Influence of comprehensive physical rehabilitation on the restoration of motor deficiency in patients suffered ischemic stroke

The article consideres the issue of restoring lost motor function through comprehensive physical rehabilitation. The results of a study of 84 patients with cerebral ischemic stroke (CIS) are presented. The study of patients was conducted in the recovery period (from 3 to 6 months after the vascular accident). The average age of patients was 64.2±1.7 years. During the study all patients were divided into two groups depending on the type of rehabilitation treatment. The main group consisted of 43 patients who received standard medicines therapy aimed at secondary prevention (antihypertensive, hypocholesterolemic, hypoglycemic and other medicines), as well as therapy aimed at the correction and prevention of neurocognitive and dyscirculatory disorders (medicines with metabolic and vasoactive action) during the entire period of supervision. All patients of the main group underwent a course of comprehensive physical rehabilitation treatment. The latter included classes in kinesiotherapy, occupational therapy, speech therapy classes and, if necessary, patients received psycho-correctional and psychotherapeutic methods of treatment. The second (comparison) group consisted of 41 patients who received only drug treatment: standard basic therapy in the framework of secondary prevention of CIS and therapy aimed at the correction and prevention of neurocognitive, dyscirculatory disorders. The results of our study showed that the use of a comprehensive rehabilitation treatment program consisting of physical and medical methods are signifi cantly more eff ective for patients with motor disorders who have suff ered an ischemic stroke compared with the use of only drug therapy in these patients.

Nootropic drugs for correction of cognitive functions through the focus of evidence-based medicine (literature review)

Relevance. In today's world, the first cause of death is pathology of the cardiovascular system. Vascular disease is influenced by many factors: lack of sleep, physical inertia, poorly balanced diet, obesity, heart disease. The fast pace of life forces a person to be in permanent stress, so as not to miss anything and have time for all the goals. This is why there is a demand for excipients and substances that could improve the peak of human cognitive abilities, maintain psychological stability. Today, the pharmaceutical market offers drugs that, according to pharmaceutical marketers, have solutions to the problems outlined above. These substances are classified to group of nootropic drugs (racetams). Objective. Review of high quality research on the effectiveness of nootropic drugs. Materials and methods. The literature review was performed using such scientometric databases as: PubMed, Cochrane Library, Scopus, BMJ Evidence-Based Medicine, Ingecta, Web of Science, UpToDate. The review included studies of randomized trials, placebo-controlled randomized trials, meta-analyzes, and systematic reviews. Data meet criteria A and B of evidence-based medicine. In the absence of high quality studies, studies with a lower level of evidence were selected. The search was made by topics: improving of cognitive functions, improving ability to work, improving sleep, improving mood, treatment of mental and psychiatric pathologies (Alzheimer's disease, dementia with various etiologies, depression), application in pediatrics. Results. The literature review included more than 40 high quality studies, but no conclusive evidence was found on the effectiveness of any drug. Conclusions. Data on the undeniable efficacy in relation to the cognitive functions of any of these nootropic drugs were not found in any study. In the treatment of Alzheimer's disease, some (Cerebrolysin, Nicergoline) drugs show controversial results of efficacy and safety. They require continued clinical research and they need to be approved by the FDA.

Emotional intelligence and its relationship with subjective perception of happiness in patients with mental disorders

The aim of this study was to research emotional intelligence and its relationship with the level of "happiness" in patients with various forms of mental disorders. The study involved 210 patients with mental disorders (70 with organic mental disorders, 70 with endogenous disorders and 70 with neurotic disorders) and 105 healthy people. Patients with mental disorders were characterized by a lower level of emotional intelligence (EQ), which is equal to medium-low normative gradations, which defined patients as less able to adequately understand, guide and express their own emotions and experiences, as well as understand and adequately respond to the emotions of others, compared with individuals. without mental pathology. Patients with endogenous disorders were characterized by a low level of EQ. According to the data obtained, the least satisfied with life, and, accordingly, having a low level of happiness, were patients with neurotic disorders, in which the degree of satisfaction with life (the difference between needs and their realizability) had low values ​​(0.90 ± 0.39), which defined them as less lucky. The level of happiness and, accordingly, the least low indicators of the degree of satisfaction with life among the forms of mental disorders were determined by organic disorders (1.22 ± 0.46), the indicators of which were as close as possible to the results of healthy individuals. The level of dissatisfaction with life in people with endogenous disorders was higher (1.57 ± 0.39) than in healthy people, at p ≤ 0.05, which determined them as less successful. The level of happiness of patients was directly correlate to the severity of emotional intelligence (the higher the level of EQ, the higher the level of happiness is), motivational focus on development and social activity, as well as sthenism in emotional experiences. These emotional and motivational features cause an increase in the level of subjective perception of happiness.

