Abstract

The issue of combat-related psychological trauma and the development of post-traumatic disorders during wartime are of great significance now. The ongoing conflict with the invasion of neighbouring forces and the large-scale war against Ukraine poses a threat that could extend for years, if not decades, and potentially affect other regions. The constant shelling of border areas, missile attacks, and the dire social, humanitarian, and epidemiological conditions in occupied territories of Kherson, Zaporizhzhia, Donetsk and Luhansk regions have resulted in profound psychological distress among not only military personnel but also the entire population of Ukraine. This situation has led to a complex and diverse development of post-traumatic stress disorder in the contemporary context. However, despite these tragic events, this topic is of interest due to its scientific, practical, epidemiological significance, among other aspects. There is still no universally accepted theoretical framework defining approaches to the study of the psychological and biological mechanisms underlying post-traumatic stress disorder. Several pathogenetic models of the development of this disorder are currently under development. This disorder is characterized by a wide range of symptoms, including asthenia, anxiety, affective, behavioural, and psychotic disorders, which often present challenges in therapy. The most effective approach involves the use of combined pharmacological and psychotherapeutic interventions, with antidepressants being the only pharmacological agents endorsed in international clinical guidelines as first-line treatments. While experimental treatment methods exist, they require further investigation. Nonetheless, only about half of the patients achieve remission. Consequently, symptomatic therapy, placebo medications, and polypharmacy have become common in clinical practice, as clinicians attempt to address various comorbid psychopathological symptoms. This approach, to some extent, reflects the lack of well-established effective therapeutic methods and often results in prolonged illness, the development of treatment resistance, and the occurrence of side effects. In general, the efficacy of comprehensive therapy is insufficiently studied and necessitates further representative placebo-controlled and comparative clinical studies, as well as the development of more suitable and effective experimental approaches to investigate novel treatment methods.

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