Mental Maladaptation Research Articles

Mental health of residents of radioactively contaminated territories of the Chelyabinsk region in the late period after the resettlement

In case of radiation accidents, one of the radical protective measures is the evacuation of residents from contaminated areas. Its purpose is to reduce the possible radiation effect to the population. At the same time, evacuation itself becomes a serious stressful factor that has a negative impact on a person’s health and mental status. The objective of this work is to assess the state of mental health of residents of the Muslyumovo settlement in the Chelyabinsk region (the territory exposed to radioactive contamination as a result of radioactive waste releases into the Techa River) who participated in the resettlement program in the period from 2006 to 2010. Mental health was assessed twice: primarily in 2008-2010 against the background of resettlement, and again in 2019-2020, 10 or more years after the resettlement. The study includes 2 groups formed by random selection. The main group consisted of 100 persons from among the participants of the resettlement program. The comparison group included 80 persons living in the territories exposed to radioactive contamination, but not participating in the resettlement program. According to the main socio-hygienic characteristics, the groups are homogeneous and comparable. The following methods were used: clinical, clinical and psychological, and the method of statistical processing of materials. As a result, it was found that both in the primary and in the repeated study, residents of the Muslyumovo settlement, Chelyabinsk region, participating in the resettlement program, were statistically significantly more likely (p<0.001) to have mental disorders and behavioral disorders (neurotic, stress-related and somatoform disorders (F 40)), compared with the control group. Also, according to the results of the survey, statistically significantly more often the psychogenic effect of resettlement (p≤0.001) was detected in patients of the main group. The data obtained suggest a long-term effect of resettlement on the mental health of the population involved. Understanding the consequences of the protective measures carried out (resettlement) will clarify the criteria for their application, as well as predict the manifestations of mental maladaptation in the population with the potential development of radiation accidents.

Особенности актуального состояния обучающихся в регионе с высокой степенью вовлеченности в последствия боевых действий

<p style="text-align: justify;"><strong>Objective.</strong> The study is aimed on estimation of students’ current state in regions with high degrees of involvement in the consequences of hostilities. <br><strong>Background.</strong> Research data, mainly foreign ones, indicate a high prevalence of violations of various degrees of severity, from mild adaptation disorders to symptoms of PTSD, in children either living in military conflict zones or having experience related to their involvement into consequences of hostilities. Such students have a great need for targeted psychological assistance. There is still a gap in domestic studies devoted to the analysis of the impact of involvement into consequences of hostilities on minority. Also, specialists are still experiencing deficits in compact tools allowing comprehensive assessment of children current state and their need for psychological assistance. <br><strong>Study design.</strong> We studied features of the students’ current state in regions highly involved into the consequences of hostilities. using specially developed screening tools designed for students of 9–11 grades.<br><strong>Participants.</strong> 646 students in grades 9–11 (36% male, 64% female) living in regions experiencing the impact of events related to hostilities, mainly from Lugansk People’s Republic. <br><strong>Measurements.</strong> The study is based on a questionnaire developed to assess the current state in adolescents including items assessing a) manifestations of socio-psychological and mental maladaptation in various spheres of life, b) symptoms of posttraumatic stress disorder, c) psychological (personal and social) resources for coping with stress. This part of questionnaire includes lists if features among which student must choose those which fit his/her current state on the base of multiple choice. The questionnaire also contains items assessing the subjective well-being of children in life areas mentioned above by the 10-point Likert scale. The questionnaires were presented electronically, using the AnketologBox platform. Results were analyzed using IBM SPSS 27.0. <br><strong>Results.</strong> Results were obtained regarding the prevalence and severity of signs of socio-psychological maladaptation, including PTSD symptoms, and subjective estimation of well-being and psychological resources for coping with stress in students of 9–11 grades. Significant differences were found between students according to the criterion of gender: a significantly higher level of vulnerability of girls compared to boys in the psychophysiological, emotional, behavioral spheres, as well as in relationships with loved ones.<br><strong>С</strong><strong>onclusions.</strong> The data analysis allowed us to identify the main features of the current state of students in the regions highly involved in the consequences of hostilities: the presence of severe distress in some children in the psychophysiological, cognitive, emotional, communicative and behavioral spheres, the tendency to decrease the level of well-being in these areas with age in secondary school students, the existence of special risk groups, which include female students of 9–11grades. The proposed diagnostic tool appeared to be sensitive to phenomena under study varying from psychological resources of coping with stress to signs of maladaptation in students living in territories involved into the consequences of hostilities.</p>

