Psychosomatic Medicine and General Practice

Psychoemotional and Somatic Indicators in Relation to Quality of Life Among Medical Students at Different Stages of Training

2026-06-11T15:50:24+03:00

Background. Psychoemotional disturbances and somatic symptoms are common among medical students and can be accompanied by a decrease in quality of life and impaired adaptation to the educational process.

Objective. To analyze the relationship between psychoemotional and somatic manifestations and quality of life among medical students at different stages of training.

Materials and methods. The study involved 193 medical students of О.О. Bogomolets National Medical University, from the first to the sixth year of study, aged 18 to 24 years. Data collection was carried out by anonymous online survey using the Google Forms platform. The Generalized Anxiety Disorder 7-item scale (GAD-7), the Beck Depression Inventory-II (BDI-II), the Somatic Symptom Scale-8 (SSS-8), and the quality of life assessment scale (ed. prof. Chaban O.S.) (CQLS) were used to assess the psychoemotional state and somatic manifestations. Statistical processing of the results was carried out using descriptive statistics, the Student's t-test, and Spearman's rank correlation coefficient.

Results. The level of anxiety in the studied sample ranged from 9.5 ± 4.1 to 11.4 ± 5.0 points, the level of depressive symptoms ranged from 19.5 ± 8.3 to 24.2 ± 9.6 points, somatic symptoms ranged from 13.9 ± 5.9 to 17.6 ± 6.1 points, and quality of life indicators ranged from 50.8 ± 15.8 to 59.5 ± 19.0 points. Statistically significant inter-year differences were found for individual indicators of somatic symptoms, depressive manifestations, anxiety, and quality of life (p < 0.05). Statistically significant direct correlations were found between the level of anxiety, depressive manifestations, and somatic symptoms: GAD-7 ↔ SSS-8 (rₛ = 0.554; p < 0.001), BDI-II ↔ SSS-8 (rₛ = 0.562; p < 0.001), GAD-7 ↔ BDI-II (rₛ = 0.567; p < 0.001). Statistically significant inverse correlations were found between quality of life indicators and the level of anxiety (rₛ = −0.412; p < 0.001), somatic symptoms (rₛ = −0.444; p < 0.001), and depressive manifestations (rₛ = −0.763; p < 0.001).

Discussion. The obtained results indicate a close relationship between psychoemotional and somatic manifestations among medical students. Higher levels of anxiety and depressive symptoms were associated with a greater somatic symptom burden and lower quality of life. Depressive symptoms demonstrated the strongest association with quality of life indicators.

Conclusions. The obtained results confirm the interconnected nature of psychoemotional and somatic manifestations in medical students. Depressive symptoms demonstrated the strongest association with quality of life. The identified features support the need for early psychodiagnostic screening and the implementation of medical and psychological support programs for medical students.

Keywords: medical students, psychoemotional state, anxiety, depressive symptoms, somatic symptoms, quality of life.

Alexithymia and Impaired Interoceptive Awareness in Patients with Anorexia Nervosa

2026-06-11T15:55:30+03:00

Background. Anorexia nervosa (AN) remains one of the most severe clinical challenges in modern psychology and psychiatry. In recent decades, there has been a steady upward trend in the prevalence of this disorder, especially among adolescents and young adults. The disease is characterized not only by the highest mortality rate among all psychiatric disorders but also leads to profound social maladaptation: the destruction of interpersonal ties, impaired professional fulfillment, and a severe deterioration in the quality of life. Traditional therapies often focus on behavioral manifestations, ignoring the fundamental mechanisms of emotional and bodily dysregulation, which leads to a high risk of relapse.

Objective. To improve the diagnosis and psychological interventions for individuals with AN through theoretical justification and empirical investigation of the role of alexithymia and interoceptive impairments in the pathogenesis of this disorder.

Materials and Methods. A total of 84 individuals were examined (30 in the clinical group with AN symptoms, 54 in the control group). The psychodiagnostic battery included: TAS-20, MAIA-2, EAT-26, SCOFF, HADS, and CQLS. Statistical processing was performed using the Mann-Whitney U test, Spearman’s and Pirson’s correlation analysis.

Results and Discussion. A clinically significant level of alexithymia was found in the clinical group (68.42±9.80). The phenomenon of an «interoceptive disconnect» was established: with a preserved ability to notice bodily signals, patients demonstrate critically low body trust (1.1). Alexithymia acts as a mediator linking anxiety with pathological eating attitudes (r=0.54) and a decreased quality of life (r=−0.68).

Conclusions. The necessity of shifting the therapeutic focus from weight control to the restoration of interoceptive trust and emotional mentalization has been demonstrated.

Keywords: anorexia nervosa (AN), alexithymia, interoception, quality of life, eating behavior.

The Unified Clinical Protocol “Acute Stress Reaction. Post-Traumatic Stress Disorder. Adjustment Disorders” as a Basis for the Practical Training of Psychiatry Interns in Providing Medical Care to Patients with Anxiety-Phobic Disorders

2026-06-11T16:02:19+03:00

Background. The ongoing war in Ukraine has led to an increased prevalence of anxiety-phobic disorders, highlighting the need for high-quality training of psychiatrists in providing primary and specialized mental health care. Mastering the Unified Clinical Protocol “Acute Stress Reaction. Post-Traumatic Stress Disorder. Adjustment Disorders” through practice-oriented educational approaches is an essential component of such training.

