Diagnosis of cognitive dysfunction in the military with mental and behavioral disorders due to alcohol use associated with depression
Cognitive impairment, which in most cases are not considered by the doctor, and thus remain outside the scope of medical care, are characteristic for almost all patients with mental illness. Ignoring the manifestations of cognitive impairment is primarily due to the fact that the range of cognitive abilities has individual characteristics for each person and therefore their definition does not have clear criteria for evaluation. The article presents the traditional methods of psychodiagnostics studies for identifying cognitive disorders, depressive states, individual typological features in the military with mental and behavioral disorders due to alcohol consumption to improve the quality of diagnosis and further medical support for patients in this category. Typical symptoms in this group of patients were: sleep disturbances; low mood; unexpected attacks of anger, indignation, unreasonable fear; anxiety; irritability, autonomic disorders, depression. According to the informed consent, we used several standardized neuropsychological tests, which had high characteristics of validation and reliability, to study the individual psychological differences of patients, according to the literature [1,2]. Emotional disturbances were assessed before and after treatment using the Mini Mental State Examination (MMSE) scale , which determined short-term and long-term memory in patients; auditory functions were studied according to the method of A.Luria; to conduct a clock drawing test, the subject was asked to draw a clock, the results of which indicated that the patient had clinically significant cognitive impairment; G. Eisenko's questionnaire was used to identify the main individual personality traits; Spielberger-Hanin questionnaire was used to assess the manifestations of reactive and personal anxiety ; the level of depression was determined by the Tsung scale. To objectively assess the pain response, dynamic recording of pupil diameter (pupillometry) was used to determine the human autonomic response  and a visual analog scale (VAS). According to the results of the study, it was found that in patients of both groups - 86 people (main and control) revealed up to 50% borderline cognitive impairment, which can be considered a reliable prognostic informative sign of the mental state of patients. Low anxiety on the Spielberger-Hanin scale has been reported in patients with depressive symptoms. All other screening diagnostic scales revealed borderline cognitive impairment in all patients. Thus, it has been proven that borderline cognitive impairment in patients with mental and behavioral disorders due to alcohol use interacts with depression, which significantly affects cognitive abilities. To eliminate cognitive impairment (CI), patients of both groups were offered a comprehensive traditional treatment with the additional use of the metabolic drug cytoflavin. Literature sources  confirm the expediency of using a complex metabolic neuroprotective drug, the action of which is directed at the synthesis of energy complexes through various receptor, enzymatic and mediator systems. According to the authors , cytoflavin can be attributed to metabolic drugs, which acts as an inducer of major metabolic pathways in cells, promotes the utilization of free oxygen and prevents ischemic changes in organs and tissues by reducing the level of peroxide processes. Complex therapy of treatment of borderline cognitive states with a course of cytoflavin is pathogenetically justified, which provided in our study an improvement in the psychological state of soldiers of both groups. Purpose: to study the dynamics of the validity and effectiveness of methods for assessing the cognitive status of patients with mental and behavioral disorders due to alcohol use associated with depression and carrying out a correction of cognitive dysfunction by additional administration of cytoflavin. Conclusion: Based on a battery of diagnostic tests, accurate and adequately comparable indicators were obtained, which allowed to establish an objective picture of cognitive impairment, their correlation with depression, which significantly affected the outcome of treatment. Correction of cognitive dysfunction was performed by additional administration of cytoflavin 2 tablets 2 times a day PO for half an hour before meals.
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