Psychosomatic relationships between the state of mental health and the level of vital threat of dermatological disease

Introduction According to the literature, 25-60% of dermatological patients have mental disorders. In the case of oncodermatological disease, the patient is under the influence of two stressogenic factors – existential experiences and social discomfort from the manifestations of the disease, which imprints on the patient’s mental health and promotes the development of mental maladaptation (MM).ObjectivesTo study the features of mental state in patients with dermatological diseases with different levels of vital threat.Methods The examination included the use of clinical-psychological, psychodiagnostic and psychometric research methods.Results120 dermatological patients were examined: 60 patients with non-vital dermatological diseases (L82, A63.0, D18.0, L80), and 60 patients with dermatological diseases posing a vital threat (C43, C44, D04).The identification of clinical signs of MM proved their presence in 70 (58.4%) people in the total sample. Among patients with non-vital diseases, the signs of MM were established in 33 (55.0%), among the patients with vital diseases – in 37 (61.7%). So, among patients with dermatological diseases, there are both psychologically adapted and maladapted individuals, regardless of the vitality/non-vitality of the pathological process.In dermatological patients with signs of MM, the clinical picture is dominated by anxious (mainly in patients with non-vital diseases) and depressive (mainly in patients with vital diseases) radicals. Auxiliary psychopathological constructs are represented by manifestations of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, and phobic anxiety. Affective symptoms are most pronounced in patients with MM and vital diseases, it is less pronounced in patients with non-vital pathology.The presence and intensity of maladaptive pathopsychological-affective reactions in patients with dermatological pathology are not clearly associated with the vitality of the dermatological process, but are based on mechanisms of the mutual influence of biological predisposition and psychological and psychosocial factors, the mosaic combination of which determines the individual’s resource capabilities for constructive acceptance the fact of the presence of a dermatological disease and the development of an adequate strategy for its mastery, regardless of the severity of the disease.ConclusionsThese patterns should be considered when developing treatment measures and rehabilitation for patients with dermatological pathology.Disclosure of InterestNone Declared

Application of screening tools to detect mental maladaptation in neurological patients in outpatient settings

In the practice of primary care physicians, there is a large number of patients whose somatic complaints are combined with emotional disorders or disguise them. In this regard, it is essential to identify manifestations of mental maladaptation and recommend these patients to visit a clinical psychologist or psychotherapist. In this work, screening tools were applied at the neurologist’s primary appointment in order to identify patients with anxiety and depressive states as the main markers of mental maladaptation. As a result of the study, mental maladaptation was detected in more than half of the cases, with the pain syndrome ranking first in this group. Such results provide a basis for recommending the use of screening tools for the detection of mental maladaptation during primary care visits, especially in patients with chronic pain complaints. The set of scales applied in this study is easy to use and can be utilized in an outpatient setting due to the shor t time required.

Mental status in patients with different forms of diffuse alopecia: analysis of the spectrum and expression of psychopathological symptoms

