Clinical and psychopathological characteristics and social functioning of patients with hallucinatory-paranoid disorders in moderate vascular dementia.

Abstract

The relevance of the study is determined by a high prevalence of dementia, significant economic costs of treatment, negative consequences in the form of disability and decrease in the quality of social functioning. The aim of the research was to study the clinical and psychopathological characteristics and specificity of the social functioning of patients with hallucinatory-paranoid disorders (НРD) in moderate vascular dementia (MVD). To achieve this goal, a comprehensive methodological approach was used, which was implemented using the clinical and psychopathological method, supplemented by the use of psychometric scales (neuropsychiatric inventory (NPI), global assessment functioning scale (GAF), disability assessment scale (WHO / DAS), Bristol daily activity scale (BADL)) and methods of mathematical data processing. In a study of clinical-psychopathological characteristics and social functioning of patients with HPD in MVD 75 patients took part. 41 patients with HPD (main group) and 34 patients without psychotic disorders (control group) were examined. In the structure of clinical-psychopathological mani­festations in patients with HPD in MVD the following symptoms were revealed: the prevalence of frequent delusional ideas of material damage, robbery and jealousy - in a moderate degree; a combination of HPD with frequent vagrancy; periodic moderate verbal aggression; frequent rhythm disturbances day / night, frequent low mood, manifested in the form of dysphoria; fear of being alone; frequent states of irritability. The expressed negative influence of HPD on communication function, quality and level of participation in fulfilling the parental role, the need and effectiveness of social contacts, the effectiveness of behavior in non-standard and difficult conditions was established. The influence of HPD on the formation of limitations of their vital functions in communication, ability to use the phone, make purchases, manage finances and use transport in patients of this group was defined. It was proved that the range of social functioning of patients corresponded to disorders ranging from a serious deterioration in functioning in the social and professional spheres - to the inability of functioning in certain areas of life.