Methods. The study involved 19 psychiatry interns undergoing the educational stage of internship training at the Department of Psychiatry, Narcology and Medical Psychology of Dnipro State Medical University. A case-based learning approach was used to master the provisions of the Unified Clinical Protocol through the analysis of clinical scenarios and practical training in psychological first aid and psychotherapeutic interventions.

Results. A structured model for mastering the Protocol using case-based learning was developed and implemented. Clinical cases involving panic attacks, hysteria-like reactions, and fear were used to develop psychological first aid skills. Trauma-focused cognitive behavioral therapy techniques, including the “Downward Arrow” and “Reductio ad Absurdum” methods, were applied to train psychotherapeutic competencies. The use of clinical cases promoted the development of clinical reasoning, decision-making skills, and practical application of treatment algorithms for patients with anxiety-phobic disorders.

Discussion. Case-based learning enabled the simulation of various clinical situations and facilitated the integration of theoretical knowledge with practical competencies. The approach proved useful for mastering psychological first aid algorithms and psychotherapeutic techniques aimed at modifying dysfunctional beliefs and catastrophic thinking patterns underlying anxiety-phobic disorders.

Conclusions. Case-based learning is an effective tool for mastering the Unified Clinical Protocol “Acute Stress Reaction. Post-Traumatic Stress Disorder. Adjustment Disorders” during psychiatry internship training. The proposed approach facilitates the acquisition of psychological first aid and specialized psychotherapeutic skills and may be recommended for broader implementation in postgraduate medical education.

Keywords: anxiety-phobic disorders, psychiatry interns, case-based learning, psychological first aid, trauma-focused cognitive behavioral therapy, clinical protocol, postgraduate medical education.

Psychopathological characteristics of behavioral responses in the context of long-term psychiatric outcomes after mechanical thrombectomy for thrombotic occlusion: an analysis of aggression and hostility

2026-06-11T15:46:51+03:00

Objective. To establish the long-term psychiatric consequences of mechanical thrombectomy for thrombotic occlusion.

Materials and Methods. A prospective study of 129 patients was conducted between 2022 and 2025 at the Center of Interventional Neuroradiology of the Municipal Non-Profit Enterprise "Kyiv City Clinical Hospital No. 1" (Kyiv, Ukraine) and the Department of Interventional Neuroradiology of the State Institution "Main Medical Clinical Center of the Ministry of Internal Affairs of Ukraine" (Kyiv, Ukraine). The mean age of the participants was $68.4 \pm 11.4$ years. The assessment of psychiatric outcomes was performed during the late postoperative period, specifically on the 30th–35th day following thrombectomy. To achieve the study’s objective, a comprehensive methodology was employed: anamestic, clinical-psychopathological, psychodiagnostic, and statistical methods. The psychodiagnostic method was implemented using the Symptom Checklist-90-Revised (SCL-90-R) by Leonard Derogatis (as adapted by S. Dembitskyi and Yu. Sereda, 2015).

Results. The study revealed a predominance of the somato-affective component within the structure of psychological distress. The highest severity levels ("severe" and "very severe") were recorded on the scales of somatization (98.4% of patients), anxiety (92.2%), and depression (89.1%). Clinically, these manifestations included hypochondriacal fixation on bodily sensations, vital anxiety centered on the fear of stroke recurrence, and a "crisis of awareness" accompanied by depressive affect and apathy. The Global Severity Index indicated a significant severity of the condition in 74.4% of the examined patients.

Conclusions. It was established that the long-term psychiatric consequences of thrombectomy are characterized by the formation of "post-thrombectomy distress syndrome" with a somato-affective dominance. The primary clinical features include hypervigilance toward somatic signals, fear of a recurrent vascular catastrophe, and decreased rehabilitation motivation. The results justify the necessity of implementing a personalized psychocorrection system tailored to the individual distress profile.

Keywords: ischemic stroke, mechanical thrombectomy, psychiatry, depression, anxiety.

УДК 616.89-008.45/.47:616.831-005.1-089.87]-036.8-085.851

Coping behavior in women with alopecia: its role in the development of psychological maladjustment and its association with disease genesis

2026-06-11T15:45:41+03:00

Background. Coping behavior is a key mechanism of mental adaptation in patients with alopecia; however, its relationship with disease genesis and level of maladjustment remains insufficiently studied.

Objective. To investigate coping strategies in women with alopecia of different genesis and their association with the level of psychological maladjustment.

Methods. A total of 153 women with alopecia (metabolic – 45, mixed – 108) were examined using the Ways of Coping Questionnaire. Comparative and correlational analyses were performed.

Results. Patients with metabolic alopecia demonstrated a predominance of adaptive coping strategies (problem-solving, seeking social support), whereas patients with mixed alopecia showed higher levels of maladaptive coping (avoidance, distancing). Increasing maladjustment was associated with a shift from adaptive to maladaptive coping strategies.

Conclusions. Coping behavior is a significant predictor of mental maladjustment in alopecia and represents a potential target for personalized psychotherapeutic interventions.

Keywords: alopecia, coping behavior, mental maladjustment, anxiety, depression, stress, psychodermatology.

УДК 616.891:616-052:615.851