Psychotherapeutic methods acceptable for sanatoriums were analyzed in this work due to the high frequency of borderline mental disorders exampled in the general medical practice, including sanatorium- resort institutions, and the frequent prioritization of psychotherapy (compared to psychopharmacology) for the treatment of such conditions; as well as the lack of structure in the systematics of psychotherapeutic methods used in the sanatorium treatment conditions, and the frequent lack of convincing evidence of their eff ectiveness. Aim. Various group and individual methods that can be used for short-term psychotherapy have been studied. In accordance with the modern principles of evidence- based medicine, an assessment of the available evidence of their eff ectiveness was carried out. Material and Methods. The RSCI and Medline electronic databases were used, the search was carried out by keywords (names of relevant techniques and mental dysfunctions, such as anxiety, depression, adjustment disorders, stress states, psychosomatics). The effi cacy and safety evidence levels were evaluated in accordance with the National Standard of the Russian Federation GOST R 56034– 2014. Results. As a result of the work performed, a wide range of psychotherapy methods related to its various directions, applicable in sanatorium- resort conditions (most of them are also suitable for hospitals / rehabilitation centers) is analyzed. Some of them have a high level of evidence, while others have less convincing data, which is often associated with the diffi culty of reproducing them in experimental conditions. Conclusion. The information provided may be useful to specialists working in sanatoriums, rehabilitation centers and hospitals, for solving issues of organizing and improving the quality of psychotherapeutic care for patients with concomitant borderline mental disorders as well as for further scientifi c research.
psychotherapy, sanatorium-resort, levels of evidence of effectiveness, psychotherapy in sanatoriums, borderline mental disorders, somatic diseases, somatic hospital, methods of short-term psychotherapy, psychosomatics Acknowledgments: The study had no sponsorship
1. Smulevich A. B. Lekcii po psihosomatike pod redakciey akademika RAN. Medicinskoe informacionnoe agenstvo. Moskva. 2014: 340 s.
2. Suhovershin A. V., Pantin A. V. Transpersonal'naya psihoterapiya v komplekse kurortnogo lecheniya bol'nyh s affektivnymi rasstroystvami pri psihosomaticheskih zabolevaniyah. Arhiv' vnutrenney mediciny. 2016; 6(S1): 129-130.
3. Rouillon F., Gasquet I., Garax R. P. Lancrenon S.. Prévalence des troubles bipolaires en médecine générale: Enquête Bipolact Impact. Annales Medico- Psychologiques Revue Psychiatrique. 2009; 167(8): 611-615. https://doi.org/10.1016/j.amp.2009.08.005 4. Barlou D. Klinicheskoe rukovodstvo po psihicheskim rasstroystvam. Moskva. Piter. 2008: 911 s.
4. GOST R 56034-2014. Nacional'nyy standart Rossiyskoy federacii. Klinicheskie rekomendacii (protokoly lecheniya). Data vvedeniya 2015-06-01. Dostupno na: https://docs.cntd.ru/document/1200110991 (data obrascheniya 13.07.2021).
5. Karvasarskiy B. D. Psihoterapiya. SPb. Piter. 2002: 672 c. 7. de Jonghe F., Hendricksen M. et al. Psychotherapy alone and combined with pharmacotherapy in the treatment of depression. British Journal of Psychiatry. 2004; (185): 37-45. https://doi.org/10.1192/bjp.185.1.37
6. Reinares M., Sanchez- Moreno J., Fountoulakis K. N. Psychosocial interventions in bipolar disorder: what, for whom, and when. Journal of Aff ective Disorders. 2014; (156): 46-55. http://doi.org/10.1016/j.jad.2013.12.017
7. Bandelow B., Seidler- Brandler U., Becker A., Wedekind D., Ru¨ ther E. Meta-analysis of randomized controlled comparisons of psy- chopharmacological and psychological treatments for anxiety disorders. World Journal of Biological Psychiatry. 2007; 8(3): 175-187. http://doi.org/10.1080/15622970601110273
8. Cuijpers P., Sijbrandij M., Koole S. L., Andersson G., Beekman A. T., Reynolds III C. F. The effi cacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry. 2013; 12(2): 137-48. http://doi.org/10.1002/wps.20038
9. Cuijpers P., Sijbrandij M., Koole S. L., Andersson G., Beekman A. T., Reynolds III C. F. Adding psychotherapy to antidepressant medication in depres- sion and anxiety disorders: a meta-analysis. World Psychiatry. 2014; 13(1): 56-67. http://doi.org/10.1002/wps.20089
10. Montero- Marin J., Garcia- Campayo J., López- Montoyo A., Zabaleta- Del- Olmo E., Cuijpers P. Is cognitive- behavioural therapy more ef- fective than relaxation therapy in the treatment of anxiety disorders? A meta-analysis. Psychological Medicine. 2018; 48(9): 1427-1436. http://doi.org/10.1017/S0033291717003099
11. Khoury B., Lecomte T., Fortin G., Masse M., Therien P., Bouchard V., Chapleau M. A., Paquin K., Hofmann S. G. Mindfulness- based therapy: a com-pre- hensive meta-analysis. Clinical Psychology Review. 2013; 33(6): 763-771. https://doi.org/10.1016/j.cpr.2013.05.005
12. Hall J., Kellett S., Berrios R., Bains M. K., Scott S. Effi cacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta- Analysis, and Meta- Regression. The American Journal of Geriatric Psychiatry. 2016; 24(11): 1063-1073. http://doi.org/10.1016/j.jagp.2016.06.006
13. Cuijpers P., Cristea I. A., Weitz E., Gentili C., Berking M. The eff ects of cognitive and behavioural therapies for anxiety disorders on depression: a me- ta-analysis. Psychological Medicine. 2016; 46(16): 3451-3462. http://doi.org/10.1017/S0033291716002348
14. Golubev M. V., Kukshina A. A., Haritonov S. V. Gruppovaya kognitivno- povedencheskaya psihoterapii kak metod psihologicheskoy reabilitacii bol'nyh s hronicheskimi somaticheskimi zabolevaniyami. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul'tury. 2016; 93(2-2): 63 c.
