The dissertation provides a theoretical substantiation and proposes a novel solution to an important problem of contemporary psychiatry, namely, improving the effectiveness of treatment of non-psychotic mental disorders in combat veterans through the implementation of psychoeducation as a means of enhancing treatment adherence, strengthening motivation for therapy, and promoting psychosocial adaptation.
The study involved 410 combat veterans aged 18–65 years. The empirical part included clinical psychopathological assessment, psychodiagnostic examination using standardized instruments for evaluating anxiety, depression, post-traumatic stress symptoms, cognitive functioning, and psychophysiological status, as well as modern statistical methods of data analysis. To evaluate the effectiveness of the psychoeducational program, participants were randomly allocated to an experimental group (n = 332) and a control group (n = 78).
The study demonstrated that the structure of non-psychotic mental disorders was dominated by neurotic, stress-related, and somatoform disorders (45.2 %), followed by organic mental disorders (36.4 %), affective disorders (9.0 %), mental and behavioural disorders due to psychoactive substance use (6.3 %), and personality and behavioural disorders (3.1 %). A high level of psychiatric comorbidity was identified, with the most common combination being post-traumatic stress disorder (PTSD) and anxiety disorders, followed by PTSD with depressive disorders.
The clinical presentation of non-psychotic mental disorders was characterized by the predominance of anxiety, depressive, asthenic, and post-traumatic syndromes, accompanied by cognitive impairment. Significant associations were identified between anxiety, depression, post-traumatic stress symptoms, psychophysiological functioning, and cognitive performance. Cluster, factor, and regression analyses made it possible to identify typological profiles of psychopathological responses and determine predictors of psychopathological disorders.
A psychoeducational program was scientifically substantiated, developed, and implemented based on the biopsychosocial model of mental disorders, the principles of psychosocial rehabilitation, and the concept of the patient's active participation in the therapeutic process. The program comprises three consecutive modules: informational-educational, motivational-psychocorrectional, and adaptive-rehabilitation. It is aimed at improving mental health literacy, treatment adherence, psychological self-regulation skills, and psychosocial adaptation.
The effectiveness of the proposed program was confirmed by a statistically significant reduction in anxiety, depressive and post-traumatic symptoms, emotional exhaustion, sleep disturbances, and intrusive memories, as well as by an overall improvement in the psychoemotional state of combat veterans. Participants in the experimental group demonstrated significantly greater improvements in anxiety and depression scores after completion of the psychoeducational program compared with the control group.
Scientific novelty. For the first time, a comprehensive characterization of the psychoemotional profile of combat veterans with non-psychotic mental disorders during psychoeducational intervention has been provided. The relationships among affective functioning, post-traumatic stress response, psychophysiological status, and cognitive functioning in the development of psychopathological manifestations have been comprehensively evaluated. Predictors of psychopathological disorders have been identified, and approaches to improving treatment effectiveness have been substantiated. A psychoeducational program for combat veterans with non-psychotic mental disorders has been scientifically developed and validated for implementation at all stages of medical and psychological care. Furthermore, current knowledge regarding the structure, prevalence, nosological and syndromological characteristics of mental disorders, as well as the affective, post-traumatic, psychophysiological, and cognitive features of combat veterans, has been expanded.
Practical significance. The study proposes, for the first time, a comprehensive algorithm of psychoeducational interventions aimed at improving the effectiveness of treatment of non-psychotic mental disorders through enhanced patient engagement and treatment adherence. The implementation of the proposed program contributes to reducing the severity of psychopathological symptoms, improving mental health outcomes, and decreasing the risk of mental health disorders among combat veterans.
