Psychopharmacotherapy of Suicidal Behavior in Schizophrenia and Schizophrenic Spectrum Disorders

Abstract

Background. Suicidal behavior in schizophrenia correlates with the severity of productive and negative personality symptoms.Aims. Study of the clinic, the effectiveness of psychopharmacotherapy of paranoid schizophrenia and schizotypal disorder with the presence of suicidal behavior.Material and methods. Patients with paranoid schizophrenia, episodic type of course (n = 19) and schizotypal disorder (n = 15) were studied, in the clinical picture of which various variants of suicidal behavior were revealed. Clinicalpsychopathological, clinical-anamnestic, and psychometric methods were used.Results. Suicidal behavior in patients with an actual attack of paranoid schizophrenia was represented by suicidal intentions to avoid persecution (42.1 %), exposure to “voices” with an order to end their lives (36.8 %), and suicidal attempts (21.1 %). In patients with schizotypal disorder, suicidal thoughts were detected (84.6 %) in the form of loss of meaning in life, and suicidal attempts (15.4 %). Psychopharmacotherapy of suicidal behavior in schizophrenia and schizotypal disorder included the use of antipsychotics (atypical and traditional), antidepressants, tranquilizers, and normotimics. Among patients with paranoid schizophrenia, a decrease in the overall score of the PANSS scale was detected by day 14 of therapy (p < 0.05). The effectiveness of therapy was due to the reduction of delirium, verbal hallucinosis, and deactualization of suicidal behavior. Among patients with schizotypal disorder, a statistically significant decrease in the overall score of the PANSS scale was observed by 21 days of therapy (p < 0.05). The favorable dynamics was characterized by a decrease in manifestations of depression, suicidal thoughts, loss of interests.Conclusion. Combined therapy (antipsychotic, antidepressant, normotimic) helps reduce mental disorders and suicidal tendencies in patients with schizophrenia and schizophrenic spectrum disorders.