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Peculiarities of combination of the postviral fatigue syndrome and posttraumatic stress disorder (lecture)

ISSN 2223-6775 Ukrainian journal of occupational health Vol.16, No 4, 2020

Peculiarities of combination of the postviral fatigue syndrome and posttraumatic stress disorder (lecture)

Zaitsev D.V., Alekseieva L.M., Opanasenko V.V.

https://doi.org/10.33573/ujoh2020.04.311

State institution «Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine», Kyiv

Full article (PDF), UKR

Introduction. Posttraumatic stress disorder (PTSD) and postviral fatigue syndrome (PFS) were nosologically defined several decades ago and need for futher study. Both syndromes belong to the group of adjustment disorders and have similar features in pathogenesis and clinic. In Ukraine, the problem of PTSD has become relevant since 2014 through the hostilities in the east of the country; at the same time, insufficient attention is paid to the problem of PFS and especially to the comorbidity of PFS and PTSD.

Aim. Review and analyze of the comorbidity of PTSD and PFS in combatants.

Methods. We selected literary data in the search engines Google Scholar, PubMed and sources of clinical guidelines recommended by the Order of the Ministry of Health of Ukraine No. 1422 (2016) for the keywords "chronic fatigue syndrome", "post-traumatic stress disorder", "military personnel" (Ukrainian, Russian and English) for the period of 2000-2020.

Results. The prevalence of PTSD and PFS is estimated roughly; in Ukraine, we suspect insufficient identification of such disorders. For combatants, the tension of adaptation mechanisms persists throughout their stay in the conflict zone. Risk factors for the development of PTSD and PFS in combatants are individual and situational. The pathogenesis of PFS and PTSD has similar features. The clinical manifestations of PFS attract attention when they are significant, while in PTSD the symptoms rapidly progress and are quite clear. Diagnosis of PTSD passes a well-established algorithm, while the diagnosis of PFS is less defined and is based on some number of controversial diagnostic criteria. The tactics of therapy and rehabilitation are supportive and symptomatic. In PTSD, preference is given to psychotherapy and pharmacotherapy with selective serotonin reuptake inhibitors. For PFS, specific pharmacotherapy has been proposed for variants associated with herpesvirus infection only.

Conclusion. Considering PTSD and PFS as maladaptosis caused, by superintense and superlonged stressors, respectively, it is clinically advisable to take into account their pathogenetic relationship. The comorbidity of PTSD and PFS in combatants requires further study, in particular, from the standpoint of psychophysiology.

Key words: chronic fatigue syndrome, post-traumatic stress disorder, combatants.

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