Особливості клінічної складової континууму психологічної адаптації-дезадаптації у хворих дерматологічного профілю з різним рівнем вітальної загрози

Abstract

Purpose: to investigate the state of the clinical component of the continuum of psychological adaptationmaladaptation in patients with a dermatological profile with diseases of various levels of vital threat, in order to develop, in the future, personalized psychocorrection programs for this category of patients. Contingent and research methods. On the basis of informed consent, in compliance with the principles of biomedical ethics and deontology, we examined 120 dermatological patients who were treated in three branches of the clinic “Dr. Zapolska Clinic” during 2020-2021, namely: 60 patients with non-vital dermatological diseases (seborrheic keratosis L82, condylomas A63.0, angiomas D18.0, pigmentation disorders L80), and 60 patients with dermatological diseases posing a vital threat ( melanoma C43, basal cell carcinoma C44, skin carcinoma D04). The results. Among patients with dermatological diseases, there are both psychologically adapted and maladapted individuals, regardless of the vitality/non-vitality of the pathological process. Among persons with signs of psychological maladjustment with non-vital dermatological diseases, the majority are persons with individual signs of maladjustment or with manifestations of neuroticism with a high level of psycho-emotional tension, while in the sample of patients with vital diseases and the presence of maladaptive manifestations, persons with high neuroticism and psycho-emotional tension predominate , as well as patients with pronounced pathopsychological symptoms of syndromic and/or nosological delineation. In patients with a dermatological profile with signs of psychological maladjustment, the clinical picture is dominated by anxious (mainly in patients with non-vital diseases) and depressive (mainly in patients with vital diseases) radicals, and auxiliary psychopathological constructs are represented by manifestations of somatization, obsessive-compulsive symptoms, interpersonal sensitivity and phobic anxiety. Affective symptomatology is most pronounced in patients with maladjustment with vital dermatological diseases, it is less pronounced in patients with non-vital skin pathology, and the severity of individual indicators of anxiety-depressive response in the examined subjects without signs of maladaptation does not differ significantly in the examined depending on the nature of the dermatological pathology (non-vital or vital). The presence and intensity of maladaptive pathopsychological-affective reactions of varying degrees of severity in patients with dermatological pathology are not clearly associated with the vitality of the dermatological process, but are based on more complex mechanisms of the mutual influence of biological predisposition and psychological and psychosocial factors, the mosaic combination of which determines the individual’s resource capabilities for constructive acceptance the fact of the presence of a dermatological disease and the development of an adequate strategy for its mastery, regardless of the severity of the disease. Conclusion. The identified regularities should be taken into account when developing treatment-rehabilitation and psycho-prophylactic measures in patients with dermatological pathology with different levels of vital threat.