Optimization of psychosocial rehabilitation of patients with schizoaffective disorder according to a typology of pathopersonological transformations
DOI:
https://doi.org/10.14739/2310-1210.2020.6.218462Keywords:
psychotic disorder, pathopersonological features, diagnostics, treatment, rehabilitationAbstract
Currently, there is a significant increase in the prevalence of schizoaffective disorder (SAD) inUkraineand in the world, an increase in the direct and indirect economic costs of this disease, and rise in the risk of socially dangerous acts. Personality changes in the formation of pathopersonological transformations (PpT) influenced by a range of factors (endogenous, psychogenic, pharmacogenic) result in impaired work and social adjustment as well as re-hospitalization due to exacerbation of psychosis or social factors. The study on the typology of PpT in SAD would allow using a personalized treatment and rehabilitation program in order to maintain the state of remission and counteract social maladjustment.
The aim of the study was the development and testing of a complex therapy and rehabilitation program considering the typology of PpT in SAD based on the analysis of clinical-psychopathological, medical-psychological, clinical-etiological characteristics of remission states.
Contingents and methods. A total of 102 patients with the diagnosis of SAD were examined in theRegionalClinicalPsychiatric Hospital (Zaporizhzhіa). The main methods of examination were clinical-psychopathological, psychodiagnostic, pathopsychological, clinical-anamnestic, follow-up study, social medical and statistical analysis.
Results. The presence and prevalence of the four main PpT types were found in SAD (“affective-labile” (20.1 % of the contingent), “paranoid-dysthymic” (17.3 %), “hysterical-agonistic” (25.9 %), “neurocognitive deficient” (16.9 %) and mixed type of PpT (19.8 % of the contingent). The program of complex therapy and rehabilitation was developed and tested considering the typology of PpT in SAD based on the analysis of clinical-psychopathological, medical-psychological, clinical-etiological characteristics of remission states.
Conclusions. Developed and tested in the study program of complex therapy and rehabilitation for patients with SAD addressing the typology of PpT and combining psychopharmacological, psychoeducational, psychosocial and psychotherapeutic measures, has proved to be effective and can be used in clinical settings to prevent exacerbation, improve the quality of remission and the level of social adjustment.
References
Das, S., Pantoji, M. V., Mehta, U. M., & Thirthalli, J. (2018). Sequential type schizoaffective disorder: A concept missed in the classificatory system. Asian Journal of Psychiatry, 36, 86-87. https://doi.org/10.1016/j.ajp.2018.06.013
Pai, N., & Vella, S. L. (2019). The misdiagnosis of schizoaffective disorder. The Australian & New Zealand Journal of Psychiatry, 53(11), 1124-1125. https://doi.org/10.1177/0004867419872246
Peterson, D. L., Webb, C. A., Keeley, J. W., Gaebel, W., Zielasek, J., Rebello, T. J., Robles, R., Matsumoto, C., Kogan, C. S., Kulygina, M., Farooq, S., Green, M. F., Falkai, P., Hasan, A., Galderisi, S., Larach, V., Krasnov, V., & Reed, G. M. (2019). The reliability and clinical utility of ICD-11 schizoaffective disorder: A field trial. Schizophrenia Research, 208, 235-241. https://doi.org/10.1016/j.schres.2019.02.011
Santelmann, H., Franklin, J., Bußhoff, J., & Baethge, C. (2015). Test-retest reliability of schizoaffective disorder compared with schizophrenia, bipolar disorder, and unipolar depression - a systematic review and meta-analysis. Bipolar Disorders, 17(7), 753-768. https://doi.org/10.1111/bdi.12340
Serikova, O. (2018). Klinichna dyferentsiatsiia psykhopatolohichnoi symptomatyky depresyvnoho, maniakalnoho ta zmishanoho typiv shyzoafektyvnoho rozladu u dynamitsi [Clinical differentiation of psychopathological symptomatics in depressive, maniacal and mixed types of schizoaffective disorder in dynamics]. Science Rise: Medical Science, (4), 43-48. https://doi.org/10.15587/2519-4798.2018.132560 [in Ukrainian].
Maruta, N. O., Panko, T. V., Fedchenko, V. Yu., Semikina, O. Ye., Kalenska, H. Yu., & Terenkovskyi, D. I. (2017). Diahnostychni kryterii depresyvnykh rozladiv na etapakh nadannia medychnoi dopomohy [Diagnostic criteria for depressive disorders at the stages of medical assistance]. Ukrainskyi visnyk psykhonevrolohii, 25(1), 135. [in Ukrainian].
Chugunov, V. V., & Kireeva, E. N. (2014). Mediko-psikhologicheskie prediktory prodromal'nogo perioda povtornogo epizoda rekurrentnogo depressivnogo rasstroistva [Medical and psychological predictors of prodromal period of repeated episode of major depressive disorder]. Zaporozhye medical journal, (3), 71-76. https://doi.org/10.14739/2310-1210.2014.3.26035 [in Russian].
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276. https://doi.org/10.1093/schbul/13.2.261
Vasserman, L. I., Dorofeeva, S. A., & Meerson, Ya. A. (1997). Metody neiropsikhologicheskoi diagnostiki: Prakticheskoe rukovodstvo [Methods of neuropsychological diagnostics: A Practical Guide]. Stroilespechat'. [in Russian].
Vasserman, L. I., Iovlev, B. V., Karpova, E. B., & Vuks, A. Ya. (2005). Psikhologicheskaya diagnostika otnosheniya k bolezni: posobie dlya vrachei [Psychological assessment of attitude towards disease: a guide for doctors]. Sankt-Peterburgskii nauchno-issledovatel'skii psikhonevrologicheskii institut im. V. M. Bekhtereva. [in Russian].
Sobchik, L. N. (2000). Standartizirovannyi mnogofaktornyi metod issledovaniya lichnosti SMIL [Standardized multifactorial method of studying personality SMIL]. Rech'. [in Russian].
Samokhvalov, V. P., & Samokhvalova, O. E. (2011). Toward a Neuroethology of Schizophrenia: Findings from the Crimean Project. In M. Ritsner (Ed.), Handbook of Schizophrenia Spectrum Disorders (Vol. 2, pp. 121-164). Springer. https://doi.org/10.1007/978-94-007-0831-0_6
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)
