scholarly journals An algorithm for the diagnostic differentiation of schizoaffective disorder and other endogenous psychoses with episodic course (schizophrenia and affective disorders)

Pathologia ◽  
2020 ◽  
Vol 0 (1) ◽  
Author(s):  
M. Ye. Khomitskyi
Keyword(s):  
Schizoaffective Disorder ◽  
Affective Disorders ◽  
Endogenous Psychoses ◽  
Episodic Course ◽  
Diagnostic Differentiation

scholarly journals Characteristics of personality in patients with endogenous psychoses with an episodicаl course in the context of post-manifest pathopersonаlogical transformations (comparative analysis)

2020 ◽  
Keyword(s):  
Differential Diagnosis ◽  
Comparative Analysis ◽  
Schizoaffective Disorder ◽  
Affective Disorders ◽  
Economic Consequences ◽  
Personality Characteristics ◽  
Simultaneous Increase ◽  
Personal Profile ◽  
Endogenous Psychoses ◽  
Episodic Course

Solution of the problems of differential diagnosis, treatment and social rehabilitation of patients with endogenous psychoses with episodic course is one of the most complex and urgent problems of clinical psychiatry, which is caused by polymorphism and variability of symptoms, decrease or loss of critical attitude toward the disease, with grave social and economic consequences. The aim of the study is to establish, on the basis of the results of the comparative analysis of the characteristics of the personal profile, the features and nosospecific differences of post-manifest pathopersonаlogical transformations in patients with schizophrenia, schizoaffective disorder and affective disorders in remission / intermissions. The study examined the personality characteristics of endogenous psychoses with an episodic course in remission / intermission conditions and established signs and nosospecific differences in post-manifest pathological transformations in patients with schizophrenia, schizoaffective disorder, and affective disorders. Existing pathopersonalogical transformations are characterized by signs of multidirectional tendencies of compensatory tension of personal resources, which is confirmed by the presence of several moderately elevated (65-75 T-points) indicators of individual scales and a simultaneous increase in indicators of both hyposthenic (2nd and 7th scales) and hypersthenic ( 4th and 9th scales) registers. In schizoaffective disorder, such scales are the 2nd (65.36±12.28 T-points), 4th (73.23±11.83 T-points), 8th (68.40±12.33 T-points) and 9th (66.05±12.02 T-points); in affective disorders, these are the 2nd, 4th and 8th scales (67.72±13.96, 67.08±9.53 and 65.90±10.08 T-points, respectively); for schizophrenia, such scales are the 2nd (72.37 ± 16.80 T-points), 4th (69.47±12.48 T-points), 7th (66.59±15.69 T-points) ) and 8th (71.73±19.95 T-points). The obtained data can be used as a component of the differential diagnosis system and personified psychotherapeutic support.

scholarly journals Clinical-psychopathological and medical-social characteristics of patients with endogenous psychoses with an episodic course in the context of post-manifestation pathopersonological transformations

2019 ◽  
Author(s):  
Mykola Khomitskyi
Keyword(s):  
Schizoaffective Disorder ◽  
Complex Structure ◽  
Diagnostic System ◽  
Personal Characteristics ◽  
Social Characteristics ◽  
Clinical Aspects ◽  
Rehabilitation Care ◽  
Main Research ◽  
Endogenous Psychoses ◽  
Episodic Course

The determination of the nosological affi liation of a separate clinical case in the group of endogenous psychoses is a decisive factor in adequate psychopharmacotherapy. The clinical aspects of post-manifestation pathopersonological transformations of endo genous psychosis with an episodic course remain the least studied and require study to improve the quality of diff erential diagnosis, treatment and rehabilitation. The aim of this study was to conduct a comparative analysis of personal characteristics, types of attitude toward the disease and adaptability of patients with schizophrenia and schizoaff ective disorder. On the basis of the Regional Clinical Psychiatric Hospital (Zaporizhzhia, Ukraine), 312 patients were examined, among them 102 patients with aff ective disorders; 102 patients suffering from schizoaffective disorder and 108 patients diagnosed with schizo phrenia, paranoid form, episodic course. The main research methods were clinical-psychopathological, clinical-follow-up, clinical-anamnestic and medical-social, as well as medicalstatistical analysis. The study revealed signs and nosospecific diff erences in indicators of social (labor and family) maladjustment, as well as positive, negative and general psychopathological disorders (according to PANSS) in endogenous psychoses with an episodic course, confi rming the presence of post-manifestation pathopersonological transformations. In the group of endogenous psychosis with an episodic course, pathopersonological transformations in schizoaff ective disorder are characterized by the most complex structure and are a nosospecific marker. Further studies of remission/intermission in endo genous psychosis open up the possibility of developing a differential diagnostic system and algorithms for providing personalized medical and rehabilitation care. Keywords: schizoaffective disorder, affective disorders, schizophrenia, clinic, social maladjustment, differential diagnosis, pathopersonological transformations