The purpose of the work is to study the spectrum and severity of psychopathological symptoms, to create, in the future, personalized approaches to the management of trichological patients with mental health disorders associated with alopecia. 153 women aged 25 to 45 with diffuse alopecia were surveyed: without signs of mental maladaptation (MM), 45 people, with separate signs of maladaptation, 73 persons, and with the presence of adaptation disorders according to the ICD-10 criteria, 35 persons. Within each of these groups, two subgroups, considering the genesis of alopecia were distinguished: metabolic (45 patients) or mixed (108 patients). Almost half of people with diffuse alopecia (47.7 %) have some symptoms of psychopathological spectrum, among others — the number of mentally healthy persons and respondents with adaptation disorders F43.2 is approximately the same (29.4 % and 22.9 %, respectively). Among patients with mixed alopecia, the majority (59.3 %) have symptoms at the level of PD, and more than a quarter 28.8 %) — nosologically defined adaptation disorders, while among patients with metabolic alopecia, most (66.7 %) are mentally healthy, 20.0 % have signs of PD and 13.3 % suffer from adaptation disorders. Persons with diffuse alopecia have almost the entire spectrum of psychopathological symptoms, except for significant manifestations of paranoid and psychoticism. The severity of all other manifestations — somatization, obsessive-compulsive disorders, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety — significantly differs depending on the genesis of diffuse alopecia, demonstrating the general trend of greater expressiveness in patients with a mixed form of alopecia, against patients with metabolic alopecia. Clinical filling and severity of the entire spectrum of psychopathological symptoms is more significant in patients with mixed alopecia (with a natural increase in the severity of all studied psychopathological manifestations in simultaneously with the increase in the severity of MM) than in patients with its metabolic form. The integral indicators of severity and number of psychopathological symptoms, and the severity of symptomatic distress are also significant in persons with mixed alopecia The identified patterns should be considered when constructing a strategy of personalized curation of patients with diffuse alopecia. Key words: psychodermatology, mental health disorders, alopecia, mental state, mental maladaptation, adaptation disorders, psychopathological symptoms

HYGIENIC ASPECTS FOR MAINTAINING THE HEALTH OF MILITARY SPECIALTIES CADETS: ASSESSMENT, OPTIMIZATION OF LEARNING AND LIVING CONDITIONS, AND OVERCOMING RISK FACTORS

This research theme was approved by the Academic Council of Kharkiv National University as a dissertation for Doctor of Philosophy degree.
 The aim of this publication is to present a literature review summarizing the findings from national and international scientific and practical works on the training of military personnel. The focus is on the hygienic and psychophysiological foundations of health, optimization requirements for the training conditions of cadets in military educational institutions, and other critical aspects related to this important issue.
 The materials and methods were based on well-known methodological aspects of analytical evaluation and interpretation of scientific and practical information from the literature.
 The results obtained by the analytical assessment of relevant materials indicate that the issue of training military personnel is pertinent globally and particularly crucial in the context of the ongoing conflict with the Russian aggressor in Ukraine. It has been established that in recent decades, Ukraine has lacked studies specifically focused on understanding the dynamics of mental states and the development of mental maladaptation. The absence of such research has hindered the formulation of health protection measures and the enhancement of combat readiness for cadets in higher military educational institutions throughout their entire course of study. Literature findings on the study of educational conditions for both civilian students and cadets in military educational institutions underscore the intricacies of the adaptation process for young individuals pursuing higher education. This complexity arises from age-related psychological characteristics influencing their reactions to changes in social status brought about by the transition to the environment and conditions of higher education institutions. In particular, the change in lifestyle affects cadets and junior students. This is due to an increase in the amount of received information, the unusual form of its presentation, the lack of systematic control by teachers and parents, and other factors that increase the burden on the psycho-emotional sphere of students. Specifically, cadets and junior students are significantly affected by the shift in lifestyle. This can be attributed to the heightened volume of information, its unconventional presentation, the absence of systematic monitoring by educators and parents, and various factors that contribute to an increased load on the psycho-emotional well-being of students.
 Conclusions.
 
 The issue of cadets' learning conditions in military educational institutions is a pressing concern globally.
 Through a review of scientific and practical literature, it is evident that there is an immediate need to establish criteria for the effectiveness of socio-pedagogical prevention in addressing maladjustment among junior cadets in higher military educational institutions, including those in the Ukrainian Air Force. The inadequacies in a cadet's socio-psychological characteristics may lead to maladjustment, becoming a potential factor contributing to health disorders.
 The review of existing scientific and practical literature highlights a gap in research pertaining to the psycho-emotional profile of cadets in higher military Air Force educational institutions. This lack of comprehensive study hinders efforts to preserve health and combat capability while developing hygienic preventive measures, underscoring the relevance of our scientific work.

