ИСТИНА

Introduction. The problem of enduring negative disorders in schizophrenia and approaches to their conceptualization and methods of research attracts attention of researches in the field of psychiatry for many years. One of the ways of looking at the study of primary enduring negative symptoms (PENS) and changes in their severity is presented in this paper. Objectives Aims. Metod On basis of criteria of deficit syndrome in schizophrenia five signs of PENS were formed: diminishing of emotional repertoire, poverty of speech, constriction of interests, diminishing of sense of aim and diminishing of social drive. On platform of CGI-S the system of assessment instruments of PENS was developed: CGI-S-emotional deficit, CGI-S-poverty of speech, CGI-S-restricted interests, CGI-S-diminishing of purposefulness, CGI-S-diminishing of social activity and general assessment of severity of PENS as a summa of them. In addition GAF, PSP, CGI-S-compliance and the scale of autonomy were administrated. For study of compensatory recourses the list of coping-activities, activities addressing to satisfaction of patients needs, attempts to cope with the feeling of impoverishment of inner world or/and general discomfort was developed. Sixty six patients of both sex with diagnosis of episodic schizophrenia without sins of treatment resistance were included into the study. The period of observation varied from one tear to ten years, 61% of patients were observed for more than 4 years. All patients were assessed twice. Results. All patients of the group demonstrated the signs of PENS. Severity of all signs of PENS except “constriction of interest” reduced during the study. The reduction of severity was small but statistically significant. Severity of REMS correlated with functional scales (GAF r=-0.71; PSP r=-0.70, scale of autonomy r=-0,84). Changes of severity of PENS was linked with changes of functional scales (r>0,50). Reduction of severity of PENS accompanied with improvement of functioning and capability for independent living. Sixty eight percentage patients demonstrated positive changes of PENS and 32% - none or negative. The groups differed at the end of the study (p<0,05) but not in the beginning. The difference was seen in the indices of compliance and number of coping-activities. Conclusion. PENS are the important feature of episodic schizophrenia. This psychopathological entity has close connection with functioning of patients. In spite of significant rigidity, there is some space for reduction in certain conditions including activation of compensatory mechanisms.