Predisposition to depressive symptoms in patients with paranoid schizophrenia: constitutional-biological, socio-demographic factors and the debut of the disease
DOI:
https://doi.org/10.14739/2310-1210.2016.6.85530Keywords:
депрессия, шизофрения, поведениеAbstract
Aim. To identify the constitutional-biological, socio-demographic (microsocial) and clinical-dynamic (the debut of the disease) factors of predisposition to the depressive symptoms development in patients with paranoid schizophrenia.
Materials and methods. A clinical-anamnestic, socio-demographic, clinical-psychopathological and pathopsychological examinations of 82 patients with paranoid schizophrenia with depressive symptoms identified and compared with 47 patients with paranoid schizophrenia without depressive symptoms. The study was managed using the PANSS, CDSS, HDRS scales and a questionnaire for the assessment of social functioning and quality of the mentally ill life. Groups did not differ in the basic demographic indicators. The study of constitutional and biological predisposition factors included the study of heredity and premorbid characterological features of patients. Socio-demographic (before the onset of the disease microsocial conditions and the current stage) factors –family relationships; characteristics of living conditions; financial position; the quality of nutrition. To factors of the disease onset were attributed: age debut; factors that preceded the first episode; syndromes of the first episode; the first reference to a psychiatrist; suicidal statements and intentions.
Results. It was evaluated the prognostic significance of individual predisposing factors to depression in patients with paranoid schizophrenia and found the following factors of predisposition (p<0.05): the heredity of schizophrenia and affective disorders; low level of erudition, combined with emotional and volitional immaturity, anxiety, prone to mood swings; low income and the cost of food, clothing and leisure; poor living conditions; unstable or conflictual family relationships; the presence of the first episode of affective symptoms, such as depressive, which is stored in the further course of the disease, as well as anhedonia, sleep and appetite disorders, weight loss; statements of suicidal thoughts or intentions for life. Age and factors that preceded the disease onset had no statistically significant effect on the development of depressive symptoms in this group of patients.
Conclusions. The revealed features allow improving the quality of depressive symptoms diagnosis in patients with paranoid schizophrenia, and the development of their medical and social rehabilitation measures complex based on identified features. It will enhance both the results of treatment and the level of social functioning and life quality of this patients group.
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