Prolonged Depressive Reaction Research Articles

Peculiarities of commissions of forensic medical examinations in criminal cases related to crimes against sexual inviolability

The investigation of criminal cases related to sex crimes determines the range of circumstances to be immediately proved during investigations. Issues arising in the process of conducting such cases must be resolved as part of forensic medical examinations. Illegal acts of a sexual nature generally end in the violation of human health, not only physical with bodily harm but also psychological. During such examinations, specialists of various clinical specialties are included in the composition of expert commissions. These are specialists in the fields of obstetrics-gynecology, venereology, traumatology, psychiatry, and clinical psychology. During investigation and trial, important information can be provided by medical documents on the state of health of the victim, including the testimony of medical workers. Not only forensic medical experts who conducted examinations but also medical workers are called to court hearings as witnesses to incidents. This article analyzed the commissions of forensic medical examinations in a teenager harmed by violent sexual acts. The results of forensic medical examinations were analyzed. This article provides an expert observation of a victim of crimes against sexual inviolability that led to severe complications. During the investigation, the development of a mental disorder in the teenager was examined, and a forensic medical examination was performed. Psychological injuries are no less serious than physical ones. The body’s response to stress causes a pathological state of the psyche. Such a painful reaction can persist for many years. A prolonged depressive reaction due to an adaptation disorder arose in the victim after the unlawful actions committed against her with a direct causal relationship. When conducting forensic medical examinations related to illegal acts of a sexual nature, specialists in the fields of gynecology, traumatology, venereology, psychiatry, and clinical psychology must take part in the examinations.

Hypoactive Sexual Desire Due to Mental and Neurological Disorders

The article presents data on hypoactive sexual desire which occurs in neurotic and stress-related disorders (neurasthenia, anxiety-phobic and obsessive-compulsive disorders, including the syndrome of anxious expectation of sexual failure, dissociative disorders, adaptation disorders [prolonged depressive reaction, anxiety-depressive reaction]). In particular, characterizing sexual disorders in patients with neurasthenia, one group of authors believes that these disorders differ depending on the form of this disease (hypersthenic, hyposthenic). In their opinion, in the hypersthenic form increased excitability of the sexual sphere is observed which can lead to the appearance of various sexual disorders, including increased libido. In the hyposthenic form of neurasthenia, according to this group of authors, various hypoactive sexual manifestations can be noted, including a decrease in libido, and in addition, premature ejaculation. Another group of researchers found in patients with neurasthenia, regardless of its form, only hypofunctional sexological manifestations, as well as premature ejaculation (that is, those symptoms that were named by the first group of authors as characteristic of the hyposthenic form of neurasthenia). The article also presents data on hypoactive sexual desire which can be observed in personality disorders and character accentuations (schizoid personality disorder and character schizoid accentuation, accentuations of the cycloid, asthenoneurotic, hysteroid, unstable, psychasthenic, sensitive and infantile-dependent types); mood disorders [affective disorders] (dysthymia [depressive neurosis], bipolar disorder); schizophrenia; mental retardations; dementia due to organic brain damages; epilepsy; organic brain damages; multiple sclerosis. Clinical observations are given; these concern hypoactive sexual desire in patients with schizophrenia and organic brain damage.

