[The effectiveness of autogenic training in the psycho-corrective treatment of the patients presenting with chronic somatic diseases]. / Autogennaia trenirovka v psikhokorrektsii patsientov s khronicheskimi somaticheskimi zabolevaniiami: éffektivnost' i ee prediktory.

BACKGROUND: The autogenic training (AT) is one of the most widely used methods for psychotherapy of patients suffering from chronic somatic diseases (CSD). A number of studies have demonstrated the improvement of the psychological status in the patients under the influence of autogenic training. However, up to the present time, both the mechanisms underlying the therapeutic effectiveness and the predictors of the AT effectiveness have remained to be poorly studied which hampers the development of differentiated indications for the application of this technique. AIM: The objective of the present study was to estimate the effectiveness of AT and to identify the predictors of the outcomes of the treatment of patients presenting with chronic somatic diseases. MATERIAL AND METHODS: The study included 325 patients with CSD who were examined with the use of the shortened multifactorial personality inventory (SMPI), the Spielberger State-Trait Anxiety Inventory (STAI), and the Beck depression inventory (BDI) scales. The patients were randomized into two groups. Group 1 (main) was comprised of 163 patients who underwent AT-based psychotherapy, group 2 (control) consisted of 162 patients who did not receive the psychotherapy. In order to identify the predictors of AT effectiveness, the patients of the main group were subdivided into two subgroups at the end of the study period: (a) including 128 patients whose psychologic status was normalized under psychotherapy and (b) containing 35 patients showing the improvement of their health status. The comparative analysis of the baseline characteristics of the patients belonging to each group was performed. RESULTS: The study has demonstrated that by the end of the observation period the patients of the main group showed a significantly more pronounced (compared with controls) decrease of scales 1, 2, and 7 indicators, an increase of the SMPI scale 9 indicators, and a decrease of STAI and BDI indicators. The positive impact of autogenic training on the psychological status of the patients was mostly attributable to the reduction of anxiety, tension, fixation on negative sensations, and sensitivity to the stress factors as well as to the increased activity and the improved mood. The study of AT predictors revealed that the increase of scales 4 and 6 of SMPI and BDI indicators fairly well predicts the lack of the effectiveness of the method under consideration. CONCLUSIONS: The beneficial influence of the autogenic training on the psychological status of the patients presenting with chronic somatic diseases is mainly mediated through the decrease of anxiety, tension, fixation on negative feelings, sensitivity to stressful influences, increased activity, and improved mood of the patients. A study of AT effectiveness predictors revealed that an increased level of rigidity reduces the effectiveness of this method because of the tendency of the patients toward making excessive efforts to achieve the state of relaxation. The predictors of the high effectiveness of AT the development of which requires regular training proved to be a moderate decrease of the psychological adaptation level together with such characteristics as the ability of the patients to control their behavior, purposefulness, and perseverance in achieving the goal.

[The specific features of the psycho-emotional status and the application of psychotherapy for the rehabilitative treatment of the patients presenting with rheumatoid arthritis]. / Osobennosti psikhoémotsional'nogo sostoianiia i psikhoterapiia v reabilitatsii bol'nykh revmatoidnym artritom.

The relevance of the problem of rheumatoid arthritis arises from the influence of such factors as its prevalence rate, unpredictability, tendency towards the transition to the chronic form, severe pain syndrome, high levels of disability, and long-term loss of working ability, as well as the accompanying psycho-emotional disorders. The present reviews article was designed to analyze the premorbid personality characteristics, the specifics features of mental health, and the response to the disease in the patients presenting with rheumatoid arthritis. Special emphasis is placed on the discusses of the relationship between the intensity of the pain syndrome and psycho-emotional disorders. The factors responsible for the development of the depressive states associated with rheumatoid arthritis are distinguished; they are shown to be related to both pathogenesis and the clinical symptoms of the underlying pathology as well as the general course of the disease and the specific features of the patients' psychological condition. The most extensively applied psychodiagnostics techniques are described, and the commonest psychotherapeutic approaches to the combined therapy and rehabilitation of the patients presenting with rheumatoid arthritis are overviewed.

[The application of the biological feedback technique for the treatment of the patients presenting with chronic somatic diseases]. / Primenenie metoda biologicheskoi obratnoi svyazi pri lechenii patsientov s khronicheskimi somaticheskimi zabolevaniyami.

