ALGORITHM OF PSYCHOLOGICAL AND PSYCHOTHERAPEUTIC SUPPORT OF PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA

Introduction. Nowadays, it is important to study the mechanisms of psychological adaptation in patients with early stage of chronic cerebral ischemia (ES CCI) from the standpoint of biopsychosocial approach.

The objective of the study was to develop the algorithm for identifying psychosocial characteristics of patients with ES CCI and providing them with psychotherapeutic care. Material and methods. 280 patients with ES CCI developed against a background of arterial hypertension and/or cerebral atherosclerosis (middle age 53.9±8.1 years (from 30 to 72 years) gender index 1:1) were selected for the study. The control group included healthy individuals comparable to those in the main group according to gender and age characteristics (n=32, middle age 52.4±6.5 years (31–65 years), gender index 1:1, p>0.05 ). The panel of psychological methods was used to identify the individual psychological and socio-environmental factors in patients with ES CCI.

Results and conclusions. A three-stage algorithm of psychological and psychotherapeutic support of patients with early stage of chronic cerebral ischemia (ES CCI) was developed and tested by the multidisciplinary team of specialists. At the stage of opportunistic screening, the neurologist used express methods for diagnosing cognitive (Mini-test of mental state), emotional (Hospital scale of anxiety and depression), vegetative disorders (the Wayne test) among the studied persons. At the stage of selective screening, the medical psychologist performed systemic psychodiagnostics of the ES CCI. At the stage of treatment, a correction was made: psychovegetative disorders by progressive muscular relaxation; anxiety-depressive manifestations – cognitive re-attribution according to A. Beck; obsessive-phobic disorders – direct motivated suggestion in reality with elements of clarification and persuasion. The indicators of the effectiveness of psychological and psychotherapeutic correction in patients with ES CCI were: positive dynamics of the Scale of quality of life SF-36 and regression of integrative indicators of the Scale of psychopathological manifestations of SCL-90-R – «Index of overall severity of symptoms» and «Total number of affirmative answers». Thus, the algorithm described above is suitable for use in practical healthcare for optimizing individual therapeutic strategies. 

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