Disorders of the psychoemotional sphere of the ATO/JFO military services

In this article, we have presented the results of our own research concerning the state of psychoemotional disorders in the military personnel of the ATO/JFO. It is known that the state of mental health is infl uenced by various external factors, both socio-economic and physical, traumatic, environmental, etc. The professional activity of the ATO/JFO military personnel is carried out in extreme conditions associated with psychophysical overload, an increased level of responsibility, etc. Therefore, the psychoemotional state of this contingent requires signifi cant attention and correction. The aim of this study was to study the psychoemotional state of the ATO/JFO military personnel. The study involved 66 ATO/JFO combatants (31 men and 35 women) with signs of adjustment disorders who were in Clinic of Neurology, Psychiatry and Narcology of Military Medical Clinical Centre of the Northern region (Kharkov, Ukraine). The control group consisted of 29 people (14 men and 15 women) who did not take part in hostilities and also had signs of adjustment disorders. Using the clinicalanamnestic method in the main group, we identifi ed 32 people with prolonged depressive reaction caused by adaptation disorder (F43.21 according to ICD-10) and 34 people with mixed anxiety and depressive reactions (F43.22). In the control group, 15 people had F43.21 and 14 examined had F43.22. The use of the psychodiagnostic methodology «Tsung Scale for Self-Assessment of Depression» (adapted by T.I. Balashova, 2003) made it possible to reveal a subdepressive state in 12,1±1,9% of the surveyed combatants (men 4,5±1,2%, women 7,6±1,5%). Severe depression was diagnosed in 87,9±1,9% military personnel (men 42,4±2,8%, women 45,5±2,9%). In the control group, a state without depression was revealed in 79,3±5,2% of individuals (37,9±6,3% men, 41,4±6,4% women), and mild depression was also identifi ed (10,3±4,1% men, 10,3±4,1% women, there were 20,6±5,2% people in total). It was concluded that it is necessary to take into account the data obtained when developing an algorithm for psychocorrectional measures in this contingent of patients.

The influence of the dimensions of perfectionism on the formation of emotional maladjustment

The growing complexity of the medical profession places increased demands on the future physician’s adaptive capacity. The problem of the relationship of the aff ective spectrum disorders with such a dysfunctional personality trait as perfectionism is intensively discussed in clinical psychology. Medical students are in a more diffi cult position than others. It’s related to their future profession requires a high level of training and also associated with a high responsibility for the lives and patient’s health. High pace, intense workload, stress of life makes increased demands on the compensatory mechanisms of the medical student’s psyche, failure of which leads to psychological and social confl icts. The paper presents an empirical study of the severity of symptoms of depression, anxiety, and daily stress as the main components of emotional maladaptation, depending on the level of perfectionism in the medical student environment in conditions of increased psychological stress and pre-examination stress. Subjects with a low level of perfectionism are as emotionally prosperous as possible - they have no signs of depression in 89% of cases. In the group of subjects with a medium level of perfectionism, the number of respondents in whom there are no signs of depression decreases and the number with mild, moderate and high levels of depression increases. In the group with a high level of perfectionism, the number of people without signs of depression is half of the whole group, a sharp increase in the number of subjects with moderate and high levels of depression. The level of depression in all three groups is statistically signifi cantly diff erent from each other: the lowest in the group with a low level of perfectionism and the highest in the group with a high level of perfectionism (p <0.001). Positive correlations between the general indicator of perfectionism, its separate parameters and indicators of depression, anxiety and daily stress in the studied groups are revealed. The data obtained as a result of the study confi rm the high level of emotional maladaptation of medical students. In the academic student medical environment, respondents with a pronounced level of perfectionism experience more high-intensity, daily stress (both in the interpersonal and academic spheres of student life) compared to respondents with moderate and low levels of perfectionism.

