Psychological consequences of combat trauma at the hospital stage of rehabilitation

Evgeniy V. Kryukov; Крюков Евгений Владимирович; Dmitrii V. Ovchinnikov; Овчинников Дмитрий Валерьевич; Vladislav V. Yusupov; Юсупов Владислав Викторович; Konstantin P. Golovko; Головко Константин Петрович; Natalya V. Zelenina; Зеленина Наталья Васильевна; Vladimir А. Korzunin; Корзунин Владимир Александрович; Ivan I. Dorofeev; Дорофеев Иван Иванович; Evgeniy A. Chernyavsky; Чернявский Евгений Александрович

doi:10.17816/rmmar562808

Psychological consequences of combat trauma at the hospital stage of rehabilitation

作者: Kryukov E.V.¹, Ovchinnikov D.V.¹, Yusupov V.V.¹, Golovko K.P.¹, Zelenina N.V.¹, Korzunin V.А.¹, Dorofeev I.I.¹, Chernyavsky E.A.¹
隶属关系:
1. Military Medical Academy
期: 卷 42, 编号 3 (2023)
页面: 219-228
栏目: Original articles
URL: https://journals.rcsi.science/RMMArep/article/view/264760
DOI: https://doi.org/10.17816/rmmar562808
ID: 264760

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BACKGROUND: Currently, the issues of restoring the somatic and mental health of combatants undergoing treatment and rehabilitation in hospital conditions are becoming particularly relevant.

AIM: To examine and compare the mental states and psychological consequences of combat trauma at the hospital stage of rehabilitation of combatants.

MATERIALS AND METHODS: The study involved 97 combatants with various wounds and injuries that were hospitalized in the clinical units of the surgical and therapeutic profile of the Military Medical Academy. Of these, 44 people were examined in 2014 and 53 people in 2022.

RESULTS: Comparison of independent samples of combatants in 2014 and 2022 at the stage of treatment and rehabilitation showed a statistically significant twofold decrease in asthenic manifestations from 38.6% in 2014 to 20% in 2022 (p < 0.05). The relative number of combatants with negative psychological consequences of combat trauma in the form of manifestations of post-traumatic stress disorder in 2014 and 2022 was similar and amounted to 15.9% and 17%, respectively, which is apparently due to the homogeneity of the sample and the similarity of factors causing these stress-reactive changes. Uncompensated negative psychological consequences of combat trauma can be fixed in the form of combatant accentuation and chronic, irreversible personality change. These stress-reactive changes reduce both the professional qualities of the combatants and their quality of life.

CONCLUSION: The clinical and psychological characteristics of patients indicate the need for psychological assistance, starting from the moment of injury and continuing throughout the wound disease.

关键词

combat trauma, combatants undergoing treatment and rehabilitation, medical and psychological rehabilitation, mental state, post-traumatic stress disorder, psychological assistance, psychological consequences of hostilities

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M.D., major of medical service, adjunct

俄罗斯联邦, Saint Petersburg

参考

Kryukov EV, Shamrey VK, eds. Military psychiatry in the XXI century: modern problems and development prospects. Saint Petersburg: SpetsLit Publ.; 2022. 367 p. (In Russ.)
Yusupov VV, Baurova NN, Chernyavsky EA, Yatmanov AN. Psychological features of combatants who received severe wounds. Russian Journal of Humanistic Psychology. 2021;8(3):48–56. (In Russ.)
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Zelenina NV, Nazarov SS, Marchenko AA. et al. Features of adaptation after mental traumatic stress in military personnel performing special tasks. Bulletin of the Russian Military Medical Academy. 2018;3(63):153–158. (In Russ.)
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Yusupov VV, Kobryanova IV, Chermyanin SV. et al. Goals and objectives of medical and psychological rehabilitation. In: Medico-psychological rehabilitation: problems, trends, prospects. Materials of the scientific-practical conference. Main Military Medical Directorate of the Russian Ministry of Defense; Federal State Institution “SKK “Krymsky” of the Ministry of Defense of Russia. Sevastopol’; 2019. 2019. P. 90–93. (In Russ.)
Belevitin AB, ed. Medical and psychological correction of specialists of “power” structures: a methodological guide. Saint Petersburg: Aising Publ.; 2010. 268 p. (In Russ.)
Korzunin VA, Ziborova PA. An express method for assessing the state of socio-psychological adaptation and predicting the likelihood of developing maladjustment disorders and signs of PTSD in people who have experienced a real vital threat. In: Rybnikov VYu, Chermyanin SV, eds. Psychodiagnostic methods for identifying maladjustment disorders in the practice of clinical psychologists: a textbook. Saint Petersburg: Pharmindex Publ; 2009. P. 216–222. (In Russ.)
Maercker A, Schützwohl M, Solomon Z, eds. Post-Traumatic Stress Disorder: A Lifespan Developmental Perspective. Seattle: Hogrefe&Huber; 2008.
Ivanov DA, Rychka OV. Psychological and psychiatric support of military personnel in combat conditions. Management and Personnel: psychology of management, socionics and sociology. 2016(7–8(163–164)); 34–47. (In Russ.)
Narov MYu, Semke VYa, Aksenov MM. Features of clinical correlations of acute and protracted reactions to stress. Siberian Bulletin of Psychiatry and Narcology. 2006(4 (43)):17–20. (In Russ.)
Belinsky AV, Golov YuS, Lyamin MV. The effectiveness of medical and psychological rehabilitation of combatants in a multidisciplinary hospital. In: Ushakov IB, Golov YuS, eds. Pain stress: correction strategies. Moscow: State Scientific Research Testing Institute of Military Medicine of the Ministry of Defense of the Russian Federation Publ. House; 2002. P. 127–134. (In Russ.)

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2. Fig. 1. Normalized average values of cluster centers according to the scales of the 2014 SSA questionnaire for combatants (cheer., cheerfulness; int., interest in work; attent., attentiveness; m., mood; gh, general health; tranq., tranquility; conf., self-confidence)

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3. Fig. 2. Normalized average values of cluster centers according to the scales of the MFI-20 questionnaire for combatants in 2022 (General Ast., general asthenia scale; Physical Ast., physical asthenia scale; As Activity, activity scale; As Motivation, motivation scale; Mental Ast., mental asthenia scale)

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4. Fig. 3. Results of the analysis of the frequency distribution of SPA questionnaire scores among combatants in 2014, expected normal distribution, and the Shapiro–Wilk test

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5. Fig. 4. Average values of cluster centers according to the SPA method for combatants in 2014, points

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6. Fig. 5. Results of the analysis of the frequency distribution of ASR questionnaire scores among combatants in 2022, expected normal distribution, and the Shapiro–Wilk test

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7. Fig. 6. Average values of cluster centers according to the 2022 ASR methodology for combatants and points

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