Aim. To systematize neuroleptic-induced and neurologic components of residual condition in schizophrenia. Materials and methods. 100 patients of Communal Non-Profit Enterprise “Regional Clinical Institution for the Provision of Psychiatric Care” of Zaporizhzhia Regional Council with diagnosis of recurrent schizophrenia (ICD-10: F20.5) were examined. Results. The study has found correlations between pharmacotherapy and cerebrovascular pathology with positive and negative symptoms of residual schizophrenia. Noticeable positive correlations were established between specific antipsychotic prescriptions and positive negative schizophrenia symptoms, while only minor correlations with negative symptoms were found. Analysis of cerebrovascular pathology with positive and negative symptoms showed that most noticeable positive correlations were anterior area stroke with hallucinations. Overall dominance of negative correlations over positive ones showed possible trend of “forced normalization” caused by cerebrovascular pathology of schizophrenia manifestations in recurrent condition, which was, however, also minor. Conclusions. The study has found correlations between pharmacotherapy and cerebrovascular pathology with positive and negative symptoms of residual schizophrenia. The concept of “antipsychotic course experience” was introduced.

* Дослідження виконано в межах наукової тематики кафедри психіатрії, психотерапії, загальної та медичної психології, наркології та сексології Запорізького державного медичного університету МОЗ України «Коморбідність психічної та іншої патології» (номер державної реєстрації 0117U006966), Харківської медичної академії післядипломної освіти МОЗ України «Порушення психічного здоров`я в умовах соціального стресу: клінічна феноменологія, предиктори формування, система психодіагностики, психотерапії і психологічної реабілітації» (номер державної реєстрації 0120U101490). Установою, що фінансує дослідження, є МОЗ України. Автори гарантують повну відповідальність за все, що опубліковано в статті. Автори гарантують відсутність конфлікту інтересів і власної фінансової зацікавленості при виконанні роботи та написанні статті. Рукопис надійшов до редакції 7.12.2019.

The aim of the work is to study the world experience and views on the clinic and systematics of non-psychotic manifestations in schizoaffective disorder (SAD) by analyzing modern scientific literary sources. The relevance of study on SAD is determined by the significant prevalence in the population (0.2–0.6 %) and negative socio-economic consequences of the disease. Significant problems in SAD are family and work maladjustment, suicidality and states of psychoactive substance use comorbidity. The nosological independence of the disease was put into question and it was reflected in diagnostic approaches and classifications. In the clinical practice, SAD is considered independently and as a variant of schizophrenia or affective disorders. Diagnostics and prognostic criteria regarding personality changes in SAD are still at the stage of determining. Conclusions. Understanding of definitions “prognosis”, “outcome”, and “maladjustment” in SAD is not unified. Signs of SAD in remission and intermission is the most recent aspect of the SAD clinic, which dictates the need to assess personality changes and the level of social adaptation and functioning.

Issues of treatment and rehabilitation of adolescents with mental retardation, improvement of old and new therapies using an integrated approach to rehabilitation, which allows increasing social activity of adolescents with mild mental retardation and improving their quality of life, are remaining relevant and needing further study. The aim of the work is a comprehensive study of clinical and phenomenological structure, comorbid pathology, socio-hygienic factors and criteria for assessing the limitations of life and its quality among adolescents with mild mental retardation, and to develop recommendations for rehabilitation measures in modern conditions. Materials and methods. At the Kryvyi Rih Psychoneurological Dispensary, 154 patients born in 2003–2008 who were under the dispensary observation of a teenage psychiatrist were examined. The study consisted of two stages: the first – at the initial visit for psychiatric care of patients with mild mental retardation, and the second – follow-up, at the age of 18–23 years. Clinical and epidemiological, clinical and psychopathological, psychodiagnostic and statistical methods were used in the study. The main tool of the study was the “Map for clinical and epidemiological studies”, which included socio-demographic and anamnestic information, the clinical part with a description of existing symptoms and syndromes. Results. As a result of rehabilitation measures, there was a decrease in cases and in the severity of comorbid pathology, improved cognitive functioning (attention, memory, language and writing skills, reading, arithmetic), motility, spatial orientation. Adaptive skills of statodynamic functions were improved in 36.4 % of cases, self-care ability – in 22.7 %. At the time of the study completion, 73.38 % of all respondents could be considered socially adapted. Among adolescents with mild mental retardation and comorbid mental and other pathologies, in addition to positive dynamics, there were negative dynamics (19.04 %) or no dynamics (14.29 %), emphasizing the need for longer time and larger number of rehabilitation measures among this category of patients. Conclusions. Biopsychosocial model of care for adolescents with mental retardation with the inclusion of medical-biological, psychological-pedagogical and social aspects helps to increase the effectiveness of rehabilitation measures aimed at reducing the severity of the underlying disease and improving social adaptation.

Psychosocial rehabilitation for patients with mental disorders is one of the priority areas of scientific research in modern psychiatric discourse. The key to solving this problem is a multidisciplinary approach, within which it becomes possible to select congruent rehabilitation and psychoeducational techniques, taking into account the clinical and psychopathological content of this nosological form. In this context endogenous procedural mental disorders deserve special attention, as they are characterized by the highest level of social and labor maladjustment. Aim. To investigate the effectiveness of the developed model of complex psychosocial rehabilitation for patients with schizophrenia. Materials and methods. On the basis of Municipal Non-Commercial Enterprise “Regional Clinical Institution for Provision of Psychiatric Care” of Zaporizhzhia Regional Council, 80 patients with a simple form of schizophrenia were selected at the outpatient stage of treatment for the purpose of further examination. Clinical diagnostics of the studied mental pathology was carried out in accordance with the differential diagnostic criteria of the International Classification of Diseases 10 revision (ICD-10). The inclusion criteria for the study contingent were: informed consent to participate in the study, the absence of severe somatic pathology and information about craniocerebral trauma. In order to analyze the effectiveness of the developed model, the study contingent was randomized into the study group (SG) – 40 patients who received complex therapy within the framework of the developed model of psychosocial rehabilitation, and the comparison group (CG) – 40 patients who received treatment in accordance with the current protocols. Results. Based on the formed principles of psychosocial rehabilitation for patients with a simple form of schizophrenia, a comprehensive model of psycho-rehabilitation support for this patient contingent was generated including four stages: psychopharmacological, family intervention, cognitive-behavioural and ergotherapeutic. Analysing the effectiveness of the developed model, statistically significant differences (P < 0.05) were established between the average indicators in the studied groups according to the criteria “socially useful activity, including work and study” (4.18 ± 0.25 and 3.33 ± 0.27 points in SG and CG, respectively) and “relationships with family and other social relations” (4.35 ± 0.24 and 3.60 ± 0.25 points in SG and CG, respectively) in the absence of statistically significant differences in the criteria for “self-care” and “bothering others and aggressive behaviour”. Conclusions. The effectiveness of the complex model of psychosocial rehabilitation for patients with a simple form of schizophrenia in the areas of socially useful activities (study and work) and social relations was developed and proved, which made it possible to increase the effectiveness of therapy for this contingent of patients.