Clinico-psycological characteristics of schizoaffective disorder remission in the context of pathopersonological transformations in the post-manifestation period (a clinical-ethological aspect)

Abstract

The study of patient behavior is an integral part of a clinical psychopathological study, the significance of which is difficult to overestimate. Timely diagnosis in the period of remission in schizoaffective disorder (SAD) with a high degree of confidence through the clinical-ethological approach, as well as the ability to quantify the dynamics of psychopathological disorders is a promising direction of modern psychiatry. A solution to this problem would provide an opportunity to optimize therapeutic and rehabilitation measures, thereby improving the quality of life for patients and their families.

The aim of this study was to study the clinical and psychopathological (using the clinical and ethological method) characteristics of remission conditions in patients suffering from SAD.

Materials and methods. On the basis of the Regional Clinical Psychiatric Hospital (Zaporizhzhia), 81 patients were examined with an established diagnosis of schizoaffective disorder. Diagnosis of the disease was carried out according to the 10th Revision of the International Classification of Diseases (ICD-10).The average age in the sample was 41.8 ± 8.9 years. The distribution by sex was: 41 women and 40 men. The disease duration in the sample ranges from 3 to 35 years, the average was 15.5 ± 6.3 years. All patients signed an informed consent to participate in the study. The mandatory criterion for inclusion in the sample was the state of clinical remission with psychotic symptoms reduction. The main research methods were clinical-psychopathological, clinical-ethological, clinical-anamnestic and clinical-catamnestic, as well as medical-statistical analysis.

Results.The clinical-ethological characteristics of the socio-communicative interaction of patients with SAD obtained through postures, facial expressions and gestures have statistically significant differences regarding the characteristics of healthy individuals and indicate the presence of persistent transformations of pathopersonological range. Patients suffering from SAD demonstrate a specific complex of non-verbal behavioral components, which is characterized by a significant content of aggressively-warning elements: aggressive posture P < 0.001), aggressive head lunge (P < 0.001), close look (P < 0.01), grin (P < 0.05), lip-biting (P < 0.001), tightening of the lips (P < 0.001), teeth chatter (P < 0.01), raising the arm (P < 0.05), clinched fist (P < 0.001), spreading knees (P < 0.01).By the level of non-verbal aggression in the socio-communicative relationship, as well as by the content of elements indicating an increased level of anxiety (gesture with fixation on the neck (P < 0.01), gesture with fixation on the stomach (P < 0.01), gesture of walking away (P < 0.01), gesture of hand-rubbing (P < 0.001)), patients with SAD exceed the corresponding figures in healthy individuals. Conclusions. The stable pathopersonological transformations that are present in SAD require a comprehensive study of the structure, typology of factors in their formation, development of prevention and correction systems with a view to reducing their disadaptive effects.