Optimization of psychosocial rehabilitation of patients with schizoaffective disorder according to a typology of pathopersonological transformations
Keywords:psychotic disorder, pathopersonological features, diagnostics, treatment, rehabilitation
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.
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