CLINICAL-PSYCHOPATHOLOGICAL ANALYSIS OF THE STRUCTURE AND EXPRESSION OF NEGATIVE AND POSITIVE SYMPTOMS IN PATIENTS WITH SCHIZOPHRENIA

Nataliya О. Maruta, Yurii Kushnir, Marianna V. Markova, Ts. B. Abdryakhimova, M. Denysenko
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Abstract

The aim: to determine the features of the clinical-psychopathological structure and severity of negative and positive symptoms in patients with schizophrenia to improve diagnosis and treatment of schizophrenia. Materials and methods. 252 patients with negative symptoms (NS) in schizophrenia and 79 patients with positive symptoms (PS) in schizophrenia were examined. The research used a comprehensive approach, which consisted in the use of clinical-psychopathological, psychometric (PANSS scale) and statistical research methods. Results. Manifestations of positive symptoms in patients with NS in schizophrenia were mainly delineated by delusions of a minimal and weak level; minimal manifestations of delirium, unusual behavior and thought disorders; the predominance of patients with no disorders, minimal disorders and a weak level of disorders of hallucinatory behavior, excitement, ideas of grandeur, suspiciousness, and hostility. Manifestations of negative symptoms in patients with NS in schizophrenia were characterized by a predominance of medium and severe levels of blunted affect; moderate and average levels of emotional alienation; violation of abstract thinking of a weak and moderate level; average level of impaired fluency and spontaneity of speech; moderate communication impairment; passive-apathetic social detachment of the average level. Among patients with PS in schizophrenia, the manifestations of positive symptoms were mainly delineated by delusions of medium and strong levels of severity; moderate and pronounced manifestations of delirium; a moderate level of severity of thinking disorders and unusual behavior; predominance of moderate, medium and strong levels of expression of hallucinatory behavior, excitement, ideas of grandeur, suspicion and hostility. Manifestations of negative symptoms in patients with PS in schizophrenia were characterized by a predominance of a minimal level of expression of dulled affect, social exclusion and impaired fluency and spontaneity of speech; minimal and weak levels of emotional alienation; average level of communication disorders and abstract thinking. Conclusions. Features of the clinical-psychopathological structure and severity of negative and positive symptoms in patients with schizophrenia were established. The obtained data can serve as diagnostic criteria for conducting differential diagnosis and choosing treatment strategies for patients with schizophrenia.
对精神分裂症患者阴性和阳性症状的结构和表现的临床心理病理学分析
目的:确定精神分裂症患者的临床心理病理结构特征以及阴性和阳性症状的严重程度,以改进精神分裂症的诊断和治疗。 材料和方法研究对象为 252 名精神分裂症阴性症状(NS)患者和 79 名精神分裂症阳性症状(PS)患者。研究采用综合方法,包括使用临床心理病理学、心理测量(PANSS量表)和统计研究方法。 研究结果精神分裂症 NS 患者的阳性症状主要表现为:妄想程度轻微和较弱;谵妄、异常行为和思维紊乱表现轻微;无紊乱、紊乱程度轻微和幻觉行为、兴奋、妄想、多疑和敌意等紊乱程度较弱的患者占多数。精神分裂症 NS 患者的阴性症状表现为:中度和重度情感迟钝占多数;中度和一般程度的情感疏远;弱度和中度抽象思维障碍;一般程度的言语流畅性和自发性受损;中度交流障碍;一般程度的被动-同情性社会疏离。 在精神分裂症 PS 患者中,阳性症状的表现主要表现为中等和严重程度的妄想;中等和明显的谵妄表现;中等程度的思维障碍和异常行为;主要表现为中等、中等和严重程度的幻觉行为、兴奋、妄想、怀疑和敌意。精神分裂症 PS 患者的阴性症状主要表现为情感淡漠、社交排斥、言语流畅性和自发性减弱;情感疏远程度轻微和较弱;交流障碍和抽象思维程度一般。 结论确定了精神分裂症患者的临床心理病理结构特征以及阴性和阳性症状的严重程度。所获得的数据可作为对精神分裂症患者进行鉴别诊断和选择治疗策略的诊断标准。
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