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

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

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.


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.


2015 ◽  
Vol 19 (2) ◽  
pp. 54-65 ◽  
Author(s):  
Ganesan Balasankar ◽  
Luximon Ameersing

The human foot is a complex structure, which includes bones, joints, muscles, ligaments, soft tissues, nerves and veins. It supports the weight of the whole body and helps one to walk, run, and jump. Ankle and foot biomechanical functions that are interrupted by various pathological deformities lead to pain or other deformities, and result in difficulties during mobility. Foot problems are very common in children and adults. In this article, attempts are made to explore the clinical aspects of the most common foot and ankle deformities and their management by children and adults. Foot deformities may be congenital or acquired, and may involve arthritis conditions, such as rheumatoid arthritis and osteoarthritis. In children, congenital clubfoot, cavus, and flat feet are the most common disorders and can be treated by non-operative means or surgical management. Hallux valgus and rigidus, lesser toe deformities, and arthritis are mostly present with or without pain in the adult population.


1992 ◽  
Vol 7 (6) ◽  
pp. 271-276
Author(s):  
S Dollfus ◽  
M Petit ◽  
JF Menard

SummaryChronic Hallucinatory Psychosis (CHP) is typically a French disease entity initially described by G Ballet (1911) and whose diagnostic criteria were established by Pull (1987). This diagnosis is not used in English and German literature. The aim of this study was to investigate the relationship between Pull's criteria for CHP and the criteria for schizophrenia defined by 14 different diagnostic systems and schizoaffective disorders. Seventy-two non-affective psychotic patients (34 men, 38 women), aged 20 to 84, in exacerbated or stabilized phase, were interviewed by the same investigator (SD). The patient distribution between the diagnoses in the different diagnostic systems was carried out using a computerized 208-item checklist. The main results indicated that the definite CHP diagnosis was significantly related to the Catego S + (C = 0.52; P < 0.01), New-Haven, (C = 0.40; P < 0.05) and Schneider (C = 0.54; P < 0.001) systems for schizophrenia and with the depressive-schizoaffective disorder (C =0.39; P < 0.05) in the RDC system. The probable CHP diagnosis was significantly linked with the same systems and with the probable RDC (C = 0.39; P < 0.05) for schizophrenia. These results emphasize that in 13 out of the 14 diagnostic systems, schizophrenic and schizoaffective disorders overlapped with CHP in the French diagnostic system. Among these systems, four schizophrenic diagnoses were significantly linked to CHP. In contrast, the Bleuler system for schizophrenia was not related to CHP at all.


A quantitative and qualitative analysis of personality characteristics in patients with schizoaffective disorder was carried out, and nospecific signs of post-manifest pathopersonalogical transformations were established using the standardized method of personality research. During the survey, a stress response was observed as a natural response to interference with the inner world of the individual. There was a certain increase in diligence, self-criticism and openness in the survey. The mood was unstable, there was a tendency to dissatisfaction with themselves, a sharp change in attitude towards others under the influence of fleeting emotions and circumstances. Declaring an active life position was inconsistent with actual behavior. The L score was 49.41±8.84 T points, indicating no effort to make a better impression on examination. The score obtained on the F scale was 62.07±8.47 T-points, what is a reflection of the state of distress, anxiety, emotional instability caused by internal psychological problems. The K scale was 55.43±8.58 T-points, indicating that the subjects did not want to deny the presence of problems and that they were sensitive about their personality and behavior. The revealed pathopersonological 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 the hypostenic scales (scale 2 = 65.36 ± 12.28 T-points) and hypersthenic (indicators of scales 4 and 9 = 73.23 ± 11.83 and 66.05 ± 12.02 T-points, respectively) registers. The use of the obtained data will help to improve the quality of diagnosis and assessment of the current state of patients with schizoaffective disorder, which will allow the formation of a system of treatment and rehabilitation measures based on the principles of a personalized approach.


2019 ◽  
Vol 8 (4) ◽  
pp. 9626-9630

Purpose: The aim of the study is to investigate the development of leadership and military management as the basis of effective management of the military organization. Methodology: The methodological basis of the study was the principles of historicism, objectivity and reliability. Main Findings: The authors have suggested three groups of elements of the leader's image in relation to the political leader are outlined, namely, personal characteristics – physical, psycho-physiological features, his character, type of personality, individual style of decision making; social characteristics – the status of a leader associated with the official position, as well as related to the origin, wealth. Applications: The research findings can be used by lecturers and graduate students of universities, military educational institutions and business management institutions. Novelty/Originality: In the paper for the first time it is singled out the main psychological and pedagogical properties of the military commander and his functions in modern military management.


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


2019 ◽  
Vol 4 (2) ◽  
pp. 101-105
Author(s):  
L. A. Ivanova ◽  
O. P. Vorsina ◽  
T. A. Eliseeva ◽  
K. A. Frolovа ◽  
E. V. Sapozhnikova

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.


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