The dissertation is devoted to the prevention of adverse medical consequences of adjustment disorders in students of higher education institutions who have experienced psychoemotional stress, a comprehensive program of diagnostic, therapeutic and rehabilitation measures aimed at their prevention and correction.
The aim of the study is to develop the principles of a comprehensive differentiated phased system of correction and a program for the prevention of adjustment disorders in students who have experienced psychoemotional stress based on the analysis of anamnestic, clinical, psychopathological and psychological characteristics of higher education students.
To achieve this goal, a comprehensive socio-demographic, clinical, anamnestic, psychopathological and psychodiagnostic examination of 249 students of both sexes was conducted in compliance with the principles of bioethics and deontology. The study was conducted at Dnipro State Medical University (DSMU) and Dnipro Basic Medical College (DBMC).
It was found that in the main group there are significant direct correlations between increased levels of components of personal anxiety and situational anxiety (p<0.001). According to the results of the study, students with high general indicators of personal anxiety and situational anxiety had significantly higher rates of somatization, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety according to the SCL-90-R (p<0.001). A high level of situational anxiety and personal anxiety had a significant direct relationship with asthenia (p<0.001), and worsened the overall level of quality of life and psychological well-being (p<0.001).
It was found that students who had experienced psychoemotional stress, with a high level of somatization and anxiety, significantly more often used sedatives as a means of overcoming stress (p<0.001).
It was found that the highest risk of forming existing signs of adjustment disorder with a high level of probability is observed in students with a high level of asthenia according to the asthenic state scale, which significantly correlates with the severity of psychopathological symptoms by the SCL-90-R method, the general indicator of situational anxiety, personal anxiety and its individual components by the IAT method; and also significantly worsens the overall quality of life and psychological well-being (p<0.001).
After the correctional, therapeutic and preventive measures, the results were monitored, maintained and consolidated. The analysis of the dynamics of psychopathological symptoms showed a significant reduction in the symptoms of anxiety and depression, a decrease in asthenia, and normalization of the emotional state. A significant leveling of clinical symptoms was observed, which was reflected in the control psychometric examination.
Based on the data obtained, a set of medical, educational, professional and psychosocial measures was substantiated and developed. The obtained algorithm for early detection of students with signs of stress-associated disorders and the proposed comprehensive phased differentiated system of correction and prevention programs for adjustment disorders can reduce the incidence of non-psychotic mental disorders, including maladaptive ones.
The scientific novelty of the results obtained in the dissertation is expanded and supplemented by scientific ideas about the specificity of manifestations of adjustment disorders in professional groups experiencing the stress of social change, namely in the group of higher education students of medical profile, internally displaced students, children of ATO soldiers, etc.
For the first time, the clinical and psychopathological features of adjustment disorders in students who have experienced psychoemotional stress are presented; individual psychological features and pathopsychological mechanisms of the formation of non-psychotic mental disorders in high-risk groups are systematized; socio-psychological patterns of adjustment disorders in students of medical higher education institutions who have experienced psychoemotional stress are determined.
A comprehensive phased differentiated system of correction and a program for the prevention of adjustment disorders in students who have experienced psychoemotional stress, aimed at effectively overcoming the manifestations of psychosocial maladjustment and stress-related disorders, and further preventive work, have been developed and implemented, and their effectiveness has been analyzed.
For the first time, the scheme of organization of medical and psychological monitoring of mental health, in terms of a personalized multimodal approach, complex medical, educational, professional and psychosocial measures to reduce the risk of non-psychotic mental disorders, including maladaptive ones, is presented.