INTERCONNECTION OF COGNITIVE DISORDERS AND CLINICAL AND PSYCHOPATOLOGICAL FEATURES IN PROLONGED DEPRESSIVE REACTION

Aim of research. The aim of the study was to determine the relationship between the clinical and psychopathological features of anxiety and depressive manifestations and the features of cognitive dysfunctions in patients with prolonged depressive reaction.
 Materials and methods. The study involved 98 patients with prolonged depressive reactions. The study used an integrated approach, which consisted in the use of clinical-psychopathological, psychometric, psychodiagnostic and statistical research methods.
 Results. According to the research results, a correlation analysis was carried out, which made it possible to determine the combination of clinical and psychopathological symptoms with the features of the cognitive functioning of patients with prolonged depressive reaction. Obsessive thoughts and hypochondriacal ideas have been shown to be associated with marked levels of anxiety; suicidal thoughts - with a protracted onset of depression and a minor depressive episode; mild violations of verbal productivity were associated with a major depressive episode and with a prolonged onset of depression, with 1-2 episodes of depression in anamnesis; a low level of attention switching was associated with an episode duration of up to 2 years, a protracted onset of depression, a major depressive episode, and an increased level of anxiety; average work efficiency correlated with a low level of anxiety, an episode duration of up to a year, 1-2 episodes of depression in anamnesis, a remission duration of more than 24 months; mobilization of mental processes was associated with a remission duration of more than 24 months and a reduced level of anxiety; high selectivity of attention to negative stimuli was combined with the duration of the episode up to 2 years and a pronounced level of anxiety; moderate disturbances in aggressive behavior patterns were associated with an episode duration of up to a year and a moderate level of anxiety.
 Conclusions. The relationship between clinical and psychopathological features of anxiety and depressive manifestations and features of cognitive dysfunction in patients with prolonged depressive reaction were identified. It should be considered in the differential diagnosis and in the development of psychocorrective measures to reduce cognitive impairment in patients with depressive disorders.

Evaluation of Psychiatric Disorders in Spouse of Patients with Alcohol Dependence Syndrome

Background and Aim: Alcohol Dependence Syndrome has deleterious consequences not only on the patient with Alcohol Dependence Syndrome but also on the members of his family. The psychopathology in wives of patients with Alcohol Dependence Syndrome is a largely neglected area in psychiatric research. Aim of the present study was to evaluate the frequency and nature of psychiatric disorders in wives of patients with Alcohol Dependence Syndrome.
 Materials and Methods: A total of 177 wives, 100 wives of patients with Alcohol Dependence Syndrome and 77 wives of patients with Bipolar Affective Disorder- current episode mania were evaluated. Tools used were ICD-10 AM symptom checklist and modules for assessment of psychiatric morbidity and diagnosis was made based on The International Classification of Diseases – (Diagnostic Research Criteria DCR-10).
 Results: Psychiatric disorders are diagnosed in 75% of the wives of patients with alcohol dependence syndrome out of which 45% have dysthymia, 12% have mild depressive episode, 8% have adjustment disorder- prolonged depressive reaction, 5% have moderate depressive episode and 5% have anxiety disorder unspecified.
 Conclusion: The present study concludes that the wives of patients with Alcohol Dependence Syndrome have significant psychiatric morbidity when compared to wives of patients with Bipolar Affective Disorder-current episode mania. The most common psychiatric disorder is dysthymia.

Disorders of the psychoemotional sphere of the ATO/JFO military services

In this article, we have presented the results of our own research concerning the state of psychoemotional disorders in the military personnel of the ATO/JFO. It is known that the state of mental health is infl uenced by various external factors, both socio-economic and physical, traumatic, environmental, etc. The professional activity of the ATO/JFO military personnel is carried out in extreme conditions associated with psychophysical overload, an increased level of responsibility, etc. Therefore, the psychoemotional state of this contingent requires signifi cant attention and correction. The aim of this study was to study the psychoemotional state of the ATO/JFO military personnel. The study involved 66 ATO/JFO combatants (31 men and 35 women) with signs of adjustment disorders who were in Clinic of Neurology, Psychiatry and Narcology of Military Medical Clinical Centre of the Northern region (Kharkov, Ukraine). The control group consisted of 29 people (14 men and 15 women) who did not take part in hostilities and also had signs of adjustment disorders. Using the clinicalanamnestic method in the main group, we identifi ed 32 people with prolonged depressive reaction caused by adaptation disorder (F43.21 according to ICD-10) and 34 people with mixed anxiety and depressive reactions (F43.22). In the control group, 15 people had F43.21 and 14 examined had F43.22. The use of the psychodiagnostic methodology «Tsung Scale for Self-Assessment of Depression» (adapted by T.I. Balashova, 2003) made it possible to reveal a subdepressive state in 12,1±1,9% of the surveyed combatants (men 4,5±1,2%, women 7,6±1,5%). Severe depression was diagnosed in 87,9±1,9% military personnel (men 42,4±2,8%, women 45,5±2,9%). In the control group, a state without depression was revealed in 79,3±5,2% of individuals (37,9±6,3% men, 41,4±6,4% women), and mild depression was also identifi ed (10,3±4,1% men, 10,3±4,1% women, there were 20,6±5,2% people in total). It was concluded that it is necessary to take into account the data obtained when developing an algorithm for psychocorrectional measures in this contingent of patients.

