CLINICAL FEATURES OF MEDICINAL COMPLIANCE OF PATIENTS WITH HALLUCINATORY-PARANOID DISORDERS IN VASCULAR DEMENTIA
DOI:
https://doi.org/10.11603/1811-2471.2019.v.i4.10816Keywords:
vascular dementia, medical compliance, hallucinatory-paranoid disordersAbstract
The relevance of the problem of the clinical features of medical compliance (MC) in patients with vascular dementia (VD) is connected with prevalence of this pathology. A sufficient number of studies have been devoted to the problem of MC in patients with dementia, but in modern science there is no systematic idea of patient compliance, clinical picture of which includes not only cognitive but also non-cognitive disorders. A particular problem is hallucinatory-paranoid disorders (HPD) in VD. Research in this direction is of great medical and social importance.
The aim – to establish the features of MC among patients with HPD in VD.
Material and Methods. In order to determine the characteristics of MC in patients with HPD in VD, 75 patients with this pathology were examined. 51 patients with partial and incomplete MC were included in the main group, 24 patients with full MC made up the control group. To achieve the goal of the study, a set of research methods was used, including the clinical and psychopathological method, supplemented by the MC scale, the GAF scale and the BPRS scale.
Results. It was shown, that in 67.9 % of patients with HPD in VD, violations of MC were detected (in 34.6 % – partial, in 33.3 % – low MC).
The signs of such a violation were factors: attitude to medication (refusal/avoidance of prescribed drugs and procedures, negative attitude to drugs that are taken and low assessment of their effectiveness), factors related to the patient (lack or partial criticism of the disease and its manifestations, a high level of productive symptoms in the form of a breakdown of thought processes, hostility, suspicion, hallucinatory-paranoid symptoms and a low level of social functioning); factors related to the close encirclement (low level of social support); factors associated with the doctor (low level of therapeutic alliance).
Conclusions. The factors of MC in individuals with HPD in VD are determined. It is necessary to use them to improve the diagnosis of HPD in these patients and to develop a personalized program for their psychosocial rehabilitation, which will increase the effectiveness of therapy in this population.
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