Analysis of Problems Associated with Diagnostics Combat Post-Traumatic Stress Disorder in a Psychiatric Hospital

Background : in recent years, it has become relevant to study the effects of military operations on the mental health of veterans. The aim was to identify and evaluate the leading psychopathological symptoms in veterans of a special military operation (SMO), as well as to compare diagnoses upon admission and discharge from the hospital. Patients and Methods : 140 male veterans of local wars and armed conflicts who were treated at N.A. Alekseev Psychiatric Clinical Hospital No. 1 in the period from 2023 to 2024 were examined. The average age of the participants was 34.2 ± 8.3 years. During the study, a clinical and psychopathological analysis of the identified symptoms and risk factors in patients was carried out. Results: the study revealed a high prevalence of anxiety (75.7%) and depression (51.4%) among participants with a preliminary diagnosis of post-traumatic stress disorder (PTSD). An analysis of the symptoms of PTSD showed that intrusion (72.1%) is the most common. The high incidence of organic mental disorders caused by traumatic brain injury (TBI) (26.4%), PTSD (18.6%) and affective disorders (20%) was confirmed, in addition, the presence of patients with preliminary diagnoses of the schizophrenic spectrum (15.7%) was noted, which are subsequently confirmed. Conclusions : in clinical practice, the phenomenology of mental disorders due to combat stress is characterized by a variety of symptoms, many of which are not specific to PTSD and therefore are not included in the set of diagnostic criteria. The observed dominant severity of affective register disorders, behavioral disorders, asthenia and individual symptoms of organic brain damage determines the evolution of the diagnosis from the initial examination to the time of discharge with a decrease in the frequency of diagnosed PTSD. Despite the presence of leading or even typical symptoms of PTSD, attention should be paid to other complaints and psychopathological signs, since they can be predominant in the picture of the disease, have a significant impact on the patient’s quality of life and become the most important or promising target of therapy.