Lakynskyi R. Suicide activity of patients with depressions and reactions to severe stress (risk factors, differential diagnostics and treatment)

The dissertation presents the theoretical generalization and new resolve of actual problem - the optimization of methods of differential diagnostics and treatment of patients with depressions and reactions to severe stress, burdened with suicidal activity, based on results of the comparative analysis of their socially demographic, clinical, psychopathological and psychodiagnostic characteristics. The medical documentation about 809 cases of the complete and 775 cases of not complete suicide attempts (monitoring-contingent) was analyzed. Besides the study involved 30 patients with a depressive episode and recurrent depressive disorders (disorders F32-33 in ICD-10) and 60 patients with reactions to severe stress with adjustment disorders" (disorders F43 in ICD-10) which have carried out not complete suicide attempts (clinical contingent) was surveyed. Through complex clinical psychopathological, psychodiagnostic (using: Hamilton and Zung depression scales, Spilberger-Khanin State-Trait Anxiety Inventory, technique for diagnostics of the latent suicide intentions) and methods of mathematical statistics are defined informative predictors of completion of suicide attempts, and also additional markers for differential diagnostics of depressive disorders and reactions to severe stress. The method of complex treatment-and-prophylactic intervention with use of standard therapy together with the modified variant of cranial-cerebral hypothermia (patent №75654) is offered. It is established that the offered variant of treatment (in comparison with standard therapy only): in patients with disorders F43 provides 3,09 times bigger (p<0,001) reduction of psychasthenia symptoms and 2,72 times bigger (p<0,001) reduction of suspiciousness (estimated by technique of diagnostics of the latent suicide intentions); and in patients with disorders F32-33 provides significantly (p<0,001) bigger reduction of depressive symptoms: 1,47 times for Hamilton scale and 1,45 times for Zung scale.