Primary diagnosis of schizophrenia in the framework of inpatient forensic psychiatric examination

Abstract

To study the primary diagnosis of schizophrenia spectrum disorders within the framework of an inpatient forensic psychiatric examination. A retrospective analysis of 52 accused, who underwent inpatient forensic psychiatric examination at Alexeev Mental Clinic No. 1 in the period 2018-2020, was carried out. Patients were divided into two groups. Group 1 included 39 patients newly diagnosed with paranoid schizophrenia and group 2 consisted of 13patients diagnosed with schizotypal disorder. Diagnosis was based on the ICD-10 criteria (F20 and F21). Clinical and psychopathological method was used as the main research tool. The study group is represented mainly by young people (88.4%, n=46) with secondary (78.8%, n=41), less often higher (21.25, n=11) education, with a decrease in social adaptation and signs of «social drift» (90.3%, n=47). Difficulties in diagnosis at the initial stages of an endogenous disease are due to the presence of neurotic disorders that do not affect the nature of social functioning. In group 2, there was a slow increase in personality changes. The commission of unlawful actions by productive-psychopathological mechanisms was observed in 73% of cases (n=38). The primary diagnosis of endogenous mental disorders in a forensic situation, carried out during an inpatient forensic psychiatric examination, determines the correctness of the assessment of the level of danger and the choice of compulsory medical measures.