15. Semke V. Ya., Haritonov S. V. Sravnitel'naya ocenka effektivnosti kognitivno- povedencheskoy, racional'noy i kombinirovannoy (kognitivno- povedencheskoy i racional'noy) psihoterapii u bol'nyh s lichnostnymi rasstroystvami. Sibirskiy vestnik psihiatrii i narkologii. 2011; 2(65): 49-52. 18. Mosolov S. N., Kostyukova E. G. Lechenie bol'nyh s rekurrentnym depressivnym rasstroystvom. Psihiatriya. Nacional'noe rukovodstvo. 2018: 347-378.
16. Vlasov N. A. Istoriya kratkosrochnoy psihoterapii: kratkiy obzor. Metodologiya sovremennoy psihologii. 2020; (11): 22-27.
17. Gimaeva R. M. Opyt ispol'zovaniya metoda simvoldrama pri rabote s bol'nym, stradayuschim psihosomaticheskim zabolevaniem. Mir nauki, kul'tury, obrazovaniya. 2016; (57): 260-263.
18. Volkova M. V. Ispol'zovanie katatimno- imaginativnoy psihoterapii (simvoldramy) pri lechenii insomniiyu. Naukoviy oglyad. 2019:3 (56): 80-88.
19. Kulakov V. I., Hritinin D. F., Gardanova Zh. R., Kulakova E. V. Trevozhno- depressivnye rasstroystva u zhenschin v processe provedeniya programmy ekstrakorporal'nogo oplodotvoreniya. Sibirskiy vestnik psihiatrii i narkologii. 2007; 1(44): 14-17.
20. Nilsson D., Wadsby M. Symboldrama, a psychotherapeutic method for adolescents with dissociative and PTSD symptoms: a pilot study. The Jour- nal of Trauma & Dissociation. 2010; 11(3): 308-21. http://doi.org/10.1080/15299731003781075
21. Caldiroli A., Capuzzi E., Riva I., Russo S., Clerici M., Roustayan C., Abbass A., Buoli M. Effi cacy of intensive short-term dynamic psychotherapy in mood disorders: A critical review. Journal of Aff ective Disorders. 2020; 1(273): 375-379. http://doi.org/10.1016/j.jad.2020.04.002
22. Rahmani F., Abbass A., Hemmati A., Mirghaed S. R., Ghaff ari N. The Effi cacy of Intensive Short- Term Dynamic Psychotherapy for Social Anxiety Disorder: Randomized Trial and Substudy of Emphasizing Feeling Versus Defense Work. The Journal of Nervous and Mental Disease. 2020; 208(3): 245-251. http://doi.org/10.1097/NMD.0000000000001097
23. Semke V. Ya., Haritonov S. V. Sravnitel'naya ocenka effektivnosti kognitivno- povedencheskoy, racional'noy i kombinirovannoy (kognitivno- povedencheskoy i racional'noy) psihoterapii u bol'nyh s lichnostnymi rasstroystvami. Sibirskiy vestnik psihiatrii i narkologii. 2011; 2(65): 49-52.
24. Pogosov A. V., Shibaev P. V. Effektivnost' racional'noy psihoterapii rasstroystva adaptacii u sotrudnikov. Rossiyskiy psihiatricheskiy zhurnal. 2017; (3): 50-55.
25. Haritonov S. V. Osobennosti reagirovaniya na stress i effektivnost' dyhatel'nyh uprazhneniy u bol'nyh s generalizovannym trevozhnym rasstroystvom. Psihicheskoe zdorov'e. 2018; 16(8): 15-23.
