Анализ эффективности антипсихотической терапии у больных параноидной шизофренией с несуицидальной аутоагрессией и дефицитарными личностными изменениями

Abstract

Aim. A comparative analysis of the effectiveness of neuroleptics in patients with paranoid schizophrenia with deficit changes at the personal level and non-suicidal auto-aggressive actions (NAA) who are on compulsory treatment. Design. Full-scale non-randomized longitudinal study Materials and methods. The study included 237 patients with paranoid schizophrenia during maintenance therapy: 76 people were on risperidone monotherapy, 61 patients received quetiapine, and 100 patients took haloperidol. The clinical effectiveness of therapy was determined by comparative analysis of the frequency of exacerbation of psychotic symptoms, the severity of negative disorders, the frequency of acts of non-suicidal auto-aggression and the level of social functioning. In addition to clinical observation, the Scale of Negative Psychopathology (SANS) and the Social Functioning Scale (PSP) were used. Fisher's test and ANOVA analysis of variance were used to statistically evaluate the data. Results. All drugs helped reduce the incidence of exacerbation of psychotic disorders, while only with the use of risperidone and haloperidol positive changes in antipsychotic activity were statistically significant (p < 0.01). All drugs helped reduce the severity of negative disorders. When taking risperidone, a statistically significant decrease in disorders associated with flattening and rigidity of affect and attention was noted (p ≤ 0.05). Haloperidol caused a decrease in flattening and rigidity of affect, attention and speech disorders, and apato-abulic syndrome (p ≤ 0.05). All drugs statistically significantly reduced the risk of NAA (p ≤ 0.05), and also contributed to an increase in the level of social functioning of patients, and in patients taking haloperidol, statistically significant changes in this indicator appeared earlier. By the end of the study, while taking each of the drugs included in the study, statistically significant positive changes in the studied parameters were noted (p ≤ 0.05). Conclusion. The first-line drug for patients with paranoid schizophrenia with deficient personality changes and NAA who are on compulsory treatment is haloperidol. An alternative treatment method for this group of patients may be the administration of risperidone. Keywords: schizophrenic defect at the personal level, neuroleptics, paranoid schizophrenia, non-suicidal auto-aggression.