Modern Features of Clinical Content, Transformation and Comorbidization of States of Dependence, Effectiveness of Step-By-Step Treatment of Combatants and Civilians Under Martial Law

Abstract

Alcohol dependence during martial law may be accompanied by changing consumption patterns, multiple addictive behaviors, and substantial psychiatric and somatic comorbidity. This study examined the clinical characteristics of alcohol dependence and outcomes of an individualized, stepwise treatment program among combatants and civilians. This observational study included 100 men with alcohol dependence treated at an outpatient medical center during 2023–2025. Two consecutive cohorts were evaluated: 50 patients treated in 2023–2024 and 50 treated in 2025. Clinical, family-history, developmental, and substance-use data were collected using a study-specific questionnaire. Treatment combined consultation, detoxification, and individualized pharmacotherapy with sequential stress psychotherapy based on the Dovzhenko method. Remission was assessed through follow-up observation. In the 2025 cohort, 49 of 50 patients (98.0%) reported alcohol dependence in at least one relative, while 48 (96.0%) had tobacco dependence, 23 (46.0%) cannabinoid dependence, 17 (34.0%) dependence involving psychostimulants, and 15 (30.0%) gambling-related problems. Forty-one patients (82.0%) had stage II alcohol dependence, and 20 (40.0%) reported binge episodes lasting from 15 days to two months. Perinatal complications were identified in 31 patients (62.0%), and 44 (88.0%) had at least one adult somatic or neurological condition. Following stepwise treatment, complete therapeutic remission was observed in 35 of 50 patients (70.0%) in the 2023–2024 cohort. In the 2025 cohort, 38 of 50 patients (76.0%) were in remission after 6–10 months of follow-up. Alcohol dependence in this clinical population was characterized by substantial familial burden, polysubstance and behavioral comorbidity, and coexisting health problems. The observed remission rates support further prospective evaluation of individualized stepwise psychotherapy and pharmacotherapy using standardized outcomes, longer follow-up, and a comparison group.