PATHOPSYCHOLOGICAL FACTORS OF DISADAPTIVE STATES IN AFFECTIVE DISORDERS OF NEUROTIC GENESIS

Скрипников А. Н., Животовская Л. В., Боднар Л. А., Животовская А. И.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Currently, affective disorders of neurotic genesis and associated psychological and social disadaptation are among the topical problems of present-day psychiatry. The aim of the research was to study the pathopsychological features of disadaptive states in patients with affective disorders of neurotic genesis. The comprehensive examination of 65 patients (46 women and 19 men) aged from 21 to 49 years was carried out. According to ICD-10, 29 patients were diagnosed with adaptation disorders (F43.2), 15 patients presented with neurasthenia (F48.0), 12 patients −with mixed anxiety and depressive disorder (F41.2) and 9 patients −with hypochondriacal disorder (F45. 2). Clinical-psychopathological, psychodiagnostic and statistical methods of investigation were used to assess the patients’ condition. According to the level of psychosocial disadaptation, three clinical groups representative of age and sex were formed: 1 group included 22 patients with insignificant disadaptation, 2 group included 23 patients with moderate disadaptation, and 3 group included 20 patients with severe disadaptation. The analysis based on the data of mental state assessment of patients using HADS scale has found that among the symptoms of the depressive circle, namely, feeling of anhedonia (1.55 ± 0.17 and 2.15 ± 0.15 points, respectively , p = 0.01) and decreased activity (1.41 ± 0.20 and 2.25 ± 0.15, p = 0.006) were significantly lower in patients of 1 group compared to 3 one. Among the symptoms of anxiety, reliably lower (p = 0.01) were complaints of constant tension feeling (1.68 ± 0.20 and 2.35 ± 0.17 points, respectively) and restless thoughts (1.23 ± 0.18 and 1.9 ± 0.20) in 1 group of patients compared to 3 group, complaints of restless thoughts (1.35 ± 0.17 and 1.9 ± 0.20, p = 0, 04) were presented by examined patients of 2 group in comparison with group 3. While diagnosing coping mechanisms for conflict situations management, it was determined that non-adaptive coping strategies significantly prevailed in 3 group of patients in comparison with 1group: behavioral −in 70.0 ± 10.25% and 9.1 ± 6.13%, respectively, χ2 = 16.481, p <0.01, cognitive −in 65.0 ± 10.67% and 18.2 ± 8.22%, χ2 = 9.531, p <0.01, emotional −in 60.0 ± 10. 95% and 27.3 ± 9.49%, χ2 = 4.582, p <0.05. However, examined patients of 3 group did not present with adaptive variants of coping behavior, which significantly prevailed in 1group: behavioral −in 40.9 ± 10.48% of cases, χ2 = 10.413, p <0.01, cognitive – in 45.4 ± 10.62%, χ2 = 11.932, p <0.01, emotional −in 31.8 ± 9.93%, χ2 = 7.636, p <0.01. Significant differences in the adaptive models of coping behavior were not determined when comparing the examined groups, although they were more common in groups 1 and 2. When investigating the level of social frustration, it was determined that significantly higher rates were found in 3 group of patients compared to group 1 (χ2 = 11.165, p <0,01), indeterminate level − in group 1 (χ2 = 11.165, p <0.01) and moderate level −in 1 (χ2 = 11.165, p <0.01) and 2 group (χ2 = 11.165, p <0.01) in comparison with 3 group. The study regarding the level of subjective loneliness feelings revealed that in patients of 3 group, the high level prevailed −65.0 ± 10.67% compared to group 1 −27.3 ± 9.49%, (χ2 = 6.019, p <0.05) and 2 group −34.8 ± 9.93%, (χ2 = 3.909, p <0.05); the low level of loneliness was significantly higher in patients of 1 group than in group 3 −45.4 ± 10.62% and 10.0 ± 6.71%, respectively (χ2 = 6.453, p <0.05). Thus, the main pathopsychological factors of disadaptive states formation in patients with neurotic disorders have been identified in research, which were the targets for psychotherapeutic correction and psychological support, differentiated depending on the level of psychosocial disadaptation.

affective disorders of neurotic genesis, psychopathological characteristics, psychosocial disadaptation

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«Bulletin of problems biology and medicine» Issue 1 Part 1 (142), 2018 year, 177-181 pages, index UDK 616.89-008:616.895-02:616.8

10.29254/2077-4214-2018-1-1-142-177-181