THE STATE OF PSYCHOLOGICAL HEALTH OF DOCTORS AND NURSES WORKING IN TREATMENT AND CARE OF CORONAVIRUS PATIENTS

The quality of work of healthcare workers (doctors and nurses) is directly dependent on the state of their psychological health, as well as on their ability to adequately and promptly respond to the occurrence of pathological stress reactions and neurotic disorders. In May-June 2020, 373 medical workers were interviewed in the Sverdlovsk region, including 86 specialist doctors and 287 paramedical workers involved in the treatment and care of patients with coronavirus decease COVID-19 who are in hospital. The results of the study showed: the level of psychological stability among doctors and nurses is quite low; the state of adaptation to extreme situations is unsatisfactory. One third of the subjects reported increased exhaustion and neurotization, the loss of the most important guidelines and values, which was accompanied by extremely negative and intense external and internal emotions. The indices of the private scales of neurotization indicate the development of tendencies towards psychological instability and maladjustment, which can lead to acute and chronic psychogenic disorders. From one fifth to one third of healthcare workers are susceptible to various disorders of psychological stability and neurotization. All this indicates the need for psychological support and the development of strategies for psychotherapeutic work with doctors and nurses involved in the treatment and care of patients in the event of emergencies.

Dissociation in Patients with Non-Psychotic Mental Disorders

Background. Dissociation is a generally recognized phenomenon in psychology and psychiatry; however, questions are still not fully resolved about the di!erence between pathological and normal dissociation, as well as the role of dissociation, depending on its aetiology, in the formation of clinical manifestations of mental disorders. Objective. To complement the existing data about the signi"cance of dissociation in non-psychotic mental disorders. Design. Using the Dissociative Experience Scale (DES), we screened 62 patients (13 male and 49 female) from the Non-Psychotic Conditions Inpatient Department of the Udmurt Republican Clinical Psychiatric Hospital (Izhevsk, Russia). Nineteen of the patients had mental disorders of organic aetiology and 43 patients had mental disorders of psychogenic aetiology. Results. Dissociation at the pathological level was detected in 12.9% of the patients, all of them female. Among patients with psychogenic disorders, the proportion of patients with pathological dissociation was more than three times that of patients with organic disorders. Among the particular dissociative phenomena, absorption had the highest average severity, both in the general sample and in each aetiological group of patients, while dissociative amnesia had the lowest average severity. #e highest levels of dissociation were found in young female patients who had never been married. In patients with psychogenic disorders, the average dissociation severity was signi"cantly higher than in the general population, while in patients with organic disorders it was signi"cantly lower. Conclusion. #e dissociation phenomenon may play a signi"cant symptomforming role in young women su!ering from non-psychotic mental disorders of psychogenic aetiology. In the case of organic mental disorders, the severity of dissociative manifestations decreases even below the conditionally normal level, which may indirectly indicate the destruction of dissociative physiological mechanisms by an organic brain process.

Neuroses And The Factors Which Contribute To It

Neuroses are psychogenic disorders that develop as a result of long-term exposure to a traumatic event with low intensity and sharpness. In these cases, there is usually talked of disagreements in the family, production, and work community, which are not even perceived by the patient as a factor of emotional trauma. The depth of mental disorders is relatively low in neuroses - there are no deep disturbances of thinking, cognition and consciousness, and a critical attitude to others and one's own state is preserved. The article looks into the neurosis and its causes and correlation with other illnesses.

Aetiological evaluation of chest pain in childhood and adolescence

Background:Chest pain, as a common cause of hospital admissions in childhood, necessitates detailed investigations due to a wide range of differential diagnoses. In this study, we aimed to determine the distribution of diseases causing chest pain in children and investigate the clinical characteristics of children with chest pain.Methods:This study included 782 patients aged between 3 and 18 years who presented to a paediatric cardiology outpatient clinic with chest pain between April 2017 and March 2018. Aetiological causes and demographic features of the patients were analysed.Results:Most prevalent causes of chest pain were musculoskeletal system (33%) and psychogenic (28.4%) causes. Chest pain due to cardiac reasons was seen in eight patients (1%). Diseases of musculoskeletal and gastrointestinal systems and psychogenic disorders were significantly more common in male and female patients, respectively (p < 0.001 for all). In winter, patients’ age and the number of patients with ≥12 years were higher than those in other seasons (p < 0.001). Most of the parents (70.8%) and patients (90.2%) thought that chest pain in their children was caused by cardiac causes.Conclusion:Most of the diagnoses for chest pain in childhood period are benign and include the musculoskeletal system and psychogenic diseases. Although chest pain due to cardiac diseases is rare, a comprehensive analysis of medical history, detailed physical examination and cardiac imaging with echocardiography is needed to reach more accurate diagnoses.

Structure of social support for women with depressive disorders and macrosocial, mesosocial and microsocial maladaptation of different expression

The structure of social support in women with depression of different genesis and different severity of macrosocial, mesosocial and microsocial maladaptation was studied to determine further targets of differentiated psychosocial rehabilitation of patients of this group. 252 women with depressive disorders were examined: 94 women were with psychogenic disorders, 83 women were with endogenous disorders and 75 patients were with organic depression. 48 women did not show signs of psychosocial maladaptation, the other 204 showed manifestations of macrosocial, mesosocial and microsocial maladaptation of varying severity. The study was conducted using clinical-psychopathological and psychodiagnostic methods. The study revealed a decrease in the level of social support of family, social support of friends and social support of significant others as the degree of psychosocial maladaptation of any level (macrosocial, mesosocial or microsocial). The structure of the ratio of social support varied depending on the degree of macrosocial, mesosocial and microsocial psychosocial maladaptation: in general, in the absence of signs of psychosocial maladaptation, the highest level was social support of family, lower level was social support of significant others, and the lowest level was social support of friends; with mild psychosocial maladaptation, the highest level was social support of significant others, the lowest level was the social support of friends, and the lowest level was social support of family; with moderate and severe psychosocial maladaptation, the highest was the level of social support of friends, the lowest level was social support of significant others, and the lowest level was the social support of family. The identified patterns should be taken into account in the development of treatment and rehabilitation and preventive measures for depressive disorders in women. Keywords: depressive disorders, macrosocial maladaptation, mesosocial maladaptation, microsocial maladaptation, social support, women.