Abstract
In our work, we propose one of the options for a prognostic criterion, which at the beginning of the disease can provide sufficient evidence to predict the form and severity of negative symptoms in schizophrenia. Aim. To investigate the influence of the presence of ear on music on the degree of severity of deficiency symptoms in paranoid schizophrenia. The study was conducted on the basis of the third clinical department of the Lviv Regional Clinical Psychiatric Hospital for the period of 2015. 40 patients with paranoid form of schizophrenia, aged 18 to 35, were examined, of which: group I – 20 patients with advanced ear on music (average age 28.60±1.01 years) and group II – 20 patients with no ear on music (average age 27.30±1.15 years). The main methods of studying the observation groups were: clinical-psychopathological, pathopsychological, and statistical. The pathopsychological study of the evaluation of negative symptoms was conducted using the "Qualitative Assessment Scale for Positivity, Negative and General Psychopathological Syndromes" (PANSS – Positive and Negative Syndrome Scale), namely, its PANSS-NS subscale. Comparison of the probability of the difference between the average indices of unrelated groups was carried out using the Mann-Whitney method, comparing the relative parameters of the distribution structure by the xi-square criterion. Analysis of the results of the study shows that in patients with developed ear on music, the level of deficiency symptoms of negative symptoms under the PANSS-NS subclass is 2.2 times lower (p <0.01) than in patients with no developed ear on music: 2.04±0.14 against 4.46±0.17 points, respectively. Comparing the key indicators of the PANSS-NS subscale in patients with paranoid schizophrenia with advanced ear on music, it was found that the manifestations of "Violations of abstract thinking" (N5 – 2.35±0.15 points), "Violation of spontaneity and smoothness in the conversation" (N6 – 2.30±0.15 points) and "Stereotyped thinking" (N7 – 2.20±0.16 points). All these negative symptoms were in patients with muscular earache with significantly lower scores: from lack of severity (1 point) to weakness (3 points). The lack of expressiveness (1 point) was most common in N4 "Passive-apathy social strangeness " - 35.00±10.67 % of patients, very weak severity (2 points) - for N1 "Blurred passion" - 75.00±9.68 % of patients (p <0.05 with the proportion of negative symptoms 1 and 3 points), weakness (3 points) - for N5 – 45.00±11.12 % of patients (p <0.05 with the proportion of negative symptoms 1 point ) The highest proportion (70.00±10.25 %, p <0.05 with a share of negative symptoms of 6 points) of patients with paranoid schizophrenia without ear on music had a high severity (5 points) of rigidity and stereotyping of thinking (N7). The obtained data prove the influence of the factor of the presence of ear on music on deficit syndrome, as well as on the forms and degree of severity of negative symptoms in paranoid schizophrenia.
Highlights
Problems of the forecast in schizophrenia, and in particular - the formation and severity of negative symptoms during its long-term course remains the key to the clinical study of this disease
In our work, we propose one of the options for a prognostic criterion, which at the beginning of the disease can provide sufficient evidence to predict the form and severity of negative symptoms in schizophrenia
Comparing the key indicators of the PANSS-NS subscale in patients with paranoid schizophrenia with advanced ear on music, it was found that the manifestations of “Violations of abstract thinking” (N5 – 2.35± ±0.15 points), “Violation of spontaneity and smoothness in the conversation” (N6 – 2.30±0.15 points) and “Stereotyped thinking”
Summary
Problems of the forecast in schizophrenia, and in particular - the formation and severity of negative symptoms during its long-term course remains the key to the clinical study of this disease. Diagnosis of schizophrenia and disorders of the schizophrenic spectrum most often, compared to other mental illness, causes significant diagnostic and expert difficulties [3] This is due to the pathomorphism of the “classic” clinical picture of the disease, the similarity of a number of symptoms with manifestations of other nosological forms [4]. One of the most common is PANSS, which was developed by Keem and co-authors on the basis of the classification of schizophrenia type I and type II (for Crow) in 1980, and which, in essence, is a semi-structured interview with a clinical evaluation, provides a balanced representation of positive, negative and general psychopathological symptoms [7, 8] This scale is divided into positive, negative and subscale of general psychopathological syndromes [9]. Summing points for all seven items gives a global assessment of the negative symptoms [12, 13]
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