AFFECTIVE DISORDERS IN LONG-TERM CONSEQUENCES OF POST-TRAUMATIC STRESS

Zhyvotovska L. V., Skrypnikov A. M., Sokil A. A., Boiko D. I.

LITERATURE REVIEWS

Scentific article

The extreme and life-threatening situations provoke the development of response to severe stress in the form of acute and post-traumatic stress disorders. Post-traumatic stress disorder (PTSD) is one of the most frequent and unfavorable forms of mental disorders in people who have experienced life-threatening situations. According to the recent research data the post-traumatic stress disorders in combatants of combat operations in the East of Ukraine have delayed and chronic form. Moreover, it has been determined that the long-term manifestations of chronic PTSD in combatants depend on its clinical variant. In 2-3 years after the onset of disease the patients with PTSD presented with the development of affective-unstable type of personality disorder in combination with social exclusion, alienation and hostility towards others. Manifestations of affective-unstable type of personality in patients were characterized by emotional instability, tendency to impulsive actions disregarding the possible consequences, outbursts of violence, affective-destructive forms of behavior in response to disapproval and criticism. As the result of the addictive PTSD type development, the systematic (almost daily) alcohol consumption to influence the “reexperience” and “flight” syndromes was registered in patients at the long-term stage. Moreover, in 100% of combatants with this type of PTSD, the primary pathological craving for alcohol was registered. In case of neurosis-like clinical variant of PTSD development, the long-term effects in the form of “energy reduction” was observed in 70.49% of patients and “loss of interests and pleasure” (anhedonia) − in 49.18% of cases. The loss of pleasure also affected the vital functions, such as sexual relations, feeling of thirst, hunger and taste of food. In 31.57% of patients the episodic paroxysmal anxiety (panic attacks) was observed. The study conducted has determined that in 75% of people who experienced psycho-emotional stress in long-term variant the somatogenic predisposition was associated with local (organ) somato-vegetative dysfunction or certain psychosomatic diseases in combination with neurosis-like psychopathological disorders and focal symptoms of organic nature. About 70% of suicidal acts in case of depressive states were associated with the problems of interpersonal relations of combatants with other people after their return from the combat area. Despite the fact that the percentage of the diagnosed post-traumatic stress disorder has been growing in recent years, there are few researches regarding emotional and personality disorders in the period of long-term effects in case of combat psychic traumas. Thus, the study of affective disorders in case of long-term effects of post-traumatic stress remains relevant issue in the modern psychiatry. The priority direction is the study of predictors, mechanisms of development and clinical features of long-term post-traumatic stress effects, which will make it possible to improve the present-day rehabilitation programs, quality of live indicators and return patients to full-fledged social functioning.

