UKRAINS'KYI VISNYK PSYKHONEVROLOHII

The Scientific and Practical Journal of Medicine
ISSN 2079-0325(p)
DOI 10.36927/2079-0325

MECHANISMS OF DEVELOPMENT OF STRESS-RELATED MENTAL DISORDERS IN COMBAT-INJURED MILITARY PERSONNEL: THE ROLE OF COMORBID PATHOLOGY AND SYNDROMAL ORGANIZATION

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Abstract

Disorders specifically related to stress (DSRS) are a significant problem for the mental health of military personnel who have experienced combat trauma. The heterogeneity of clinical manifestations of DSRS indicates a multifactorial nature of their pathogenesis. Understanding the role of concomitant somatic pathology (comorbidity) and the specificity of psychopathological syndrome formation is critically important for improving diagnosis and developing effective, differentiated therapeutic strategies.

Aim of the study — to develop and empirically substantiate a multifactorial model of DSRS formation in military personnel with combat trauma, integrating the influence of the type of injury/ comorbidity received and the specificity of the syndromal structure. The study was conducted on a sample of 242 male military personnel with combat trauma, divided into three groups by the profile of the treatment department. Clinical-psychopathological, psychodiagnostic methods, assessment of combat experience intensity, and statistical analysis (ANOVA, correlation, factor) were used.

Significant differences were found in the intensity of combat experience between the groups (p<0.05) and a reliable influence of the type of trauma/comorbidity on symptom severity (sleep, mood, etc.). Symptoms are clustered into stable syndromes. The type of trauma/comorbidity significantly influenced the frequency of final diagnoses (anxiety-depressive syndrome was reliably more often detected in patients of group III (26,1 %, p<0.01), and post-concussion syndrome — in patients of group II (32.7%, p<0.01)), which confirmed the influence of the type of trauma/comorbidity on the final diagnostic outcome.

A multifactorial model of DSRS formation that explains these regularities was developed.

The developed model is empirically substantiated and emphasizes the central role of the type of concomitant somatic pathology in the formation of specific syndromes and final diagnostic categories of DSRS in military personnel with combat trauma, justifying the necessity of differentiated approaches in clinical practice.

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