The dissertation research was conducted on the basis of analysis of clinical-psychopathological and pathopsychological features of patients with human immunodeficiency virus who had concomitant neurotic disorders, in order to identify pathogenetic patterns of deviant behavior in this cohort of patients and develop criteria for diagnosis, correction and prevention. For which clinical-anamnestic, clinical-psychopathological, psychodiagnostic and statistical research methods were used.
The dissertation was performed within the research department of Psychiatry, Narcology and Medical Psychology of Dnipro State Medical University: "Optimization of psychiatric care and psychosocial rehabilitation of patients with psychosomatic and somatopsychic disorders in accordance with modern conditions", work code IH.047017, state register.
In total, the study, with informed consent, involved 114 patients with human immunodeficiency virus disease, aged 21 to 62 years, who were treated at the Municipal Enterprise "Dnipropetrovsk Regional Center for Socially Significant Diseases" of the Dnipro Regional Council and had symptoms non-psychotic level. Depending on the presence of deviant behavior of patients was divided into two groups of observations: the first (main) group consisted of 51 patients (44.7%) with signs of deviant behavior, the second (comparison) group - 63 patients (55.3%) without signs of deviant behavior .
Analysis of the distribution of neurotic disorders throughout the sample revealed a prevalence of reactions to severe stress and maladaptation and other anxiety disorders. Psychopathological and pathopsychological risk factors for deviant behavior in neurotic disorders in HIV-infected people were identified and a model for predicting deviant behavior was developed based on personality indicators, the level of depressive symptoms and the overall severity index of psychopathological symptoms. Statistical evaluation of the logistic regression equation showed its significance: χ2 = 60.25 (p <0.001). Early prognostic criteria for the risk of deviant behaviors have been established, which allow to improve the measures of primary prevention of behavioral disorders
Scientific novelty of the obtained materials. For the first time on the basis of complex clinical-anamnestic, clinical-psychopathological, psychodiagnostic and statistical researches the data on features of neurotic frustration at HIV-infected with signs of deviant behavior are received. For the first time the pathogenetic patterns of deviant behavior in neurotic disorders in HIV patients were studied, diagnostic criteria for deviant behavior in HIV-infected people with neurotic disorders were formulated and the role of socio-psychological factors in its occurrence was proved.
For the first time, a logistic model for predicting the probability of deviant behavior based on the severity of psychopathological symptoms, levels of anxiety and depression in HIV-infected people has been developed.
For the first time, a set of treatment and prevention measures for neurotic disorders accompanied by deviant behavior in HIV-infected people has been developed. For the first time, the principles of differential treatment of neurotic disorders in HIV-infected patients depending on the presence of deviant behaviors and neurotic disorders were formulated.
Practical significance of the results obtained. Clinical-psychopathological and socio-psychological characteristics of HIV patients with neurotic mental disorders, which contribute to the formation of mental maladaptation and the development of deviant behaviors among this group of patients. The obtained results allowed to create prognostic criteria for the formation of deviant behavior in HIV-infected people with neurotic disorders for use in outpatient and prehospital stages of psychiatric care, and they can be used by infectious disease specialists and general practitioners.
The effectiveness of complex psychopharmacological and psychotherapeutic correction of deviant behavior in neurotic disorders in the framework of treatment-diagnostic and rehabilitation measures in HIV is substantiated.
The use of the obtained data in psychiatric, infectious and family medicine practice will lead to timely detection of deviant behaviors among HIV-infected patients with neurotic disorders and will increase the effectiveness of treatment and rehabilitation measures in this group of patients at all stages of deviant behavior.
Key words: HIV, neurotic disorders, deviant behavior, depression, anxiety, correction, prevention.