scholarly journals TYPOLOGY OF PATHOPERSONOLOGICAL TRANSFORMATIONS IN PATIENTS WITH SCHIZOAFFECTIVE DISORDER

2020 ◽  
Vol 8 (1) ◽  
pp. 34-42
Author(s):  
M. Ye. Khomitskyi
Keyword(s):  
Statistical Analysis ◽  
Psychiatric Hospital ◽  
Schizoaffective Disorder ◽  
Social Rehabilitation ◽  
Endogenous Psychoses ◽  
Quantitative Characteristics ◽  
Definitive Solution ◽  
Episodic Course ◽  
Social Labor

The issue of diagnostics, treatment and social rehabilitation of patients with endogenous psychoses with episodic course remains one of the most urgent problems of psychiatry, which, despite the considerable advances of science and practice, has not found a definitive solution. Significant difficulties of nosological separation in the group of endogenous psychoses with episodic course and evaluation of the pathopersonological aspect of the clinic are related to schizoaffective disorder. The aim of the study was to establish a typology of pathopersonological transformations in patients with schizoaffective disorder based on the analysis of clinical-psychopathological, medical-psychological, clinical-ethological characteristics of remission. On the basis of “Regional Clinical Psychiatric Hospital” (Zaporizhzhіa) 102 persons with the established diagnosis of schizoaffective disorder were examined. The main methods of the study were clinical psycho-pathological, psychodiagnostic, patho-psychological, clinical-anamnestic, clinical-medical, social-medical and statistical analysis. As a result of the conducted research, on the basis of the analysis of clinical-psychopathological, medical-psychological, clinical-ethological characteristics of remission, the typology of pathopersonological transformations was established. The presence and prevalence of 4 main types of pathopersonological transformations in schizoaffective disorder (“affective-labile” (20.1 % of the contingent), “paranoid-dysthymic” (17.3 %), “hysteroid-agonistic” (25.9 %), “Neurocognitive-deficient” (16.9 %) and “mixed” (19.8 % of the contingent)), which differ in clinical-anamnestic, clinical-psychopathological, medical-psychological, neuropsychological and clinical-ethological characteristics and cause social (labor and family) maladjustment of varying degrees. The clinical-anamnestic, clinical-psychopathological, medical-psychological, neuropsychological and clinical-ethological features identified in the study can be used to determine the type of pathopersonological transformations and its severity in patients with schizoaffective disorder and, accordingly, quantitative characteristics of individually needed psychopharmacological, psychotherapeutic and social rehabilitation activities and evaluation of their effectiveness in dynamics.

scholarly journals Structure and types of response to disease and indexes of adaptability/maladaptation in endogenous psychoses with episodic course in the context of pathopersonalogical transformations in post-manifestation period

2019 ◽  
Vol 27 (3) ◽  
pp. 57
Author(s):  
Mykola Khomitskyi
Keyword(s):  
Key Words ◽  
Adaptive Capacity ◽  
Key Words Schizophrenia ◽  
Endogenous Psychoses ◽  
Episodic Course ◽  
Endogenous Psychosis

