[On the problem of hysterocatonia in the clinical space of schizophrenia and schizophrenic spectrum disorders].

OBJECTIVE

To determinate the premorbid personality dimensions in patients with hysterocatatonia; to study the psychopathological characteristics, making it possible to distinguish the manifestations of hysterical catatonia among other hysterical and catatonic phenomena; to establish the prognostic value of the hysterocatatonia, occurring in the structure of schizophrenia and schizophrenic spectrum disorders (SSD).

MATERIAL AND METHODS

25 patients with a verified diagnosis of schizophrenia and SSD (according to ICD-10) with a predominance of «mild» catatonic phenomena in the clinical picture of the disease (manifestations of hyperkinesia, pseudoepileptic paroxysms, isolated parakinesis, psychomotor agitation, accompanied by local muscle spasm and/or an increase in general muscle tone, etc.).

RESULTS

The overall severity of catatonic disorders corresponded to 22.7±8.3 BFCRS scale points. The phenomenon of abulic deficiency prevailed in the structure of negative disorders (SANS avolition-apathy - 3.7±0.6; SANS anhedonia-asociality - 2.8±0.7). The increase in the subscales of delusional (2.1±0.2) and hallucinatory phenomena (mild signs of somatic passivity according to K. Schneider), accompanied by a feeling of uncontrollability and «alienation» of motor symptoms, was observed according to the SAPS scale. The correlation between the BFCRS scores and the hallucinations (0.765) and delusions (0.653) subscales of the SAPS scale has been found. The hysterocatatonia phenomenon is an independent psychopathological construct, forming in the space of schizophrenia and SSD and revealing a tropism to the pathocharacterological structure of conversion hysteria. The key characteristic, that distinguishes the manifestations of hysterocatonia - is the formation mechanism of movement disorders, based on the phenomenon of mental automatism by G.G. Clérambault.

CONCLUSION

The inclusion of hysterocatatonical symptoms into the clinical picture of schizophrenia and SSD serves as the predictor of adverse course of the disease as long as the condition is accompanied by the "layering" of catatonic-hypochondrical and catatonic-delusional symptoms, and the previously low-progressive course of the disease starts being aggravated by the development of repeated attacks with exacerbation of psychomotor symptoms.