Classification features of return losses of troop personnel: the problem of stress-associated mental disorders in modern military conflicts and emergencies

This study investigates the classification features of return losses of the personnel of the troops, specifically focusing on psychiatric profile losses and stress-associated mental disorders in the context of modern military conflicts and emergencies of various natures. The term return losses refers to individuals who have regained their combat and work capacity after a temporary loss during military conflicts and are deemed physically fit to resume their functional duties. Additionally, temporarily lost combat and working capacity refers to individuals unable to perform their functional duties for a short period, typically ranging from several minutes to 24 hours. This category includes individuals with stress-associated mental disorders. The research finds that at least 20% of victims in modern military conflicts and emergencies exhibit signs of mental maladaptation within the first day of battle or during the elimination of the medical and sanitary consequences. To address the classification of personnel losses in psychiatric and stress-related cases, as well as the inconsistency in existing terminology, a proposed classification system based on the ability to return to service is presented. Furthermore, new principles have been established to determine the return losses of military personnel, facilitating the provision of adequate and timely assistance for individuals affected by stress-associated mental disorders. The article also outlines medical and psychological correction measures at various levels and elements of first aid for combat stress-induced maladaptive phenomena. Additionally, the study recommends future research on developing a methodology to assess the size and structure of contingents consisting of individuals who temporarily lose their combat and working capacity due to modern enemy weapons during combat operations, as well as in diverse emergency situations.

Impact of vibration on the workers' psychological health

Industrial vibration is one of the most common factors of the labor process that have a negative impact on the health of employees. The search and selection of sources to identify the features of the psychological state under the influence of vibration was carried out using bibliographic databases Scopus, MedLine, Web of Science, PubMed, The Cochrane Library, RSCI (Russian Science Citation Index), Cyberleninka. Data analysis has shown that there are relatively few studies of the psychological health of people working in contact with vibration, mainly they relate to clinical and paraclinical problems. The research results of domestic and foreign authors presented in the review indicate mental maladaptation, psychoemotional disorders, alexithymia, violations of the mnestic-attentional sphere and a low level of health-related quality of life, changes in psychoaffective status, the predominance of maladaptive coping strategies, destructive psychological defenses. In addition, the severity of pain, which are characteristic of vibration pathology, correlates with the severity of depression, anxiety, reduced stress resistance. The presented data indicate the need for active identification of psychological characteristics, monitoring of changes in psychoemotional status, the formation of personal profiles of both practically healthy people working in contact with vibration and patients with vibration pathology to prevent the consequences of exposure to industrial vibration.

Влияние производственных факторов на формирование психической дезадаптации у медицинских работников во время пандемии новой коронавирусной инфекции COVID-19

Summary. The aim of the study is to analyze the modern foreign and domestic scientific literature devoted to the influence of production factors on the formation of mental maladaptation in medical workers, as well as possible methods of its prevention and curing. Materials and research methods. Scientific studies of negative psychological reactions and manifestations of mental disorders in medical workers of various profiles in the COVID-19 pandemic were analyzed. The search protocol included the use of various databases, including PubMed; Russian information and analytical portal in science, technology, medicine, and education — eLIBRARY.ru; open-access statistical reporting data; and official websites of scientific journals on the subjects under study. Study results and their analysis. The results of the study showed that most medical professionals experienced stress caused by organizational factors such as a lack of personal protective equipment (PPE), fears of not being able to receive quality medical care if they were sent to work elsewhere, fears of rapidly changing context, lack of access to current information and communication, lack of special medications, shortage of ventilators and beds in intensive care units In the conditions of regular health care work, most of the professionals noted tension in the process of performing professional duties, exceeding their physical and mental capacities, which was one of the main reasons for anxiety, nervousness or stress at work.

