ПСИХОФИЗИОЛОГИЧЕСКИЕ АСПЕКТЫ КЛИНИЧЕСКИ ВЫРАЖЕННЫХ НАРУШЕНИЙ ПСИХИЧЕСКОЙ АДАПТАЦИИ У БОЛЬНОЙ, ПОЛУЧИВШЕЙ МЕСТНОЕ ЛУЧЕВОЕ ПОРАЖЕНИЕ IV (КРАЙНЕ ТЯЖЕЛОЙ) СТЕПЕНИ (23 ГОДА НАБЛЮДЕНИЯ)

Abstract

Purpose: To evaluate in dynamics the psychophysiological adaptation of a patient who received local radiation damage to the tissues of the left half of the chest IV (extremely severe) severity (23 years of observation).
 Material and methods: Patient KTS, 66 years old, as the main diagnosis are the effects of local radiation damage to the skin and underlying tissues of the left half of the chest from external radiation (about 3 % of body surface area) IV extremely severe. Before receiving a radiation injury, she was able-bodied and socially adapted, worked as a nurse. In 1996, she was diagnosed with stage I left breast cancer T1N0M0 stage I, in connection with which she underwent a sectoral resection of the mammary gland. Then the patient underwent a course of radiation therapy. By retrospective assessment, the total dose of therapeutic effect before the incident was 10 Gy. At the time of the next session of radiation therapy in connection with the breakdown of the apparatus, a sharp uncontrolled increase in the dose of ionizing radiation (more than 100 Gy) occurred, causing serious injury. The patient was admitted to the Institute of Biophysics Clinic on the 5th day. Psychophysiological research was carried out with the use of automated software and methodic complex «Expert», designed to study the personal characteristics of a person, cognitive and intellectual personality characteristics in 2001 – 2017 years.
 Results: The effects of local radiation damage to the skin and underlying tissues of the left half of the chest from external irradiation of IV (extremely severe) degree in the form of cicatricial-atrophic changes of the soft tissues, with no bone skeleton remain. Disorders of mental adaptation are expressed in the form of senesto-hypochondria disorders, autism of perception, demonstrativeness, apathetic depression and introversion. The most profound contribution to the reduction of the adaptation of the victim is brought about by the features of deep internal disharmony caused by contradictory combinations of demonstrativeness, schizoid traits, anxious depression and affective rigidity.
 Conclusion: The data obtained indicate that impaired mental adaptation is an integral part of the clinical picture of local radiation injuries, and reveal the urgent need not only of specific treatment of radiation injury, but also of psychotropic pharmacotherapy and psychotherapy.