Self-destructive behavior in patients with psychotic disorders of the schizophrenia spectrum

Abstract

The present study assesses the peculiarities and the pathways of self-destructive behavior (SDB) and self-injury acts (SI) in a group of inpatients who have schizophrenia spectrum psychotic disorders (SSPsD). They were 77 patients with schizophrenia, schizoaffective disorder and acute polymorphic psychotic disorder examined in this issue and divided into 2 groups according to the pathways types of SDB: the first group — patients with permanent peculiarities of SDB as comorbid disturbance (Gr1 PermSDB), the second group — patients with impulsive SDB manifestations as secondary behavior disturbance on background acute psychotic episode with imperative pseudo-hallucinations (Gr2 ImpSI) There was a weighty predominance of patients with schizophrenia and hallucinatory-paranoid syndrome in both groups. Patients with schizophrenia more frequently realized impulsive SI exactly with imperative pseudo-hallucinations as the cause of them. Significant difference in motivation of SDB and SI was found in different groups. In Gr1 PermSDB the main motivation was psychological problems associated with mental illness, social and interpersonal problems, while in Gr2 ImpSI the exclusive reason of SI was «command» to do it under influence of imperative pseudo-hallucinations. The psychometric results (the Plutchik’s impulsivity scale) revealed a much higher level of impulsivity in Gr1 PermSDB. Results confirmed that fundamentally diverse pathways for SDB manifestation and dynamic of it, also SI motivation exist in patients with SSPsD. It should be taken in the treatment tactic and rehabilitation course for such different patients. Key words: self-destructive behaviour, self-injury, psychotic disorders of the schizophrenia spectrum