Organizational and methodological aspects of providing psychiatric and narcological care to patients with post-traumatic stress disorder in the Russian Federation

Post-traumatic stress disorder (PTSD) is a condition that occurs in direct participants of potentially traumatic events, such as natural or man-made disasters, physical or sexual violence, combat, accidents, and is characterized by obsessive re-experiencing of such events. Effective medical care for patients with PTSD requires not only individualized approach but also a well-structured organizational and methodological framework. This article reviews key aspects of organizing medical care for patients with PTSD, new approaches to early detection, treatment, and rehabilitation. Aim. Analysis of organizational and methodological aspects of providing specialized psychiatric and narcological care to patients with PTSD in the Russian Federation and other countries and to present an innovative psychosocial and medical rehabilitation program. Materials and methods. Based on comprehensive approach to studying the problem, a new organizational and methodological model of providing medical care to patients with PTSD was developed. It includes a comprehensive medical and psychosocial rehabilitation program developed by specialists of the V.P. Serbsky National Medical Research Center for Psychiatry and Narcology of the Russian Federation Ministry of Health. The rehabilitation program was tested in 2024 at the center’s branches: Moscow Research Institute of Psychiatry, the National Research Centre on Addictions, and the Khmolino Clinical Rehabilitation Center. Results. The methodological basis for developing the program included legal, organizational and economic foundations for protecting citizens’ health; clinical guidelines; national guidelines on psychiatry, psychotherapy and narcology; analysis of Russia’s and other countries’ experience in providing care to individuals with PTSD. The presented organizational and methodological model for providing specialized psychiatric and narcological care for patients with PTSD and comorbid disorders is based on comprehensive, rather than frequently used sequential approach. Conclusion. Given the diversity of traumatic factors, of clinical manifestations of PTSD, and its course, as well as the high incidence of comorbid mental, substance abuse, and somatic disorders, a shift from a sequential model of patient management to a comprehensive approach is needed. This will facilitate higher treatment adherence and maximize therapeutic effectiveness. Key factors for success also include development of a unified methodology and conceptual framework to apply screening techniques and early motivational interventions, specialist training, and introducing advanced innovative technologies into medical practice.

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