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Neuropsychiatric characteristics of antiterrorist operation combatants in the Donbass (Ukraine)

Published online by Cambridge University Press:  15 August 2017

Konstantin N. Loganovsky ,
Natalia A. Zdanevich ,
Marina V. Gresko ,
Donatella Marazziti  and
Tatiana K. Loganovskaja
Konstantin N. Loganovsky
Affiliation:
Department of Radiation Psychoneurology, National Research Center for Radiation Medicine of National Academy of Medical Sciences of the Ukraine, Kyiv, Ukraine
Natalia A. Zdanevich
Affiliation:
Department of Radiation Psychoneurology, National Research Center for Radiation Medicine of National Academy of Medical Sciences of the Ukraine, Kyiv, Ukraine
Marina V. Gresko
Affiliation:
Department of Radiation Psychoneurology, National Research Center for Radiation Medicine of National Academy of Medical Sciences of the Ukraine, Kyiv, Ukraine
Donatella Marazziti*
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Tatiana K. Loganovskaja
Affiliation:
Department of Radiation Psychoneurology, National Research Center for Radiation Medicine of National Academy of Medical Sciences of the Ukraine, Kyiv, Ukraine
*
*Address correspondence to: Donatella Marazziti, Dipartimento di Medicina Clinica e Sperimentale, University of Pisa, Via Roma, 67, 56100 Pisa, Italy. (Email: [email protected])
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Abstract

Objective

The present paper aimed to explore the neuropsychiatric characteristics of the antiterrorism (ATO) combatants in the Donets Basin (Donbass) and to propose therapeutic strategies for managing their mental healthcare.

Methods

A total of 54 ATO combatants were included in our study and compared with four groups of subjects exposed to other emergencies, including the Chernobyl disaster and the war in Afghanistan. The neuropsychiatric features were assessed through psychopathological assessments, neurological examinations, and quantitative electroencephalography (qEEG).

Results

The ATO combatants were characterized by low health self-estimation, somatic concerns, a high prevalence of posttraumatic stress disorder, anxiety, insomnia, depression, social dysfunction, mild cognitive impairment, and neurological soft signs, similar to individuals involved in the Chernobyl disaster and veterans of the Afghan War. Quantitative EEG showed abnormalities suggestive of irritation of the corticolimbic system and diencephalic structures. Some post-conflict personality changes in ATO combatants were recorded. The treatment of ATO combatants included a comprehensive strategy: from psychotropic drugs to different psychotherapies.

Conclusions

On the basis of 30 years of experience in the management of the consequences of Chernobyl disaster and the available studies on war veterans, the authors proposed a method for assessment and an approach to providing mental healthcare for ATO combatants, refugees, and migrants from the Donbass, which perhaps can be used as guidelines for other conflicts. Taken together, the findings of the study suggest that voluntary participation in war may decrease but does not eliminate the risk of developing the neuropsychiatric consequences caused by such conflicts. A comprehensive strategy—one that would encompass psychopharmacological, psychological, and rehabilitation techniques—seems to be the most successful approach to managing the main symptoms and disorders involved.

Keywords

Antiterrorist operationsthe Donbasscombatantsrefugeesmigrantsmental healthcareneuropsychiatric disorders/symptoms
Type
Original Research
Information
CNS Spectrums , Volume 23 , Special Issue 2: Evil, psychiatry, and terrorism: understanding the roots of evil , April 2018 , pp. 178 - 184
Copyright
© Cambridge University Press 2017 

