Targets of medical-psychological assistance for medical university students with adaptation disorders

Abstract

Background. In the course of work is to identify and develop a system of measures for psychotherapeutic correction on the basis of identification and comprehensive evaluation of clinical and psychological manifestations and mechanisms of formation of maladaptive states in medical students.
 Objective – to comprehensively study the mechanisms of formation of students’ maladaptation states and develop a system of their psychotherapeutic correction and psychoprophylactic support in a medical institution of higher education.
 Materials and methods. Complying with the principles of bioethics and deontology, 412 students of the 2-5 academic years of the Kharkiv National Medical University (KhNMU), of both sexes, at the age of 17-22 years, were examined. All the surveyed people were divided into three groups: Group 1 included 215 students-inhabitants of the Eastern Ukraine; Group 2 consisted of 87 students-residents of Luhansk and Donetsk regions, who entered the study at the KhNMU before the ATO; Group 3 consisted of 110 students-migrants from the ATO zone.
 Results. Students-migrants have a higher level of adaptation disorders, compared with the students of the first and second groups. It was established that the structure of adaptation disorders is represented by depressive, neurasthenic, anxious and dissociative syndrome complexes. Prognostically significant elements in the formation of adaptation disorders are excitability and imbalance, proneness to conflicts in relationships, disturbing confidence, disorganization of behavior, failure to self-regulation, inability to successfully overcome stressful situations, act in conditions of uncertainty, rigidity, and focusing on traumatic and negative feelings. According to the results of the pathopsychological examination, high levels of somatization, depression and anxiety by the SCL-90-R scale; the prevalence of severe depressive and anxiety episodes by the Hamilton scale; clinical manifestations by the hospital anxiety and depression scale were characteristic for the examined students with disorders of adaptation. Based on the data obtained, a system of medical and psychological support of the medical student during the study period was developed, which envisages the use of complex differentiated psychotherapeutic, psychoeducational and psychoprophylactic influences.
 Conclusions. Against the background of the psychotherapeutic correction, a positive dynamic of the psychological state was noted: rapid reduction of anxiety and depressive symptoms, reduction of the level of neuro-psychic tension, increase of students’ psychophysical activity, positive change of coping strategy.