Psychosomatic Medicine and General Practice

Psychotherapy at the crossroads of eras: the conflict of postmodernity and postindustrial society as a new challenge for Homo sapiens

Oleg Chaban — 2026-06-30

Історія людства знає чимало періодів, коли технологічний розвиток випереджав здатність людини осмислити його наслідки. Винайдення друкарського верстата, парової машини, електрики, антибіотиків, комп'ютера або Інтернету незмінно змінювали не лише спосіб життя, а й саме розуміння людиною себе. Проте вперше за всю історію цивілізації людство опинилося перед феноменом, який здатний не просто виконувати фізичну роботу чи автоматизувати обчислення, а вступати з людиною у діалог, демонструвати ознаки емпатійної взаємодії, адаптуватися до її особистості, аналізувати її переживання і навіть створювати враження психологічної підтримки. Надто глибокий і достовірний конструкт суто людського мозку ставить перед людиною великі питання сутності діяльності та взаємодіяльності самої людини.

Characteristics of the response in patients with major depressive disorder, who have experienced repeated internal displacement, in relation to the change of socio-demographic factors

Iryna Chumakova — 2026-06-30

The goal of this work is to identify the components that contribute to increased psychosocial vulnerability, due to their socio-demographic status acquired by repeated internal displacement, among individuals with major depressive disorder.

Between 2024 and 2026, 150 patients suffering with major depressive disorder (MDD) were examined at mental health centers in Luhansk and Rivne; of these, 75 were repeatedly internally displaced (RID) persons, and 75 were patients who had not experienced displacement. Research methods: anamnestic, clinical-psychopathological (using ICD-10 criteria, the M.I.N.I. international neuropsychiatric interview for the assessment of psychotic disorders (Ukrainian version 7.0.2 for DSM-5) and clinical. The study was conducted using semi-structured interviews based on the relevant sections of a patient assessment form that had been developed and tested. These sections covered socio-demographic status (including education, employment, and financial circumstances), family anamnesis, family and social connections’ state. Data obtained was processed using analytical statistical methods, including correlation analysis (t-test, χ²) by “Data analysis” function on Excel.

We carried out a comparative analysis of socio-demographic indicators to identify the social, demographic and economic components of psychosocial vulnerability (PV) associated with the social status of patients with MDD who have experienced RID.

Among the components of PV related to social status in patients with MDD who have been internally displaced more than once, economic and social predictors of increased PV and, consequently, increased distress have been identified. Thus, a significant and statistically significant reduction was found in the level of satisfaction among RID patients with MDD with their current living and financial conditions and leisure activities at the moment of the examination, compared with the control group (1.47-fold and 1.36-fold, respectively, at p<0.001), which constitutes an additional risk factor for the development of affective disorders, as well as a factor contributing to resistance to antidepressant therapy

The results will help us optimize treatment for MDD in people who have been displaced twice, predict treatment’s effectiveness, and identify factors that influence it.

Keywords: major depressive disorder, repeated internal displacement, psychosocial vulnerability, distress, resilience, socio-demographic predictors

Patient-Reported Effectiveness of Proactive Psychiatric Care in Patients with Chronic Pain: A SPAASMS-Based Assessment

Azize Asanova — 2026-06-30

Background. Contemporary approaches to chronic pain management extend beyond the assessment of pain intensity alone and increasingly emphasize a broader range of outcomes reflecting functional status, psychological well-being and patient’s subjective perception of treatment effectiveness. Consequently, the use of comprehensive assessment tools has become increasingly important for evaluating the effectiveness of multimodal chronic pain treatment programs.

Objective. To evaluate the impact of proactive psychiatric support on pain perception, functional status, and psychological well-being in patients with chronic pain using the SPAASMS scale.

Methods. A prospective cohort clinical psychopathological study was conducted involving 302 patients with chronic pain who completed a personalized multimodal treatment program delivered within the framework of proactive psychiatric support. According to a psychiatric-oriented stratification model, patients were allocated to five groups: primary psychogenic pain (PPP1), primary psychophysiological pain (PPP2), mixed primary psychogenic and psychophysiological pain (PPP3), secondary mixed pain (SMP) and secondary organic pain (SOP). Mental disorders were verified according to ICD-10 diagnostic criteria, with subsequent alignment of diagnoses with ICD-11. Subjective pain-related outcomes were assessed using the SPAASMS scale at baseline and after 12 months after treatment initiation. Statistical analyses were performed using RStudio. Data normality was assessed with the Shapiro–Wilk test, and repeated measures were analyzed using the Friedman test. A p-value <0.05 was considered statistically significant.

Results. Following completion of proactive psychiatric support, a statistically significant reduction in total SPAASMS scores was observed across all study groups (p<0.001). The most pronounced improvement was found in the PPP1 and PPP3 groups, where total SPAASMS scores decreased 5.7-fold and 4.2-fold, respectively. All groups demonstrated significant reductions in pain intensity, accompanied by improvements in physical activity, sleep quality, and mood, as well as decreased reliance on additional analgesic medications and fewer healthcare visits related to pain. A reduction in treatment-related adverse effects was also observed. The least pronounced improvement in pain-related outcomes was found in the SOP group.

