Abstract
The problem of psychotic disorders with onset in the age of involution from broader perspective, guided by modern multidimensional paradigm, was never discussed before. Involutional psychosis is considered as a constellation of the biological changes that are irrefutable in this age period. Certain personality traits and coping strategies can be predisposing to psychotic response, as well as typical features of the “life curve” and external stressors that can run a psychotic reaction. The paper presents the result of our study. This study pays much attention to study of premorbid personality, with emphasis on characteristic features, peculiarities of the emotional reaction and motivation-behavioral area, which completely coincided with characteristics of the narcissistic personality disorder listed in DSM-V (2013). Aim : To explore the psychosomatic pathogenetic connections inherent involutionary psychosis, given pathogenic and pathoplastic impact of premorbid personality structure their syndromic form and dynamics, determine their place on the psychosomatic continuum and develop adequate and pathogenetic justified method of therapy. Methods. Data obtained by the clinical method were confirmed by the results of experimental psychological and neuropsychological researches. Results. Clinical characteristics of psychotic disorders in the patient population showed in the structure of psychosis the existence of two oppositely directed continuums: affective (depressive) and delusional. This allows to allocate four main clinical forms of psychosis and their tendency to unite in two clusters that differed each other by the features, and also by their response to therapy and, therefore, by the prognosis. Conclusions: The psychodynamic approach to understanding the involutional psychosis, that was introduced by the author, got natural development in the proposed method of treatment that included complex medication and psychotherapy. The schemes of psychotherapeutic influences were developed on the psychotic and post-psychotic stages, higher efficiency of this approach to treatment compared with standard drug treatment schemes was statistically proven. Principal directions of secondary and tertiary psychoprophylaxis and rehabilitation measures aimed at improving quality of life of patients were revealed.
Highlights
Modern medicine widely applies the principles of integrative psychosomatic approach to the study of the relationships between the different states of the central nervous system, functional activity of organs and systems as well as individual psychological characteristics [1]
The method of event-related evoked potentials was to register the electrical activity of the brain in response to auditory stimulus, and in response to endogenous events related to expectations and identification of significant stimulus in a series of insignificant
We examined all involutionary patient who were hospitalized to psychiatric hospital for the first time or repeatedly with the preliminary diagnosis “involutional psychosis” during a period from January 2003 to December 2007
Summary
Modern medicine widely applies the principles of integrative psychosomatic approach to the study of the relationships between the different states of the central nervous system, functional activity of organs and systems as well as individual psychological characteristics [1]. Psychosomatic and somato-psychic disorders form psychosomatic continuum that reflects the systemic regulation of human life in all its aspects and extends between the poles of physical and mental disorders. The basic pathogenetic mechanism of regulation disorder is based on a circular relationship of psychological, physical and social factors [4]. It’s focused on a ponderable pathogenetic factor – the personality of a patient, that perceives the change of functions in each moment (or not perceives), responds (or not responds) to a certain behavior (ie, emotions and actions) that eventually leads (or does not) to change of the structure
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