Clinical and psychopathological features and psychopharmacotherapy of patients with the first episode of schizophrenia hospitalized in a psychiatric hospital with and without voluntary consent
Background: There are a number of features in the psychopharmacotherapy of patients with the first episode of schizophrenia. Therapy should be differentiated depending on the type of hospitalization in a hospital (with or without the consent of the patient). The aim of the study: To analyze the features of social maladjustment and approaches to psychopharmacotherapy applied to patients with a first psychotic episode and schizophrenia were examined: 68 (46.9%) males and 77 (53.1%) females. Clinical interviews, psychometric and statistical research methods were used. Results: It has been established that personality-negative factors of social maladjustment occur equally often in patients hospitalized on a voluntary and involuntary basis, addictive factors are more typical for persons hospitalized without consent, and productive psychopathological factors are more typical for patients who consented to hospitalization and treatment. Those hospitalized on a voluntary basis were more adapted in the industrial, administrative, legal and leisure areas. They were also more critical in terms of the need for treatment and the effect of medications, and also demonstrated a higher level of social intelligence. More than 5 drugs during inpatient treatment were taken by a third of the hospitalized involuntarily, they were also more often prescribed combinations of typical and atypical antipsychotics (p=0.042 OR=2.6). Hospitalized voluntarily took a smaller number (from 1 to 4) antipsychotics) in lower dosages. Conclusion: For patients hospitalized on a voluntary basis, a greater adherence to treatment is characteristic, which makes it possible to use more sparing psycho-pharmacotherapy regimens. When treating patients on an involuntary basis, it is necessary to take into account both the symptoms of the underlying disease and comorbid dependencies, which complicates the selection of therapy.
Rzhevskaya NK, Ruzhenkova VV, Retyunskiy KYu, et al. Clinical and psychopatological features and psychopharmacotherapy of patients with the first episode of schizophrenia hospitalized in a psychiatric hospital with and without voluntary consent. Research Results in Biomedicine. 2023;9(2):278-288. Russian. DOI: 10.18413/2658-6533-2023-9-2-0-10
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treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry. 2013;52(9):976-990. DOI: https://doi.org/10.1016/j.jaac.2013.02.008