Сomparative analysis of social disadaptation and criticality indicators in patients with schizoaffective disorder and paranoid schizophrenia as components of pathopersonological transformations

Authors

  • M. Ye. Khomitskyi Narcology and Sexology Department, Zaporizhzhіa State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2018.02.125281

Keywords:

schizophrenia, schizoaffective disorder, differential diagnosis, anomie

Abstract

Differential diagnosis of schizophrenia or schizoaffective disorder (SAD), both are included in endogenous psychoses group, which represents an extremely important problem in clinical practice and modern psychiatric theory considering steady expanding and transforming ideas about the systematic typology of mental diseases in recent years. Correctness of psychiatric disease diagnosis by clinicians determines therapeutic strategy, which directly influences the quality and duration of remission, the side effects of medicines severity, medical and social prognosis and quality of patient’s life.

The aim – to carry out a comparative analysis of pathopersonological transformations, types of attitude to the disease and adaptability of patients with schizophrenia and SAD.

Contingents and methods. On the basis of the Regional Clinical Psychiatric Hospital (Zaporizhzhia, Ukraine) there were examined 76 patients with an diagnosis of "schizoaffective disorder" and 96 patients with an established diagnosis of "paranoid schizophrenia, episodic type of course", both with pronounced affective component in the structure of exacerbation episodes. Inclusion criterion in the sample for both groups was the state of clinical remission with reduction of psychotic symptoms. The main methods of investigation were catamnestic, clinical, psychopathological, psychodiagnostic (MMPI and PQBI techniques), as well as medical and statistical analysis.

Results. The obtained results revealed a negative effect of both diseases on the level of psychosocial adaptation in various vectors (interpsychic for SAD and intrapsychic for schizophrenia), and also indicated the specific personological characteristics of the studied contingents. The prevalence of personality autization among patients with schizophrenia combined with anxious and neurotic features, which define the leading mechanism of delusion formation, while impulsivity and psychopathyzation, which dominate the personality profile of patients with SAD, corresponded to the affective radical associated with the context of delusional-like experiences.

Conclusions. Detection of specific pathopersonological transformations contributes to the differential diagnosis of schizophrenia and SAD accuracy, thereby resulting in greater efficiency and purposefulness of therapeutic and rehabilitation measures.

References

Kostyukova, E. G., & Mosolov, S. N. (2012) Sovremennaya diagnostika i terapiya bipolyarnogo affektivnogo rasstrojstva: ot dokazatel'nykh nauchnykh issledovanij k klinicheskoj praktike [Modern diagnosis and treatment of bipolar disorder: evidence from research to clinical practice]. Biologicheskie metody terapii psikhicheskikh rasstrojstv (Dokazatel'naja medicina – klinicheskoj praktike). (P. 491–528). Moscow: Social'no-politicheskaya mysl'. [in Russian].

Kritskaya, V. P., & Meleshko, T. K. (2015) Patopsikhologiya shizofrenii [Pathopsychology of schizophrenia]. Moscow: IP RAN. [in Russian].

Muchnik, P. Y., & Snedkov, E. V. (2013). Tipichnye vrachebnye oshibki v differencial'noj diagnostike e'ndogennyh psikhozov [The study of differential diagnosis of endogenous mental disorders in hospital practice]. Obozrenie psikhiatrii i medicinskoj psikhologii, 2, 32–36. [in Russian].

Kholmogorova, A. B., Moskacheva, M. A., Rychkova, O. V., Pugovkina, O. D., Krasnova, V. V., Dolnykova, A. A., et al. (2015). Sravnenie sposobnosti k mentalizacii u bol'nykh shizofreniej i shizoaffektivnym psikhozom na osnove metodiki «Ponimanie psikhicheskogo sostoyaniya po glazam» [Comparison of the ability to mentalization in patients with schizophrenia and schizoaf- fective psychosis based on the methodology «Understanding the mental state of the eyes»]. E'ksperimental'naya psikhologiya, 8(3), 99–117. [in Russian].

Kholmogorova, A. B., Tsarenko, D. M., & Moskacheva, M. A. (2016) Narusheniya social'nogo poznaniya pri rasstrojstvakh shizofrenicheskogo i affektivnogo spektrov [The Social Cognition Impairments of People with Schizophrenia and Affective Spectrum Disorders]. Klinicheskaya i special'naya psikhologiya, 5(4), 103–117. [in Russian].

Mosolov, S. N., Shafarenko, A. A., Ushkalova, A. V., Alfimov, P. V., & Kostyukova, A. B. (2014). Formalizovannaya diagnostika bipolyarnogo affektivnogo rasstrojstva u bol'nykh s pristupoobraznoj shizofreniej i shizoaffektivnym rasstrojstvom [Misdiagnosis of Bipolar I Disorder among patients with the diagnoses of paranoid schizophrenia and schizoaffective disorder in Russian Federation]. Sovremennaya terapiya psikhicheskikh rasstrojstv, 3, 2–7. [in Russian].

Ruocco, A. C., Reilly, J. L., Rubin, L. H., Daros, A. R., Gershon, E. S., Tamminga, C. A., et al (2014). Emotion recognition deficits in schizophrenia-spectrum disorders and psychotic bipolar disorder: Findings from the bipolar-schizophrenia network on intermediate phenotypes (B-SNIP). Schizophrenia Research, 158(1–3), 105–112. doi: 10.1016/j.schres.2014.07.001.

Horan, W. P., Hajcak, G., Wynn, J. K., & Green, M. F. (2013). Impaired emotion regulation in schizophrenia: evidence from event-related potentials. Psychological Medicine, 43(11), 2377–2391. doi: 10.1017/S0033291713000019.

Thaler, N. S., Sutton, G. P., & Allen, D. N. (2014). Social cognition and functional capacity in bipolar disorder and schizophrenia. Psychiatry Research, 220(1–2), 14–309. doi: 10.1016/j.psychres.2014.08.035.

Pinkham, A. E., Penn, D. L., Green, M. F., Buck, B., Healey, K., & Harvey, P. D. (2014). The Social Cognition Psychometric Evaluation Study: Results of the Expert Survey and RAND Panel. Schizophrenia Bulletin, 40(4), 23–813. doi: 10.1093/schbul/sbt081.

How to Cite

1.
Khomitskyi MY. Сomparative analysis of social disadaptation and criticality indicators in patients with schizoaffective disorder and paranoid schizophrenia as components of pathopersonological transformations. Zaporozhye Medical Journal [Internet]. 2018Mar.7 [cited 2024Oct.6];(2). Available from: http://zmj.zsmu.edu.ua/article/view/125281

Issue

Section

Original research