The program of complex differentiated medical and psychological rehabilitation of suicidal behavior in dementia

Abstract

IntroductionThe course of dementia is accompanied by aggression, wandering, agitation, sexual and eating disorders, suicidal behavior (SB).ObjectivesDevelop and approbate a program of medical and psychological rehabilitation (MPRP) SB in patients with dementia.MethodsIt were treated 199 patients with SB in dementia of which 107 get cured according to the developed programs and 92 people received traditional treatment.ResultsThe program of MPRP combines pharmacotherapy, psychotherapy psychoeducation, psychological training and developed taking into account the mechanisms and predictors of SB. The program included phases: diagnostic phase, phase of active intervention, psychoprophylactic phase. Pathogenetic treatment of dementia was performed with acetylcholinesterase inhibitors and / or NMDA-receptor blockers for 4-6 months. Patients with dementia with a depressive mechanism of SB were additionally prescribed antidepressants from the class of SSRIS for 3-4 months; with the psychotic mechanism of SB – atypical neuroleptics (risperidone, quetiapine) for 2-3 months. The system of psychotherapeutic and psychosocial intervention included rational and family psychotherapy, cognitive training, self-care training and psychoeducation for patients with the cognitive mechanism of SB – art therapy and family psychotherapy, communicative trainings and psychoeducation for patients with the depressive mechanism of SB; crisis psychotherapy and art therapy, social skills training and psychoeducational classes for patients with a psychotic mechanism. Improvement of mental state and reduction of symptoms of SP were diagnosed in 72.9% of patients, and after the use of traditional forms of prevention – only in 40.2% (DC=2.58; MI=0.43, p>0.001).ConclusionsThe results of approbation MPRP program in SB testify to its effectiveness.DisclosureNo significant relationships.