Zhyvilova Y. Psychosocial rehabilitation of patients with mental disorders of organic origin in a psychiatric hospital with strict supervision

Psychosocial rehabilitation of patients with mental disorders of organic origin in a psychiatric hospital with strict supervision The study solved an important task of modern clinical psychiatry - the development of a psychosocial rehabilitation system for patients with organic brain lesions who have committed socially dangerous actions and are being treated in a psychiatric hospital with strict supervision based on the study of the clinical structure and pathopsychological mechanisms for the formation of mental disorders of organic origin. In the overwhelming majority of patients who have committed socially dangerous actions, mental and behavioral disorders due to illness, damage, dysfunction of the brain, or somatic illness are found (F 07 according to ICD-10). In 40% of patients, the leading syndromes are dementia and psychoorganic ones; in 30% of patients - syndromes of productive personality disorders (hallucinatory, hallucinatory-paranoid, paranoid) in 30% of patients - personality disorders caused by organic brain lesions (asthenic, epileptiform, convulsive, twilight, anxious-depressive syndromes). All patients studied showed a decrease in both general and verbal and non-verbal intelligence. For all patients, the prevalence of reactive anxiety indicators over personal anxiety is characteristic, in patients with leading dementia and psychoorganic syndromes both indicators are in the moderate range, in patients with leading personality disorders caused by organic brain lesions and leading syndromes of productive personality disorders - in the high values. Patients with the leading syndromes of productive personality disorders are distinguished by the absence of signs of depression, patients with dementia and personality disorders caused by organic brain lesions, the presence of signs of mild depression. High levels of the index of general and motivational aggressiveness, a rather high index of hostility indicate the presence of a high risk of re-committing socially dangerous acts. For all patients, significant decrease in the quality of life and the prevalence of non-constructive compliance options is typical. The system of psychosocial rehabilitation is developed according to the stepwise and multimodal principles. Testing of the system proved its high efficiency and allowed to reduce the duration of stay in a psychiatric hospital with strict supervision by an average of 6 months.