Psychiatry - O. K. Napreyenko 2001

From the Authors

The conceptual framework of this textbook aligns with the primary trends in global medical science. Above all, this involves the integration of modern scientific concepts spanning various levels of human biology—from molecular-biological to socio-psychological—into psychiatric practice. A crucial driver of psychiatry's advancement is its comprehensive integration both with core medical sciences (such as anatomy, physiology, biochemistry, and medical psychology) and with every single branch of clinical medicine. It is at the intersection of these disciplines that we can thoroughly examine the objective and subjective processes occurring within both relatively closed systems (soma — psyche — micro-social environment) and open systems (the individual — ecological environment — macro-social environment). Only by accounting for the states and mutual influences of all these components can we realistically enhance the effectiveness of both theoretical and practical psychiatry.

In light of the above, and alongside the traditional chapters of classical psychiatry, the textbook for the first time features a dedicated chapter on "Psychosomatic and Somatopsychic Disorders." This addition fulfills a core objective of the psychiatric curriculum in medical universities: preparing general practitioners with a sufficiently deep understanding of clinical neuropsychiatry. This is vital today, given the understandable tendency of medical professionals in our highly technologized era to rely on Instrumental Diagnostic Methods, and the inclination of young doctors toward narrow specialization. Ukrainian scientists are widely recognized for pioneering the in-depth investigation of psychiatric issues stemming from the aftermath of the Chornobyl disaster. This prompted the publication in Ukraine of the world's first monograph on "Ecological Psychiatry" (Kyiv, 1997). Given the intense international interest in how the environment affects mental health, we felt it essential to include a chapter bearing the same title.

Unlike other domestic publications from the past decade, this book combines biologically oriented diagnostic and therapeutic approaches with significant attention to person-centered methods (including psychoanalytic and behavioral therapies). Notably, early 20th-century Ukrainian specialists made substantial contributions to the theory and practice of psychoanalysis. However, due to well-known historical circumstances beginning in the 1920s, the achievements of these pioneers of global culture were largely lost in Ukraine. Our strong emphasis on this area of the humanities reflects its contemporary revival and its return to the professional focus of physicians, psychologists, educators, philosophers, politicians, and business leaders alike.

A major pathway for progress in modern psychiatry is the development and clinical Structure/175.html">Implementation of novel, more effective psychotropic medications. This textbook highlights a wide range of neuroleptics (antipsychotics), antidepressants, antiepileptics, tranquilizers, and other advanced Pharmaceuticals recently introduced and successfully utilized in medical practice.

In accordance with the psychiatric care reform strategy in Ukraine, a primary objective is to guarantee the social protection of patients with mental disorders, their families, and mental health caregivers. The legal framework for mental health protection, aligned with civilized international standards, was established by the pioneering Law of Ukraine "On Psychiatric Care," adopted in 2000. This legislation outlines the legal and organizational foundations of psychiatric care based on the supremacy of individual rights and freedoms. The social dimension of psychiatry grows increasingly significant as Ukrainian society continues to democratize.

The social aspects of psychiatry demand heightened attention to the societal standing of psychiatric patients, safeguarding their rights to high-quality Treatment, informed consent for medical interventions, confidentiality, the right to refuse treatment, access to legal representation, professional engagement, and specific social benefits. A vital component of these social rights is the strict adherence to ethical principles in psychiatric practice.

In recent years, researchers and mental health administrators have adapted the relevant section of the International Classification of Diseases, 10th Revision (ICD-10), approved by the World Health Organization, to the context of Ukraine. In 1998, it was implemented across domestic psychiatric institutions, and preparatory work for the ICD-10 successor, ICD-11, is currently underway. This motivated us to include not only the traditional domestic classification of mental disorders but also ICD-10 and the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), as the most globally recognized frameworks. To facilitate comprehension, these classifications are presented in excerpts within the relevant chapters, helping young specialists develop a broad professional perspective.

Perspectives on The history of domestic psychiatry found in previous decades' publications have been supplemented with contemporary, evidence-based insights into the contributions of Ukrainian scholars and clinicians to global psychiatry.

We consider it essential to outline the main trajectories for the ongoing reform of psychiatric services, specifically: strengthening the outpatient care sector;

expanding the network of psychiatric day hospitals, and establishing psychosomatic departments and psychotherapeutic units within general somatic medical facilities;

intensifying mental hygiene and primary Prevention measures, particularly through primary healthcare networks, manufacturing facilities, agricultural enterprises, and educational institutions;

optimizing the teaching of psychological and psychiatric disciplines across all stages of training for psychiatrists, other medical specialists (such as family physicians), medical psychologists, sociologists, and nursing staff;

systematically covering relevant topics in the mass media to overcome prejudice against individuals with mental or psychosomatic health conditions, raising public awareness of the biological, psychological, and social causes of mental disorders, and highlighting modern medical advancements that alleviate the suffering of patients and their families, reduce social isolation and stigmatization, and reintegrate most patients into an active lifestyle. This also entails enhancing the legal literacy of all stakeholders involved in providing and receiving psychiatric care.

The first Ukrainian-language textbook on psychiatry was authored by V. A. Poliarskyi, translated from Russian in 1936. In 1971, a textbook by N. P. Tatarenko and N. I. Streltsova was published, which, much like subsequent works of that era, provided concise overviews of major mental illnesses.

This book represents the first comprehensive, fundamental Ukrainian textbook on psychiatry, developed with THE CONTRIBUTION OF leading domestic psychiatric scholars. The authors welcome any feedback, recommendations, and suggestions aimed at improving this publication.

On behalf of the authors, sincerely yours, O. K. NAPRIYENKO — Doctor of Medical Sciences, Professor, Chief Psychiatrist of the Ministry of Health of Ukraine, HEAD of the Department of Psychiatry at O.O. Bogomolets National Medical University