2 diabetes mellitus in the modern society is growing rapidly. Type 2 diabetes mellitus on the one hand acts as psychosomatic disorder. That is, primary antecedent mental disorders play a significant role in its development. On the other hand, type 2 diabetes mellitus itself acts as a factor of development of secondary mental disorders that develop as somatogenic and nosogenic disorders. An important role in formation of secondary mental disorders in type 2 diabetes is played by a lack of compliance to the treatment of patients. Therefore, improving compliance of patients to the therapy of type 2 diabetes mellitus is a topical issue of modern endocrinology and psychiatry. The purpose of the study was to develop a compliance−oriented integrated system of psychological prevention and treatment of mental disorders in patients with mild type 2 diabetes mellitus. Its efficacy was proven by the experience of examination and treatment of patients with mild type 2 diabetes mellitus who received psychopreventive and therapeutic interventions. History investigation, psychopathological, psychodiagnostic, clinical and psychopathological methods were used. Mental disorders acting as a risk in patients with mild type 2 diabetes mellitus were analyzed. Optimal psychopreventive and psychotherapeutic techniques for their leveling were selected. High efficiency of the developed system of psychological prevention and treatment of mental disorders in patients with mild type 2 diabetes mellitus was proven.
Key words: type 2 diabetes mellitus, psychological prevention, therapy, compliance, mental disorders.
Institute of Neurology, Psychiatry and Narcology of National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
Characteristic of combat stressors of the hybrid war in the east of ukraine in 2014−2015
98 - 100
The purpose of the hybrid war is to transfer the victim state to external management, the strategy is to create instability of the current government and organize a protest movement. As a rule, it is conducted in several stages and includes military actions, information war, energy influence. During the anti−terrorist operation in the east of the country, the military personnel of the Ukrainian Armed Forces suffered irrevocable and sanitary losses of the personnel. A significant proportion falls on the sanitary losses of psychiatric profile, which became the consequence of combat stressors, affecting the psyche of military personnel. On the basis of the anamnestic data of the patients of the military hospital, ATO participants, a series of combat stressors (psychotraumatic events) that became the cause of psychogenic mental disorders was determined, as well as the distribution of them into groups. Combat psychogeny: directly related and not related to the combat situation. 2. Non−combat psychogeny connected with the logistics, arrangement of everyday life, addictions, etc. 3. Socio−psychological psychogeny caused by untimely payment, delay in vocations and transfer of the term of demobilization, rotation, disintegration of the family, etc. Among the treated and examined persons we identified the combatants with pathognomic signs of post−traumatic stress disorder, caused by the most commonly occurring stressors, which include the death of the colleagues during the battle; sudden attack of commandos; battles in the surroundings; bombardment with rocket launchers; artillery and mortar bombardment; death of colleagues on trip wires; violent defeat over ATO of the contracters of self−proclaimed DPR and LPR; the threat of death in captivity; sniper fire. Thus, the results of the study of combat stressors (traumatic events) will help psychiatrists, psychologists and psychotherapists in the diagnosis and treatment of psychogenic mental disorders in combatants who participated in hostilities in the east of Ukraine.
Key words: combat stressors, post-traumatic stress disorder, hybrid war.
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