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BEHAVIORAL CHANGES IN PATIENTS OF INFECTIOUS DISEASES HOSPITAL: CURRENT PROBLEMS OF MANAGEMENT AND IVESTIGATIONS IN UKRAINE

B. V. Mikhailov, A. V. Kanishchev

* Electronic publication:
Mikhailov, B. V., Kanishchev, A. V. (2001). Behavioral changes in patients of infectious diseases hospital: current problems of management and investigations in Ukraine [Electronic resource]. Ukrainian psychiatry news. Mode of access: http://www.psychiatry.ua/eng/eng001.htm.

Various behavioral changes in patients of infectious diseases hospital (IDH) are significant clinical problem, which had been investigated insufficiently. Lately acute psychotic states of infective genesis are rarely observed by physicians, and a wide range of non-psychotic disturbances is in the foreground. The main problem is that even mild forms of behavioral changes, despite of their transience and, as a rule, preclinical level, often cause difficulties in treating such patients.

Both psychopathological manifestations and psychological reactions are associated here with patientsí attitude toward the treatment and their behavior during its course. Fears because of contagious character of disease and different neurotic reactions are common phenomena. However, underestimation of disease severity, rejection of different “dangerous” diagnostic procedures (e.g. lumbar puncture) and medications (e.g. glyco-corticoids), infringement of therapeutic regime are also frequently met by therapeutists. In all cases of patientsí inadequate perception of disease there is a risk of discordance or disruption of therapy.

So far, however, these problems are still considered insignificant by medical staff of IDH; in fact, therapeutists are unable to solve them without assistance. At the same time psychiatric experience in this field is virtually absent, because psychiatric consultations in IDH are restricted to urgent intervention for acute psychotic patients, and there is no organizational foundations for routine consultative work. Thus, slightly expressed behavioral changes are out of medical attention.

Nowadays adequate solution of these problems is impossible without functioning system of liaison psychiatry. In our opinion, psychiatrist or psychotherapeutist should be integrated into the staff of IDH. Besides, scientific investigations in this field, which formerly were not numerous and contained a lot of contradictions with a lack of practical orientation, now must be directed by unified methodological approach and oriented toward the momentary needs of IDH.

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