Emotional sphere disorders in patients with cognitive impairments in depressive disorders

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 patients with prolonged depressive reaction (PDR). A set of research methods was used: clinical-psychopathological and statistical. As a result of the study, the clinical and psychopathological features of affective disorders in different types of depressive disorders were identified: a predominance of apathy, emotional lability, hypothymia, anxiety, feelings of dissatisfaction, despair and anhedonia were identified in patients with RDD; a low mood, apathy, emotional coldness, hypothymia, ambivalence of emotions, dysphoria, dissatisfaction, feelings of sadness and annoyance were identified in patients with BAD; a feelings of despair, anxiety, dissatisfaction, hypothymia, fear, sadness, feelings of horror and fear, emotional lability, feelings of anger, hostility and shame and sensitivity were dominated in patients with PDR.

INTERCONNECTION OF COGNITIVE DISORDERS AND CLINICAL AND PSYCHOPATOLOGICAL FEATURES IN PATIENTS WITH PROLONGED DEPRESSIVE REACTION

Aim: to determine the relationship between the clinical and psychopathological features of anxiety and depressive manifestations and the features of cognitive dysfunctions in patients with prolonged depressive reaction.
 Material and methods. The study enrolled 98 patients with prolonged depressive reactions. The study used an integrated approach, which consisted in the use of clinical-psychopathological, psychometric, psychodiagnostic and statistical research methods.
 Results. According to the research results, a correlation analysis was carried out, which made it possible to determine the combination of clinical and psychopathological symptoms with the features of the cognitive functioning of patients with prolonged depressive reaction. Obsessive thoughts and hypochondriacal ideas have been shown to be associated with marked levels of anxiety; suicidal thoughts – with a protracted onset of depression and a minor depressive episode; mild violations of verbal productivity were associated with a major depressive episode and with a prolonged onset of depression, with 1-2 episodes of depression in anamnesis; a low level of attention switching was associated with an episode duration of up to 2 years, a protracted onset of depression, a major depressive episode, and an increased level of anxiety; average work efficiency correlated with a low level of anxiety, an episode duration of up to a year, 1-2 episodes of depression in anamnesis, a remission duration of more than 24 months; mobilization of mental processes was associated with a remission duration of more than 24 months and a reduced level of anxiety; high selectivity of attention to negative stimuli was combined with the duration of the episode up to 2 years and a pronounced level of anxiety; moderate disturbances in aggressive behavior patterns were associated with an episode duration of up to a year and a moderate level of anxiety.
 Conclusions. The relationship between clinical and psychopathological features of anxiety and depressive manifestations and features of cognitive dysfunction in patients with prolonged depressive reaction were identified. It should be considered in the differential diagnosis and in the development of psychocorrective measures to reduce cognitive impairment in patients with depressive disorders.

Model of formation of non-psychotic mental disorders in participants of hostilities who were injured

The study involved 98 patients with a prolonged depressive reaction. The majority of patients had a predominance of anxiety, apathetic-dynamic, obsessive-depressive and senescent-hypochondriac symptom complexes. Anxiety symptom complex was associated with catastrophism, hypochondriac ideas, increased selectivity of attention to negative stimuli, obsessive thoughts, increased sensitivity to criticism, weak visual-motor coordination disorders, decreased switching, average mental performance, mobilization, accusation of others, weak violations in the field of personal and social interaction, moderate violations in the field of aggressive patterns of behavior. Apathetic-adynamic symptom complex was associated with difficulties in decision-making, weak disorders of visual-motor coordination and executive functions, weak disorders of verbal performance, low levels of switching attention, reduced selectivity of attention to neutral and negative stimuli, weak personality disorders and social activities, and social interaction. Obsessive-depressive symptoms correlated with obsessions, mild executive impairments, ruminations, decision-making difficulties, low levels of switching, and mild personality and social impairments. Senesto-hypochondriac symptom complex was associated with hypochondriac ideas, obsessive-compulsive disorder, decreased switching, increased selective attention to negative stimuli, ruminations, mild executive impairments, and mild social disorders. Keywords: cognitive impairment, depressive disorders, clinical and psychopathological features, symptom complex, prolonged depressive reaction.

