STRATEGY AND PRINCIPLES OF THERAPY OF PATIENTS WITH SСHIZOPHRENIA WITH COMBINED CARDIOVASCULAR DISEASES
DOI:
https://doi.org/10.11603/2415-8798.2018.4.9800Keywords:
schizophrenia, cardiovascular diseases, antipsychotic therapy, psychotherapy, psycho-education, symptom control, stress controlAbstract
Comorbidity of mental disorders with somatic pathology is one of the leading and most complex problems of modern psychiatric practice, particularly in matters of therapy. Schizophrenia is one of the most common mental disorders, characterized by a high frequency of combination with somatic pathology, the presence of which is noted in almost every second patient with schizophrenia.
The aim of the study – to develop a strategy and principles for its treatment based on a comprehensive analysis of the clinical and psychopathological features of schizophrenia combined with cardiovascular diseases. As a part of a comprehensive study, 100 patients with schizophrenia (F20) were examined, of whom 50 patients with chronic cardiovascular pathology constituted the main group of the study, 50 patients without chronic somatic burden – the control group.
Materials and methods. The following research methods were used: the clinical-psychopathological method, which was supplemented by the use of the clinical rating scale of positive and negative symptoms (Positive and Negative Syndrome Scale - PANSS) to assess psychopathological manifestations; as well as the psychodiagnostic method using a modified version of the Dembo-Rubinstein method for determining the features of self-assessment of general health and separate mental and physical health; an adapted version of the SUMD (The Scale to Assess Unawareness of Mental Disorder) methodology for assessing the "insight" level of mental illness; and a short questionnaire of perception of the disease (BIPQ) in the adaptation of Yaltonskyi V. M.; Personal and Social Performance Scale (PSP) and the short health questionnaire (The 36-Item Short Form Survey (SF-36) for assessing the quality of life of the patients examined).
Results and Discussion. The leading strategic tasks and tactics of treating these patients were identified and described, including: stopping antipsychotic symptoms with regard to the specificity of the physical condition; mastering the skills of somatic symptom control and stress control, as well as increasing social competence and social and personal functioning of patients. Accounting for the physical condition of patients with comorbid cardiovascular diseases allows the increasing the level of social competence of this cohort of patients.
Conclusions. The leading strategic tasks and tactics of treating patients are identified and described, including: stopping antipsychotic symptoms taking into account the specifics of the somatic condition; mastering the skills of controlling somatic symptom and stress, as well as improving social competence and social and personal functioning of patients. Taking into account the somatic status of persons with comorbid cardiovascular diseases improves their social competence.
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