Истерошизофрения (аспекты дефицитарных расстройств и трудовой дезадаптации)

Abstract

Background information: The first supposition for conducting this study was hypothesis based on the analysis of literature data according to which there is the possibility of «partial» character of apathoabulic disorders («lability of volitional effort» by D.E. Melekhov). The second presumption was the selection of the construct of «selective» (according to Marin, 1990) «job apathy» (Schmidt G. et al., 2015) by the foreign scientists. In the light of reasons supplied, of special interest is apathy to work in patients with schizophrenia, proceeding on the basisof a hysterical constitution — which is associated with obvious difficulties in diagnosing between partial abulia («job apathy») within the hysterical form of schizophrenia and the dynamics of hysterical psychopathy with the phenomenon of «pension neurosis». A current hypothesis was based on the assumption that there is a special type of deficit symptoms in schizophrenic patients with hysterical personality, according to which apathoabulic disorders «invade» into the sphere of constitutional anomalies, act «under the mask» of intensified pathocharacterological disorders and are accompanied by partial misadaption of life and activities. The purpose of this work was to study the negative symptoms in hysterical form of schizophrenia, proceeding with a predominance of partial apathoabulic disorders. Materials and methods: the present study summarizes the results of observations of 10 patients who applied to the FSBSI NHRC due to exacerbation of schizophrenic process. The diagnostics included clinical and psychometric assessment techniques. Results: the data obtained in the course of the study allowed us to figure out a special type of partial schizophrenic defect state, named as «hysteroabulia», according to which the negative symptoms affect voluntary activity (in particular — labour function), while recreational activity, being hysterical involuntary, doesn’t need to be volitional initiated, so may not reveal an apathoabolic disorder.