Features of social and psychological adaptation in patients with depressive disorders

The problem of depressive disorders is one of the key problems of modern psychiatry due to the high prevalence, large-scale social losses and negative medical consequences of depression, as well as severe dysfunction of patients, which determines the relevance of the study of socio-psychological adaptation in depressive disorders. The aim of the study: to determine the features of socio-psychological adaptation in patients with depressive disorders, taking into account age and gender Objectives of the study: to define the structure and quantitative indicators of socio-psychological adaptation and analyze its features in patients with depressive disorders in different age groups and taking into account the gender factor. Methods: using diagnostic techniques for socio-psychological adaptation C. Rogers et R.F. Dymond clinically and psychologically examined 107 men and 138 women with depressive disorders. Results. It was found that patients with depressive disorders are characterized by a low level of socio-psychological adaptation, while men have indicators of socio-psychological adaptation are significantly lower than women in terms of adaptability, self-acceptance, acceptance of others, emotional comfort, adaptation, self-acceptance, acceptance of others, as well as on integrated indicators of emotional comfort and internality. Indicators of maladaptation are higher in men than in women: maladaptation, self-rejection, rejection of others, emotional discomfort and external control. There is a tendency to decline the state of socio-psychological adaptation with age, which is manifested by a decrease in older age groups of adaptability, self-acceptance, emotional comfort, adaptation, self-acceptance, and integrated indicators of emotional comfort and internality, and increasing indicators of maladaptation, self-rejection, rejection, external control, payroll and escapism. The most significant violation of socio-psychological adaptation occurs in the age group of 45 years and older.

History of formation of medical psychology of Ukraine

The article in the historical aspect considers the problems of formation of medical psychology. The work contains the results of the analysis of the history of the formation of medical psychology in Ukraine, the development of its most promising directions in solving specific problems of medical practice. On the way to the formation of Ukrainian psychology as a science, there were different schools, directions and concepts. They were different in nature, often contradicting each other. Thus, in Soviet psychological science, based on the communist idea, the task was to develop a single, monistic approach to the study and explanation of mental phenomena. It is emphasized that when the connection with practice is lost, the subject of psychology is eroded, the scientific status of this knowledge is lost. On the way to overcoming the crisis of modern medical psychology, it is necessary to theoretically comprehend the practical experience for the development of technologies for solving urgent practical problems of psychological care. Comprehension and generalization of the invaluable experience of the first practical psychologists of our country can serve modern researchers and practitioners, as psychological practice now faces the same problems that arose at the beginning of the last century before the then scientists and practitioners. Traditional in the history of psychology is the general idea that the allocation of medical psychology as an applied field was due to the closure of experimental research to address current issues and practical problems in psychiatry and neurology in the late XX - early XXI century. The methodological basis for the study of the psyche was to be a dialectical-materialist orientation. However, despite ideological pressure, a single approach to the study of the psyche could not be developed. In specific studies of the Soviet period, sometimes directly, and in most cases, the positions of psychologists of various fields and schools were used in disguise, which was evidence of the creative use of the achievements of world psychological science.

Structural and functional changes of abdominal organs in patients with hepatocerebral degeneration

The paper presents the results of ultrasound diagnostic of 76 patients with neurological forms of hepatocerebral degeneration (HCD) or Wilson’s disease (WD), who were examined and treated at the clinic of the Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine. According to ultrasound diagnostic, all patients had pathological changes in the liver. In 58% of patients these changes corresponded to chronic hepatitis, in 42% - liver cirrhosis, and in 32% of patients were reported for portal hypertension. Background hepatic hemodynamics of patients was within normal limits, but in 82% of them the reaction to food load was negative. Doppler study showed that background hepatic hemodynamics in patients with neurological forms of hepatocerebral degeneration (GCD) was within normal limits. However, the food load showed that 82% of patients had impaired reciprocal autoregulation of liver microcirculation. This indicates a decrease in their compensatory-adaptive capacity of the liver. This position is confirmed by the fact that 70% of these patients have a decrease in vasoactive endothelial function. Our study of the functional state of the vascular endothelium showed that patients with GCD have a significant decrease in vasoactive endothelial function. In general, the group was only 8.12% at a rate of 10% or more. Despite the young average age of our patients (29.7 years), only 30% of patients had a normal vasoactive reaction. These were patients under the age of 25 from the group of chronic hepatitis. The degree of endothelial dysfunction was significantly higher in patients with liver cirrhosis compared with chronic hepatitis. According to ultrasound elastography, in the vast majority of examined patients with GCD (88%) there was increased stiffness of the liver parenchyma. On the average on group of patients it made 10,62 KPA with a range from 4,74 to 20,69 KPA (norm 0,4-6,0 KPA). Thus, patients with neurological forms of GCD, which are observed by a neurologist, it is necessary before each course of treatment, but at least 1-2 times a year, to conduct ultrasound of the abdominal cavity.

