№ 93 (2025)

Objective. To evaluate the long-term dynamics of medical and statistical indicators of mental illness in various categories of military personnel of the Russian Ministry of Defense in order to optimize psychoprophylactic measures.

Methodology. The primary medico-statistical indicators of mental morbidity among various categories of military personnel were examined, utilizing data from medical reports in Form 3/ MED spanning 19 years (2003–2021) and open-source publications. The analyzed indicators were correlated with Chapter V “Mental and behavioral disorders” of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Morbidity rates were calculated per 10,000 military personnel (10–4). Mean multi-year and mean annual indicators (M ± m) were determined, and their development was assessed using dynamic series analysis and by calculating a second-order polynomial trend.

Results and analysis. The average long-term indicator of primary morbidity of the cohort of military personnel of the Russian Ministry of Defence with mental disorders was 70.7 · 10–4, with the proportion of cases among officers being 10.7 %, among contract sergeants and warrant officers –

9.3 %, among female military personnel – 2.9 %, and among conscripted military personnel – 77.1%. Hospitalization rates were 61.8 · 10–4 with a proportion of 10.6, 8.6, 2.0, and 78.8 % respectively; days of sick leave were 1839 · 10–4 with a proportion of 7.4, 6.5, 1.7, and 84.4 % respectively; discharge rates were 42.6 · 10–4 with a proportion of 3.9, 4.9, 0.4, and 90.8 % respectively. There is a decrease in the indicators in the studied types of morbidity in all categories of military personnel, with the exception of conscripted military personnel, who have an increase in the analyzed data and, compared with other categories of military personnel, statistically significantly higher levels of morbidity.

Conclusion. An analysis of the long-term dynamics of medical and statistical indicators of mental illness in various categories of military personnel has shown that more than 80 % of mental disorders were reported in conscripted military personnel, usually due to underestimation of the mental health status of the conscripted contingent by military medical commissions of military commissariats. Accordingly, improving the quality of the selection of conscripts for military service (“barrier functions”) and psychoprophylactic measures during the period of conscription training in military training centers will significantly reduce the development of mental adaptation disorders and, thereby, improve the quality of mental health of this category of military personnel.

Relevance. Pain is one of the major medical and socio-economic problems in the world. Since the problem of pain remains relevant, it is necessary to pay close attention to the study of risk factors for the occurrence of combat syndrome, among which psychosocial factors play a significant role, such as stress, depression, anxiety and other factors.

Intention. The purpose of the study is to assess the characteristics of the psychological state of patients in the process of complex treatment of pain syndrome.

Materials and methods. A study was conducted to evaluate the levels of anxiety, depression, and stress in patients reporting prolonged pain sensations. All study participants underwent a neurological examination using standard methods, and testing was performed using a visual analogue scale (VAS).

The study group included patients (n = 220), men and women, aged from 23 to 63 years, with diagnosed pain in the cervical and thoracic spine.

Inclusion criteria: documented adult patients aged 18 to 65 years with complaints of pain present at the time of the study, who had their levels of anxiety, stress and depression assessed using the Distress, Depression, Anxiety and Somatization Questionnaire, and their relationship with chronic pain.

Exclusions included respondents under the age of 18 years, patients over 65 years of age, as well as patients suffering from cancer pain syndromes and pain syndromes of a psychogenic nature, the occurrence of which is due to the presence of a psychological conflict, and not damage to somatic or visceral organs or structures of the somatosensory nervous system.

Statistical analysis included a comparative assessment of the Spearman rank correlation test, the G-sign test.

Results. The results obtained indicate a high level of anxiety and depression in patients complaining of pain. The anxiety levels of such patients range from elevated to high levels. A statistically significant (p ≤ 0.01) correlation between the level of pain determined using VAS and indicators of anxiety, depression and stress in patients was shown.

The cervical dorsopathy therapy carried out included drug therapy in combination with the use of a rehabilitation complex of physiotherapeutic and psychotherapeutic influences.

A comparison of indicators of anxiety, depression and stress levels before and after application of the treatment method using the Sign G test confirms the presence of a statistically significant (p ≤ 0.01) difference in the values of anxiety, depression and stress before and after treatment, which proves the effectiveness of the therapy.

Conclusion. The study confirms the effectiveness of a treatment approach that integrates psychotherapeutic interventions (including autogenic training by J. Schultz and applied relaxation therapy based on E. Jacobson’s method, adapted by Lars-Göran Öst) alongside pharmacological and physiotherapeutic treatment in addressing the psychological distress (anxiety, depression, and stress) associated with pain syndrome. These conclusions are supported by the results of using the mathematical-statistical G-Sign test, confirming the presence of a statistically significant difference (p ≤ 0.01) between indicators of anxiety, depression and stress before and after treatment. Indicators of psychological state in all patients complaining of pain showed increased values (moderately increased and high values). Accordingly, it is necessary, regardless of the form and history of the disease, to include methods of psychological influence in the treatment and rehabilitation program for patients with acute pain.

Relevance. Smoking and alcohol consumption are widely prevalent among pregnant women and negatively impact both pregnancy progression and outcomes. Compared with demographic and psychosocial characteristics, the onset of pregnancy is the strongest predictor of cessation of nicotine products and alcoholic beverages for most women; however, some women continue to use them.

Intention. The aim is to study the predictors affecting smoking and alcohol abuse among pregnant women by conducting correlation and factor analysis.

