Cybernetics and Computer Engineering, 2019, 2 (196), pp. 80-100
Shvets A.V., DSc (Medicine), Assistant Professor,
Head of Research Department of Special Medicine and Psychophysiology
Research Institute of Military Medicine of Ukrainian Military Medical Academy,
24, Melnikova str., Kyiv, 04655, Ukraine
PSYCHOMEDICAL INTERVENTION MODEL FOR SERVICEMEN BASED ON A STUDY OF MENTAL DISORDERS
Introduction. Many domestic and foreign experts work under the problem of mental health at combat environment in various aspects, however, a lot of unsolved questions regarding to psychomedical consequences of hybrid war in Ukraine still exists.
The purpose of the article is to assess and to analyze of influence of various harmful factors in combat environment on the psychological status and mental health of military personnel and ex-combatants for development of psychomedical intervention model.
Materials and methods. The materials of research were based on the study of more than 200 servicemen in different conditions and health state using own and adopted questionnaires with further descriptive and multivariate exploratory technics of data analysis. Bibliosemantic, information-analytical, comparative analysis of domestic publication from the last 4 years have been done for summarizing the national experience regarding to psychological aftereffects of armed conflict in Ukraine.
Results. A retrospective summarizing of available information on the medical and psychological consequences of hybrid war relating to the characteristics of their aftereffects in recent years among military and demobilized persons has been performed. An assessment of stress factors impact at combat environment (physical, informational, organizational and anticipation) on military personnel participated in military conflict has been done. The specific features and structure of mental disorders in the military personnel, which were treated in hospital conditions have been revealed. The decision support model for reliable (p<0.001) prediction further adjustment disorders after extreme conditions has been developed.
Conclusions. The greatest influence on the stress formation of combatants had “anticipation” factors as well as not much less pronounced “physical”, “informational” and “organizational” environmental factors. Research permits to conclude that some of them significantly influence on the psycho-emotional state of military personnel and can be grouped into two main factors: the 1st – factor of negative future prediction and the 2nd – factor of negative impact of physical environment. The phenomenon of exaggerating of negative feelings among servicemen after the 4th-month impact of the stress factors has been discovered. The decision support model to predict further adjustment disorders (F43.2) after extreme conditions has been created for developing the Psychomedical Intervention Model in Ukrainian Armed Forces.
Keywords: psychomedical intervention model, decision support model, mental health, adjustment disorders, posttraumatic stress disorder, stress factors.
1 Comprehensive mental health action plan 2013-2020. Sixty-sixth World Health Assembly 66.8, 2013. 27 P.
2 Advocacy actions to promote human rights in mental health and related areas – WHO Quality Rights training to act, unite and empower for mental health (pilot version). Geneva: World Health Organization; 2017 (WHO/MSD/MHP/17.15). License: CC BY-NC-SA 3.0 IGO.
3 World Health Organization. Mental health and development: targeting people with mental health conditions as a vulnerable group. Geneva: WHO, 2010. 108 P.
4 World Health Organization, War Trauma Foundation and World Vision International Psychological first aid: Guide for field workers. Geneva: WHO, 2011. 57 P.
5 World Health Organization, Mental health action plan for Europe facing the challenges, building solutions. Helsinki: WHO 2005. 12 P.
6 Richardson L.K, Frueh C., Acierno R. Prevalence Estimates of Combat-Related PTSD: A Critical Review. Australian & New Zealand Journal of Psychiatry. 2010; 44 (1). P. 4-19. https://doi.org/10.3109/00048670903393597
7 Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery. Ed. by Tanielian T., Jaycox L.H. Santa Monica: RAND Corporation, 2008. 453 P.
8 Ralevski E., Olivera-Figueroa L., Petrakis I. PTSD and comorbid AUD: a review of pharmacological and alternative treatment options. Subst Abuse Rehabil. 2014; 5. P. 25-36. https://doi.org/10.2147/SAR.S37399
9 Shvets A.V. Improving the psychophysiological assessment methodology of combat conditions influence on the servicemen functional state. Military medicine of Ukraine. 2015; 2. P. 84-92. (in Ukrainian).
10 Inpatient treatment of the ATO participants. Kyiv: Ministry of Health of Ukraine; Ukrainian research Institute of social and forensic psychiatry and drug abuse, 2016. 28 P. (in Ukrainian).
