Characteristic features of psychological and psychiatric care for military personnel in modern armed conflicts

Abstract

Relevance. The problem of improving the military personnel psychological and psychiatric care in combat conditions is due to high levels of psychogenic losses, sometimes up to 80 % of the combatants. At the same time, insufficient theoretical development of the problem of reactive states in the combat situation, unclear definitions and boundaries, pronounced differences in terminology, classification and methodological approaches used by different specialists significantly impede specialized care.Intention. Based on the analysis of current conception about combat related stress-induced mental disorders in military personnel, to develop proposals for organizing a staged system for providing psychological and psychiatric care from the standpoint of modern military medical doctrine.Methodology. Approaches to systematization of stress-induced disorders and the related system of psychological and psychiatric care organization were analyzed using a heuristic method. Results and Discussion. Based on the analysis of taxonomic and severity characteristics of stress-induced disorders, 2 subgroups were identified – short-term and prolonged ones, as well as 4 organizational categories (levels) in accordance with the type of required care: psychological, preclinical, borderline (neurotic) and psychotic. It is proposed to consider the first category as not requiring medical and psychological care, the second - as related to short-term casualties (psychogenic losses), the third - mainly to psychiatric sanitary casualties, and the fourth, mainly to irrecoverable casualties. The content of psychological and psychiatric care at the stages of medical evacuation in relation to the selected categories of the casualties is revealed. An idea is given about psychological and psychiatric intelligence, probable factors that need to be taken into account in prediction of psychogenic losses, and an example of such a calculation is given.Conclusion. It is stated that the existing approaches to psychogenic losses prediction do not take into account organizational and staffing changes in the troops and modern forms and methods of armed confrontation. The necessity of developing objective methods for predicting individual resistance to combat negative factors, remote monitoring of the military personnel mental health, as well as improving methods of treatment and prompt correction of stress-induced disorders, including those based on a mobile psychoprophylactic platform, is postulated.