SELF-DESTRUCTIVE BEHAVIOR IN PATIENTS WITH SCHIZOPHRENIA SPECTRUM DISORDERS. FEATURES OF PATHOGENESIS AND PATHODYNAMICS.

Abstract

The aim: To prove the heterogeneity of pathogenetic mechanisms and pathodynamics of self-destructive behaviour (SdB) in patients with schizophrenia spectrum disorders (SSD). Materials and methods: We examined 112 patients with different kinds of SSD: 55 men (49.1%) and 57 women (50.9%), 34.9±8 years old. In 44.6% of patients the features of SdB were present during more than half of disease time (Gr1) - before and after self-injury or suicidal attempt (SI\SA) as well as in acute psychosis exacerbation or in remission. They committed SI\SA mainly in a psychotraumatic situations and due to permanent feelings with a self-destructive content. In 55.4% of patients (Gr2) acute manifestations of SdB with realization of impulsive SI\SA were caused only as secondary symptoms of the severe exacerbation of psychosis. Self-destructive or suicidal ideas disappeared in Gr2 patients after the reduction of acute psychotic symptoms. Results: Psychometric testing by the PANSS confirmed the comparability of these groups. линеpatients' reaction on a psychological problems, especially family conflicts, the desire to reduce the high level of subjective anxiety or to draw attention to themselves. In 92% of these patients at the moment of examination manifestations of SDB and the same self-destructive motives persisted. While patients of Gr2 committed impulsive SI\SA only by the influence of command pseudohallucinations or delusional ideas at the acute psychosis. At the time of the study (in state without acute psychotic symptoms or in remission) all patients of Gr2 showed no SDB signs. The data according to the Big Five Personality Test fixed substantial distinctions in personal characteristics of patients in Gr1 and Gr2 as well. Conclusions: Our study proved the scientific hypothesis that the pathogenesis and dynamics of SdB in patients with SSD (who committed SI\SA) have essential differences. The research results allowed to describe two types of personal portrait of patients with SSD and SdB who had realized SI\SA. This crucial pathogenetic variances are important to design of the therapy strategies of those patients.