Predictors of suicidal behavior in patients with cognitive impairments in depressive disorders

The aim of the study was to determine predictors of suicide risk in patients with cognitive impairment in depressive disorders.Material and methods. 362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder, 141 patients with bipolar affective disorder and 98 patients with prolonged depressive reaction. A set of research methods was used to study the factors of suicidal behavior in patients with cognitive impairment in depressive disorders: clinical-psychopathological, psychodiagnostic (questionnaire "Self-assessment of the severity of autoaggressive predictors") and mathematical-statistical. Results of the research. Predictors of suicide risk in patients with cognitive impairment in depressive disorders were identified. The moderate level of autoaggression and aggression, low level of impulsivity, high and severe narrowing of cognitive functions, severe narrowing of interpersonal relationships, severity of affective disorders, moderate and severe autonomic disorders were identified in patients with recurrent depressive disorder. Pronounced and moderate level of autoaggression, aggression and impulsivity, high and pronounced level of narrowing of cognitive functions, pronounced narrowing of interpersonal relationships, severity of affective disorders, moderate and severe level of autonomic disorders were identified in patients with bipolar affective disorder. Moderate levels of autoaggression and narrowing of cognitive functions, low levels of aggression, severe impulsivity, affective disorders and narrowing of interpersonal relationships, and high levels of autonomic disorders were identified in patients with prolonged depressive reaction.Conclusions. As a result of the study, the features of suicidal behavior in patients with cognitive impairment in depressive disorders were identified. It can act as diagnostic criteria and predictors of suicidal behavior in differential diagnostics and could take into account when creating psychocorrectional programs aimed at reducing suicidal risk in patients with cognitive dysfunctions in depressive disorders.

SYNDROMAL CHARACTERISTICS OF DEPRESSIVE MANIFESTATIONS AMONG PATIENTS COGNITIVE IMPAIRMENTS IN DEPRESSIVE DISORDERS

362 patients with cognitive impairment at depressive disorders were examined, of them 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 patients with prolonged depressive reaction (PDR). Differentiated clinical and psychopathological features of patients with cognitive impairment at depressive disorders were established: 1) combination of apathetic-adynamic, astheno-energetic and anxious symptom complexes; predominance of moderate and major depressive episodes; severity of apathy, subjective and objective signs of depression, decrease in concentration and ability to feel were determined in patients with RDD; 2) combination of astheno-energetic, apathetic-adynamic, and melancholic symptom complexes; predominance of moderate and major depressive episodes; the severity of apathy, subjective signs of depression, suicidal thoughts, insomnia and decrease in concentration in patients with BAD; 3) combination of anxious and apathetic-adynamic symptom complexes; the predominance of moderate and minor depressive episodes; the severity of internal stress, apathy, suicidal thoughts and loss of appetite in patients with PDR.

Characteristics of Executive Functions in Patients With Cognitive Impairments in the Presence of Depressive Disorders