The study examined the structure and types of attitude toward the disease (ATD) and adaptability/maladaptation indices in 312 patients with endogenous episodic episodes (schizophrenia, schizoaff ective disorder (SAD) and aff ective disorders (AD)) in remission/ intermittent states and compared them. Characteristics of ATD and indicators of adaptability/disadaptation in endogenous psychosis with episodic course in the remission/intermission period are a sign of stable post-manifestation of pathopersonalogical transformations and have nosospecifi c diff erences. Patients suffering from endogenous episodic psychosis have a reserve of personal adaptive capacity. This is confirmed by the fact that among patients with maladaptive types of ATD, a signifi cant percentage is of the types with an interpsychic orientation (74.0 % of the contingent in AD, 55.9 % of those surveyed with SAD and 57.6 % with schizophrenia), which is a sign of the use of personal reserves in confronting the negative eff ects of the disease. The above-mentioned reserve of personal adaptation possibilities in AD is the largest, as shown by the larger (χ2 = 6.065, p < 0.05) percentages of types with an interpsychic orientation in the structure of maladaptive types of ATD. The obtained data can be implemented into the system of diff erential diagnosis and counteraction to social maladaptation, which is formed as a result of the disease. Key words: schizophrenia, schizoaff ective disorder, aff ective disorders, clinic, adaptation, pathopersonalogical features

Therapy of Schizoaffective Disorder and Paranoid Schizophrenia with Episodic Course

2019 ◽  
Vol 4 (2) ◽  
pp. 101-105
Author(s):  
L. A. Ivanova ◽  
O. P. Vorsina ◽  
T. A. Eliseeva ◽  
K. A. Frolovа ◽  
E. V. Sapozhnikova
Keyword(s):  
Adverse Events ◽  
Schizoaffective Disorder ◽  
Paranoid Schizophrenia ◽  
Cognitive Disorders ◽  
Tolerability Profile ◽  
Clinical Impression ◽  
Treatment Level ◽  
Icd 10 ◽  
Episodic Course ◽  
Pre Treatment

Background. The use of atypical antipsychotics in schizophrenia contributes to the reduction of psychotic, affective, negative and cognitive disorders.Aims. To evaluate the effectiveness of ziprasidone therapy in patients with schizoaffective disorder and paranoid schizophrenia with episodic course.Materials and methods. In accordance with ICD-10 there were 14 (63.6 %) people with schizoaffective disorder (F25), 8 (36.4 %) people with paranoid schizophrenia, episodic course (F20.x1). Treatment with ziprasidone lasted 42 days. The dose of ziprasidone in 6 patients (27.3 %) was 80 mg, in 10 patients (45.5 %) – 120 mg, in 6 patients (27.3 %) – 160 mg. Evaluation of the effectiveness of ziprasidone therapy was carried out using psychometric scales (PANSS, General clinical impression scale to assess the effectiveness of therapy – CGI-S, CGI-I), adverse events were registered with the UKU scale.Results. The number of respondents was 19 (86.3 %) (reduction of the total score on the PANSS scale > 20 % of the pre-treatment level). Ziprasidone was effective in patients with schizoaffective disorder with a significant decrease in total score on PANSS subscales to the 14 th day of therapy (p < 0.05), with paranoid schizophrenia with episodic course – by the 21st day (p < 0.01). According to the CGI-S scale at the end of therapy, “borderline condition” was observed in 10 patients (52.6 %), mild severity – in 3 (15.8 %), normal condition – in 6 (31.6 %). CGI-I scale showed a significant improvement in 10 patients (52.6 %), marked improvement – in 9 patients (47.4 %). Among the mild adverse events that do not require discontinuation of the drug, we noted: weakness – in 3 patients (15.8 %), drowsiness – in 3 (15.8 %), impaired concentration – in 2 (10.5 %), orthostatic dizziness – in 2 (10.5 %), galactorrhea – in 1 (5.3 %).Conclusions. Ziprasidone is an effective antipsychotic drug that has a safe tolerability profile. It can be used in patients with schizoaffective disorders and paranoid schizophrenia with episodic course.

scholarly journals Understanding psychosis: diagnosis and clinical presentation (updates for clinicians)

2022 ◽  
Vol 13 (1) ◽  
pp. 065-071
Author(s):  
Gayane Kirakosyan ◽  
Alina Frolova
Keyword(s):  
Social Factors ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
Clinical Presentation ◽  
Chronic Alcoholism ◽  
Review Article ◽  
Educational Material ◽  
Mental Illnesses ◽  
Endogenous Psychoses ◽  
Mechanisms Of Development