post-traumatic stress disorder, long-term effects, affective disorders

1. Voloshin PV, Shestopalova LF, Pidkoritov VS. Posttravmatichni stresovi rozladi: diagnostika, likuvannya, reabilitatsiya: metod. rek. Harkiv; 2002. 47 s. [in Ukrainian].
2. Zagurovskiy VM. Rol stressornoy reaktsii v klinicheskoy kartine neotlozhnyih sostoyaniy. Meditsina neotlozhnyih sostoyaniy. 2013;2(49):62-4. [in Russiаn].
3. Belov VG, Parfenov YuA. Psihologiya krizisnih situatsiy: ucheb.posob. SPb.: Nevskiy Institut upravleniya i dizayna; 2010. 175 s. [in Russiаn].
4. Voloshin PV, Shestopalova LF, Podkoryitov VS. Posttravmaticheskie stressovyie rasstroystva: problemyi lecheniya i profilaktiki. Mezhdunarodnyiy meditsinskiy zhurnal. 2004;1:33-7. [in Russiаn].
5. Briere J, Hodges M, Godbout N. Traumatic stress, affect dysregulation, and dysfunctional avoidance: a structural equationmodel. J. Traum. Stress. 2010;23:767-74.
6. Gurevich PS. Psihologiya chrezvyichaynyih situatsiy. M.: Yuniti; 2012. 495 s. [in Russiаn].
7. Panchenko OA, Kutko II, Zaytseva NA. Sotsialno-stressovyie rasstroystva: mirnoe naselenie v epitsentre voennyih deystviy. Novosti meditsinyi i farmatsii. 2014;15(509):6. [in Russiаn].
8. Maercker A, Brewin CR, Bryant RA. Proposals for mental disorders specifically associated with stress in the International Classification of Diseases-11. Lancet. 2013;381:1683-5.
9. Voloshin PV, Maruta NO, Shestopalova LF. Diagnostika, terapiya ta profilaktika medikopsihologichnih naslidkiv boyovih diy v suchasnih umovah: metod. rek. HarkIv. 2014. 79 s. [in Ukrainian].
10. Akarachkova ES. K voprosu diagnostiki i lecheniya psihovegetativnyih rasstroystv v obschesomaticheskoy praktike. Lechaschiy vrach. 2010;10:60-4. [in Russiаn].
11. Kutko II, Panchenko OA, Rachkauskas GS, Linev AN. Distress vooruzhennogo konflikta: psihopatologiya i lechenie. Novosti meditsinyi i farmatsii. 2014;16(510):7. [in Russiаn].
12. Bryant RA, Creamer M, O’Donnell ML. A multisite study of the capacity of acute stress disorder diagnosis to predict posttraumatic stress disorder. J. Clin. Psychiatry. 2008;69:923-9.
13. Buchok YuS. Viddaleni proyavi posttravmatichnogo stresovogo rozladu: osoblivosti kliniki, formuvannya ta kompleksnogo likuvannya. Ukrayinskiy visnik psihonevrologiyi. 2014;22,3(80):42-7. [in Ukrainian].
14. Markova MV, Kozira PV. Poststresovi dezadaptivni stani na tli sotsialnih zmin: analiz problemi. Medichna psihologiya. 2015;1:8-13. [in Ukrainian].
15. Yurtsenyuk OS, Rotar SS. Nepsihotichni psihichni rozladi v osib, yaki brali uchast v zbroynomu protistoyanni na Shodi Ukrayini. Zdobutki klinichnoyi i eksperimentalnoyi meditsini. 2015;4:85-7. [in Ukrainian].
16. Denisenko MM, Lakinskiy RV, Shestopalova LF, Linskiy IV. Osnovni klinichni varianti post stresovih rozladiv u kombatantiv. Ukrayinskiy visnik psihonevrologiyi. 2017;25,2(91):40-4. [in Ukrainian].
17. Bryant RA. Acute stress disorder as a predictor of posttraumatic stress disorder: a systematic review. J. Clin. Psychiatry. 2011;72:233-9.
18. Stadnik IV, Mushkevich MI. Psihologichni osoblivosti perezhivannya posttravmatichnogo stresovogo rozladu (PTSR) uchasnikami zoni antiteroristichnoyi operatsiyi (ATO). Zbirnik naukovih prats RDGU. 2015;4:224-48. [in Ukrainian].
19. Bryant RA. Grief as a psychiatric disorder. Br. J. Psychiatry. 2012;201:9-10.
20. Sochivko YuM. Otdalennyie posledstviya posttravmaticheskih stressovyih rasstroystv u kombatantov (kliniko-psihopatologicheskiy i reabilitatsionnyiy aspektyi) [avtoreferat]. Tomsk; 2012. 25 s. [in Russiаn].
21. Petryuk PT, Yakuschenko IA. Sotsialno-psihologicheskie i psihiatricheskie aspektyi psihosomaticheskih rasstroystv u bolnyih, perenyosshih psihoemotsionalnyiy stress. Vestnik Assotsiatsii psihiatrov Ukrainyi. 2003;3–4:140-59. [in Russiаn].
22. Napreenko OK, Napreenko NYu. Kompleksna psihologichna, psihiatrichna ta narkologichna dopomoga postrazhdalim u zbroynih konfliktah pri mirnih protestah i vimushenim pereselentsyam. Ukrayinskiy terapevtichniy zhurnal. 2015;3:80-5. [in Ukrainian].

«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 32-36 pages, index UDK 616.895-06:[616.45-001.1/3-06:616-001]-036.86

10.29254/2077-4214-2019-1-1-148-32-36