Роль психогении в клиническом оформлении эндогенных бредовых расстройств

Abstract

213 in-patients with schizoaffective disorder (56,3 %) and paranoid schizophrenia (43,7 %) which delusional disorder processed (exacerbated) under psychogenic exposure have been examined. Check group (the same disorders processed without psychogenic exposure) consisted of 107 patients. Results: It has been determined that schizophrenics have constitutional and biological background for psychogenic forced delusions: 1) epileptoid, psychastenic, paranoic, hysteric and cycloid premorbid; 2) cognitive shortage as a result of mental retardation and/or cerebral organic disease; 3) asthenia ahead of psychosis. Three diagnostic nonhomogenous and polymorphous development stages of endogenic delusion under psychogenic trauma have been marked out: 1) stage of psychogenic provoked prognostic of delusion (prodrome); 2) stage of endoreactive delusion (transitional syndrome); 3) stage of clinically completed delusional syndrome. Specific stereotype of syndromes transformation has been determined: from neurotic to transitional and then to delusional. Conclusions: Endogenic delusional disorders coursed after psychogenic provocations are clinically nonhomogenous, polymorphic and atypical. Possibility of psychogenic disorders to transform into endogenic proves a hypothesis about a multifactor pathogenesis of schizophrenic spectrum psychosis. The mentioned clinical atypia requires differentiated therapeutic approaches.