Introduction. The urgency of the problem of affective pathology and, above all, depression, due to a number of factors: the growing prevalence of depression, reaching 10.0 % in the population, the high risk of chronic such conditions, their maladaptive impact on social functioning, efficiency and quality of life, the burden of economic costs etc. According to epidemiological indicators in Ukraine over the past 10 years, the incidence of affective disorders has increased by 6.13 %, and the prevalence – by 13.16 %. Impaired thinking and executive functions, decreased concentration and difficulty making decisions are key diagnostic signs of depression. Cognitive impairment (CI) has a cumulative effect on the functionality of patients with depression and is associated with a longer duration of depressive episodes, which indicates the need for its diagnosis and treatment. At the present stage, there are no systematic ideas about the specifics of disorders of executive functions in the presence of different types of depressive disorders (DD), which determines the relevance of the study in this direction. The aim of the study. Describe the executive functions in patients with CI in the presence of DD. Materials and methods. The study included 362 patients with CI in the presence of DD, which were stratified into three groups of comparisons by the mechanism of DD: 123 patients with recurrent depressive disorders (RDD), 141 patients with bipolar affective disorder (BAD) and 98 people with prolonged depressive reaction (PDR). The predominant numbers (38.12 %) of patients with CI in the presence of DD were in adulthood (30-44 years). There were more young people (18-29 years) among patients with PDR (21.43 %, DC = 8.19) and among patients with BAD (31.21 %, DC = 9.82), and middle-aged people (45-59 years) (37.40 %, DC = 1.54) and the elderly (60-74 years) (17.07 %, DC = 4.78) – among patients with RDD. A set of research methods was used: clinical-psychopathological, psychodiagnostic and statistical. Results. Peculiarities of executive functions in patients with CI in the presence of DD were established: the moderate and severe disorders of visual-motor coordination (39.84 % and 19.51 %, respectively) and impaired visual-spatial functions (13.72 %), moderate and severe violations of executive functions (54.47 % and 13.01 %, respectively), moderate, severe and weak violations of the executive function of the lexical system (39.84 %, 32.52 % and 23.58 %, respectively) were present in patients with RDD; the moderate violations of verbal performance (58.54 %); moderate and severe violations of visual-motor coordination (41.13 % and 26.24 %, respectively), executive functions (65.96 % и 21.38 %, respectively), executive functions of the lexical system (47.52 % и 39,01 %, respectively) and verbal productivity (58.16 % and 21.28 % respectively) were found in BAD; absence and weak impairments of visual-motor coordination (45.92 % and 36.73 %, respectively), executive functions (23.47 % and 66.33 %, respectively), executive functions of the lexical system (31.63 % and 45.92 %, respectively) and verbal productivity (26.53 % and 58.16 %, respectively) were presented in patients with PDR. Conclusions. The study revealed the features of executive functions in patients with cognitive impairment in the presence of depressive disorders, which should be taken into account in the algorithm of their psychosocial rehabilitation.

Peculiarities of the perception process in patients with cognitive impairments in depressive disorders

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 patients with prolonged depressive reaction (PDR). A set of research methods was used: clinical-psychopathological, psychodiagnostic (Munsterberg test) and statistical. The features of the perception process were established for various types of depressive disorders: in patients with RDD, there was a predominance of average, increased and decreased selectivity of attention to neutral stimulus (30.89 %, 21.95 % and 21.95 %, respectively), high selectivity of attention to negative stimulus (33.33 %) and decreased and low selectivity of attention to positive stimulus (54.47 % and 20.33 %, respectively); in patients with BAD, a predominance of average and reduced selectivity of attention to neutral stimulus (45.39 % and 36.17 %, respectively) and average selectivity of attention to negative and positive stimulus (38.30 % and 38.30 %, respectively) were recorded; in patients with PDR, the prevalence of average and reduced selectivity of attention to neutral stimulus (42.86 % and 34.69 %, respectively), increased and decreased selectivity of attention to negative stimulus (29.59 % and 16.33 %, respectively), increased selectivity of attention to positive stimulus (43.88 %). Key words: patients with cognitive impairment, depressive disorders, perception process, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction

System of psychotherapeutic support for injured combatants

The effects of combat stress most often cause non-psychotic mental disorders, which are manifested in significant emotional experiences, disorders of cognitive processing of information, deformation of social ties of combatants. We examined and treated 145 male combatants, who were injured and treated at the Military Medical Clinical Center of the Northern Region (Kharkiv), aged 20-55 years. According to the data obtained during the study, the following non-psychotic disorders were noted in the surveyed combatants: acute stress reaction (F43.0) in 36.2 % of combatants, post-traumatic stress disorder (F43.1) in 32.1 %, prolonged depressive reaction (F43.21) in 11.3 %, mixed anxiety-depressive reaction (F43.22) in 12.2 %, depressive episode (F32.1, F32.2) in 8.2 % of combatants. We developed and tested a program of personalized psychotherapeutic support for combatants, based on the obtained data from clinical psychopathological features of non-psychotic mental disorders. It is proved that the developed program of psychotherapeutic support of combatants promotes productive dynamics of psychopathological symptoms, forms a feeling of self-sufficiency, psychological well-being, promotes improvement of interpersonal relations and general perception of quality of life. Keywords: combatants, mental trauma, psychotherapeutic support.