Glycine application in the treatment of patients with adjustment Disorders

Manifestations of mental maladaptation play an important role in diagnosing the consequences of stressful situations, and methods of their treatment include a wide range of therapeutic interventions. This paper describes a randomized placebo-controlled study of the efficacy and tolerability of the drug glycine based on a pharmaceutical composition of microencapsulated glycine and magnesium stearate in adjustment disorder with a predominance of disturbances in other emotions. In the glycine group, 82.4 % of patients achieved a significant improvement in the CGI score, while in the placebo group, this figure was 14.3 %. Glycine was safe and well tolerated by patients, none of the patients was prematurely excluded due to adverse events. The results of the study confirm the effectiveness of glycine and its superiority over placebo in this sample of patients with an improvement in all measured parameters.

Факторы профессионального риска и последствия психической дезадаптации у медицинских специалистов и спасателей при чрезвычайных ситуациях: современное состояние проблемы

The purpose of the study is to analyze modern domestic and foreign publications, devoted to the study of factors of professional risk and consequences of mental disadaptation in rescuers and medical workers in emergency situations. Materials and research methods. The publications’ analysis was performed using the PubMed database, electronic scientific library eLIBRARY.RU, open access statistical reporting data, as well as official websites of relevant scientific journals. Combinations of specific terms related to emergency services, post-traumatic stress disorder, mental maladaptation and professional risk factors of extreme professions, including medical ones, were used. Results of the study and their analysis. While performing their service duties, rescuers and medical workers, acting in conditions of emergency with numerous human and material losses, being exposed to the threat to their own life, health or psycho-emotional condition, face a variety of critical incidents. As the number of lived traumatic situations and events increases, individuals involved in rescue operations are at higher risk of developing the pathology known as post-traumatic stress disorder. Throughout the relevant scientific literature, there is a consensus that health care workers in emergencies are at increased risk for high-level stress, anxiety, depression, burnout, addiction, and PTSD, which can have long-term psychological consequences. The specialists developed and implemented new methods and approaches to support medical specialists participating in the liquidation of medical and sanitary consequences of emergencies; substantiated the need for normative legal regulation of psychophysiological examination of personnel during periodic medical examinations, which will allow to maintain “health of the healthy”.

Predictive model of the risk of formation of mental deadaptation in chemical production workers

IntroductionAccording to WHO, 30-50% of workers experience psychological stress, which contributes to the development of mental and psychosomatic disorders. It’s important to develop the problem of prenosological diagnosis and determination of criteria for the formation of mental maladaptation as predictors of mental disorders in relation to occupational risk factors. Mental disorders in workers in a dangerous environment are of the nature of prenosological, not clearly delineated by a circle of diagnostic symptoms.Objectives1st chemical factor in combination with noise and emotional stress, 2d chemical factor in combination with a threat to life (explosion and fire hazard), 3d working in conditions of noise and emotional stressMethodsThe influence of working environment conditions and non-production factors on the formationResultsPredicting the development of mental mailadaptive state model was developedConclusionsVegetative disorders are most likely to manifest in group 1, comorbid of which with obsessive-phobic disorders and depressive spectrum disorders. The group 2 is characterized by astheno-vegetative symptoms in correlation with the conversion type of response. In the third professional group, the nature of predictors is characterized by a pronounced isolation of groups of symptoms, the leading of which is the vegetative pattern.Vegetative syndroms are most likely to manifest in group 1, comorbid of which is obsessive-phobic disorders and depressive spectrum disorders. The group 2 is characterized by astheno-vegetative symptoms in correlation with the conversion type of response. In the third professional group, the nature of predictors is characterized by a pronounced isolation of groups of symptoms, the leading of which is the vegetative pattern.DisclosureNo significant relationships.

