Polshkova S. Mental and psychosomatic disorders in persons of dangerous professions (Autoaggressive mechanisms of forming, diagnosis, clinical features, treatment)

The thesis is devoted to one of the current scientific and practical problems of psychiatry - integrated study of mental and psychosomatic disorders in persons of dangerous professions with autoagressive behavior. That will determine predictors and preventers autoagressive behavior in these persons, to improve diagnosis and develop a system of treatment of mental and psychosomatic disorders in these patients. With the help of clinical-psychopathology, experimental-psychological, clinical-anamnestic, information-analytical and statistical methods examined 534 patients (screening). As a result of screening in the first phase of the study was formed two groups - the main (354 persons of dangerous professions) and the control group (123 patients, whose trade had no danger). The study identified predictors of behavior in individuals autoagressive dangerous professions, studied and systematized clinical and phenomenological features of mental and psychosomatic disorders in workers dangerous professions based on the analysis of the pathogenetic mechanisms of the formation of a socio-psychological characteristics of the individual, conflict, his conscious and unconscious impulses and the motivations of life. Improved screening of auto-aggression and mental disorders in these patients, which allowed to identify risk groups individuals with elevated levels of auto-aggression for professional selection and provide more early intervention for these patients. In the second phase of the study was developed and tested system of treatment of psychiatric and psychosomatic disorders in workers dangerous professions (psychopharmacotherapy, individual and group therapy, physical therapy), to investigate its effectiveness based on the dynamics of indicators of anxiety and depression as a result of clinical scales HAM-A, HAM-D and CGI. For this purpose, the main group patients were divided into two therapeutic subgroups: subgroup "A" - the patients were treated by the system and the subgroup "B" - without psychotherapy.