IMPROVED MODEL OF THE TREATMENT AND REHABILITATION PROCESS FOR MILITARY PERSONNEL WITH COMORBID POST-TRAUMATIC STRESS DISORDER AND MINE-EXPLOSIVE INJURY (BLAST-RELATED INJURY)

Abstract

The article presents the results of a comprehensive clinical and experimental study assessing the effectiveness of an improved treatment and rehabilitation methodology for military personnel with comorbid post-traumatic stress disorder (PTSD) and mine-explosive injury (MEI, blast-related injury) sustained during combat operations in the context of the Russian–Ukrainian war. The relevance of this study is determined by the high prevalence of combined mental and somato-neurological consequences of blast injuries, which significantly complicate the course of PTSD and reduce the effectiveness of standard therapeutic approaches. The aim of the study was to evaluate the clinical effectiveness of an improved multidisciplinary model of treatment and rehabilitation measures compared with a standard protocol, as well as to determine its impact on the dynamics of psychopathological, functional, and quality-of-life indicators. A prospective controlled study included 200 male military personnel diagnosed with PTSD and consequences of MEI (blast-related injury), who were randomized into a control group (standard treatment) and an experimental group (improved model). Assessment was performed using structured clinical interviews (CAPS-5), HADS, CD-RISC scales, the SF-36 quality-of-life questionnaire, as well as instrumental and laboratory methods. The improved model combined trauma-focused cognitive-behavioral therapy, EMDR, group psychotherapy, optimized pharmacotherapy, intensive physical rehabilitation, and innovative non-pharmacological interventions (VR therapy, art therapy, digital support tools), with mandatory coordination by a multidisciplinary team. The results demonstrated that the improved methodology provided a statistically significantly greater reduction in PTSD symptom severity (up to 64 % versus 50 % in the standard group), increased resilience and quality of life, and better indicators of social and professional reintegration. The overall integral effectiveness index in the experimental group was 18 % higher compared with the standard approach. The obtained data confirm the feasibility of implementing multidisciplinary models of comprehensive rehabilitation for military personnel with the “MEI–PTSD” profile in military and civilian medical practice