Therapeutic targets for pharmaco- and psychotherapy in persons with mental disorders who have undergone Covid-19 and have been exposed to Sars-Cov-2 pandemic stressors

Abstract

Background. For effective therapeutic tactics, it is necessary to determine the structure of mental disorder and the goals of therapeutic effect. Purpose – Determination of targets of therapeutic effects in mental disorders revealed as a result of coronavirus infection on the basis of anamnestic, clinical-andpsychopathological and pathopsychological studies. Materials and Methods. To study the state 95 patients at the time of examination had various psychopathological disorders and had in anamnesis the infection Covid-19 (neurotic, stress and somatoform disorders – 31 people, affective disorders – 31 persons and organic mental disorders – 33 persons). The comparison group includs the persons who did not have a history of coronavirus infection. Research methods were clinical-psychopathological, psychodiagnostic, statistical. Results. On the basis of careful analysis of clinical-anamnestic, psychopathic and pathopsychological features of patients with psychopathological disorders, which suffered infection of the Covid-19 and were exposed to stressful factors of pandemic, the targets of therapeutic influence were determined. Among the anamnestic factors, the most significant was the impact of Sars-Cov-2 pandemic stressors (potentially life-threatening situation with indefinite duration; high risk of getting sick and family members who care for the patient; large-scale quarantine measures with the main component in the form The background with excess controversial information). At the same time, maladaptive forms of overcoming stressful situations in patients in the form of response of coping strategies, oriented on emotions, led to immersion in their own experiences, and were not aimed at solving specific problems. In addition, low rates of personal adaptive potential, behavioral regulation were determined. Among the frustrating factors, «health and productiveness», «relationships with relatives», «relationships with friends» are important. Among the clinical features of patients were identified three main groups – disorders of affective spectrum – anxiety and depressive symptoms, impaired cognitive sphere – mild and moderate cognitive symptoms – attention, memory and dynamic thinking disorders, and sympathicotonic autonomical disorders. Conclusions. The features of the clinical picture, anamnesis, adaptation potential and protective psychological mechanisms are established are targets of therapeutic effects in the treatment and rehabilitation.