The dissertation is devoted to the complex study of clinical and psychological manifestations and risk factors for the development of functioning disturbance in families, where patients with endogenous mental disorder live; development and scientific substantiation of a complex system of appropriate medical and psychological support. The dissertation presents theoretical justification and practical solution to the current problem of modern medical psychology - new approaches to medical and psychological support for families, where patients with endogenous mental disorders live, based on identification of psychological components and predictors of deformation of family adaptive potential. The study was based on a survey of 541 persons, of whom 243 - patients with endogenous mental disorders, 168 – family caregivers of patients with paranoid schizophrenia, 75 persons - family caregivers of patients with affective disorders and 55 healthy people, who do not have a mentally ill family member. Differences in the psychopathological profile of endogenous mental disorders, depending on the total duration of the disease, have been identified. The typology of psychopathological profile in patients with paranoid schizophrenia was represented by apathic-abulic (48.8%), depressive-paranoid (34.5%), depressive-hypochondriac (11.3%) and paraphrenic (5.4%) syndromes. Syndromes, leading in the psychopathological profile of patients with affective disorders, were anxiety-depressive - 49.3%, depressive-hypochondriac - 32.0%, asthenic-depressive - 18.7% syndromes. Study of the attitude typology in family caregivers in families, where a patient with endogenous mental disorder lives, allowed to identify certain features, that were determined by the total duration of pathological process in patients. Thus, during the initial stages of the disease (up to 4 years), an adequate type of attitude of family caregivers to the patient's disease prevails, which creates favorable basis for medical and psychological interventions. As the pathological process develops, the dominant position is taken by dramatizing and negative types of attitudes from the side of family caregivers (p <0.001). Identification of psycho-emotional, individual-psychological, interpersonal-communicative and psychosocial descriptors of adaptive potential in families with patients with endogenous mental disorders, allowed to determine features of particular stages of development of changes in family homeostasis with different duration of the disease in a family member. Taking into consideration specifics of clinical and psychopathological manifestations, psychopathological features and mechanisms of deformation of family adaptive potential, depending on the nosological affiliation and duration of endogenous mental disorder, a complex system of medical and psychological support for the family with endogenous mental disorder, which is based on elements of psychoeducation for patients, psychocorrection by methods of cognitive-behavioral therapy; mindfulness-oriented cognitive therapy; psychological training; art therapy and psycho-educational interventions for family caregivers, considering clinical-dynamic and nosological development of mental disorder and the stage of deformation of family adaptive potential. According to the results of approbation of the proposed system of medical and psychological support, its high efficiency is confirmed.
