DETERMINING THE PSYCHOPATHOLOGICAL STRUCTURE’S FEATURES OF POSTTRAUMATIC STRESS DISORDER COMORBID WITH TRAUMATIC BRAIN INJURY, USING THE CAPS-5 SCALE

Abstract

The issues of diagnostic and treatment algorithms for comorbidity of PTSD and TBI are quite controversial, as the symptoms inherent in PTSD are not specific and can occur in other psychogenic disorders.

The aim – to study of the presence of key clinical and psychopathological differences in the symptomatic structure of the mental status of patients with PTSD and those in whom clinically defined PTSD was combined with comorbid trauma, which may be the basis for further development of a system of specific focused psychotherapeutic measures.

Material and Methods. Material of the study – 329 servicemen who took part in hostilities: 1 group – 109 people (33.1 %) with PTSD; Group 2 – 112 people (34.0 %) with the consequences of trauma; 3rd group of TBI – 108 people (32.8 %) with PTSD with comorbid consequences of TBI.

Results. When comparing the indicators of the scales in the respondents of the PTSD and TBI groups, it was found that the respondents who made up the PTSD group had significantly (p≤3E-07) higher scores on all test scales: according to the complex criterion "E" such an advantage was more than in 4 times, according to criterion "C" and "G" – more than 5 times, according to criteria "B" – more than 18 times.

When comparing the results obtained in the survey of PTSD and KCHMT groups, it was found that all scales of clusters "B", "C", "E", the total cluster "G", the scale G3 and the integrated indicator "savCAPS", as in the case compared with the respondents of the TBI group, had higher rates in the PTSD group (p≤0.05), then between the indicators of the cluster scales "D", "dCAPS", as well as scales G1 and G2 in the respondents of the PTSD groups and CSFM statistically significant differences was not (p≥0.1).

Conclusions. The CAPS-5 technique showed high sensitivity not only to the diagnosis of the presence or absence of clinically delineated PTSD, but also to study the features of the psychopathological structure of conditions when the manifestations of PTSD are combined with comorbid trauma. At the same time there are no significant differences which testify to advantage in a clinical picture of any separate group of psychopathological symptoms.