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References

REFERENCES

1. Davidenkov, SN, ed. Neurological diseases (peculiarities of their origin, course, prevention and treatment during the war) [in Russian]. In. The Experience of Soviet Medicine in the Great Patriotic War of 1941–1945, Part 2: Therapy, Vol. 26, §10. Moscow: Medgiz; 1949: 55–91.Google Scholar
2. Kessler, RC, Üstün, TB, eds. The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders. New York: Cambridge University Press; 2008. Available at: assets.cambridge.org/97805218/84198/frontmatter/9780521884198_frontmatter.pdf.Google Scholar
3. World Health Organization. Guidelines for the Management of Conditions Specifically Related to Stress. Geneva: World Health Organization, 2013. Available at: http://apps.who.int/iris/bitstream/10665/85119/1/9789241505406_eng.pdf.Google Scholar
4. Steel, Z, Chey, T, Silove, D, Marnane, C, Bryant, RA, van Ommeren, M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement. JAMA. 2009; 302(5): 537–549.CrossRefGoogle ScholarPubMed
5. World Health Organization. World Health Report 2001. Mental Health: New Understanding, New Hope . Geneva: World Health Organization, 2001. Available at: http://www.who.int/whr/2001/en/whr01_en.pdf?ua=1.Google Scholar
6. Stratta, P, de Cataldo, S, Bonanni, R, Valenti, M, Masedu, F, Rossi, A. Mental health in L’Aquila after the earthquake. Ann Ist Super Sanita. 2012; 48(2): 132–137. Available at: http://www.iss.it/publ/anna/2012/2/482132.pdf.CrossRefGoogle ScholarPubMed
7. Bromet, EJ. Emotional consequences of nuclear power plant disasters. Health Phys. 2014; 106(2): 206–210. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898664/.CrossRefGoogle ScholarPubMed
8. Legha, RK, Solages, M. Child and adolescent mental health in Haiti: developing long-term mental health services after the 2010 earthquake. Child Adolesc Psychiatr Clin N Am. 2015; 24(4): 731–749. Epub ahead of print Jul 8.CrossRefGoogle ScholarPubMed
9. Napryeyenko, OK, Syropyatov, OG, Druz, OV, et al. Psychological and Psychiatric Assistance to Victims of Armed Conflicts (Guidelines) [in Ukrainian]. Kyiv: Ministry of Public Health of Ukraine; 2014.Google Scholar
10. Napryeyenko, OK, Loganovsky, KM, Napryeyenko, NY, Loganоvskaya, TK. Scientific support of non-governmental organizations of psychiatrists, narcologists and medical psychologists activities in Ukraine. Clin Neuropsychiatry. 2015; 12(2): 23–26.Google Scholar
11. Bogomolets, OV, Pinchuk, IY, Druz, OV, et al.Approaches of Optimization for Mental Health Care According to Current Needs of Participants of Military Actions (Guidelines) [in Russian]. Kyiv: Ministry of Public Health of Ukraine, Ministry of Defence of Ukraine, Ukrainian Center of Scientific Medical Information and Patent License Activities; 2014.Google Scholar
12. Voloshin, PV, Maruta, NO, Shestopalova, LF, et al. Diagnosis, Treatment and Prevention of Medical and Psychological Consequences of Combat Operations in Modern Conditions (Guidelines) [in Ukrainian]. Kharkiv: Ministry of Public Health of Ukraine, National Academy of Medical Sciences of Ukraine, Ukrainian Center of Scientific Medical Information and Patent License Activities; 2014.Google Scholar
13. Kolesnik, M. Posttraumatic stress disorder: diagnostic, therapy, rehabilitation [in Ukrainian]. Ukr Med J. 2015; 4(108): 8–10.Google Scholar
14. Moroz, SM, Makarova, II, Semenikhina, VE, et al. Phytoneuroregulation opportunity in patients with anxiety-depressive disorders as a result of military stress [in Russian]. Ukr Med J. 2015; 4(108): 60–62.Google Scholar
15. Khaustova, OO, Kovalenko, NV. Current problems of life and mental health disorders in internally displaced persons [in Ukrainian]. Arch Psychiatry. 2015; 2(81): 42–47.Google Scholar
16. Kochin, IV. Features of medical and sanitary losses and emergency medical care organization for population and military personnel in the area of anti-terrorist operations [in Ukrainian]. News Med Pharm Ukr. 2015; 14(52): 16–18.Google Scholar
