Clinical-correlative analysis of patients at risk of schizophrenia

Abstract

   Objective: Establishing a link between the structure and severity of psychopathological symptoms and the level of functioning in patients at risk of schizophrenia.   Material and Methods: The study examined 38 patients with a depressive episode with attenuated positive symptoms (APS) from the risk group of schizophrenia hospitalized in 2011-2015. The follow-up was 7.3 ± 1.7 years. At the time of the examination, all patients were in remission. HDRS (Hamilton Depression Rating Scale), SOPS (Scale of Prodromal Symptoms) and (SANS) Scale for Assessment of Negative Symptoms were used. Statistical analysis was carried out using the Statistica 12 program.   Results: At the time of the survey, 21.1% of the cases were diagnosed as schizophrenic (F25 and F20 according to ICD-10), 28.9 % as affective (F34.0, F31.3, F31.7 and F33.4), 13.2 % as personal disorders (F60.1, F60.a, F3.8 per cent) and 36,8 % as schizotypal disorders (F21.3, F21.4, F21.5, F21.8). Social performance on the PSP scale of 13.2 % was rated as high (100-81 points), 28.9 % and 31.6 % as average (80-61 and 60-41 points respectively) and 26.3 % as low (less than 40 points). The strongest correlations (p˂0.05) are found between total scores on the SOPS scale, negative SOPS scores, total SANS score and PSP score (- 0.854, - 0.876, - 0.812 respectively), subscale of negative SOPS symptoms and socially beneficial PSP activity (-0.831) subscale of apathy-anhedonia SANS and social relations PSP (0,801).   Discussion: A high level of social functioning is possible provided there is a complete reduction of the prodromal and depressive symptoms, at medium levels, functioning is determined primarily by increasing negative symptoms, especially the domain of avolition - apathy, and low levels are formed by persistent APS, increasing symptoms of disorganization and negative symptoms.   Conclusion: The study showed that the outcome of the first depressive episode with the risk symptoms of schizophrenia is generally characterized by some degree of decline in social functioning, which cannot be considered as a phenomenon in its own right, on the contrary, it’s a derivative of psychopathological symptoms.