Study of the emotional state of residents of St. Petersburg and the Leningrad region in connection with the forced self-isolation during the COVID-19 pandemic

The study is devoted to the study of the emotional state of people in the conditions of self-isolation during the pandemic of a new coronavirus infection. The online study involved 380 «conditionally healthy» respondents aged 18 to 60 years. A special questionnaire was developed; to assess the emotional state of the subjects, the Hospital Anxiety and Depression Scale (HADS) and the Bass-Darkey aggressiveness level questionnaire were used. Only 45–54% of respondents tried to comply with the sanitary regime, men violated the established requirements more often than women. No clinical symptoms of anxiety or depression were found. The level of anxiety reached subclinical values in women. At the same time, there was an increased level of aggression (verbal and indirect) and irritation, an increase in the integral indicators of aggressiveness and hostility. These emotional manifestations characterize the well-known reactions of a person’s mental maladaptation in difficult life situations.

IMMUNE CELLS AS A POTENTIAL THERAPEUTIC AGENT IN THE TREATMENT OF DEPRESSION

The immune and neuroendocrine systems play a critical role in maintaining a dynamic homeostasis in normal conditions and at mental maladaptation. Psycho- and immunopathology closely interrelated: pathological changes in the functioning of both systems occur simultaneously and are interdependent. Depression, as a mental disorder, is a major public health concern. The estimations are showing rise of the depression’s incidence in the future. However, currently used therapy of depression doesn’t provide a complete cure. It is known that a violation of neuroimmune interaction is an essential link in the pathogenesis of the disease, having a negative impact on its course, making the clinical picture worse, reducing effectiveness of the therapy, therefore, it’s urgent to search for a new treatment approaches. There are a sufficient amount data on the immune cells and their biologically active products leading role in the pathogenesis of depression. The unidirectional effect of most psychoactive substances on the central nervous system and the immune system confirms intersystem mutual regulation and allows considering the immune cells as model objects for influencing the intersystem functional relationship; so, cells immunotherapy can be the method of choice in the treatment of depressive disorders. We first demonstrated the possibility of animal’s behavior directed regulation by the transplantation of immune cells with definite functional characteristics, including those with functional activity modulated extracorporeally by a psychoactive substance. Based on the previous results we investigated the effect of the in vitro caffeine- treated immune cells on the behavior and immune phenotypes in depressive-like singeneic recipients. Transplantation of caffeine-treated splenocytes from depressive-like donors has been shown to induce depressive-like behavior editing in syngeneic recipients, which was manifested in anhedonia decrease, stimulation of exploratory behavior in the Open Field test and motor activity in the Porsolt forced swimming test. Recipient’s behavioral changes were registered on the background of decreased brain pro- inflammatory cytokines (TNFα, IL-1β, IL-6, IFNγ) and IL-10 increased in some pathogenetically significant for depressive-like state brain structures (hippocampus, hypothalamus, frontal cortex, striatum), which indicates a decrease in neuroinflammation. It was also detected recipient’s immune system functional activity modulation. The cytokines-mediated mechanisms of depressive-like behavior editing by the in vitro caffeine- modulated immune cells are discussed.

Indicators of the psychoemotional state of palliative polymorbid cancer patients

Introduction. Palliative care is aimed at maintaining and improving the quality of life of the patient. Without taking into account the psychosocial aspects, psychological rehabilitation is impossible in the conditions of a psychotraumatic situation of the disease.The aim of the study was to assess the psychoemotional state of polymorbid palliative cancer patients.Materials and methods. An observational, analytical, single-stage (cross-sectional) study was conducted, which included 74 cancer patients of a palliative profile. The patients underwent laboratory and instrumental examination. The following tests were evaluated: resilience (S. Maddy's method, D. A. Leontiev's adaptation), life-sense orientations, the level of subjective control, C. D. Spielberger, the severity of chronic pain syndrome; the value of the Charlson comorbidity index, the Karnovsky index (ECOG) was calculated.Results. The level of the comorbidity index was 3 [2; 5] points, the intensity of chronic pain syndrome-2 [2; 3] points, ECOG-2 [2; 3] points. In polymorbid cancer palliative patients, the presence of a belief in the impact of the struggle on the outcome of what is happening was revealed, however, patients are not always ready to act in a difficult situation. In the examined group, signs of dissatisfaction with their life in the present prevailed, the lack of sufficient freedom of choice, the existence of hope for recovery as a result of the actions of others, primarily doctors. The average (and in some cases high) level of situational and personal anxiety was noted. The association of the comorbidity index and the indicators of the life-meaning orientations test; the indicator of the general internality scale and the ECOG value; the glomerular filtration rate and the indicator of resilience, risk acceptance was revealed. A number of correlations between the indicators of the psychoemotional state and laboratory parameters (the level of hemoglobin, albumin, iron, C-reactive protein) were noted.Conclusion. In cancer patients with a palliative profile, signs of mental maladaptation were revealed. The average (and in some cases high) level of situational and personal anxiety was noted. The revealed number of correlations focuses on the role of chronic non-communicable diseases in aggravating the psychoemotional status of chronic polymorbid cancer palliative patients.

