Post-traumatic stress disorder in combatants with the inclusion of comorbid disorders (alcohol use disorders, cognitive dysfunctions)

Abstract

In the context of active military operations in Ukraine, post-traumatic stress disorder (PTSD) has become an extremely important health problem for both combatants and civilians. During the war in Ukraine, the prevalence of PTSD is increasing, and its clinical manifestations can accumulate and manifest themselves remotely, combining with comorbid disorders. PTSD is often associated with alcohol use disorders (AUD ), cognitive dysfunctions (CD), depression, anxiety, and mania. Today, the diagnosis of PTSD is a problem due to the multiplicity of the patient population (military personnel, veterans, civilians of different age groups), diverse clinical manifestations, different approaches to diagnosis, frequent combination with other psychopathological conditions and addictions, in particular alcohol. A certain formal distinction of these conditions is made based on the characteristics of the clinical picture, as well as taking into account the time of onset and duration of the disorders. PTSD was diagnosed in 585 patients who participated in the study using information-analytical, clinical-anamnestic, socio-demographic, clinical-psychopathological, psycho-diagnostic and statistical research methods. PTSD was diagnosed in 46.84±2.06% of the subjects, while it was not registered in 53.16±2.06% of the subjects. Two main groups of patients with PTSD were created, totaling 274 combatants: OG1 (n = 150; mean age 31.0±2.6 years) with isolated PTSD and OG2 (n = 124; 27.5±4.0 years; p > 0.05) with PTSD combined with AUD. The comparison group (CG) included 105 individuals with AUD aged 28.1±3.7 years. Additionally, 2 control groups (CGs) were formed for statistical comparison: CG1 (n = 105; mean age 22.4±4.2 years) to determine the psychological state of military personnel who were not in the combat zone, and CG2 (n = 50; mean age 30.1±6.5 years) of healthy individuals. The main, comparison, and CG2 groups were comparable in age distribution. All patients underwent an assessment of clinical symptoms and the frequency of disorders was determined. It was proven that alcohol dependence in combatants with PTSD negatively affected cognitive function, which was manifested by a deterioration in the performance of cognitive-executive functions and memory; all p < 0.05. The connection between PTSD and the somatic condition of the combatant has been demonstrated, i.e., evidence has been obtained of PTSD as an exogenous-organic disorder. The aim of the study is to identify clinical specific symptoms of PTSD and combined PTSD with AUD in combatants.