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International neurological journal 4 (66) 2014

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Factors of autogenic exacerbation of schizophrenia-like psychosis disorders of different genesis in the differential diagnosis of view

Authors: I.F.Pirogov - The municipal medical and preventative institution «Municipal psychoneurological hospital №2», Donetsk, Ukraine

Categories: Neurology

Sections: Specialist manual

print version

The questions of nosological facilities of schizophrenia-like psychosis manifestations in the modern world is becoming more important with the increasing dependency of the individual layers of the population from psychoactive substances (PAS), as well as the emergence of new types of surfactants that can cause psychopathology, identical productive symptoms as endogenous diseases and organic psychosis.

In this context, insufficient differential diagnostic significance of the fact of narcotization makes the search for new diagnostic markers, first of all – medico-psychological markers of differentiation this nosologies.

In this regard, the aim of the study was the analysis of the features of the response to autogenic factors and types of psychogenic exacerbation of schizophrenia-like psychosis disorders of different genesis.

Examined 150 patients ranging in age from 23 till 35 years. The main group (MG) amounted to 50 patients with schizophrenia-like psychosis disorder due to use the PAS; other 100 people entered the group of comparison. The first group of comparison (GC-1) amounted to 50 patients suffering from paranoid schizophrenia with concomitant use of PAS; the second group comparison (GC-2) included 25 patients with paranoid schizophrenia without concomitant use of PAS; in the third group comparison (GC -3) was 25 patients with organic disorder schizophrenia-like psychosis.

Used the following methods: historical, follow-up, clinical-psychopathological, pathopsychological, clinical-psychophenomenological, statistical.

In the work studied and analyzed psychological / psychopathological response to autogenic-deterministic psychogenic factors exacerbation of schizophrenia-like psychosis in patients with disorders of different genesis. In the examined contingent circle of autogenic-deterministic factors was presented metaphysical (autometaphysical, allometaphysical) and egodeformations (egodystonic, deprivation-frustration) factors.

Identified the stages of the development of a response to psychotrauma in the context of the autogenic-deterministic psychogenic factors. It has been three stages: the first - initial, second – stagnation, the third – permitting. Psychogenic diseases of autogenic-deterministic genesis often began gradually and rapidly become chronic, and therefore the first stage of the response to psychotrauma in most cases had no clear-cut boundaries and psychopathogenetically could be included in the second phase.

It was noted different significance potentially stressful situations, depending on their species in the induction and amplification of psychopathological disorders, and the difference in the ways of exacerbation. So, in patients OG, HS-1 and HS-2 noted increased reactivity to the situation autogenic-deterministic type (which, however, had differences in the strength of severity), whereas patients GS-3 remained similar situations virtually intact (p < 0.01).

Within the group of metaphysical factors more pathogenicity for patients OG possessed autometaphysical factors, for patients GC-1 and GC-2 factors allo - and autometaphysical group had approximately equal value, both in terms of frequency of provoking psychotrauma answer, and the power of subjective response.

This situation allo- and autometaphysical groups were, in fact, secondary-psychogenic for patients GC-3 in relation to sociogen-deterministic or egodystonic factors, which is the true primary cause of psychotrauma.

Among egodystonic factors mentioned disproportion in psychogenic significance in patients GC-1 and GC-2, whereas for patients HS-3, both factors that are included in this group were not significant differences in frequency induction of psychotrauma and power subjective significance, which for patients GC-3 was significantly lower than patients of other groups who were in the range of medium and high values.

The power of subjective significance of situations egodystonic circle most groups was average, except for the HS-3, where the strength of the response was low.

Factors deprivation-frustrated character had a maximum psychogenic effect on the frequency and force of expressiveness in MG; in GC-3 – minimum.

Were fitted with various types of response to Psychotrauma autogenic-deterministic circle depending on the patient groups. So, for MG have been characteristic confrontational-impulsive and creative-metaphysical type of response to psychotrauma;; for GC-1 – psihopato-paranoid and paranoid-metaphysical; for GC-2 – paranoid-metaphysical and apato(depressive)-senestopatical; for GC-3 – anxiety-paranoid and astheno-depressive.


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