Psychopathological manifestations of endogenous psychoses in remission / intermission state as a predisposal factor to personological transformations (comparative analysis)
DOI:
https://doi.org/10.14739/2310-1210.2018.5.141541Keywords:
schizophrenia, schizoaffective disorder, affective disorders, differential diagnosis, comparative analysisAbstract
Differential diagnosis of endogenous episodic psychoses is an extremely important task of modern psychiatric theory and practice in view of the existing pathomorphosis of mental illness and tendency of the recent years to steady expansion and transformation of ideas about taxonomy and typology. To make the correct diagnosis at the onset of endogenous illness is a significant factor for adequate and successful further therapeutic and social rehabilitation measures, which determine the medical and social prognosis and the quality of patients’ life.
The aim of this study was a comparative analysis of the clinical and psychopathological characteristics of remission states in patients suffering from schizophrenia, schizoaffective disorder (SAD) and affective disorders (AD).Contingents and methods. 49 patients suffering from AD (31 patients were diagnosed with bipolar affective disorder and 18 - with recurrent depressive disorder), 76 patients with diagnosis of schizoaffective disorder and 96 patients – paranoid schizophrenia, episodic type of course were examined on the basis of the Regional Clinical Psychiatric Hospital (Zaporizhzhia). The structure of the disease episodes was characterized by a pronounced affective component in all studied patients. The mandatory inclusion criterion for both groups was the state of clinical remission with psychotic symptoms reduction. The main methods of examination were clinical-catamnestic and clinical-psychopathological as well as medical-statistical analysis.Results. The obtained results allowed to reveal the presence of negative, general and productive disorders in patients with periodic endogenous psychoses in the state of remission, which are related to pathopersonological transformations. Nosologically specific increase in pathopersonological transformations severity was recorded in the AD-SAD-schizophrenia direction. There was a discrepancy between the aforementioned tendency (the increase in psychopathological symptoms severity in the AD-SAD-schizophrenia direction) and some indicators of positive disorders subscale (P4 (Excitement) and P5 (Grandiosity)). The profile of pathopersonological transformations in SAD had the most complex structure in the group of periodic endogenous psychoses.Conclusions. The study of stable pathopersonological transformations of these contingents would help to increase the accuracy of differential diagnosis in the group of periodic endogenous psychoses, leading to enhanced efficiency of the treatment and rehabilitation measures undertaken.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 rasstroistv (dokazatel'naya medicina – klinicheskoj praktike). S.N. Mosolova (Ed), (P. 491–528). Moscow: Social'no-politicheskaya mysl'. [in Russian].
Kritskaya, V. P., & Meleshko, T. K. (2015) Patopsikhologiya shizofrenii [Pathopsychology of schizophrenia]. Moscow. [in Russian].
Maruta, N. O., & Verbenko, G. N. (2017). Kohnityvni porushennіa u khvorykh na bipoliarnyі afektyvnyі rozlad (klinika, diahnostyka, terapiіa) [Cognitive impairments in patients with bipolar affective disorder (clinical features, diagnosis, therapy)]. Zdorovia Ukrainy, 3, 32–34. [in Ukrainian].
Muchnik, P. Yu., & Snedkov, E. V. (2013). Tipichnye vrachebnye oshibki v differencial'noj diagnostike e'ndogennykh psikhozov [The study of differential diagnosis of endogenous mental disorders in hospital practice]. Obozrenie psikhiatrii i medicinskoj psikhologii, 2, 32–36. [in Russian].
Pidkorytov, V. S., Sazonov, S. O., & Baybarak, N. A. (2014). Osoblyvosti diahnostyky shyzoafektyvnoho rozladu sered spektru afektyvno-paranoidnykh staniv [Diagnostic features of schizoaffective disorder in the spectrum of affective-paranoid states]. Medychna psykholohiia, 9(3), 71–77. [in Ukrainian].
Pidkoritov V. S., Serikova O. S. (2017). Predyktory ta osoblyvosti klinichnoi kartyny povtornykh napadiv shyzoafektyvnoho rozladu [Predictors and peculiarities of the clinical picture of recurrent attacks of schizoaffective disorder]. Ukrainskyi visnyk psykhonevrolohii, 25, 1(90), 142–143. [in Ukrainian].
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 [Formalized diagnosis of bipolar disorder in patients with paroxysmal schizophrenia and schizoaffective disorder]. Sovremennaya terapiya psikhicheskikh rasstrojstv, 3, 2–7. [in Russian].
Chugunov, V. V. (2012) Istinnyj patomorfoz psikhiatricheskoj kliniki [The true pathomorphosis of a psychiatric clinic]. Ukrainskyi visnyk psykhonevrologii, 20(3), 233–234. [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). Study Schizophr Res., 158(1–3), 105–112. doi: 10.1016/j.schres.2014.07.001.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin (Oxford), 13(2), 261–276.
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), 309–14. doi: 10.1016/j.psychres.2014.08.035.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)