Psychosis is understood as the brightest manifestations of mental illness, in which the patient's mental activity does not correspond to the surrounding reality, the reflection of the real world in consciousness is sharply distorted, which manifests itself in behavioral disorders, abnormal pathological symptoms and syndromes. Psychosis is a combination of biological (genetic, neuroanatomical, neurophysiological), psychological and social factors in various proportions. Psychoses are classified according to their origin (etiology) and reasons (pathogenetic mechanisms of development) into endogenous (including endogenous psychoses include schizophrenia, schizoaffective disorder, some psychotic forms of affective disorders), organic, somatogenic, psychogenic (reactive, situational), intoxication, withdrawal and post-withdrawal. Most often, psychoses develop in the framework of so-called endogenous disorder. The concepts of psychosis and schizophrenia are often equated, which is incorrect as psychotic disorders can occur in a number of mental illnesses: Alzheimer's disease and other types of dementia, chronic alcoholism, drug addiction, epilepsy, intellectual disabilities, etc. Other types of psychosis, such as infectious, somatic and intoxication psychoses are quite often find among patients in non-psychiatric practices. This review article is a good educational material for medical and psychological practitioners whose goal is to improve knowledge and diagnostic processes of psychosis and its related disorders.

the Long Term Evolution of Periodical Affective Disorders, with and without Psychotic Symptoms

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Lazarescu
Keyword(s):  
Schizoaffective Disorder ◽  
Affective Disorders ◽  
Long Term Evolution ◽  
Psychotic Symptoms ◽  
Psychiatric Clinic ◽  
Term Evolution ◽  
Bipolar Patients ◽  
Worse Prognosis

In the Psychiatric Clinic in Timisoara, we began a study of the long term evolution (over 10 years) on two comparative groups of patients with affective disorders, with and without incongruent psychotic symptoms. We compared one group of 20 bipolar patients with psychotic symptoms with another group of 20 bipolars without psychotic symptoms. the same was done with two groups of 20 patients with monopolar depression. We did not include the cases with more than one schizoaffective episode, which were studied separately. We came to the conclusion that affective disorders associated with incongruent psychosis, had an earlier onset, a worse prognosis and other genetic and temperamental characteristics, than the ones without psychotic symptoms. Also the cases with schizoaffective disorder (schizo-bipolar and schizo-depressive) we have studied had an earlier onset and a bad prognosis.

Pharmacotherapy of acute psychotic states: The reason for benzodiazepines and valproic acid augmentation

2016 ◽  
Vol 33 (S1) ◽  
pp. S612-S612
Author(s):  
A. Veraksa ◽  
A. Egorov
Keyword(s):  
Valproic Acid ◽  
Mental Disorders ◽  
Mental State ◽  
Schizoaffective Disorder ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
Bipolar Affective Disorder ◽  
Schizophrenia Spectrum ◽  
Icd 10 ◽  
Competing Interest

Acute psychotic states (APS) usually are diagnosed as schizophrenia spectrum and affective disorders and make up about 45% of cases. The goal of the study was to elucidate the effect of benzodiazepines (BDZ) and valproic acid augmentation in the APS pharmacotherapy. The study was carried out on 102 inpatients diagnosed up to ICD-10 as schizophrenia (n = 24), acute and transient psychotic disorders (n = 40), other mental disorders due to brain damage and dysfunction and to physical disease (n = 17), schizoaffective disorder (n = 12), bipolar affective disorder (n = 9). Patients were randomized into four therapeutic groups:– benzodiazepines (BDZ);– one neuroleptic or combination of one neuroleptic and one BDZ (NBDZ);– combination of valproic acid with BDZ or neuroleptic (VBDZN);– polypragmasy (PP): from two drugs of one group up to four and more drugs at the same time.The mental state of the patients was evaluated daily and estimated before, weekly and after APS termination by BPRS and CGI scale. The APS in all groups lasted from 1 to 50 days (mean 11.4). The shortest duration of APS was In BDZ group – 4.7 days; in VBDZN and NBDZ, the duration was 7.0 and 7.4 days (P < 0.05); in PP group, the treatment lasted 24.5 days (P < 0.001). Before therapy, average BPRS rate was 43.5 ± 8.1, CGI – 6.2 ± 0.8; after APS, BPRS was 18.9 ± 2.1, CGI – 1.1 ± 0.3. All rates did not differ among subgroups. APS therapy by BDZ and its combination with neuroleptics and valproic acid was effective compared to the polypragmasy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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