[Mental disorders in military personnel at the stage of medical care in a multidisciplinary military medical organization].

Abstract

Objective: To study the clinical and psychopathological structure of mental disorders associated with combat stress in the first 6 months from the moment of injury among the sanitary losses of servicemen receiving medical care in a multidisciplinary military hospital and to determine the relationship of the reported mental disorders with premorbid personal traits.

Material and methods: A single-center cohort prospective study was conducted at the Central Military Clinical Hospital, A.A. Vishnevsky (Krasnogorsk, Russia). The study examined 27 service members hospitalized in different somatic departments from October 2022 to June 2023. The mean age of the examined subjects was 36.0 years (28.25; 45.0). The duration of commitment was 5.73 months (2.83; 10.74). The duration of the period since the injury was 2.07 months (0.47; 5.88). The clinical-psychopathological, psychometric, and statistical methods of the study were used.

Results: The data obtained showed two groups of combatants, differing in the types of emotional-behavioral stress response and mental state. The first group is «military timogenies» as part of the F43 diagnosis «Reaction to severe stress and adjustment disorders» (n=22). In the psychopathological structure of this group, the leading role was played by anxiety disorders with a distinct hypothymic component with episodes of obsessive, realistic memories of hostilities, incomplete postconcussive syndrome, and conversion disorders. The second group included patients with reactive paranoid symptoms that developed in the prehospital or in-hospital stages (n=5), qualified under F23, «Acute and transient psychotic disorders.» A distinctive feature of the patients of this group was the prevailing premorbid paranoia accentuation, which was further reflected in the clinical presentation of psychosis closely related to the conditions of combat stress.

Conclusion: The obtained results make it possible to draw preliminary conclusions about the absence of differences in the clinical forms of reactive psychotic disorders and adjustment disorders in the context of modern warfare in comparison with the wars of the 20th century.