Conclusions. Proactive psychiatric support was associated with significant improvements in patient-reported pain outcomes across all SPAASMS domains. The greatest clinical benefit was observed among patients with primary psychogenic pain and mixed primary psychogenic and psychophysiological pain, highlighting the importance of psychopathological mechanisms in shaping the subjective experience of chronic pain and supporting the integration of proactive psychiatric care into multimodal treatment programs.

Keywords: chronic pain, patient-reported effectiveness, SPAASMS, psychiatric care, multimodal treatment, psychosomatic medicine.

Psychological characteristics of anxiety manifestations in children with rare diseases and craniofacial developmental anomalies: a comparative study

Anastasiia Tokarchuk — 2026-06-30

Background. Patients with rare diseases or craniofacial developmental anomalies constitute a special category due to the presence of rare hereditary disorders that are often accompanied by congenital deformities of the face, head, and neck. Compared with patients in general pediatric hospitals, they tend to experience excessive self-criticism, difficulties in social interactions, and lower self-confidence.

Objective. To investigate the characteristics and structure of anxiety in patients with rare diseases and craniofacial developmental anomalies compared with patients treated in a multidisciplinary pediatric hospital.

Materials and Methods. This study analyzed the level and structure of anxiety in patients with rare diseases and craniofacial developmental anomalies compared with patients admitted to a multidisciplinary hospital. The research was conducted at the State Non-Profit Enterprise National Children's Specialized Hospital "Okhmatdyt" of the Ministry of Health of Ukraine. A total of 205 patients aged 6–18 years (mean age: 12 years) participated in the study with informed consent obtained from both the children and their parents. Participants were divided into two groups. Group 1 included 103 patients with rare diseases and craniofacial developmental anomalies (49 girls and 54 boys). Group 2 consisted of 102 age-matched patients with general medical conditions (57 girls and 45 boys). No statistically significant demographic differences were observed between the groups. Anxiety was assessed using the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire, the Social Phobia Inventory (SPIN), and the State-Trait Anxiety Inventory (STAI). Statistical analysis was performed using the Mann–Whitney U test.

Results. Statistically significant differences were found between the two groups across all anxiety measures (p < 0.001). Patients with rare diseases and craniofacial developmental anomalies demonstrated significantly higher anxiety scores: SCARED – 52 [47; 58] versus 22 [19.3; 25]; SPIN – 45 [25; 66] versus 27 [25; 33]; STAI state anxiety – 43 [37; 48.5] versus 37.5 [34; 42]; and STAI trait anxiety – 49 [41; 55] versus 41 [36; 44]. These findings indicate that anxiety represents a dominant component of the psychoemotional status of patients with rare diseases and craniofacial anomalies, manifesting as increased sensitivity to social evaluation and impaired social adaptation. In contrast, patients with general medical conditions predominantly demonstrated moderate anxiety levels. The findings may serve as a basis for developing and improving psychological support programs tailored to the specific needs of these patients.

Conclusions. Elevated levels of both trait and social anxiety are characteristic psychological features of patients with rare diseases and craniofacial developmental anomalies. The findings support the necessity of developing specialized psychological support and intervention programs that address the individual psychological needs of this patient population.

Keywords: anxiety, psychological characteristics of anxiety, rare diseases, craniofacial developmental anomalies, children, psychological support.

Features of emotional burnout in psychologists working in the field of mental health during war

Nataliya Maruta — 2026-06-30

Relevance. Assessing the state of emotional burnout among mental health professionals during the war is extremely relevant.

Aim. To assess emotional burnout among psychologists working in municipal psychiatric care facilities during the war.

The materials and methods. Included the “Questionnaire of sociodemographic indicators of medical workers in the field of mental during the war”, the methodology of K. Maslach and S. Jackson (Maslach Burnout Inventory - MBI), the methodology of the “Professional Quality of Life Assessment Scale” (PROQOL-5), the questionnaire for measuring burnout (BAT) (work-related version) - part 1 and part 2, the questionnaire “Coping Strategies” by R. Lazarus, mathematical processing methods. The survey was conducted among 39 clinical psychologists and psychologists during the war, working in municipal psychiatric care.

Results. It was established that 100.00% of psychologists have a syndrome of emotional burnout of varying degrees of severity. The assessment of working conditions during the war was characterized by the compounding effects of an increase in the number of patients, heightened tension, worsening psychological conditions, and reduced financial support for the organization of the work process. The assessment of the professional quality of life of psychologists showed an average level of indicators on the scales "Satisfaction with compassion" and "Burnout" and a low level of indicators on the scale "Compassion fatigue / Secondary traumatic stress" in the majority of those surveyed. The ambiguous role of coping strategies in the formation of emotional burnout was determined: maladaptive coping strategies (confrontational and escape-avoidant coping) contribute to increased emotional exhaustion. Adaptive coping strategies do not affect the increase in emotional burnout in psychologists. A particularly important role is identified between all coping strategies and the reduction of personal achievements, which is supported by strong positive relationships between these indicators.

Keywords: emotional burnout, psychologists, war

УДК 616.89:159.944:159.9-051:355.01