Authors:Yuliya Chelyadyn, Natalia Dzeruzhinskaya Abstract: Introduction. The prevalence of obsessive-compulsive symptoms in modern conditions of high stress and the lack of detailed recommendations for this category of patients determine the relevance of this publication. The emergence of suffering at a young age forms insufficiently adaptive behaviors and complicates the socialization of such persons. And the emergence of these symptoms within different etiological disorders requires the development of differentiated diagnostic and therapeutic approaches. Materials and methods. The study involved 69 outpatients with leading obsessive-compulsive disorder within schizotypal disorder (F21). The following methods were used: clinical-psychopathological, psychodiagnostic, clinical-follow-up and mathematical statistics. Patients were examined using psychodiagnostic techniques: clinical scale of obsessions and Yel-Brown compulsions (Y-BOCS - Obsessive-compulsive Scale); hospital anxiety and depression scale (HADS); quality of life scale (Chaban OS, 2008); multidimensional scale of perception of social support ("MSPSS" D. Zimet); questionnaire "Lifestyle Index" ("LSI" by R. Plutchik - G. Kellerman - H. R. Conte), method "Psychological diagnosis of coping behavior strategy" by R. Lazarus. Results. The clinical typology of these symptoms: type of avoidance, type of ambivalence and type of accumulation was studied by processing the clinical scale of obsessions and Yel-Brown compulsions (Y-BOCS) in patients with schizotypal disorder (F21). It was found that these symptoms were accompanied by anxiety and depressive symptoms only at the subclinical level, which indicates a lack of criticism of one’s condition. In patients with the leading obsessive-compulsive symptoms in schizotypal disorder, not quite mature variants of the protective structure are actualized, namely, substitution (62.3%), displacement (60.9%), regression (58%) and denial (26.1%). The leading coping strategies of such individuals are self-control (73.9%) and escape-avoidance (55.1%), which differs significantly from the strategies more often used by patients with ACS at the neurotic level. We have proposed a program of comprehensive treatment of this group of patients. Patients were divided into 2 groups, the first of which received a combined (differentiated psychopharmacological interventions and psychotherapy) option of therapy, and the second – only differentiated psychopharmacotherapy. The psychotherapeutic formulation was determined by different focus targets depending on the type of obsessive-compulsive symptoms and consisted of a combination of techniques of cognitive-behavioral therapy (CBT) and gestalt therapy (GT). The results of the follow-up study indicate the effective impact of the developed treatment and rehabilitation program on all components of the mental state and social functioning of patients with all types of obsessive-compulsive symptoms of subpsychotic level. Conclusions. The leading types of ACS in schizotypal disorder and features of psychosocial functioning in patients have been identified, which allowed to create a differentiated approach to the formation of a program of their comprehensive treatment and rehabilitation. Such persons need mandatory psychopharmacotherapy and differentiated psychotherapeutic intervention. The application of the program made it possible to improve the mental state and quality of life and achieve the optimal level of adaptation of patients in various spheres of life, increase periods of remission and prevent recurrence of the disorder. PubDate: 2022-06-14 DOI: 10.26766/pmgp.v7i1.360 Issue No:Vol. 7, No. 1 (2022)
Authors:Oleh Chaban Abstract: Professor Chaban's response to Dr. Arye Shalev's report "Surviving the hardships of war. Brief advice on survival for civilians in the circumstances of war stress" PubDate: 2022-06-13 DOI: 10.26766/pmgp.v7i1.359 Issue No:Vol. 7, No. 1 (2022)
Authors:Nataliia Voloshina, Iryna Bogdanova, Ivan Voloshyn-Gaponov, Serhiy Fedoseev, Lyudmila Tereshchenko, Taisia Bohdanova Abstract: In order to study the effectiveness of the motor rehabilitation program for Parkinson’s disease patients, 48 patients who underwent a course of motor rehabilitation using the phenomenon of paradoxical kinesia and subsequently followed the rehabilitation recommendations in different ways were clinically examined. It was found that patients who underwent an additional online rehabilitation program and subsequently followed the rehabilitation recommendations demonstrated a significantly better state of the psycho-emotional sphere compared to patients who underwent online rehabilitation, but did not follow the recommendations, and patients who did not undergo online online rehabilitation and did not follow the recommendations. The indicators in these groups were, respectively: on the HDRS scale: 10.18±3.64 points, 14.56±1.82 points and 17.87±3.27 points, respectively, on the A. Beck scale: 7.18±3 .94 points, 11.63±3.59 points, 20.93±13.43 points; according to the HADS depression scale: 9.06±2.88 points, 12.88±1.67 points, 15.13±2.33 points; according to the HARS scale: 18.41±4.29 points, 21.38±3.56 points, 29.40±8.12 points; according to the HADS anxiety scale: 9.06±2.16 points, 11.06±1.88 points, 13.73±3.17 points; reactive anxiety: 34.47±6.29 points, 39.63±4.98 points, 44.93±6.83 points; personal anxiety: 38.71±10.00 points, 40.38±5.92 points, 50.80±10.90 points; somatization: 0.68±0.19 points, 0.93±0.27 points, obsessive-compulsive symptoms: 0.44±0.73 points, 1.38±0.73 points, 1.89±0.46 points; interpersonal sensitivity: 1.22±0.32 points, 1.63±0.38 points, 1.96±0.26 points; depression: 1.46±0.53 points, 1.98±0.56 points, 2.67±0.78 points; anxiety: 1.89±0.35 points, 2.32±0.39 points, 2.68±0.27 points; hostility: 0.00±0.00 points, 0.03±0.13 points, 0.25±0.20 points; phobic anxiety: 0.55±0.31 points, 0.91±0.36 points, 1.19±0.32 points; psychoticism: 0.44±0.22 points, 0.51±0.26 points, 0.69±0.27 points. Full implementation of the program and recommendations also contributed to the improvement of quality of life indicators in all key areas. PubDate: 2022-06-10 DOI: 10.26766/pmgp.v7i1.358 Issue No:Vol. 7, No. 1 (2022)
