Psychodiagnostic examination of patients with somatic pathology who use alcohol with harmful effects

Background. The use of alcohol is one of the most urgent medical and social problems of our time. Mental and behavioral disorders, severe somatic effects, especially significant in young and old age, require early diagnosis and therapeutic measures. An important part is the organization of timely and effective assistance to patients who drink alcohol and have mental and physical disorders in outpatient general-somatic health care institutions. Objective – to investigate the clinical and psychological peculiarities of patients with somatic pathology who use alcohol with harmful effects by psychodiagnostic and clinical and psychopathological research. Materials and methods. The research was conducted among patients who had a somatic complaints and have been consulted by family doctor in institutions of outpatient assistance in the general area of the Solomyansky district of Kyiv. The total number of investigated persons was 300 persons, of which 240 thematic patients were selected. Patients, subject to informed consent, were inspected using the standardized card developed by us, which includes the following psychodiagnostic techniques: AUDIT-tests; Patient health questionnaire-9 (PHQ-9); Hospital anxiety and depression scale (HADS); Type of accentuation of personality character; methodology “State of health, activity, mood”; method of coping with stress on the COPE questionnaire (Cultivating Optimal Personal Experiences). In this contingent, the clinical-psychological peculiarities that were compared with the somatic complaints with which patients turned to a family doctor with a general diagnosis, which was previously documented in a patient's medical card, was studied. Results. Analyzing the patient's mental state by the method of PHQ-9, it was revealed that the greater number of the surveyed patients had mild depression – 47,5%; moderate depression had 22,5%; moderate severity – 11%. Severe depression in patients had not detected. In 19%, the depressive component was absent, the nature of the complaints had a somatogenic background. According to the results obtained by the HADS method, the level of anxiety was 41,6% and corresponded to the boundary status category; pathological conditions not detected; and patients of the category standard are 58,4%. The level of depression revealed patients with boundary conditions – 47,5%; pathological conditions - were not observed. In turn, the patients who did not find signs of depression were 52,5%. When investigating the nature of the state of health, the activity and mood of respondents using the method «State of health, activity, mood», we can conclude that all the average indicators for the three types of survey were «disadvantaged» category. That is, the somatic complaints of patients took place on a pathogenic background of various aspects of life: state of health, activity, mood fluctuations were much lower than normal. The obtained results of the study of the accentuation of the personality of the surveyed were as follows: the number of accrued persons among the general group of respondents was 28,5%. An alarming type of accentuation was detected in 7,5% of the people, demonstrative – 6%, exalted – 5%, hypertensive – 3%, cyclothymic – 2,5%, and others. The majority of respondents had three types of accentuations – anxiety, demonstrative type, exaltation, somewhat less – hypertensive type, cyclothymic type and other kinds. The ratio of their illness to respondents coincided, respectively, with the features of accentuation. Using the method of coping with stress on the COPE questionnaire (Cultivating Optimal Personal Experiences), the most characteristic variants of the coping behavior of these patients were highlighted. The most significant aspect was the use of soothing agents. Properly for the surveyed there was a «denial». Regarding the use of alcohol, the researchers generally did not recognize this as a painful passion, arguing that using these substances, they behave like most others. Conclusions. Based on the results obtained, it was determined that the presence in patients with somatic pathology who use alcohol with harmful effects, both anxiety and depressive disorders in the mental sphere, accentuations of nature, the peculiarity of behavioral responses to a stressful situation explains the exacerbation of their somatic state.