The objective of the present work was to study the influence of the application of the biological feedback (BFB) technique on the dynamics of the psychological and clinical status of the patients presenting with various chronic somatic diseases (CSD) and to identify the predictors of the effectiveness of the treatment by this method. PATIENTS AND METHODS: The study included 337 patients suffering from CSD who were interviewed with the use of the concise standardized multifactorial personality inventory (SMPI), the Spielberger State-Trait Anxiety Inventory (STAI), and the Beck depression inventory (BDI) scales. The patients were randomly distributed into two groups. Group 1 (main) was comprised of 168 patients who underwent psychotherapeutic treatment based on the BFB method, group 2 (control) consisted of 169 patients who did not receive the psychotherapeutic treatment. In order to identify the predictors of the effectiveness of the treatment by the biological feedback technique, the patients of the main group were subdivided into two subgroups at the end of the study period. Subgroup A contained 112 (67%) patients whose health status was normalized under the influence of psychotherapy, subgroup B included 56 (33%) patients who experienced the improvement of the somatic conditions. We undertook the comparative analysis of the background characteristics of the patients belonging to each group. RESULTS AND DISCUSSION: The study has demonstrated that by the end of the observation period the patients of the main group showed a significantly more pronounced (compared with controls) decrease of the parameters estimated based on the scales 1, 2, and 7 and an increase of those evaluated based on the (SMPI) scale 9. Simultaneously, the levels of state and trait anxiety estimated based on the Spielberger и Beck inventory scales decreased. These findings give evidence of the improvement of psychological adaptation of the patients, decrease of the anxiety level and emotional stress under the influence of the treatment with the use of the biological feedback technique; these changes were concomitant with the enhancement of the general activity of the patients, the improvement of their working capacity, mood, and feelings of optimism. The study of the predictors of the effectiveness of the BFB method revealed the significantly higher background values estimated based on the SMPI scales 1, 4, and 6 in the patients with the improvement of the health status compared with those exhibiting normalized conditions (p<0,01). In 12% of the patients in the former subgroup (but in none of the patients of the latter subgroup), the values obtained based on the Beck scale were higher than 20 scores which suggested either the moderate or high level of depression. These data give reason to conclude that the patients that exhibited a relatively weak response to the treatment with the application of the biological feedback technique were initially predisposed to the un-necessary excessive fixation of attention on their sensations in the combination with enhanced impulsivity, rigidity of attitudes, and the presence of depressive disorders.

[The application of the system of «reminder stickers¼ for the rehabilitation programs with the use of behavioural therapy for the patients presenting with anxiety disorders]. / Sistema stikernykh napominanii v programmakh reabilitatsii s primeneniem povedencheskoi terapii u patsientov s trevozhnymi rasstroistvami.

UNLABELLED: This article was designed to report the results of research on the effectiveness of the new original «reminder stickers¼ technique proposed by the authors for the management of the patients undergoing rehabilitation based on behavioral therapy. The essence of this technique consists of providing the patients with systematic reminders of the need to implement skills aimed at coping with maladaptive sensations that accompany anxiety disorders. AIM: The objective of the present study was to evaluate the effectiveness of using the «reminder stickers¼ technique for the formation of stable responses to the correction of the target clinical symptoms. PATIENTS AND METHODS: The study involved 118 patients suffering from anxiety disorders allocated to two groups for comparison. Group 1 was comprised of the patients (n=76) given the reminders while group 2 contained those (n=42) not included in the system of «reminder stickers¼. The difference between the parameters of interest in the two groups was estimated with the use of Mann-Whitney and Kolmogorov-Smirnov tests. RESULTS: The analysis of diary records of the patients was used to evaluate the frequency of occurrence of maladaptive sensations that required the application of the appropriate behavioural skills and the frequency of the missed or delayed responses as well as the level of subjective satisfaction of the patients with the stability of the acquired skills. It was shown that the patients given «reminder stickers¼ significantly more frequently reported situations that required the application of the appropriate skills within the first week after the initiation of monitoring than the patients of group 2 (р<0,0001). The frequency of the missed or delayed responses in these patients was significantly lower than in group 2 (р<0,0001) whereas the degree of subjective satisfaction with the stability of the acquired skills was much higher (р<0,0001). These differences persisted during week 2 after the onset of monitoring when the frequency of maladaptive sensations that required the application of the previously formed behavioural skills of therapeutic significance in the patients given «reminder stickers¼ remained lower than in the patients to whom no such «remainders¼ were provided (р=0,001). The frequency of the missed or delayed responses in these patients decreased significantly in comparison with that in group 2 (р<0,0001),) while the degree of subjective satisfaction of the patients with the stability of the acquired skills further increased (р<0,0001). CONCLUSION: The results of the study indicate that inclusion of «reminder stickers¼ in the structure of cognitive-behavioral therapy at the stages of formation of the skills needed to cope with maladaptive sensations enhances the ability of the patients presenting with anxiety disorders to much more often timely identify situations that require the use of the appropriate behavioural skills and to apply them. It is concluded that the application of the original «reminder stickers¼ technique ensures an adequate response of the patients to maladaptive sensations that accompany anxiety disorders.

