Pecularities of mental pathology at psychiatric patient with the comorbid somatic disorders

Abstract

The paper presents the results of a comprehensive clinical and psychopathological examination of patients with schizophrenia comorbid with somatic pathology. The etiological factors and preconditions for the formation of schizophrenia combined with somatic pathology, general clinical and dynamic characteristics, and features of mental disorders, severity and specificity of clinical and psychopathological manifestations of schizophrenia are analyzed. It was found that the combination of schizophrenia with somatic diseases is more "malignant" variants of the course of psychotic disorders, including an increase in the number of hospitalizations, earlier manifestation, significant increase duration and greater severity of psychopathological symptoms.

The specificity of mental disorders in patients with schizophrenia with somatic disorders was manifested by a predominance of disorders of sensation and perception in the form of senestopathy (schizophrenia with CVD and F 20 with obesity), hyperesthesia (schizophrenia with diabetes 2) and complex hallucinations.

An important characteristic of mental disorders in patients with schizophrenia with somatic pathology is the presence of emotional disorders in the form of rigidity (in schizophrenia with CVD and obesity) and explosiveness (in schizophrenia with diabetes 2) emotional reactions, as well as depressive and anxiety (schizophrenia with CVD) and dysphoric (in schizophrenia with diabetes 2 and obesity) mood disorders. According to the frequency analysis of clinical-biological and social factors of formation, as well as features of clinical-psychopathological structure of schizophrenia in patients of the examined groups, diagnostic clinical-psychopathological signs (risk markers) of combination of schizophrenia with specific variants of somatic disorders are established.

The obtained results show that the combination of schizophrenia with somatic disorders is reflected in the deepening and peculiarities of psychopathological symptoms, reducing the level of social realization of patients and requires the attention of clinicians in developing treatment strategies.