РОЗРОБЛЕННЯ ОПИТУВАЛЬНИКА “ОЦІНЮВАННЯ МОРАЛЬНО-ПСИХОЛОГІЧНОГО СТАНУ ВІЙСЬКОВОСЛУЖБОВЦІВ ПІДРОЗДІЛІВ НАЦІОНАЛЬНОЇ ГВАРДІЇ УКРАЇНИ З КОНВОЮВАННЯ, ЕКСТРАДИЦІЇ ТА ОХОРОНИ ПІДСУДНИХ”

In this article we propose to consider the questionnaire of assessment of the moral and psychological condition of the servicemen of the National Guard of Ukraine of the escorting convicts. With the help of a questionnaire, the moral and psychological condition of a serviceman is assessed, and an expert assessment of the moral and psychological condition of servicemen is carried out with the help of certain factors. Formulation of the problem: conditions for combat missions by servicemen of National Guard of Ukraine of escorting convicts units are characterized by a negative impact on the human psyche. Adverse conditions, discomfort and threatening factors create a high level of occupational stress. The servicemen of the National Guard of Ukraine who perform a combat mission is exposed not only to physical threat (life and health) but also a significant risk of stress, neuropsychiatric disorders and mental maladaptation. They often cause disruptions in professional activities, loss or reduction of ability to work, interpersonal conflicts, violations of discipline, alcohol use and other negative phenomena. The purpose of the article is to develop a questionnaire to assess the moral and psychological condition of the personnel of the National Guard of Ukraine escorting convicts units. Analysis of recent research and publications. Today there are several methods, the main of which is the assessment of the situation during the battle with the determination of the level of readiness of servicemen for combat operations; assessment of the moral and psychological condition of the personnel of the unit in peacetime and wartime; assessment of the moral and psychological condition of the personnel of the troops on the basis of quantitative determination of its main indicators; assessment and prediction of moral and psychological condition. None of them is officially defined as normative, but mandatory for use in the military sphere.

Остеопороз у пожилых пациентов

Osteoporosis in the elderly and senile can be compared with the epidemic of the 21st century due to the high prevalence and increased incidence among people who have survived the 50-year threshold, which make up the bulk of patients. Osteoporosis is associated with a significant increase in the risk of falls and fractures, leading to adynamia and an increased risk of death. Despite the insufficient knowledge of the pathogenesis of the disease, the available data have already allowed the development of preventive measures and treatment principles. Currently, there are preventive and therapeutic measures aimed at reducing the risk of falls, fractures and repeated fractures, however, earlier detection of the disease in old age is often difficult due to the characteristic features of geriatric patients. The polymorbidity, unexpressed clinical picture, the development of frailty syndrome, sarcopenia, social and mental maladaptation and an increase in the frequency of depression make the population of elderly and senile people vulnerable to an increased risk of osteoporosis, falls and fractures and associated hospitalizations and mortality. This review highlights the features of pathogenesis, clinical features, principles of treatment and prevention of osteoporosis in the older age group.