[The role of the respiratory and relaxation training in the treatment of the patients after the surgical treatment of non-specific pulmonary diseases].

The present study included 62 patients who had undergone the surgical intervention for the treatment of non-specific pulmonary diseases. All the patients were subjected to the psychological and spirometric examination. The study has demonstrated the relationship between the characteristics of the external respiration function on the one hand and the ability to handle stress, the levels of anxiety, tension, emotional instability and hypochondriacal mood on the other hand. It was shown that the respiratory and relaxation training improves the effectiveness of the treatment of the patients presenting with such symptoms due to the correction of their psychological status and optimization of the external respiration function. The highest effectiveness of the respiratory and relaxation training was documented in the patients suffering moderate neurotic disorders.

[The color test: psychodiagnostic opportunities for the patients presenting with chronic somatic diseases].

The objective of the present study was to estimate the diagnostic potential of the Luscher color test. A total of 1083 patients presenting with chronic somatic diseases were available for the psychodiagnostic examination. It was shown that the color test makes it possible to evaluate clinically significant psychological characteristics as well as dynamics of anxiety and stress-resistance in this group of patients. Specifically, in the cases of chronic somatic diseases, the test can be used as one of the psychodiagnostic methods especially for mass screening and in the situations when the application of the standard questionnaires encounters difficulties (for example, in the patients with disturbed cognitive functions).

[The psychological characteristics of the patents presenting with pain syndrome].

The psychological characteristics of 336 patients presenting with chronic somatic diseases and long-standing pain syndrome were analysed. It was found that the severity of pain is related to the combination of hypochondriacal, anxious and depressive disorders with rigidity and the tendency toward the formation of various fixations. The impaired quality of life in these patients was attributable to their dissatisfaction about limitations of daily physical activity and communication, as well as to the attitude of the relatives that changed after the disease was confirmed.

[(2R,3R)-3-(4-Nitro-phen-yl)aziridin-2-yl]methanol monohydrate.

The title monohydrate, C9H10N2O3·H2O, contains an aziridine ring including two contiguous stereocenters, both of which exhibit an R configuration. The methyl-hydroxy and nitro-phenyl groups are cis-disposed about the aziridine ring. The mean plane of the benzene ring is tilted to the aziridine ring by 66.65 (8)°. The nitro group is nearly coplanar with the benzene ring [dihedral angle = 2.5 (2)°]. In the crystal, the components are linked by N-H⋯O, O-H⋯N and O-H⋯O hydrogen bonds, generating supra-molecular layers parallel to (001).

(4S)-4-[(R)-Chloro-(4-nitro-phen-yl)meth-yl]-1,3-oxazolidin-2-one.

In the title compound, C10H9ClN2O4, the oxazolidinone ring adopts a near-planar conformation, with mean and maximum deviations of 0.0204 (8) and 0.0328 (8) Å, respectively. The nitro group is twisted slightly from the plane of the benzene ring, making a dihedral angle of 6.79 (3)°. The dihedral angle between the mean oxazolidinone plane and the benzene ring is 56.21 (3)°. In the crystal, N-H⋯O hydrogen bonds and N-O⋯π inter-actions [O⋯centroid distances = 3.478 (1) and 3.238 (1) Å] dominate the packing, forming infinite zigzag chains along the b-axis direction. Neighbouring chains are linked together through C-H⋯O and C-H⋯Cl inter-actions. The absolute configuration of the two stereogenic centres was determined using the anomalous dispersion of the Cl atom.

[Medical and psychological rehabilitation of patients and disabled persons].

The paper unveils the concept of medical rehabilitation and defines its place in clinical medicine. It underlines the inextricable link and interaction of different components of a rehabilitation system. The value of the psychological aspect of rehabilitation is considered. Categories of patients and disabled persons who need psychological rehabilitation are identified; a classification of personal reactions to disease and the changes in the psychological state of patients in different periods after disease onset are given. The factors influencing the process of psychological readjustment in patients and the disabled are analyzed. The psychological rehabilitation system for patients and disabled persons is considered in detail. Data on its medical and socioeconomic efficiency are presented.

