Dynamics of the manifestations of stress-associated disorders and their clinical correction in individuals who engaged in volunteer activities during the war

Abstract

In press

Background. Russia’s full-scale invasion of Ukraine has led to a significant increase in the psycho-emotional burden on the population, particularly on volunteers who experience prolonged stress and regularly encounter traumatic events. This significantly increases the risk of developing stress-associated mental disorders.

Aim. To evaluate the clinical effectiveness of a therapeutic and psychosocial program in reducing the severity of symptoms of stress-associated disorders among volunteers involved in wartime activities.

Materials and Methods. Within the overall study, 288 volunteers aged [18–60] years were examined. Among them, a clinical sample of individuals with neurotic and stress-associated mental disorders was formed (n=82). This article presents the results of the analysis of a subgroup of respondents with disorders of the F43 category. The analytical sample included 25 individuals. Depending on the type of intervention, they were divided into an experimental group (n=12), which received a comprehensive therapeutic and psychosocial program, and a control group (n=13), which received pharmacotherapy. Diagnostics were performed using the clinical-psychopathological method and psychodiagnostic tools: the Primary Care Post-Traumatic Stress Disorder (PTSD) Screen, PTSD Checklist (PCL) for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Impact of Event Scale – Revised (IES-R) The treatment program combined pharmacotherapy and a low-intensity psychological intervention "Problem Management+". Treatment effectiveness was assessed by the dynamics of psychometric indicators. The study was conducted within the framework of research projects with state registration numbers 0120U101503 and 0125U001434.

Research Ethics. The study was approved by the Commission on Biomedical Ethics of Bukovinian State Medical University (Protocol No.1 of September 15, 2022). All participants signed voluntary informed consent.

Results. In the experimental group, a statistically significant reduction in the severity of post-traumatic stress disorder symptoms was found across all scales, which persisted for three months after the completion of the intervention. In the control group, which received only pharmacotherapy, improvement was also observed, however it was less pronounced and less stable.

Conclusions. The comprehensive therapeutic-psychosocial program demonstrated high clinical effectiveness and can be recommended for integration into the system of assistance to volunteers. Its implementation contributes to increased psychological resilience and reduction of the risk of exacerbation of psychopathological symptoms.

Keywords: psychiatry, volunteers, psychosocial support, anxiety, post-traumatic stress disorder, stress.