Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2025
[Rehabilitation of persons with primary organic mental disorders complicated by alcoholism in middle and elderly age].
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Kardashian R A, Efremov A A, Nikiforov I A
Аннотация
OBJECTIVE: To assess the effectiveness of the rehabilitation program for persons with primary organic mental disorders complicated by alcoholism in middle and elderly age.
MATERIAL AND METHODS: The study included male patients aged 67.5±7.2 years divided into two groups. Group 1 included 49 patients (59%), and group 2 included 34 (41%) of subjects with the symptoms of primary organic mental disorders that occurred in childhood, compensated in high school, and relapsed at the age of 38.2±2.0 and 46.5±2.2 years, respectively, and alcohol withdrawal syndrome (AWS) diagnosed at the age of 53.8±1.2 and 66.8±0.9 years, respectively. The following methods were used: questionnaire - social interview; clinical (medical history, follow-up, information from children's outpatient records of patients); assessment of mental status using various scales (quantified scale for assessing the severity of psychopathological disorders, clinical scale for assessing pathological alcohol craving [PAC], anosognosia scale, "Questionnaire for Assessing the Quality of Remission in Remote and Hard-to-Reach Regions" during the remission); prospective observation; statistical methods (parametric, non-parametric).
RESULTS: In patients of group 1, after 6 months of rehabilitation, the severity (p<0.05) of the emotional and autonomic component of PAC, depression, anxiety, and mild to moderate dysphoria decreased; after 12 months, the manifestations of psychopathy-like syndrome and the autonomic component were reduced, and the rest of the studied indicators were non-significant. In patients of group 2, after 6 months of a rehabilitation program, the severity of the emotional component of PAC, anxiety, dysphoria, and asthenia decreased (p<0.05) from moderate to mild; after 12 months, the manifestations of the emotional and ideational component of PAC, anxiety, and asthenia remained non-significant, and the other symptoms of psychopathological disorders were reduced.
CONCLUSION: The proposed step-by-step differentiated rehabilitation and preventive care program has helped many patients achieve remission of medium and high quality with a decrease in PAC to a non-significant grade.
MATERIAL AND METHODS: The study included male patients aged 67.5±7.2 years divided into two groups. Group 1 included 49 patients (59%), and group 2 included 34 (41%) of subjects with the symptoms of primary organic mental disorders that occurred in childhood, compensated in high school, and relapsed at the age of 38.2±2.0 and 46.5±2.2 years, respectively, and alcohol withdrawal syndrome (AWS) diagnosed at the age of 53.8±1.2 and 66.8±0.9 years, respectively. The following methods were used: questionnaire - social interview; clinical (medical history, follow-up, information from children's outpatient records of patients); assessment of mental status using various scales (quantified scale for assessing the severity of psychopathological disorders, clinical scale for assessing pathological alcohol craving [PAC], anosognosia scale, "Questionnaire for Assessing the Quality of Remission in Remote and Hard-to-Reach Regions" during the remission); prospective observation; statistical methods (parametric, non-parametric).
RESULTS: In patients of group 1, after 6 months of rehabilitation, the severity (p<0.05) of the emotional and autonomic component of PAC, depression, anxiety, and mild to moderate dysphoria decreased; after 12 months, the manifestations of psychopathy-like syndrome and the autonomic component were reduced, and the rest of the studied indicators were non-significant. In patients of group 2, after 6 months of a rehabilitation program, the severity of the emotional component of PAC, anxiety, dysphoria, and asthenia decreased (p<0.05) from moderate to mild; after 12 months, the manifestations of the emotional and ideational component of PAC, anxiety, and asthenia remained non-significant, and the other symptoms of psychopathological disorders were reduced.
CONCLUSION: The proposed step-by-step differentiated rehabilitation and preventive care program has helped many patients achieve remission of medium and high quality with a decrease in PAC to a non-significant grade.