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№4' 2021

PSYCHIATRY

International Medical Journal, Vol. 27., Iss. 4, 2021, P. 57−60.

DOI (https://doi.org/10.37436/2308-5274-2021-4-10)

PECULIARITIES OF MANIFESTATION AND CLINICAL SIGNS OF DISSOCIATIVE DISORDERS IN COMBATANTS OF THE ARMED FORCES OF UKRAINE PARTICIPATED IN THE ANTI-TERRORIST/JOINT FORCES OPERATION

Zaporizhia State Medical University, Ukraine

The problem of studying the structure, diagnosis and treatment of mental disorders in Ukrainian servicemen has been acute since the beginning of the Anti−Terrorist Operation in 2014 and later with the change of its format to Operation of Joint Forces with a large number of troops to participate in hostilities. To establish the features of the debut and clinical manifestations of dissociative disorders in servicemen, 34 combatants were examined. Research methods were as follows: anamnestic, psychopathological, psychodiagnostic, statistical. The following dissociative manifestations were noted: motor disorders in the form of tremor of the upper extremities or the whole body, pseudoparesis and pseudoparalysis, motor tics, globus hystericus, seizures in the form of pseudoepileptic seizures, speech disorders, stupor, short−term amnesia, partial vision loss etc. In servicemen, such manifestations were found at symptom and syndrome levels in 55.88 % of cases; those reached the nosological level were observed in 44.12 % and were part of the structure of such disorders as isolated dissociative disorder, maladaptation, post−traumatic stress disorder. The clinical picture and severity of dissociative manifestations depend on the stressor, age and personality traits of the serviceman. Their immediate causes were recognized as: the state of anticipation of an inevitable event, the occurrence of which the patient subconsciously wanted to avoid; the state of being in the middle of a psychologically uncomfortable environment; state of being in a short−term, acute life−threatening situation; condition after the last acute or a number of acute psycho−traumatic situations of a life−threatening nature; in the structure of flashbacks; a condition after or on the background of an acute or chronic psycho−traumatic situation of a life−threatening origin or a state of chronic psycho−emotional and physical fatigue, which was accompanied by sleep deprivation.

Key words: dissociative disorders, psychopathology, combatants, anti−terrorist/Joint Forces operation.

REFERENCES

1. Ukazaniya po voenno−polevoi terapii; pod nablyud. polk. med. sluzhby V. A. Arkaeva. M.: Voenizdat, 1976. 296 s.

2. Diagnostic and statistical manual of mental disorders (DSM−5) / American Psychiatric Association Publishing; Auflage: 5 Rev. ed. 2013. 911 p.

3. Diagnostic and statistical manual of mental disorders (DSM−IV) / American Psychiatric Association Publishing; Auflage: 4 Rev. ed. 1994. 915 r. doi: https://doi.org/10.1007/springerreference_179660

4. MKKh−10−AM. Mіzhnarodna statistichna klasifіkatsіya khvorob ta sporіdnenikh problem okhoroni zdorov'ya. 10−i pereglyad. Avstralіis'ka modifіkatsіya. Desyate vidannya, 1 lipnya 2017 r. URL: https://nszu.gov.ua/storage/files/Klasyfikator_xvorob_ta_sporidnenyx_problem_oxorony_zdorovya_NK_0252019.pdf

5. Ivanov F. I. Reaktivnye psikhozy v voennoe vremya. Leningrad: Meditsina, 1970. 168 s.

6. Pіshel' V. Ya., Іl'nits'ka T. Yu., Poliv'yana M. Yu. Nadannya mediko−sotsіal'noї dopomogi uchasnikam boiovikh dіi іz psikhotichnimi rozladami / NeiroNews. 2019. № 10 (111). S. 16−19.

7. Gaidabrus A. V. Kompleksnii posttravmatichnii stresovii rozlad u uchasnikіv boiovikh dіi v zonі Operatsії ob'єdnanikh sil u rakursі odinadtsyatoї redaktsії Mіzhnarodnoї klasifіkatsії khvorob / Psikhіatrіya, nevrologіya ta medichna psikhologіya. 2019. № 11. S. 19−24.

8. Boyars'ka Z. O., Pіnchuk R. S. Dinamіka trivozhnostі uchasnikіv Operatsії ob'єdnanikh sil / Science Rise:Biological Science. 2018. № 5 (14). S. 22−26.

9. Psychogenic Disorders in German soldiers during World War I and II / P. Zimmermann, H. H. Hahne, K. H. Biesold, M. Lanczik // Fortschr. Neurol. Psychiatr. 2005. № 73 (2). R. 91−101.

10. Berthier M. L., Posada A., Puentes C. Dissociative flashbacks after right frontal injury in a vietnam veteran with combat−related posttraumatic stress disorder // J. Neuropsychiatry Clin. Neurosci. 2001. № 13 (1). R. 101−105. doi: https://doi.org/10.1176/jnp.13.1.101

11. Waelde L. C., Silvern L., Fairbank J. A. A taxometric investigation of dissociation in Vietnam veterans // J. Trauma Stress. 2005. № 18 (4). R. 359−369. doi: https://doi.org/10.1002/jts.20034

12. Nejad A. G., Farahati H. Dissociative disorders and dissociative symptoms among veterans of the Iraq−Iran war suffering from chronic post−traumatic disorder // Neurosciences (Riyadh). 2007. № 12 (4). R. 318−321.

13. Peritraumatic dissociation and post−traumatic stress disorder in individuals exposed to armed conflict in the Democratic Republic of Congo / Y. Duagani Masika et al. // J. Trauma Dissociation. 2019. № 20 (5). R. 582−593. doi: https://doi.org/10.1080/15299732.2019.1597814

14. Dissociative symptoms in a nationally representative sample of trauma−exposed U. S. military veterans: Prevalence, comorbidities, and suicidality / S. Herzog et al. // J. Affect. Disord. 2020. № 272. R. 138−145. doi: https://doi.org/10.1016/j.jad.2020.03.177