26. Tukaev R. D., Sryvkova K. A., Antipova O. S. Dinamika variabel'nosti ritma serdca v gipnoze u zdorovyh molodyh muzhchin i zhenschin.
27. Psihiatriya, psihoterapiya i klinicheskaya psihologiya. 2020; 11(4): 754-763. http://doi.org/10.34883/PI.2020.11.4.008
28. Häuser W., Hagl M., Schmierer A., Hansen E. The Effi cacy, Safety and Applications of Medical Hypnosis. Deutsches Ärzteblatt International. 2016; 113(17): 289-96. http://doi.org/10.3238/arztebl.2016.0289
29. Fisch S., Brinkhaus B., Teut M. Hypnosis in patients with perceived stress - a systematic review. BMC Complementary Medicine and Therapies. 2017; 17(1): 323 p. http://doi.org/10.1186/s12906-017-1806-0
30. Fisch S., Binting S., Roll S., Cree M., Brinkhaus B., Teut M. Group Hypnosis for Stress Reduction - A Feasibility Study. International Journal of Clinical and Experimental Hypnosis. 2020; 68(4): 493-510. http://doi.org/10.1080/00207144.2020.1781537
31. Olendzki N., Elkins G.R, Slonena E., Hung J., Rhodes J. R. Mindful Hypnotherapy to Reduce Stress and Increase Mindful- ness: A Randomized Controlled Pilot Study. International Journal of Clinical and Experimental Hypnosis. 2020; 68(2): 151-166. http://doi.org/10.1080/00207144.2020.1722028
32. Ayvazyan T. A., Zaycev V. P. Autogennaya trenirovka v psihokorrekcii pacientov s hronicheskimi somaticheskimi zabolevaniyami: effektivnost' i ee prediktor. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul'tury. 2018; 95 (3):11-15. http://doi.org/10.17116/kurort201895311
33. Bokova I. A., Agasarov L. G. Tipologiya i korrekciya poststressovyh rasstroystv razlichnogo geneza. Vestnik novyh medicinskih tehnologiy. 2020; (1): 145-150. https://doi.org/10.24411/2075-4094-2020-16613
34. Seo E., Kim S. Eff ect of Autogenic Training for Stress Response: A Systematic Review and Meta- Analysis. Journal of Korean Academy of Nursing. 2019; 49(4): 361-374. https://doi.org/10.4040/jkan.2019.49.4.361
35. Duan- Porter W., Coeytaux R. R., McDuffi e J.R., Goode A. P., Sharma P., Mennella H., Nagi A., Williams J. W. Jr. Evidence Map of Yoga for Depression, Anxiety, and Posttraumatic Stress Disorder. Journal of Physical Activity and Health. 2016; 13(3): 281-8. https://doi.org/10.1123/jpah.2015-0027
36. Saeed S. A., Cunningham K., Bloch R. M. Depression and Anxiety Disorders: Benefi ts of Exercise, Yoga, and Meditation. American Family Physician. 2019; 99(10): 620-627.
37. Cramer H., Lauche R., Anheyer D., Pilkington K., Manincor M., Dobos G., Ward L. Yoga for anxiety: A systematic review and meta-analysis of random- ized controlled trials. Depression and Anxiety. 2018; 35(9): 830-843. https://doi.org/10.1002/da.22762
38. Omejc N., Rojc B., Battaglini P. P., Marusic U. Review of the therapeutic neurofeedback method using electroencephalography: EEG Neurofeed- back. Bosnian Journal of Basic Medical Sciences. 2019; 19(3): 213-220. https://doi.org/10.17305/bjbms.2018.3785
39. Markiewcz R. The use of EEG Biofeedback/Neurofeedback in psychiatric rehabilitation. Psychiatria Polska. 2017; 51(6): 1095-1106. https://doi.org/10.12740/PP/68919 42. Linhartová P., Látalová A., Kóša B., Kašpárek T., Schmahl C., Paret C. fMRI neurofeedback in emotion regulation: A literature review. Neuroimage. 2019; (193): 75-92. https://doi.org/10.1016/j.neuroimage.2019.03.011
40. Deshmukh S. R., Holmes J., Cardno A. Art therapy for people with dementia. Cochrane Database of Systematic Reviews. 2018; 9(9): CD011073. https://doi.org/10.1002/14651858.CD011073.pub2
41. Gigineyshvili G. R., Kotenko N. V., Lanberg O. A. Primenenie art-terapii u zhenschin posle mastektomii po povodu raka molochnoy zhelezy.
