Maruta N. O., Shevchenko-Bitensky K. V.


About the author:

Maruta N. O., Shevchenko-Bitensky K. V.



Type of article:

Scentific article


In order to develop and test a comprehensive personalized psychosocial rehabilitation program for patients with hallucinatory-paranoid disorders in vascular dementia, 75 patients of the main group (with hallucinatory-paranoid disorders) and 63 patients of the control group (without such disorders) with were examined. The results of clinical, psychopathological, neuropsychological and psychometric studies patients of the main and of the control group with vascular dementia allow to develop a comprehensive personalized program for the psychosocial rehabilitation of patients with hallucinatory-paranoid disorders in vascular dementia. The basic principles of the developed program for the psychosocial rehabilitation of patients with vascular dementia are the principles of a comprehensive, differentiated, personified, resource-oriented and phased continuous approaches. The targets of the rehabilitative influence are non-cognitive psychopathological disorders, cognitive impairment, psychosocial deficiency and concomitant somatic neurological diseases. Pharmacotherapy included the use of antipsychotic drugs (mainly of a second generation), antidepressants, acetylcholinesterase inhibitors, drugs that interact with NMD-receptors, and neuroprotective agents. The complex of rehabilitation measures included: • cognitive remediation aimed at restoring or improving cognitive functions; • psycho-educational training caregivers; • social and psychological counseling for family members and caregivers; • training groups on developing and maintaining skills: communication, establishing social contacts, fulfilling a parental role, behavior in unusual and difficult conditions, self-service (using the phone, making purchases, managing finances, using transport, etc.); • individual and group therapy with art and creative expression (drawing, modeling, music therapy, creative communication with nature); • stimulating therapy (employment therapy): sports exercises, games, occupational therapy; • regular physical activity, physiotherapy exercises, massage; • the use of psychological educational programs aimed at increasing drug compliance and developing a positive attitude to drug treatment. The effectiveness of the developed program of patients with hallucinatory-paranoid disorders in vascular dementia, which consists in the positive clinical dynamics of the mental state, the restoration of the basic functions of life and increasing drug compliance, has been proved.


vascular dementia, hallucinatory-paranoid disorders, social functioning, therapy, psychosocial rehabilitation


  1. Raspopova NI. Dementsiya u lits pozhilogo vozrasta (diagnostika, terapiya i profilaktika): ucheb. posobiye. Almaty: KazNMU im. S.D. Asfendiyarova; 2016. 108 s. [in Russian].
  2. Wimo A, Winblad B, Jonsson L. The worldwide societal costs of dementia: Estimates for 2009. Alzheimers and Dementia. 2010;6(2):98-103.
  3. Maruta NA. Ranneye vmeshatel’stvo pri dementsii: problemy i resheniya. Ukr. med. zhurnal. 2019. Dostupno: wpcontent/ uploads/2019/04/Cognit.pdf?upload [in Russian].
  4. Mishchenko TS. Sosudistaya dementsiya (evolyutsiya vzglyadov na problemu). Ukrains’kiy visnik psikhonevrologii. 2014;22(1(78)):5-10. [in Russian].
  5. World Health Organization and Alzheimer’s Disease International. Dementia: a public health priority [Internet]. 2012. Available from: mentalhealth/publications/dementia_report_2012/en. Accessed July 18, 2013.
  6. Mukadam N, Cooper C, Livingston G. A systematic review of ethnicity and pathways to care in dementia. International Journal of Geriatric Psychiatry. 2011;26:12-20.
  7. Levin OS. Diagnostika i lecheniye dementsii v klinicheskoy praktike. M.: MEDpress-inform; 2014: 256 s. [in Russian].
  8. Suvorova IA. Sosudistaya dementsiya: klinicheskoye techeniye, faktory riska, differentsirovannaya terapiya [avtoreferat]. Irkutsk: 2011. [in Russian].
  9. Teri L, McKenzie GL, Pike KC, Farran CJ, Beck C, Paun O, et al. Staff training in assisted living: evaluating treatment fidelity. International Journal of Geriatric Psychiatry. 2010;18:502-9.
  10. Uwakwe R. The epidemiology of dependence in older people in Nigeria: prevalence, determinants, informal care, and health service utilization. A 10/66 Dementia Research Group cross-sectional survey. Journal of the American Geriatrics Society. 2009;57(9):1620-7.
  11. Eriksson S. Developments in dementia strategy. International Journal of Geriatric Psychiatry. 2010;25(9):885-6.
  12. Woods B. Invited commentary on: Non-pharmacological interventions in dementia. Advances in Psychiatric Treatment. 2010;10:178-9.
  13. Lustenberger I, Schüpbach B, von Gunten A, Mosimann U. Psychotropic medication use in Swiss nursing homes. Swiss Medical Weekly. 2011;141:w13254.
  14. Dua T, Barbui C, Clark N, Fleischmann A, Poznyak V. Evidence-based guidelines for mental, neurological, and substance use disorders in lowand middle-income countries: Summary of WHO recommendations. PLoS Medicine. 2011;8(11):e1001122.
  15. Koch T, Iliffe S. Rapid appraisal of barriers to the diagnosis and management of patients with dementia in primary care: a systematic review. BMC Family Practice. 2010;11(52):1-8.
  16. Low LF, Anstey KJ, Lackersteen SM, Camit M, Harrison F, Draper B, et al. Recognition, attitudes and causal beliefs regarding dementia in Italian, Greek and Chinese Australians. Dementia and Geriatric Cognitive Disorders. 2010;30(6):499-508.
  17. Reisberg B, Auer SR, Monteiro IM. Behavioral pathology in Alzheimer’s disease (BEHAVE-AD) rating scale. Int. Psychogeriatr. 1996;8(3):301-8.
  18. Havrylyuk AO, redaktor. Unifikovanyy klinichnyy protokol pervynnoyi, vtorynnoyi (spetsializovanoyi), tretynnoyi (vysokospetsializovanoyi) ta paliatyvnoyi medychnoyi dopomohy. Dementsiya. K.: 2016. 57 s. [in Ukrainian].
  19. Lutova NB. Metod prohnozyrovanyya medykamentoznoho komplayensa v psykhyatryy: metodycheskye rekomendatsyy. NYPNY ym. VM Bekhtereva. SPb.: 2007. 24 s. [in Russian].
  20. Antomonov MYu. Matematicheskaya obrabotka i analiz mediko-biologicheskikh dannykh. Kiyev: 2006. 556 s. [in Russian].

Publication of the article:

«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 144-149 pages, index UDK 616.1+159.923:316.6-036.66