Authors:Olena Smashna Abstract: Background. Understanding the complex relationships between combat injuries, physical health, and mental health symptoms is critical to meeting the healthcare needs of veterans. The relationship between head injuries, posttraumatic stress disorder (PTSD), and depression among combat-injured service members is unique to modern conflicts but understudied. Research suggests a relationship between PTSD and somatic complaints in veterans, suggesting that PTSD influences somatic complaints through underlying symptoms of depression and anxiety sensitivity. Aims. To investigate the dynamics of distress, depression, anxiety, and somatization in veterans with PTSD and mTBI after an 8-week comprehensive intervention (combining a psychotherapy program with transcranial direct current electrical stimulation (tDCS)). Methods. The data of the initial and repeated examination of 329 veterans from three clinical groups were analyzed: individuals with PTSD (n=109), with mild TBI (n = 112), and with PTSD+TBI comorbid condition (n=108). All patients received standard therapy as well as psychotherapeutic intervention and transcranial direct current electrical stimulation (tDCS). The Four-Dimensional Symptom Questionnaire (4DSQ) was used to assess distress, depression, anxiety, and somatization. The rank correlation between the primary and repeated examination data for each clinical group was also determined. Results. Patients suffering from PTSD or PTSD with mTBI had significantly more symptoms of depression, anxiety, and somatization than patients with mTBI without PTSD. After the therapy, patients from the PTSD and PTSD+mTBI groups experienced a subjective increase in the feeling of distress, which was associated with a reduction of mainly depressive and somatoform symptoms in the respondents of the PTSD+mTBI group, and in patients with PTSD with a decrease of mainly depressive and anxiety symptoms. In contrast, in the patients with TBI, there was no increase in the subjective feeling of distress, and the improvement of the mental state was accompanied by a decrease in the entire investigated spectrum of symptoms - depressive, somatoform, and anxiety. In patients with TBI, a higher level of distress at the primary examination led to a lower level of depression and distress at the repeated examination, and a high somatization score was correlated with its significant reduction under the influence of therapy. In the patients of the PTSD+mTBI group, a high index of somatization at the primary examination was correlated with a subjective increase in distress, but a decrease in somatization itself at the end of therapy. Conclusions. The presence and level of expressiveness of symptoms of distress, depression, anxiety, and somatization in persons with PTSD, TBI, and a combination of these painful conditions are closely related to the effectiveness of the complex intervention, which provides the possibility of differentiated targeted therapy of individual clinical groups of patients. PubDate: 2021-03-16 DOI: 10.26766/pmgp.v6i2.362 Issue No:Vol. 7, No. 1 (2021)
Authors:Olena Smashna Abstract: Background. Significant numbers of veterans with mild traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD), usually co-morbid, have functional impairments in various areas of life, which significantly complicate the process of their readaptation and resocialization. They experience significant persistent limitations in daily life, including problems with occupational, family, social activities, and self-care due to a combination of emotional, cognitive, and behavioral impairments that should be targets of intervention, including transcranial stimulation and psychotherapy. Aims. To investigate the effectiveness of a complex intervention, namely the combination of a psychotherapy program with transcranial direct current electrical stimulation (tDCS) in the treatment of patients with PTSD and mTBI by assessing their level of functioning. Methods. Examination data of 329 veterans from three clinical groups were analyzed: individuals with PTSD (n=109), mild TBI (n = 112), and with comorbid PTSD+TBI (n=108). All patients received standard therapy as well as psychotherapeutic intervention (a combination of psychoeducation with elements of motivational interviewing and acceptance and commitment therapy for PTSD (ACT) and transcranial direct current electrical stimulation (tDCS). According to the WHODAS 2.0 scale, the level of functioning was determined in six domains: cognition (CW); mobility (MW); self-care ( SW); relationships (RW); daytime activity (LW); social activity (PW); general level of functioning (WHO). A rank correlation was also determined between individual criteria of the CAPS-5 scale and domains of the WHODAS 2.0 test. Results. In patients of all clinical groups, the most pronounced disorders were in the cognitive sphere (CW), the sphere of relationships (RW), social (PW), and daytime activity (LW). The combination of PTSD and TBI was associated with more significant and persistent cognitive impairment, as well as reduced daytime activity. In the majority of respondents, the indicators of all scales of the WHODAS 2.0 methodology at the second examination were significantly lower than at first, which indicated the effectiveness of the therapy. The state of the cognitive sphere turned out to be essential for the effective psychotherapeutic effect on patients both within the PTSD group and with CCM. The connection of separate domains of WHODAS 2.0 with pathological symptoms of PTSD determines the recommendations to increase the duration of the therapeutic program specifically for the group of PTSD. Conclusions. Impairment of functioning in persons with PTSD, TBI, and the combination of these painful conditions is closely related to the presence and expressiveness of PTSD symptoms, which provides the possibility of differentiated targeted therapy for certain clinical groups of patients. PubDate: 2021-02-11 DOI: 10.26766/pmgp.v6i1.361 Issue No:Vol. 7, No. 1 (2021)
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