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The aim of the investigationTo determine clinical-dynamic characteristics of combat-related PTSD for best understanding etiologocal and pathogenesis bases in mentioned category.Subjects478 male combatants aged 22–43 y.o., observed in 1993–2008 years.Methods of investigationClinico-psychopathological; quality of life self-evaluating scales, IES-R and statistical.According to ICD-10, only one diagnostical category - “reaction to hard stress and adaptation disturbance”- is identified as having explicit etiological connection with psycho-traumatic extraordinary impact. Negative mental symptomatology in combatants is reflected there as “chronical personality changes after catastrophe”.Contrary to “classical” position personality change may be its chronical outcome and the diagnosis should be stated not only after 2 years. That's why the period of urgent adaptation is characterized by regressive, ontogenetically more early forms of reacting; conscience disintegration.Appearance of more prolonged and more specifical PTSD symptomatology reflects pathoplastic later development.PTSD can be understood as a transforming reactive process, fixating in memory traces new behavioral stereotypes. Specifical adaptation in military conditions happens because of cortical behavior control's depression and deep-undercortical philogenetically old vital affects releasing (as the biological base). Positive PTSD symptomatology in combatants are repeated memories about psychotrauma, often transform into obsessive-phobic complexes. In case of increased cortex inhibition impulsive behavior's motives are formed. Initial war stress is complicated by the necessity to adapt to usual conditions and it often becomes a basis for behavioral deviations. That's why we should consider the treatment and rehabilitation of such persons one of the priority medical and social tasks in XXI century.

The aim of the investigation was to determine clinical-dynamic characteristics of combat-related PTSD, as well as individual and personality features and prerequisites of criminal aggression and mental disturbances observed at the moment of offence.

The objective of the study were the problems of out-patient care to schizophrenic patients having antisocial records.Materials and methods:The forensic psychiatric assessment of 98 schizophrenic patients (according to ICD-10) has been carried out. During our assessment psychopathic-like, neurotic-like disorders, depressive and psychotic symptoms were prevalent.Methods:Structured and semistructured clinical interviwes and medical and criminal records investigation.Results:The outpatient care of observed patients must be strictly deontologically consistent. Most of the patients and their relatives have a certain psychological ideas about antisocial behaviour and causes of the disease. The doctor's attempts to make alterations may break his contact with a patient and increase the dissimulating tendences. Some patients were sure that relatives “dream” to get rid of them. Continuation of multifactor pathomorphosis in schizophrenia was determined.The main causes of errors in diagnosis and therapy in schizophrenic patients were the previous treatment for combat related PTSD; alcohol and drug abuse or all of them as comorbid. Many patients and relatives were not prepared for necessary inpatient treatment and were unaware about new psychopharmacological therapy. Aggressive behaviour was the result of delirious protection which forces a patient to change his former social attitude or manifested as a postpsychotic condition as a form of adjustment to a “new health”.Conclusion:The carried out research is helpful to formulate changed diagnostic criteria and aggressive behaviour rick/protective (clinical and social) factors system in schizophrenia patients. Out-patient care to schizophrenic patients seems to remain an object of discussion.

The success and achievements in the area of neurosciences due to the development of neuroimaging, neurochemical and genome studies provide tasks for psychiatry determined by the necessity to develop new classifications of mental diseases, primarily ICD-11, specify clinical diagnostic criteria and rethink the essence of some mental disorders. In spite of the multiple direction of scientific opinions on the discussed issues, the development of modern psychiatry is characterized by intensive search of biological background of psychiatric disorders and elaboration of effective approaches to the diagnosis and treatment of mental diseases, including medical rehabilitation of patients.