MENTAL DISORDERS IN CONDITIONS OF EXTREME AND CRISIS SITUATIONS: GENERAL CHARACTERISTICS AND PATHOMECHANISM OF FORMATION

Abstract

The article defines and provides a general description of the groups of mental disorders that are the most common (according to patients' requests) and arise as a result of psychotrauma during the war in Ukraine: anxiety disorders; dissociative disorders; mood disorders; disorders associated with trauma and stress; sleep disorders; disorders associated with somatic symptoms - somatoform disorders, neurasthenia; eating disorders; personality disorders (Cluster C). According to the ICD-10, the disorders that were defined as psychosomatic are characterized: dissociative (conversion) disorder, somatoform disorders (somatization disorder, hypochondriac disorder, somatoform vegetative dysfunction, chronic somatoform pain disorder), neurasthenia, eating disorders.

It is determined that in pathogenesis somatoform disorders can be conversion or functional, however, a prolonged stressful state, or a certain neurotic disorder determine the occurrence of psychosomatic diseases. The article defines and provides a general characteristic of the methods of diagnosis of neurotic and psychosomatic disorders. Based on the psychodynamic and psychophysiological models of psychosomatic disorders, as well as neurobiological studies of A. Korb, the general pathomechanism of the formation of psychosomatic disorders is identified and substantiated. The role of the conscious and unconscious in the occurrence and therapy of psychosomatic disorders is analyzed.

Based on modern neuroscience research, it is proven that the neurobiological target of both psychotherapy and psychosomatic therapy is the activation of the prefrontal cortex of the brain. It is substantiated that an active prefrontal cortex calms the limbic (emotional) structure of the brain, helps to restrain excessive activity of the striatum. The medial prefrontal cortex can project its activity to the dorsal striatum, the amygdala, and the orbitofrontal cortex to the adjacent nucleus. It is substantiated that to activate the prefrontal cortex in the process of therapy, it is necessary to balance the interaction of the conscious with the unconscious, which can be carried out within the author's model of somatic and psychospiritual therapy.