Peculiarities of the attention process at depressive disorders

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder, 141 patients with bipolar affective disorder and 98 people with prolonged depressive reaction. Peculiarities of the process of attention of patients with depressive disorders were the presence of a decrease in concentration, stability and switching of attention, decrease in work efficiency and working capacity. The peculiarities of the functioning of attention indicators were determined for various types of depressive disorders, which can use as diagnostic criteria in the differential diagnosis of cognitive impairment in depressive disorders. Key words: cognitive impairment, depressive disorders, persistence, concentration and switching of attention, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction

Level of immune complex reactions in non-psychothotic mental disorders in combatants

The level of immune complex reactions in combatants with non-psychotic mental disorders was studied. A clinical-psychopathological and clinical-biochemical examination of 95 combatants with non- psychotic mental disorders were conducted. In the clinical picture of prolonged depressive reaction, there was a decrease in mood, feelings of sadness, anxiety, anhedonia, asthenic manifestations, detachment, lack of hope, guilt of the survivor. Mixed anxiety-depressive reaction was characterized by low mood, feelings of depression, helplessness, insecurity, feelings of despair, sadness, isolated obsessive fears, doubts about the correctness of decisions and actions that are closely related to anxious thinking in relation to their assessment in the eyes of others. Post-traumatic stress disorder was manifested by low mood, anxiety, internal tension with inability to relax, danger, anxiety, flashback effects, symptoms of intrusion, asthenia, irritability, propensity to affective reactions. It was found that in the examined patients there was an increase in the concentration of circulating immune complexes, mainly due to the most pathogenic fractions of medium and low molecular weight and suppression of phagocytic activity of monocytes. Changes in immune complex reactions were most pronounced in post-traumatic stress disorder.

CHARACTERISTICS OF COGNITIVE IMPAIRMENT IN PATIENTS WITH DEPRESSIVE DISORDERS

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 people with prolonged depressive reaction (PDR). It was found that cognitive dysfunctions were less pronounced in patients with PDR, than in patients with RDD and BAR (p<0,035). Cognitive dysfunctions in depressive disorders was underlined by the presence of disorders in the mental sphere, in the sphere of attention, executive, visual-spatial and linguistic functions. The differential features of cognitive impairment in patients with RDD, BAR and PDR are highlighted and it should be taken during conducting differential diagnosis of cognitive impairment in depressive disorders. Keywords: patients with cognitive impairment, depressive disorders, cognitive dysfunctions, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction.

Modern model of formation for post-stress disorders among military service members and veterans

The clinical phenomenology of post-stress disorders was studied in combatants. We observed 150 servicemen of the Armed Forces of Ukraine, who took a direct part in the fighting in the ATO zone, in accordance with the principles of bioethics and deontology on the basis of the National Military Medical Clinical Center «Main Military Clinical Hospital» and the Military Medical Center of the Northern Region. It is shown, that the clinical structure of post-stress disorders in combatants is represented by posttraumatic stress disorder (PTSD), acute stress response and adjustment disorders. The clinical structure of PTSD in combatants is represented by anxious (35.2 % of men and 44.2 % of women), dysphoric (33.5 % and 9.4 %), asthenic (25.4 % and 32.6 %) and somatoform (5.9 % and 13.8 %) syndrome complexes. Adjustment disorders included prolonged depressive reaction (10.1 % of men and 15.7 % of women), mixed anxiety-depressive reaction (16.5 % and 10.2 %), adjustment disorders with a predominance of disturbances of other emotions (9.8 % and 7.4 %). The major risk factors for the development of stress-related disorders in combatants were identified: prolonged participation in combat, the need to see and touch the bodies of the dead, the threat of death from sniper’s fire, the death of friends in their own eyes, the impact of harmful combat factors, family conflicts, adverse social and economic circumstances. The correlation analysis was carried out. It was found, that the severity of psychopathological symptoms is determined by the severity of combat mental trauma. High scores on the Mississippi scale are associated with prolonged mental trauma (rxy=0.64), threat of death (rxy=0.58), death of comrades (rxy=0.54), participation in close combat (rxy=0.50), the offensive (rxy=0.41), the need to touch the bodies of the dead (rxy=0.46), with the killing of opponents (rxy=0.45). There is a strong correlation of combat mental trauma with anxiety intensity (rxy=0.78), fear (rxy=0.71), sense of internal tension (rxy=0.70), disturbance of the sleep-wake cycle (rxy=0.70), incontinence of affect (rxy=0.69) and depression (rxy=0.66). Keywords: post-traumatic stress disorder, adjustment disorders, acute stress response, combat mental trauma, correlation analysis.

