Gender peculiarities of paranoid schizophrenia in the modern context

Abstract

The purpose of the work is to study the clinical-psychopathological and social-psychological features of patients with paranoid schizophrenia in terms of gender aspect. Materials and methods. The article analyzes peculiarities of clinical and psychopathological phenomenology and social support in 53 men and 49 women with paranoid schizophrenia who were in inpatient treatment at the Vinnytsia Regional Psychoneurological Hospital Academic Yushchenko Memorial in 2015–2018. Results. It was established that the most common symptoms of paranoid schizophrenia were expressed and significant changes in the general behavioral quality (100.0 %), negative symptoms (96.1%) and persistent delusional symptomatology (93.1 %), while chronic paranoid symptoms (66.7 %) and delusion of mastery, influence or inactivity, and delusional perception (61.8 %), as well as verbal hallucinations (58.8 %) were less common. At the same time, men showed significantly more symptoms of alienation of mental processes (34.0 %versus 16.3 %, P < 0.05), persistent delusional ideas (98.1 % versus 87.8 %, P < 0.05), neologisms, sperrung, incoherent speech (24.5 %versus 8.2 %), catatonic behavior (13.2 % versus 2.0 %, P < 0.05) and negative symptoms (100.0 % versus 91.8 %, P < 0.05). Men had significantly greater severity of delusion (5.45 ± 0.82 points versus 4.96 ± 1.19 points, P < 0.05), thought disorder (4.42 ± 1.01 points versus 3.71 ± 0.74 points, P < 0.01), all the negative symptoms, motor retardation (3.74 ± 1.13 points versus 2.96 ± 1.37 points, P < 0.01), a decline in insight into illness (5.30 ± 1.07 points versus 4.80 ± 1.19 points, P < 0.05), disturbance of volition (4.49 ± 0.95 points versus 3.92 ± 0.86 points, P < 0.01), preoccupation (4.70 ± 0.82 points versus 4.27 ± 0.76 points, P < 0.05). Patients with paranoid schizophrenia ranked low on the disability scale, which corresponded to apparent dysfunction, and men showed significantly lower rates on all the scales. Correlation revealed relations between the symptoms of schizophrenia severity and disability rates. Patients with paranoid schizophrenia were characterized by high rates of depression (in general 58.39 ± 14.64 points, men – 63.34 ± 13.50 points, women – 53.04 ± 14.05 points, P <0.01), trait anxiety (48.83 ± 10.89 points, 51.74 ± 9.20 points, and 45.69 ± 11.77 points accordingly, P < 0.05), state anxiety (44.98 ± 7.44 points, 47.49 ± 5.54 points and 42.27 ± 8.30 points, P < 0,01), well-being (32.04 ± 4.37 points, 30.72 ± 3.47 points and 33.47 ± 4.82 points, P < 0.01), activity (29.03 ± 3.75 points, 28.04 ± 2.78 points, 30.10 ± 4.35 points, P < 0,01), mood (29.16 ± 4.46 points, 30.17 ± 3.50 points and 28.06 ± 5.12 points, P < 0.01). Patients with paranoid schizophrenia had a low family (0.47 ± 0.66 points, 0.36 ± 0.68 points and 0.59 ± 0.61 points, P < 0.05), friends (0.79 ± 0.74 points, 0.66 ± 0.78 points and 0.94 ± 0.66 points, P < 0.05) and significant others (0.56 ± 0.74 points, 0.40 ± 0.66 points and 0.73 ± 0.78 points, P < 0.05) social support. Conclusions. The obtained data testify to the presence of gender differences in clinical-psychopathological manifestations and social-psychological characteristics of patients with paranoid schizophrenia.