The link between mental health during the COVID-19 pandemic and the use of social media

The world was faced the extensive spread of severe acute respiratory syndrome-coronavirus. The COVID-19 crisis is a crisis of both physical and mental health. Proper mental health is crucial to the functioning of society at all times in every country and should be a priority and at the center of response and recovery after the COVID-19 pandemic. Mental health and well-being - the well-being of society as a whole - have been severely compromised during the pandemic and are a priority for urgent consideration. In the qarantine period, the social media were important sourses of information. The aim of this study was to fi nd out the relation between social media use and stress together with anxiety during this pandemic of COVID-19. We are looking for trends of social media use and infl uence that on behavioral and mental disorders. This study was conducted with the help of an online based survey of individuals from a fi rst wave and during a second wave of pandemic in Ukraine. It was conducted to understand the relationship between social media and stress during the Covid-19 pandemic and to see dynamics of change. A total of 199 participants of the fi rst test period and 152 participants of a second test period responded to the survey which was conducted by snowballing sampling techniques in the convenient atmosphere. We applied two validated, self-reporting questionnaires namely Perceived Stress Scale and test of Generalized Anxiety Disorder-7. When period of use of social media had increased during the pandemic, it led to an increase in the perception and dissemination of false information (fakes) that negative aff ected psychological well-being. Negative aspects of the use of social networks can aff ect the level of anxiety and stress of the population of our country. Among the respondents, 120 (34.2%) think that their mental health and wellbeing was being deteriorated during this period of pandemic. Total percentage 51.0% of the participants were suff ering from mild anxiety, 11.1% from moderate anxiety and 6.3% from severe anxiety The dissemination of false information in the context of increased search time has all the prerequisites for increasing the risk of deteriorating mental health in our country during a pandemic.

Review of the pathogenesis, clinical manifestations and peculiarities of neuropsychic disorders caused by COVID-19

The article presents literature data numerous studies of patients with COVID-19. The available information helps to explain the nature and structure of the virus, the ways of penetration and its distribution in the human body, its interaction with the immune, nervous, endocrine, vascular, muscular systems, as well as the pathogenesis, clinic, diagnosis and treatment of this contingent of patients. Due to tropisms SARS-CoV-2 to the human cells specifi c S glycoprotein this virus can bind receptor human angiotensin-converting enzyme 2 (ACE-2), fuse with host cells and disseminate in the organism. Renin-angiotensin-aldosteron system (RAAS) plays an important role in regulation of blood vessels, heart, kidneys functions. ACE-2 has an infl uence on the infl ammatory, fi brotic and immunomodulatory mechanisms. Inhibition of these protection functions due to spread SARS-CoV-2 in human body leads to the progression of cardiovascular, renal and pulmonary diseases. Some authors describe indirectly the viral entry into the brain parenchyma by infecting the T-lymphocytes, that usually is accompanied by infl ammatory reactions with an increase in the specifi c cytokines such as interleukins (IL) — 6, IL-8, tumor necrosis factor, monocyte chemoattractant protein-1 (MCP-1). The peculiarities of the binding of the virus to the human cells are the presence of neurotropic properties and the ability to change the permeability of blood brain barier (BBB). Other authors note that the virus crosses the BBB directly through the olfactory neurons and also the brain’s circumventricular organs structures, surrounding the third and fourth ventricles, and promote the infection of nervous system. It can also cause intravascular coagulation and blood clotting, which may lead to various diseases of the nervous system. In this regard, an important task for neurologists is to further study the eff ect of the COVID-19 virus on the nervous system and prevent the occurrence of its complications.