42. Vestnik vosstanovitel'noy mediciny. 2019; 6(94): 22-26.
43. Gigineyshvili G. R., Lanberg O. A., Kotenko N. V. Nauchnyy centr art-terapii FGBU «NMIC RK» Minzdrava Rossii. Realizaciya programm art-terapevticheskogo soprovozhdeniya reabilitacii pacientov na baze medicinskogo centra. V sbornike: Arbatskie chteniya. Sbornik nauchnyh trudov. Moskva. 2021: 147-155.
44. Ciasca E. C., Ferreira R. C., Santana C., Forlenza O. V., Dos Santos G. D., Brum P. S., Nuneset P. V. Art therapy as an adjuvant treat- ment for depression in elderly women: a randomized controlled trial. Brazilian Journal of Psychiatry. 2018; 40(3): 256-263. https://doi.org/10.1590/1516-4446-2017-2250
45. Im M. L., Lee J. I. Eff ects of art and music therapy on depression and cognitive function of the elderly. Technology and Health Care. 2014; 22(3): 453-8. https://doi.org/10.3233/THC-140803
46. Mahendran R., Gandhi M., Moorakonda R. B., Wong J., Kanchi M. M., Fam J., Rawtaer I., Kumar A. P., Feng L., Kuaet E. H. Art therapy is associated with sustained improvement in cognitive function in the elderly with mild neurocognitive disorder: fi ndings from a pilot randomized controlled trial for art therapy and music reminiscence activity versus usual care. Trials. 2018; 19(1): 615 p. https://doi.org/10.1186/s13063-018-2988-6
47. Schouten K. A., de Niet G. J., Knipscheer J. W., Kleber R. J., Hutschemaekers G. J.M. The eff ectiveness of art therapy in the treatment of traumatized adults: a systematic review on art therapy and trauma. Trauma, Violence, & Abuse. 2015; 16(2): 220-8. https://doi.org/10.1177/1524838014555032
48. Aalbers S., Fusar- Poli L., Freeman R. E., Spreen M., Ket J. C., Vink A. C., Maratos A., Crawford M., Chen X. J., Gold C. Music therapy for depression. Co- chrane Database of Systematic Reviews. 2017; 11(11): CD004517. https://doi.org/10.1002/14651858.CD004517.pub3
49. Witusik A., Pietras T. Music therapy as a complementary form of therapy for mental disorders. Polski Merkuriusz Lekarski. 2019; 47(282): 240-243. 52. Gómez- Romero M., Jiménez- Palomares M., Rodríguez- Mansilla J., Flores- Nieto A., Garrido- Ardila E.M., González López- Arza M. V. Bene- fi ts of music therapy on behaviour disorders in subjects diagnosed with dementia: a systematic review. Neurologia. 2017; 32(4): 253-263. https://doi.org/10.1016/j.nrl.2014.11.001
50. Mezernickiy P. G. Lechebnye resursy YuBK i vozmozhnosti ih ispol'zovaniya. Gosudarstvennyy institut medicinskoy klimatologii i klimatoterapii. Yalta. 1936: 106 s.
51. Man'shina N. V. Kurortologiya dlya vseh. Za zdorov'em na kurort. Moskva. Veche. 2007: 592 s. 55. Antonelli M., Barbieri G., Donelli D. Eff ects of forest bathing (shinrin-yoku) on levels of cortisol as a stress biomarker: a systematic review and me- ta-analysis. International Journal of Biometeorology. 2019; 63(8): 1117-1134. https://doi.org/10.1007/s00484-019-01717-x
52. Chun M. H., Chang M. C., Lee S. J. The eff ects of forest therapy on depression and anxiety in patients with chronic stroke. International Journal of Neuroscience. 2017; 127(3): 199-203. https://doi.org/10.3109/00207454.2016.1170015
53. Lee I., Choi H., Bang K. S., Kim S., Song M. K., Lee B. Eff ects of Forest Therapy on Depressive Symptoms among Adults: A Systematic Review. Interna- tional Journal of Environmental Research and Public Health. 2017; 14(3): 321 p. https://doi.org/10.3390/ijerph14030321
54. Kim H., Kim J., Ju H. J., Jang B. J., Wang T. K., Kim Y. I. Eff ect of Forest Therapy for Menopausal Women with Insomnia. International Journal of Envi- ronmental Research and Public Health. 2020; 17(18): 6548 p. https://doi.org/10.3390/ijerph17186548
55. Razumov A. N., Ezhov V. V., Dovgan' I. A., Ponomarenko G. N. Lechebnye effekty klimatoterapii: naukometricheskiy analiz dokazatel'nyh issledovaniy. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul'tury. 2020; 97(6): 59-67. https://doi.org/10.17116/kurort20209706159
56. Igumnov S. A., Zhebentyaev V. A. Differencirovannye podhody k kratkosrochnoy psihoterapii v kompleksnom lechenii rasstroystv depressivnogo spektra nepsihoticheskogo urovnya. Social'naya i klinicheskaya psihiatriya. 2010; 20(3): 34-4.