THE ROLE OF THE COMT VAL158MET (RS4680) POLYMORPHISM IN THE DEVELOPMENT OF ANXIETY AND DEPRESSIVE SYMPTOMS IN THE UKRAINIAN POPULATION: A CLINICAL GENETIC STUDY

Abstract

Servicemen with stress-associated disorders are the  category most resistant to  standard inpatient therapy, which prompts the search for adjunctive treatments. Transcranial magnetic stimulation is  regarded as  a  promising addition, but its effect is  usually assessed by  integral scale scores, while its differentiated impact on individual symptoms and on resilience remains insufficiently studied. The purpose was to assess the impact of adding stimulation to standard therapy on the dynamics of individual post-stress symptoms and on resilience. A total of 144 male servicemen were examined and  allocated to  two comparable groups of  72  — "With  TMS” and  "Without TMS”; assessment was performed twice  — at  admission (examination No.  1) and at discharge (examination No. 2) — using the Mississippi Scale (M-PTSD) and the Connor– Davidson Resilience Scale (CD-RISC-25). Integral scores did not change significantly in  either group. At  the level of  individual symptoms, the  "With TMS” group showed reduction of  four symptoms (guilt, suicidal intent, the feeling of being unable to cope, concentration difficulties) versus one symptom in the "Without TMS” group, while sleep disturbance and reduced work-ing capacity increased. At discharge, the proportion of patients with a medium resilience level was significantly higher in the "With TMS” group (58.33 % vs 40.28 %). Cluster-based analysis showed predominance of  avoidance, intrusion and  hyperarousal over guilt and  suicidality. Adding stimulation was associated with broader symptom-specific reduction and  a  more fa-vourable redistribution by resilience level, generating hypotheses for further randomized trials.