17. Tabachnikov, SI, Osukhovska, OS, Kharchenko, YM, et al. Sociodemographic and clinical psychopathological characteristics of psychoactive substance use, comorbid with PTSD, in the combatants of antiterrorist operation in Ukraine [in Ukrainian]. Arch Psychiatry. 2015; 21(3–4): 82–83.Google Scholar
18. Kutko, II, Panchenko, OA, Linev, AN. Posttraumatic stress disorder in people suffering from armed conflict: clinical development, diagnostics, treatment and rehabilitation [in Russian]. Ukr Med J. 2016; 1(111): 24–27.Google Scholar
19. World Health Organization. International Statistical Classification of Diseases and Related Health Problems, 10th rev. Vol. 2: Instruction Manual Geneva: World Health Organization; 2010. Available at: http://www.who.int/classifications/icd/ICD10Volume2_en_2010.pdf.Google Scholar
20. Folstein, MF, Folstein, SE, McHugh, PR. “Mini-Mental State”: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3): 189–198.CrossRefGoogle ScholarPubMed
21. Goldberg, D. The General Health Questionnaire: GHQ–28. London: National Foundation for Educational Research–Nelson; 1981.Google Scholar
22. Goldberg, DP, Gater, R, Sartorius, N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997; 27(1): 191–197.CrossRefGoogle ScholarPubMed
23. Shafer, AB. Meta-analysis of the factor structures of four depression questionnaires: Beck, CES–D, Hamilton, and Zung. J Clin Psychol. 2006; 62(1): 123–146.Google Scholar
24. Horowitz, M, Wilner, N, Alvarez, W. Impact of the Event Scale: a measure of objective stress. Psychosom Med. 1979; 41(3): 209–218.CrossRefGoogle Scholar
25. Keane, TM, Caddell, JM, Taylor, KL. Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: three studies in reliability and validity. J Consult Clin Psychol. 1988; 56(1): 85–90.CrossRefGoogle ScholarPubMed
26. Loganovsky, KN, Zdanevich, NA. Cerebral basis of post-traumatic stress disorder following the Chernobyl disaster. CNS Spectr. 2013; 18(2): 95–110. Epub ahead of print Feb 27.CrossRefGoogle ScholarPubMed
27. Schmieschek, H. Questionnaire for the Determination of Accentuated Personalities [in German]. Psychiatr Neurol Med Psychol (Leipz). 1970; 22(10): 378–381.Google ScholarPubMed
28. Eysenck, HJ, Eysenck, SBG. Manual of the Eysenck Personality Questionnaire. London: Hodder and Stoughton; 1975.Google Scholar
29. Loganovsky, K, Gresko, M. Personality Changes in Participants of Anti-Terrorist Operations in the Donbass and in Chernobyl Accident Survivors. Paper presented at the International Conference on “Health Effects of the Chernobyl Accident—30-year Aftermath,” 18–19 April 2016. Geneva: World Health Organization; Kyiv: National Academy of Medical Sciences of Ukraine and National Research Centre for Radiation Medicine; 2016.Google Scholar
30. Loganovsky, KN, Bomko, MA, Chumak, SA. Scientific justification of the mental health system in radiation emergency situations (on the experience of the Chernobyl disaster) [in Russian]. Psychiatry, Psychother Clin Psychol. 2012; 2(08): 20–36.Google Scholar
31. Loganovsky, KN, Chumak, SA, Bomko, MA. Mental health care and psycho-rehabilitation in radiation emergency situations (on the experience of the Chernobyl disaster) [in Russian]. Emerg Med. 2012; 2(12): 75–106.Google Scholar
32. Loganovsky, KM, Petrychenko, OO, Morozov, OM, et al.Mental Health Care in Radiation Accidents at Nuclear Reactors and the Using of “Dirty Bombs” and Tactical Nuclear Weapons (Guidelines) [in Ukrainian]. Kyiv: Ministry of Public Health of Ukraine, Ministry of Defense of Ukraine, Ukrainian Center of Scientific Medical Information and Patent License Activities; 2014.Google Scholar
33. Niagu, AI, Noshchenko, AG, Loganovskiĭ, KN. Late effects of psychogenic and radiation factors of the accident at the Chernobyl nuclear power plant on the functional state of the human brain [in Russian]. Zh Nevropatol Psikhiatr Im S S Korsakova. 1992; 92(4): 72–77.Google Scholar