Personality disorders and schizophrenic defect (problem of comorbidity)
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01.01.2018 |
Smulevich A.
Dubnitskaya E.
Lobanova V.
Voronova E.
Zhylin V.
Kolyutskaya E.
Samoilova E.
Sorokina O.
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Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova |
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1 |
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© 2018, Media Sphera Publishing Group. All rights reserved. Objective. To test the main hypothesis that the deficit phenomena in schizophrenia act not in the «pure» form, but in the form of aggravating personality characteristics, forming so-called «common» syndromes with personality disorders (PD). Material and methods. The results of the psychopathological study (with the use of psychometric methods) of deficit disorders in a sample of 170 patients with schizophrenia and schizophrenia spectrum disorders (63 men, 107 women) are presented in relation to the abnormal structure of premorbid personality (PD of clusters A, B, C). An analysis of negative symptoms according to the comparability of defect to the profile of premorbid personality made it possible to distinguish three groups of deficit states associated with PD - «common syndromes»: defensive schizoidy by the type of deficit schizoid and expansive schizoidy by the type of «verschroben» (cluster A); pathological hysterical infantilism, malignant hysteria and defective erotomania (cluster B); pseudo-psychasthenia and pathological rationalism (cluster C). Results. It has been found that the symptomatology of «common syndromes» is subject to patterns reflecting the dichotomy of the basic defect. This pattern is valid not only for one single cluster of PD, but extends to all psychopathy- like disorders, regardless of their affiliation with a particular cluster. The pathocharacterological component of the «common syndromes» coexisting with the deficit symptom complexes is subject to the basic deficit component of the defect and is separated into polar dimensions (defensive-expansive) within specific clusters of PD, and then unified in accordance with the dichotomy of schizophrenic defect in categories with the predominance of emotional or apathoabulic disorders. Conclusion. ?sychopathy-like symptom complexes in the space of «common syndromes» can be qualified as a psychopathological construct secondary to basic deficit disorders, and their isolation as an independent entity of negative disorders appears to be unjustified.
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