Therapeutic algorithm for posttraumatic stress disorder with suicidal behavior in combatants

Abstract

Combat stress has a significant impact on the personality and is the main cause of combat mental trauma and development of suicidal behavior in the structure of post-stress disorders. 93 combatants with a diagnosis of post-traumatic stress disorder associated with suicidal behavior were examined. The main factor in suicide genesis in PTSD is the “psychological capitulation” of the combatant — a persistent inability to cope with combat trauma, feelings of feebleness, helplessness, hopelessness in the absence or low psychological resistance to stress in combat circumstances combined with a high level of impulsivity. There was also a high level of suicide risk, low self-awareness of death, high level of anhedonia, clinical manifestations of anxiety and depression by the Hospital Anxiety and Depression Scale, severe anxiety and depression by the Hamilton Rating Scale for Anxiety and Depression, major depressive episode by the Montgomery-Asberg Depression Rating Scale. Based on the obtained data, we have developed a therapeutic algorithm for post-traumatic stress disorder associated with suicidal behavior in combatants, which consists of pharmacotherapeutic and psychotherapeutic modules.