Clinical characteristics of manifestations of combat mental pathology in combatants

Clinical characteristics of manifestations of combat mental pathology in combatants

 

Authors

 

N.A. Bokhan

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation; Federal State Budgetary Educational Institution of Higher Education “Siberian State Medical University” of the Ministry of Health of the Russian Federation, Tomsk, Russian Federation

O.V. Roshchina

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

A.V. Didenko

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation; Federal State Budgetary Educational Institution of Higher Education “Siberian State Medical University” of the Ministry of Health of the Russian Federation, Tomsk, Russian Federation

V.F. Lebedeva

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

 

https://doi.org/10.26617/1810-3111-2023-3(120)-80-86

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 3 (120):  80-86.

 

Abstract

Background. Today, the attention of domestic and foreign researchers is attracted by the problem of comprehensive (physical, mental, social and labor) rehabilitation of persons who took part in hostilities. Of particular interest is the study of psychopathological, psychological, psychosocial characteristics and mechanisms of development of decompensation and maladjustment in combatants who, during their service, are exposed to multidirectional negative influences, the combined influence of which on mental health leads to the development of polymorphic and highly comorbid pathology, which poses the task of modern researchers to study disorders associated with participation in combat operations, to increase their detection and develop effective approaches to psychopharmacotherapy and rehabilitationObjective: to study the clinical and therapeutic features of mental disorders that develop under the influence of specific factors in a combat situation, using the example of patients at the Mental Health Research Institute of the Tomsk National Medical Research Center undergoing rehabilitation after participating in armed conflicts. Material and Methods. The research sample consisted of men (n=20) with an average age of 45 years (29.5; 51.75). Results. In accordance with the ICD-10 criteria, in the sample of combatants the following were diagnosed with the highest frequency: post-traumatic stress disorder (F43.1) ‒ 45%, adaptive reaction disorder (F43.2) ‒ 25%. Comorbidity with cerebral-organic pathology (organic, including symptomatic, mental disorders, F00-F09 according to ICD-10) was revealed ‒ 15%. In the syndromic aspect, sleep disturbances (95%) with nightmares (60%), a feeling of internal tension and decreased mood (85%), irritability (80%) were noted. According to the results of psychopathological, pathopsychological and neurological examination of combatants, a decrease in social adaptation (40%), organic cognitive impairment (45%), and symptoms of neurological diseases (50%) were found. Antidepressive therapy is used in personalized patient management programs: AIZS ‒ 41.2%, SSRIs ‒ 35.3%, TCAs (17.6%), often in combination with an antipsychotic (50%). Conclusion. The high comorbidity and clinical polymorphism of mental disorders among combatants dictates the need to use a wide arsenal of diagnostic, psychopharmacological and psychotherapeutic tools to provide highly qualified personalized care to each patient

 

Keywords: combatants, prolonged psychological trauma, post-traumatic disorders, comorbidity, clinical typology, psychopharmacotherapy, comprehensive rehabilitation.

 

Article (pdf)

 

Contacts

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Materials  

For citation: Bokhan N.A., Roshchina O.V., Didenko A.V., Lebedeva V.F. Clinical characteristics of manifestations of combat mental pathology in combatants. Siberian Herald of Psychiatry and Addiction Psychiatry.2023; 3 (120): 80-86. https://doi.org/10.26617/1810-3111-2023-3(120)-80-86.

 