[The efficacy of combined psychogenic correction of the compromised reserve capacities in the patients presenting with chronic somatic diseases].

The present study included 105 patients presenting with various chronic somatic diseases. Their psychological status was estimated with the use of the abridged variant of the multifactor questionnaire MMPI, STAI scale, Beck depression scale, quality of life scale, and stress tolerance self-assessment scale. It was shown that the proposed method of combined psychological correction is efficacious for the enhancement of psychological reserves of the patients, reduction of anxiety, tension, hypochondriac thoughts, irritability, impulsiveness, and ostentation, heightening of the mood and activity. The improved quality of life associated with combined correction of the psychological status is attributable to the reduction of the number of restrictions necessary to avoid situations leading to emotional stress.

[Factors affecting psychological reserves in the patients presenting with chronic somatic diseases].

The present study included 105 patients suffering chronic somatic diseases (CSD). Their health status was estimated based on the brief multifactor questionnaire for personality (BMQP) analysis; Spielberg state trait anxiety inventory (STAI); the Beck depression scale with the use of the "patient's quality of life" method; the well-being, activity, and mood (WAM) self-assessment test, and the stress-tolerance self-assistance test. The impairment of psychological reserve was documented in 85.7% of the patients with CSD. The degree of CSD deterioration was shown to be related to the frequency of exacerbation of clinical conditions, the severity of pain syndrome, the level of anxiety, depression, and hypochondriac mood. The impairment of psychological reserve was accompanied by the deterioration of the quality of life due to constraints imposed by the necessity to undergo medical treatment, avoid situations of emotional stress, restrict the scope of physical and social activities.

[The influence of respiratory relaxation training on psychological reserves in patients with chronic somatic diseases].

Comparative analysis of dynamics of the psychological status of 25 patients with chronic somatic diseases is presented. The patients were subjected to psychocorrection by respiratory relaxation training (RRT). The control group comprised 26 patients with the same problems undergoing no RRT. The evaluation was based on MMPI (Mini-Mult variant), STAI, Beck's depression inventory, quality of life inventory, and stress tolerance self-assessment scale. Respiratory relaxation training enhanced psychological reserves of the patients by reducing the anxiety and tension levels, modulating hypochondriac mood, by increasing psychological resistance to stress. These changes resulted in marked improvement of the quality of life. The efficiency of respiratory relaxation training in patients with elevated levels of impulsivity and demonstrativity proved lower than in patients with depressive disorders.

[Predictors of the efficacy of methods for psychocorrection in patients with irritable bowel syndrome and constipation].

Prognostic factors that predict the efficiency of autogenous training and psychopharmacotherapy were detected in 90 women with irritable bowel syndrome and constipation. A multifactor personality questionnaire, Spielberg's state-trait anxiety test, Beck's depression inventory scale, and visual analog scale were used for the purpose of psychodiagnosis. The efficiency of autogenous training was found to be higher in patients with irritable bowel syndrome and mildly or moderately compromised psychological adaptation associated with a moderately elevated level of anxiety. Psychopharmacotherapy proved to be especially efficacious in patients with hypochondriac, depressive, and manifest anxiety disorders. It was found that the pronouncedness of rigidity, tension, fixation-proneness, and the degree of depression could be used as predictors of positive effects of psychopharmacotherapy on stool patterns while hypochondriac trends served as predictors of the alleviation of pain syndrome in patients with irritable bowel syndrome and constipation.

[Efficiency of autogenous training in medical rehabilitation of patients with irritable colon syndrome with constipation dominance].

It was established that use of autogenous training makes possible to increase efficiency of the therapy, leading to considerable more evident improvement of somatic and psychotic state, decrease of pain syndrome. Predictors of efficiency of autogenous training were marked out. Indications for use the method in medical rehabilitation of patients with irritable colon syndrome with constipation dominance were elaborated.

[Efficacy of the psychocorrection methods in the medical rehabilitation of patients with chronic salpingoophoritis and chronic pelvic pain syndrome].

Analysis of efficiency of respiratory relaxational training and of the visualization method was performed for 90 women with chronic salpingoophoritis and the syndrome of chronic pelvic pain. Use of psychocorrection made possible to improve efficiency of the treatment significantly decreasing intensity of the pain and improving psychological status of the patients. Predictors of efficiency and indications for differentiated use of these methods for the medical rehabilitation of patients were worked out.