Osteoporosis in the elderly

Osteoporosis in the elderly and senile can be compared with the epidemic of the 21st century due to the high prevalence and increased incidence among people who have survived the 50-year threshold, which make up the bulk of patients. Osteoporosis is associated with a significant increase in the risk of falls and fractures, leading to adynamia and an increased risk of death. Despite the insufficient knowledge of the pathogenesis of the disease, the available data have already allowed the development of preventive measures and treatment principles. Currently, there are preventive and therapeutic measures aimed at reducing the risk of falls, fractures and repeated fractures, however, earlier detection of the disease in old age is often difficult due to the characteristic features of geriatric patients. The polymorbidity, unexpressed clinical picture, the development of frailty syndrome, sarcopenia, social and mental maladaptation and an increase in the frequency of depression make the population of elderly and senile people vulnerable to an increased risk of osteoporosis, falls and fractures and associated hospitalizations and mortality. This review highlights the features of pathogenesis, clinical features, principles of treatment and prevention of osteoporosis in the older age group.

Peculiarities of psychosocial stress and anxiety-depressive response in representatives of the command staff and workers of merchant and passenger-carrying fleets

300 sailors of long-distance voyages were surveyed, including 200 merchant fl eet representatives (110 crew members and 90 sailors) and 100 workers of passenger-carrying fleet of Ukraine (70 crew members and 30 sailors). The study involved the use of clinical-psychopathological and psychodiagnostic methods. Indicated that 63.0 % of sailors of long-distance voyages, including 69.1 % of command staff representatives and 58.9 % of workers of merchant fleet, and 57.1 % of command staff and 66.7 % of workers of passenger-carrying fleet, have signs of mental maladaptation, which in most cases do not reach clinically defined severity. 18 % of the examined sailors of long-distance voyages, including representatives of all surveyed groups, were diagnosed with clinically delineated adaptation disorders, namely, mixed anxiety-depression, prolonged depressive reaction, disorder with predominance of disturbance of other emotions, as well as disorders of emotions and behavior. The distribution of stress load and pathological anxiety-depressive response in the command staff and workers of long-distance voyages is heterogeneous and associated with the specificity of professional activity. The synchronicity of dynamics of the growth of indicators of level of stress and deterioration of mental health condition of the examined up to clinically defined adaptation disorders, allow to reach the conclusion about the signifi cant role of psychosocial and psychological stress in the formation of mental health disorders in sailors of long-distance voyages that should be taken into account in the development of specifi c measures of psychotherapy and psychoprophylaxis for this contingent. Keywords: sailors of long-distance voyages, merchant fleet, passenger-carrying fleet, command staff, working staff, psychosocial stress, mental maladaptation, pathological anxiety, depression, adaptation disorders

The level of psychosocial stress and mental health state in sailors of long-distance voyages

Annotation. The purpose of the work is to study the level of psychosocial stress and mental health state in sailors of long-distance voyages, to determine the need to create system-specific measures for the protection of their mental health. During 2016–2019, 300 sailors of long-distance voyages were surveyed, including 200 merchant fleet representatives (110 crew members and 90 sailors) and 100 workers of passenger-carrying fleet of Ukraine (70 crew members and 30 sailors). All surveyed were male, citizens of Ukraine. The study involved the use of clinical psychopathological and psychodiagnostic methods. Revealed that among the surveyed in each group, at least one third of the people who were consulted by a doctor did not show signs of mental health disorder or maladaptation. Among the respondents with some manifestations of mental maladaptation of different severity and clinical filling, there were more representatives of crew members (the number of merchant fleet commanders was higher than the number of passenger-carrying fleet commanders - 53% vs. 45%), and among sailors of both fleets the number of such persons was approximately the same (37% vs. 40%). The highest number of persons with pronounced manifestations of mental maladaptation of the clinical level of severity was recorded among sailors of the passenger-carrying fleet (27%), while among commanders the number of such persons had no statistical difference (16% vs. 13%). Healthy individuals without signs of maladaptation did not feel the burden of stress; surveyed with maladaptive manifestations of donozological severity and content, had a moderate level of psychosocial stress; patients with severe psychopathological inclusions have a severe level of stress. Thus, the level of psychosocial stress has a significant impact on the formation of mental health disorders in sailors of long-distance voyages, which should be taken into account when developing specific measures of psychotherapy and psychoprophylaxis for this contingent.