Methodology. The study included 204 pregnant women who were patients at the perinatal centre in the Nizhny Novgorod region. Psychometric methods were used: the Kessler Psychological Distress Scale K-10; the Impact of Event Scale IES-R; the AUDIT-C screening test; the ASSIST screening test; and the TLFB method for retrospective assessment of daily use of psychoactive substances. Data analysis was performed using multivariate factor analysis in groups of pregnant women with different risk levels for smoking and alcohol consumption (factorisation by principal component method, rotation method – Varimax).

Results. Correlation analysis identified several associations between nicotine and alcohol use and socio-demographic, psycho-emotional, and clinical-psychological risk factors, which were subsequently included in the factor analysis. The results of the factor analysis showed that among non-smoking pregnant women (Group 1), six factors were identified that influence the risk of developing nicotine (tobacco) dependence (total variance explained was 72.9 %): the factor of psychoemotional state; the factor of small social group (family composition and income distribution); the factor of psychosocial predictors of alcohol dependence; the factor of large social group (age and occupational qualification); the factor of marital status; the factor of urbanization. For pregnant smokers (Group 2), four factors were identified (total variance explained was 70.0%): also the factor of psycho-emotional state; the factor of small social group (family composition, income distribution and demographic characteristics); the factor of psychosocial predictors of alcohol dependence; and the factor of social status. Factor analysis in the group of non-drinking women (Group 3) and in the group of women who abuse alcohol (Group 4) identified six risk factors (total variance explained was 72.3 % for women in Group 3 and 80.2 % for women in Group 4). For women in Group 3 the identified factors were: psycho-emotional state factor; small social group risk factor (family composition and income distribution); psychosocial predictors of alcohol dependence risk factor; 

socio-demographic factor; urbanization factor; social status factor. For women in Group 4, the identified factors were: the factor of psycho-emotional state; the risk factor of small social group (family composition); the risk factor of psychosocial predictors of alcohol dependence; the sociodemographic factor; the factor of socio-economic status; the factor of urbanization; and the factor of occupational status.

Conclusion. The conducted factor analysis of smoking and alcohol abuse predictors among pregnant women in the four studied groups demonstrated that psycho-emotional state plays the most significant role in these behaviors. The results emphasize the need to enhance preventive measures for both women who abstain from substance use during pregnancy and those who engage in addictive behaviors, as the combined influence of identified risk factors can both trigger and exacerbate such behaviors.

Relevance. With the ongoing emergence of armed conflicts worldwide, the issue of military personnel rehabilitation remains highly relevant. This article provides an overview of the methods of habilitation and rehabilitation of military veterans and their families in Western Europe, North America and Australia as well as the governmental and non-governmental institutions involved in recovery and readaptation. The paper discusses possible ways of providing psychotherapeutic and social assistance to military personnel and their families, options for conducting psychoeducational programs for them, creating information resources, as well as systems of sanatorium treatment and socio-economic assistance.

The aim of this article is to critically assess the experience of Western European, North American, and Australian countries in the habilitation and rehabilitation of military personnel.

The data for the analysis include some regulatory acts of Western Europe, North America and Australia, Internet resources of specialized organizations and structures, sites with psychoeducational information, scientific articles devoted to the problem of rehabilitation of military personnel.

Results. It has been established that at the moment, the medical and social assistance programs implemented in the above-mentioned countries are being updated and changing the vector of development. Preference is given not to classical psychopharmacological methods of treatment and rehabilitation, but to psychotherapeutic and social-adaptive approaches. Significant attention is paid to the formation of unpaid programs for obtaining the necessary surgical, drug and sanatorium treatment, as well as providing subsidized assistance in receiving paid treatment. Assistance offered in solving employment problems, and facilitating the return of military personnel to productive civilian life. Psychoeducational programs are conducted not only for military personnel, but also for their relatives; information resources are designed to prevent various psychological complications and psychopathological conditions. Modern trends include fundamental importance of supporting the family of a veteran, supervision in the event of his death, protecting the mental health of family members and children.

Conclusions. The key principles for enhancing the effectiveness of the medico-social and professional rehabilitation and habilitation system have been identified. The study concludes that a multifaceted approach to the medico-social rehabilitation of military personnel is essential, along with the operation of organizations capable of addressing habilitation and rehabilitation based on individual characteristics while offering military personnel and their families a broad range of opportunities for continuing a fulfilling life.

Relevance. Currently there is a problem of insufficiently studied interrelationships of psychiatric disorders characterized by somatoform dysfunctions of the cardiovascular system and cardiologic diseases. The aspects of mutual pathoplastic influence between mental and somatic processes remain underexplored. Consequently, there is ongoing debate regarding whether somatoform and cardiological diagnostic definitions are mutually exclusive or, in some cases, may present as pathogenetically interrelated comorbidity. This issue significantly affects the treatment strategy for such conditions.

Intention: To demonstrate the development of somatoform disorder (SFD) of the cardiovascular system in a patient during the convalescent period of acute myocardial infarction (AMI) beyond the scope of traditional clinical concepts (using the case of patient E.), as well as to objectify the unexpected relationship between truly somatic and psychosomatic diseases.

Methodology. The study utilized clinical-archival, dimensional, and clinical-catamnestic research methods.

Results and their analysis. Following AMI, various complications may arise, including those affecting mental health. One of the consequences is the emergence of neurotic-spectrum mental disorders, particularly somatoform disorders.

Conclusion. This clinical case demonstrates that persistent neurotic-spectrum mental disorders may develop after acute myocardial infarction, leading to patient maladaptation and requiring psycho-pharmacotherapeutic intervention. Interdisciplinary collaboration between cardiologists and psychotherapeutic specialists improves prognosis.