Characteristics of the social-communicative behavior of patients with endogenous psychoses with an episodic course in the context of post-manifestation pathopersonological transformations

• Main Author: M. Ye. Khomitskyi
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2020-02-01
• Series: Zaporožskij Medicinskij Žurnal
• Subjects: schizophrenia; endogenous psychosis; social and communicative behavior; remission
• Online Access: http://zmj.zsmu.edu.ua/article/view/194543/195861

The clinical picture of exacerbations and remission / intermission states in endogenous episodic psychoses (affective disorders (AD), schizoaffective disorder (SAD) and schizophrenia) changes under the influence of true and therapeutic pathomorphosis, which makes it difficult to conduct differential diagnosis and a decision regarding the nosological entity of individual clinical cases. The study of non-verbal characteristics of the social-communicative aspect of functioning with the help of a clinical-ethological method would provide an opportunity to verify the nosological entity, quantify a patient's condition and its dynamics as a result of applying therapeutic and rehabilitation modalities. The aim - to identify features of social-communicative behavior as a sign of nosospecific pathopersonological transformations in remission / intermission states based on a comparative analysis of clinical-psychopathological, clinical-ethological and clinical-catamnestic characteristics of endogenous psychoses with an episodic course. Materials and methods. On the basis of “Zaporizhzhia Regional Clinical Psychiatric Hospital”, 312 patients were examined. Among them, 102 patients with AD (53 patients with recurrent depressive disorder and 49 patients with BAD); 102 people suffering from SAD and 108 patients diagnosed with schizophrenia, paranoid form, episodic course, in whom the structure of the disease episodes was characterized by a pronounced affective component. A mandatory inclusion criterion was the state of clinical remission with reduced psychotic symptoms. The main methods of examination were clinical-psychopathological, clinical-ethological, clinical-catamnestic and clinical-anamnestic, as well as medical-statistical analysis. Results. The signs of nosospecific post-manifestation pathopersonological transformations represented by features of social and communicative behavior were revealed. Patients with schizophrenia demonstrated signs of autism and emotional-volitional deficit during social communication. In patients with AD, subclinical non-verbal anxiety and depressive symptoms occurred. Patients suffering from SAD showed a specific non-verbal complex characterized by a significant content of aggressively warning elements. Conclusions. Nosospecific non-verbal markers have been identified in social and communicative behavior of patients suffering from endogenous psychosis with an episodic course confirming the presence of pathopersonological transformations. The study of the remission / intermission states in endogenous psychosis provides an opportunity for further identifying nosospecific markers of pathopersonological transformations using the data obtained in differential diagnosis and selection of congruent therapeutic and rehabilitation modalities.