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

Analysis of family anxiety in women with depressive disorders of different genesis and macrosocial, mesosocial and microsocial maladaptation of different expression

252 women with depressive disorders were examined: 94 people were with psychogenic (prolonged depressive reaction caused by adjustment disorder), 83 women were with endogenous (depressive episode; recurrent depressive disorder; bipolar disorder, current episode of depression) and 75 patients were with organic depression (organic affective disorders). 48 women had no signs of psychosocial maladaptation, the remaining 204 had manifestations of macrosocial, mesosocial and microsocial maladaptation of varying severity. The features of family anxiety in women with depression of various origins and different severity of macrosocial, mesosocial and microsocial maladaptation were investigated in order to determine the target targets of differentiated psychosocial rehabilitation of patients in this contingent. Clinical-psychopathological and psychodiagnostic methods were used. There was revealed a general tendency towards an increase in the indicators of family guilt, family anxiety and family tension as the degree of macrosocial, mesosocial and microsocial maladaptation increased. At the same time, the greatest differences in indicators were observed between the groups with moderate and severe maladaptation, and the smallest differences were observed between the groups without signs of disadaptation and with signs of mild maladaptation. The data obtained should be taken into account when developing treatment and rehabilitation measures for patients of this contingent.

PSYCHOSOCIAL DEZADAPTATION IN WOMEN WITH DEPRESSIVE DISORDERS OF DIFFERENT GENESIS: PECULIARITIES OF DIAGNOSTICS, DISEASES AND STRUCTURE

To create a diagnostic tool for measuring psychosocial maladjustment and its testing both on mentally healthy and on people with mental disorders, in particular, one of the most sensitive to this phenomenon group of women with depressive disorders of different genesis we examined 252 women who were diagnosed with a depressive disorder. The study included 94 people with depressive disorder of psychogenic genesis (prolonged depressive reaction due to adaptation disorder: F43.21 by ICD-10), 83 women with endogenous depression (depressive episode: F32.0, F32.1, F32.2, F32.3 for ICD-10; recurrent depressive disorder: F33.0, F33.1, F33.2, F33.3 for ICD-10; bipolar affective disorder, current episode of depression: F31.3, F31.4, F31. 5 for ICD-10) and 75 patients with a depressive disorder of organic genesis (organic affective disorders: F06.3 for ICD-10). The comparison group consisted of 150 mentally healthy women without a psychiatric history. The study was conducted using clinical, psychopathological and psychodiagnostic methods. In order to identify and quantify the degree of psychosocial maladjustment based on a comprehensive analysis of data on the characteristics of functioning in various fields, we have developed an original psychodiagnostic scale that allows you to isolate and evaluate key areas of psychosocial maladjustment. The scale is suitable for use in clinical practice and covers three main clusters of psychosocial functioning: macrosocial (provides for the assessment of socio-economic and socio-information maladaptation); mesosocial (provides an assessment of socio-professional and interpersonal maladjustment); microsocial (provides for an assessment of family and parent maladaptation). An assessment of the state of psychosocial maladjustment according to a survey of 252 patients with psychogenic, endogenous and organic depressive disorders allowed to establish that the severity of maladjustment in all 6 areas of patients with depressive disorders of organic genesis is heavy, endogenous - moderate, and psychogenic - light. The revealed patterns are important for the planning of psychoprophylactic and psychocorrectional measures in patients with depressive disorders of various origins