Chernenko I. Formation of post-traumatic stress disorder among combatants (risk factors, prevention, therapy, rehabilitation)

The dissertation is devoted to the development of the prevention and forming of the algorithms of personified programs in therapy and rehabilitation for combatants with PTSD based on the results of complex clinical psychopathological, psychodiagnostics and socio-demographic research. There were examined 150 combatants in the ATO zone. This contingent was represented by two groups of comparison, i.e.: 93 PTSD combatants (group 1) and 57 conventionally healthy combatants (group 2). The following research methods were used: clinical-psychopathological, clinical-anamnestic, socio-demographic, psychodiagnostics and methods of mathematical statistics. It was established that the greatest contribution to the combined risk of forming PTSD for combatants is: prolonged or serious (self-identified and named) psych trauma during combat operations (DC = 16.51, MI = 6.33), sensation of problems with somatic health (DC = 13.78, MI = 5.54) and their desire to withdraw from the Ukrainian Armed Forces (DC = 14.31, MI = 3.26). It was shown that affective, asthenic and psychosomatic manifestations predominate in the mental status of combatants (p <0.001) (the average informative nature of the questions regarding these manifestations (ΣMI (measure of informativeness)/ n) was 2.16, 1.77 and 1.32 units, respectively); while obsessive, hypochondriacal and hysterical manifestations were expressed among them much more weaker (1.17, 0.57 and 0.30 units, respectively). The following psychometric methods such as: SCL-90R (ΣavMI = 4.51) and the estimation of severity of sleep disturbances Y.I Levin (ΣavMI = 3.37) were proved as the most informative in terms of diagnostics of PTSD (by the indicator of ΣavMI). On the basis of the conducted research, a complex medical and rehabilitation program for combatants was created, which includes the following components: a clinical diagnostic program; a complex of methods, procedures and algorithm for conducting psychotherapy and psychopharmacotherapy of state of inadaptation among combatants; as well as the algorithm of personalized application of the developed programs (therapeutic and rehabilitation route) for combatants with PTSD. As a result of approbation of the proposed integrated treatment and rehabilitation program, it has been established that it provides smoothing of PTSD symptoms in 84.78% cases in the main group and 65.22% in the control group accordingly.