Neurocognitive disorders in endogenous psychoses with episodic course as a component of patho-personal transformations (comparative analysis)

2019 ◽  
Vol 2019 (4) ◽  
pp. 21-26
Author(s):  
M. Ye. Khomitskiy ◽  

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.


Author(s):  
Mykola Khomitskyi

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


2019 ◽  
Vol 27 (3) ◽  
pp. 57
Author(s):  
Mykola Khomitskyi

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


2020 ◽  
Vol 8 (1) ◽  
pp. 34-42
Author(s):  
M. Ye. Khomitskyi

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.


Author(s):  
Susanna Spaulding ◽  
James Banning ◽  
Clifford Harbour ◽  
Timothy Davies

In a narrative inquiry, five educators who taught college in prison share stories about working in this non-traditional learning environment that is often dangerous and frustrating. From the tension between the prison's emphasis on social control and the educators' concern for democratic classrooms, three broad themes emerged: working in borderlands, negotiating power relations, and making personal transformations. Large intact segments from transcripts of participant interviews form a dramatic text that illuminates how a selected group of educators made meaning of their experience teaching college courses to incarcerated students. A comparative analysis presented in a one act play brings together the individual participant voices to tell a collective story, which has meaning in the context of a shared emotional experience.


Author(s):  
В.Л. Підлубний ◽  
Микола Хоміцький

The aim of the study. To study the literature in order to identify modern scientific views on the clinic, systematics, diagnosis and pathopersonalogy of endogenous psychoses with episodic course. Results. The analysis of the literature shows that the diagnostic and classification approaches of endogenous psychoses with episodic course, are focused on polymorphic and variable symptoms of exacerbation of the disease. This leads to diagnostic mistakes, errors in the appointment of maintenance therapy, deterioration of compliance and further deepening of social maladaptation of patients. Refusal to develop the mechanisms of pathogenesis on the basis of the nosological approach will inevitably lead to a regression of the level of treatment and rehabilitation approaches - from ethiopathogenetic to symptomatic. Conclusions. Thus, at present, the importance of diagnostic techniques aimed at assessing and differentiating persistent symptoms of the disease in the period of remission of endogenous psychoses and relate to pathopersonalogical transformations. Research and correct diagnostic assessment of this multicomponent cluster of psychopathological symptoms allows to assess the nosological affiliation of a particular clinical case and to determine the necessary pharmacological and social rehabilitation effects in order to correct existing pathopersonalogical transformations and prevent exacerbation of endogenous psychosis.


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