The dissertation presents a theoretical generalization and a new solution to the current scientific problem of psychiatry – the development of a system of early diagnosis, psychoprophylaxis and optimization of the provision of specialized psychiatric care (SPС) to internally displaced persons (IDPs) based on the study of clinical and psychopathological features of mental and behavioral disorders (SPT) in migrants. A total of 245 adult IDPs participated in the study, subject to informed consent, from which 130 people were selected. All respondents were conditionally divided into 3 groups: 1) a group of patients with somatic pathology (HPSP) – 43 IDPs (33%) – a contingent with previously diagnosed chronic diseases/disabilities according to the somatic profile; 2) a group of patients with mental pathology (HPMP) – 43 IDPs (33%) – respondents with a disability according to the mental profile; 3) a group of "conditionally" healthy (GCH) – 44 IDPs (34%) – persons who did not have severe chronic diseases/disabilities, complaints of mental state prior to military conflict. HPMP turned out to be the least vulnerable, which is due to the inability to fully understand the severity of the situation due to a decrease in intellectual and Mnestic functions against the background of the main psychopathology, leveling experiences with the features of the internal picture of the disease and taking psychopharmacological drugs. Based on this, 87 respondents from GCH and HPSP were selected for the main body of the study. It was found that in the MBD spectrum, the most specific weight in HPSP and GCH was adaptive (64.4%), generalized anxiety (3.5%), mixed anxiety and depressive (9.2%), other mixed anxiety (8.1%) disorders; depressive episodes of mild (4.6%) and moderate (8.0%) degrees; disorders mental and behavioral disorders due to substance use (alcohol) associated with health damage (13.8%); eating disorders: overeating associated with other psychogenic disorders (6.9%), PTSD (2.2% in GCH); one person with PTSD committed complete suicide by drowning – X71 (1.2%). The spectrum of adaptive disorders in IDPs includes: prolonged depressive reaction (18.4%), mixed anxiety-depressive reaction (36.8%) and adaptive disorder with a predominance of other emotions (9.2%) without differences between the groups.
In HPSP, the percentage of detected disorders was higher than the prevalence of the latter in comorbid somatic diseases, and the plot of emotional manifestations corresponded to the content of experienced psychotraumatic events, which indicates the appearance of mental phenomena associated with the psychotraumatic factor of armed conflict and forced displacement. At the fourth stage of work, GCH and HPSP were randomized to the main (MG) and comparative (CG) groups in a ratio of 1:1 (43 people in each group, 1 IDP dropped out due to suicide), taking into account age, gender, and the presence/absence of somatic pathology. The MG took part in the implementation of the system of early diagnosis, psychoprophylaxis and optimization of the provision of SPС to IDPs with MBD, and only standard therapeutic and preventive measures were carried out in the CG. The effectiveness of the system developed by us is proved by the positive dynamics of clinical and psychopathological manifestations of MBD, the improvement of all components of the quality of life of IDPs, and its introduction into the medical and diagnostic process has improved the health status of migrants, contributing to recovery and rapid integration into social processes.
