Kosenko K. Clinical characteristics, diagnosis and prevention of borderline mental disorders in sailor of long sea

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number


Applicant for


  • 14.01.16 - Психіатрія


Specialized Academic Board

Д 64.566.01

State institution "Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Sciences of Ukraine"


The work is devoted to solving the problem of developing the concept of formation and development of borderline mental disorders in sailor of long sea (SLS) as a basis for a personalized approach to their diagnosis, treatment and prevention. The problem is solved on the basis of analysis of specific clinical-psychopathological, addictive and affective-conative manifestations, and identification of stress, socio-psychological and predisposition-biological clinical and pathogenetic factors, and determination of their role in the development of borderline mental disorders in this contingent. The study included 300 SLS, of which 200 were representatives of the merchant navy (110 of them – specialists of the command staff (SCS) and 90 – executive staff (SES) and 100 employees of the Ukrainian Navy (70 SCS and 30 SES). In the course of the work the hypothesis that the presence, severity and variability of borderline mental disorders (BMD) in SLS is determined by the specifics of their professional activity (type of navy, professional rank), which determines the predominance of stressors of psychoemotional or psychophysical content was confirmed; formation and development of BMD in SLS occurs against the background of a determining deficit of stress-protective resources of the individual and increased specific stress vulnerability (lack of viability and the presence of biological predisposition), which is potentiated by increasing family anxiety, distortion of stress mechanisms the action of which leads to the inability of the individual to neutralize the intense action of professional pathognomonic stressors, and the choice of pathological amortization and pseudocompensation of emotional and psychosocial discomfort through the formation of anxiety-depressive, affective-behavioral and / or addictive phenomena, reduces the stress-protective capabilities of the individual and promotes further progression of BMD. As a result, a personalized system of complex prevention and treatment of BMD in SLS was substantiated and developed. Complex consists of three stages, each of them contains several stages. The system allows to consistently solve the problem of diagnosis, assessment of probable prognosis of certain psychopathological phenomena, normalization of mental state and addictive status, correction of cognitive and behavioral deviations, activation of personal resource base and support of acquired skills to maintain mental health in sailor of long sea, in voyage and inter-voyage period. Evaluation of the effectiveness, conducted in 6 months after the start of therapy, proved its effectiveness in normalizing of mental state, acquiring skills to eliminate pathological stress and improve the seafarers quality of life.


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