Клинические формы психотических расстройств, связанных с употреблением синтетических катинонов

Abstract

Aim: study and analysis of psychopathological and clinical features of psychotic disorders associated with the use of synthetic cathinones. Materials and methods. The study design was observational, comparative, prospective. The study involved 98 patients treated in the Acute Poisoning Unit, the Emergency Addiction Treatment Unit and the Line Addiction Treatment Unit. In terms of gender, males predominated (n = 58; 59.2%), females accounted for 40.8% (n = 40). Median age — 30 years (Q1–Q3 — 22–33). In the first phase of the study, patients were screened and included in the study according to inclusion/non-inclusion criteria; in the second phase, the clinical picture of psychosis was analysed, depending on the leading syndrome patients were divided into three groups; In the third stage, patients were monitored for 12 months. The Brief Psychiatric Rating Scale (BPRS) was used to objectify the assessment of the severity and dynamics of psychotic symptoms. In the third stage there was 79 participants in the study, the rest of the patients refused to continue participation after 2 months or more. Results. There are three main clinical forms of psychotic disorders developing due to the use of synthetic cathinones: delirious, delusional, polymorphic. Each form had its own clinical and dynamical features. The delirious form was the heaviest: in the 1st day, patients had the highest score on the BPRS scale (Me = 80 (73–87)), but transient: psychosis was resolved within 1 day. With delusional form, the median score in the 1st day on the BPRS scale was 65 (59–82), in polymorphic — 66 (43–76). The vast majority of psychoses (91.8%) developed during intoxication. Some psychoses of delusional and polymorphic form, which developed beyond intoxication lasted notebly longer. The polymorphic form is the longest lasting, with symptoms lasting more than 2 weeks. Postpsychotic disorders were presented as asthenic and neurotic (anxiety-depressive) disorders, most pronounced and lasting (more than 6 months) in patients with a polymorphic form of psychosis. Conclusion. The study showed that psychoses with a «exogenous» clinical picture (psychomotor agitation and nonspecific psychopathological symptoms) pass faster and psychopathological disorders go away simultaneously with agitation. At the same time, psychoses with a predominance of psychopathological disorders (delusions, hallucinations) are characterized by a longer course and require long-term therapy. Key words: synthetic cathinones, SCath-induced psychoses, stimulant dependence, clinical forms of psychoses.