Yurchenko O. M.

CLINICAL-PSYCHOPATHOLOGICAL AND PSYCHODIAGNOSTIC CHARACTERISTICS OF PATIENTS WITH PARANOID SCHIZOPHRENIA AND ITS DIAGNOSTIC VALUE

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About the author:	Yurchenko O. M.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The aim of this work is to evaluate the diagnostic value of clinical-psychopathological and psychodiagnostic characteristics of patients with paranoind schizophrenia (PS) and possibilities of their use to increase the reliability of recognition of the mental disorder using modern methods of complex account of disparate symptoms. Contingent and methods The Symptom Checklist-90-Revised (SCL-90-R) by Derogatis was used in this work. 107 patients with PS and 70 healthy volunteers (all surveyed were male), of comparable age (36,45 ± 0,91 years and 36, 53 ± 1.74 years, respectively) were examined. For all studied signs diagnostic coefficients (DC) and measures of informativity (MI, by Kullback) were calculated. Results It was found that the average severity of psychopathology in patients with PS at almost all scales was expectedly and significantly (p <0,01) higher than in healthy individuals. The only exception was hostility scale. As a result, the average value of the global severity index (GSI, general severity of psychopathology) in patients with PS was at 2.24 times higher mean score than in the control group. The next phase of the study focused on determination of diagnostic coefficients (DC) and measures of informativeness (MI) for each scale in Derogatis questionnaire. So as a result, specific features of psychopathology (described in SCL-90-R) were identified as markers of presence and absence of PS (Table 1). The next step was to analyze the relationships between psychopathological symptoms and there dependence on age in the comparison groups. It was found that in patients with PS all psychopathological symptoms had moderate or strong positive correlations with each other. Thus, the general severity of psychopathological symptoms (reflected in GSI), most strongly correlated with indicators of depression (r = 0,94); obsessive-compulsive (r = 0,92) and anxiety (r = 0,92). Talking about healthy individuals, the psychopathological symptoms in this group had a much weaker correlations between each other, and it is a direct result of insignificant severity of these symptoms. But in this group were found strong correlations of GSI with additional questions scale (ADD in SCL-90-R), with range of anxiety and depression. Age weakly correlated with the severity of almost all indicators of psychopathology in both groups of comparison. The only exception was quite clear and direct correlation of age with somatization in healthy individuals. Findings 1. It was established that psychopathological symptoms, assessed with SCL-90-R, are suitable for complex use as a part of strictly formal, consecutive Wald test procedure (updating by Gubler) and it can be a reliable additional tool for paranoid schizophrenia diagnostic, capable to identify this disease with the reliability at least p <0,001. 2. It is shown that the most informative markers of paranoid schizophrenia presence are: anxiety> 0.6 points (DC = 14.69; MI = 2.98); depression> 0.6 points (DC = 11.02; MI = 2.75); obsessive-compulsive > 1.00 points (DC = 14.28; MI = 2.63); and psychoticism > 0.3 points (DC = 10.79; MI = 2.54).
Tags	paranoid schizophrenia, complex diagnostics, indirect signs, consecutive Wald procedure
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Publication of the article	«World of Medicine and Biology» №4(58), 2016 year, 087-092 pages, index UDK 616.895.8-008.447-07