Background. The presence of chronic pain in the structure of hip avascular necrosis hurts the patient's mental state, causes chronic postoperative pain, and reduces the quality of life. Treatment of nonpsychotic mental disorders may be a therapeutic strategy to reduce risk factors for health-related quality of life and satisfaction with treatment outcomes. Successful rehabilitation of patients with hip avascular necrosis consists of restoring the functions of the affected joints and providing the necessary psychological assistance, through the available nonpsychotic mental disorders and gender-age features. The study aimed to determine the gender age and socio-demographic characteristics of patients with aseptic necrosis of the femoral head, which may act as predictors of the risk of developing non-psychotic mental disorders. Methods. 137 persons with aseptic necrosis of the femoral head were examined: 92 (67.2%) men and 45 (32.8%) women, the average age was 52.01 ± 11.29 years. In addition to the clinical-psychopathological and socio-demographic examination were used the Beck depression inventory, the Beck anxiety inventory and Teilor's Manifest Anxiety Scale, the Beck hopelessness scale, and the Toronto alexithymia scale (TAS-20) were. Results. It was found that 25.8% (17/66) of people with higher education were engaged mainly in manual labour, but at the time of the survey, only 7.6% (5/66) were working. It was found that there is no difference in the levels of depression prevalence depending on gender and age. Anxiety levels at a young age are higher in females, but gender and age differences in the prevalence of anxiety levels have not been identified. Among the examined patients, a high level of alexithymia was found in all age and gender groups. There is a tendency for a higher level of hopelessness in young females compared to males.

Aseptic necrosis of the femoral head (ANFH) is a severe chronic poliaethiologic disease of the hip joint which is prevalent mainly in young people with a loss of professional and social skills. It is known that the non-psychotic mental disorders appearance in patients with ANFH can lead to the increasing disability, the decreasing in the quality of life, and difficulties in organizing the rehabilitation period. Current researches prove that the preoperative mental state assessment in patients can lead to the statistically significant decrease of the pain intensity in the postoperative period, an improvement in the quality of life related to health, a decrease in anxiety, depression and behavioural problems in the postoperative period. The aim of this research was to study the syndromic features of non-psychotic mental disorders, alexithymia and anxiety levels in patients with ANFH at the preoperative stage. The study involved 137 people aged 25 to 75 years, who were diagnosed with ANFH and identified non-psychotic mental disorders. Clinical-psychopathological and psychodiagnostic methods of examination were used (AUDIT test, Toronto alexithymia scale-20, Taylor manifest anxiety scale). The patients were divided into two groups depending on the ANFH duration. The results of the study revealed the main leading syndromes: asthenic-depressive – in 35.8%, depressive-hypochondriac – in 18.2%, anxious-phobic – in 16.1%, anxious-depressive - in 15.3% and astheno-apathetic – in 14.6% of cases. The average anxiety score was 26 (19; 37), which indicates the presence of a medium-high level of anxiety in the examined, while 52.5 percent of patients had high and very high levels of anxiety. A multivariate logistic regression analysis was performed and as a result, the duration of the disease (OR: 2.23; 95% [CI]: 1.11-4.47; p<0.05), estimates of alexithymia (OR: 2.52; 95% [CI]: 1.00-6.36; p<0.05) and female sex (OR: 2.16; 95% [CI]: 1.03-4.50; p<0.05) were found to be independent risk factors associated with the level of anxiety in persons with ANFH at the preoperative stage.

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Persistent genital arousal disorder (PGAD) is a condition of persistent genital arousal, in the absence of a psychological component and organic pathology from the vascular, endocrine and nervous system. The aim of the study is to examine the symptoms, clinical picture, developmental dynamics, risk factors, and treatment for PGAD. Materials and methods. The clinical case of observation of PGAD in a 20-year-old female patient suffering from recurrent depressive disorder is presented. Methods included in clinical, psychopathological and psychodiagnostic examination have been with using the following techniques: Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Visual Analogue Scales of pain intensity (VAS). Results. As a result of collection of life and disease history, analysis of examination findings by related specialists and additional research methods of patient with PGAD the next diagnosis has been made according to the International Classification of Diseases 10th Revision: Recurrent depressive disorder, current episode of moderate severity with somatic symptoms (F33.11). She has been treated with a number of drugs from the Selective serotonin reuptake inhibitors group and mood stabilizers, the combination of sertraline and lamotrigine appeared the optimal treatment option. The results of the treatment have been satisfactory, the symptoms of PGAD have stopped bothering the patient, the emotional state has improved significantly. Conclusions. The case of the PGAD is presented. Clinical picture of the case turned out to be typical in comparison with the results of other researchers. The peculiarity is the possible association of symptoms with withdrawal of escitalopram. The case confirms the data upon the high suicidal risk in this disorder. The patient’s treatment requires intervention of different medical specialists to rule out organic pathology and using of multidisciplinary approach. Sertraline and lamotrigine appeared effective in the treatment of PGAD.