REFERENCES

  1. Shamrey VK, Marchenko AA, Driga BV, Markin KV, Moiseev DV. Outcomes of inpatient treatment for post-traumatic stress disorder in combatants. Modern Therapy of Mental Disorders. 2022;3:14-24. doi: 10.21265/PSYPH.2022.80.39.002 (in Russian).
  2. Shamrey VK, Lytkin VM, Barazenko KV, Zun SA. PTSD development and dynamics. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2023;1:68-77 doi: 10.25016/254174872023016877 (in Russian).
  3. Pavlova I, Graf-Vlachy L, Petrytsa P, Wang S, Zhang SX. Early evidence on the mental health of Ukrainian civilian and professional combatants during the Russian invasion. Eur Psychiatry. 2022 Nov 21;65(1):e79. doi: 10.1192/j.eurpsy.2022.2335. PMID: 36408566; PMCID: PMC9724216.
  4. Bryant RA, Schnurr PP, Pedlar D; 5-Eyes Mental Health Research and Innovation Collaboration in military and veteran mental health. Addressing the mental health needs of civilian combatants in Ukraine. Lancet Psychiatry. 2022 May;9(5):346-347. doi: 10.1016/S2215-0366(22)00097-9. Epub 2022 Mar 16. PMID: 35305300.
  5. Epanchintseva EM, Kazennykh TV, Lebedeva VF, Bokhan NA. Clinical structure of mental disorders among participants in local armed conflicts in the long-term post-combat period. Advances of Modern Natural Science. 2015;1(5):760-764(in Russian).
  6. Schein J, Houle C, Urganus A, Cloutier M, Patterson-Lomba O, Wang Y, King S, Levinson W, Guérin A, Lefebvre P, Davis LL. Prevalence of post-traumatic stress disorder in the United States: a systematic literature review. Curr Med Res Opin. 2021 Dec;37(12):2151-2161. doi: 10.1080/03007995.2021.1978417. Epub 2021 Sep 23. PMID: 34498953.
  7. Haydabrus A, Santana-Santana M, Lazarenko Y, Giménez-Llort L. Current war in Ukraine: lessons from the impact of war on combatants' mental health during the last decade. Int J Environ Res Public Health. 2022 Aug 24;19(17):10536. doi: 10.3390/ijerph191710536. PMID: 36078250; PMCID: PMC9518138.
  8. Rahnejat AM, Ebrahimi M, Khoshdel A, Noorbala AA, Shahmiri Barzoki H, Avarzamani L, Avakh F, Taghva A. The prevalence of depression among iran-iraq war veterans, combatants and former prisoners of war: A systematic review and meta-analysis. Int J Psychol. 2022 Apr;57(2):295-305. doi: 10.1002/ijop.12813. Epub 2021 Oct 4. PMID: 34608645.
  9. Vafaee B. Investigation of 400 cases of mental disorders caused by the war in Razi Hospital of Tabriz. Medical Journal of Tabriz University of Medical Sciences and Health Services. 1996;30(31):68-77.
  10. Lim ICZY, Tam WWS, Chudzicka-Czupała A, McIntyre RS, Teopiz KM, Ho RC, Ho CSH. Prevalence of depression, anxiety and post-traumatic stress in war- and conflict-afflicted areas: A meta-analysis. Front Psychiatry. 2022 Sep 16;13:978703. doi: 10.3389/fpsyt.2022.978703. PMID: 36186881; PMCID: PMC9524230.
  11. Abuhadra BD, Doi S, Fujiwara T. The prevalence of post-traumatic stress disorder, depression, and anxiety in Libya: a systematic review. Middle East Curr Psychiatry. 2023;30,49 https://doi.org/10.1186/s43045-023-00322-4
  12. Azizian A, Terzyan L, Gasparyan K, Khachatryan S, English P. Inpatient residential treatment program for combat-related posttraumatic stress disorder (PTSD): Results from the 2020 Artsakh (Nagorno-Karabakh) War. Mil Psychol. 2023 May-Jun;35(3):252-261. doi: 10.1080/08995605.2022.2117536. Epub 2022 Sep 1. PMID: 37133545; PMCID: PMC10197988.
  13. Reznik AM. Mental disorders in veterans of local wars who have suffered traumatic brain injury. Health, Food & Biotechnology. 2020;2(1):11-21. doi: 10.36107/hfb.2020.i1.s168 (in Russian).
  14. Streminsky SYu, Sheremetyeva II, Stroganov AE, Leshchenko LV, Kuryshkin VI, Kuleshova EO. Psychotherapeutic target symptoms in combatants with organic brain diseases associated with an adaptation disorder. Siberian Herald of Psychiatry and Addiction Psychiatry. 2020; 2 (107): 67–74. https://doi.org/10.26617/1810-3111-2020-2(107)-67-74 (in Russian).
  15. Vasileva AV, Karavaeva TA, Radionov DS, Starunskaya DA. Diagnostic algorithm for post-traumatic stress disorder. V.M. Bekhterev Review of Psychiatry and Medical Psychology. 2023;57(1):83-95. doi: 10.31363/2313-7053-2023-741 (in Russian).