11 Zavalkoy U.M., Kutko I.I., Andreyko M.F., Yurchkova N.O. Structure of mental disorders in ATO participants (pilot study on clinical material of inpatient patients). Ukraine. Nation’s health. 2016; 4/1 (41). P. 54-57. (in Ukrainian)
12 Stepanova N.M.., Ladyk-Bryzgalova A.K., Boltonosov S.V., Sulimovska A.C. Sociodemographic and pathopsychological characteristics of post-traumatic mental disorders in combatants. Archives of psychiatry. 2015; 2 (81). P. 50-53. (in Ukrainian)
13 Pinchuk I.Ya., Pishel V.Ya., Polyviana M.Yu., Guzenko K.V., Ladyk-Bryzgalova A.K. Auto- and geteroagressive behavior in the structure of post-traumatic mental disorders at participants in the ATO. Archives of psychiatry, 2016;.3 (86). P. 5-11. (in Ukrainian).
14 Shevchuk R.V., Hanol M.V., Shimko V.A., Kiris O.P. Analysis of the work of military medical commissions in the special period. In Medical support of the antiterrorist operation: scientific-organizational and medical-social aspects: a collection of scientific works. Ed. by Academicians Tsymbaliuk V.I. and Serdyuk A.M. Kyiv: State Institution of Informational Research Center “Priorities”. 2016. P. 156-167. (in Ukrainian).
15 Druz O.V., Siropyatov O.G., Badyuk M.I. et al. Improvement of treatment and rehabilitation of servicemen of Ukrainian Armed Forces with combat psychotrauma: Methodic recommendations. Kyiv: “Lesya”, 2015. P. 52. (in Ukrainian).
16 Druz O.V., Chernenko I.O. Analysis of combat psychotrauma of participants in local combat operations. In Medical support of the antiterrorist operation: scientific-organizational and medical-social aspects: a collection of scientific works. Ed. by Academicians Tsymbaliuk V.I. and Serdyuk A.M. Kyiv: State Institution of Informational Research Center “Priorities”. 2016. P.168-179. (in Ukrainian).
17 Mykhaylov B.V., Serdyuk O.I., Galachenko O.O., Galachenko V.V., Vashkite I.D. The course of post-traumatic stress disorder among the demobilized members of the antiterrorist operation, located on rehabilitation in sanatorium conditions. Ukrainskyi visnyk psykhonevrolohii. 2016; 2 (87). P. 69-73. (in Ukrainian)
18 Pishel V.Ya., Polyviana M.Yu., Guzenko K.V. Clinical polymorphism of post-traumatic stress disorders at participants in the ATO. Archives of psychiatry. 2017; 1 (88). P. 75-76. (in Ukrainian).
19 Zavorotnyi V.I. Post-traumatic stress disorders in participants of the anti-terrorist operation (combat psychogenias, clinical-psychopathological characteristics). Ukraiskyi visnyk psykhonevrolohii. 2017; 1 (90). P. 48-50. (in Ukrainian).
20 Kalnish V.V., Pishnov G.Yu., Varivonchik D.V. Actual problems of psychophysiological state of combatants. Ukraine. Nation’s health. 2016; 41 (4/1). P. 37-43. (in Ukrainian).
21 Gifford R. Environmental Psychology: Principles and Practice. University of Victoria. Fifth edition. Colville, WA: Optimal Books, 2014. 560 P.
22 Ivanov D.A., Rychka O.V. Psychoprophylactic measures before servicemen deployment to combat zone. Mental Health. 2015; 3 (48) – 4(49). P. 87-98. (in Ukrainian)
23 Kazmirchuk A.P., Shvets A.V., Rychka O.V., Chaikovsky A.R. Suicides in Ukrainian Armed Forces: Analysis and Directions of Prevention. UMMA Scientific Papers “Problems of Military Health”, 2017, Iss. 47. P. 310-319. (in Ukrainian)
24 Pinchuk I.Ya., Petrichenko O.O., Kolodezhsky O.V., Zdorik I.F., Drevitska O.O. Morbidity and prevalence of mental and behavioral disorders as a result of the use of psychoactive substances among participants of the antiterrorist operation in Ukraine for the first half of 2016. Archives of psychiatry. 2016; 4 (87). P. 11-14. (in Ukrainian).
25 Pinchuk I.Ya., Yachniki U.V., Ladyk-Bryzgalova A.K., Bulakhova L.O. Psychological recovery and social integration of veterans in Ukraine Archives of psychiatry. 2017, 1 (88). P. 6-10. (in Ukrainian).
26 Stadnik I.V. Peculiarities of psychological trauma experience of combat operations participants in the antiterrorist operation. In Psychology today: the view as a modern student: materials of the tenth international student scientific conf. Ed. by I.V. Shtotkova. Brest: Psychology, Pushkin Brest State University, 2015. P. 151-153. (in Russian).