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<p><b>Objectives.</b> To study the psychopathological structure of refractory schizophrenia and to distinguish different clinical variants. <b>Materials and methods.</b> The study was conducted in the acute departments of the 24-h Alekseev Psychiatric Clinical Hospital No. 1, Moscow City Health Department. A total of 112 patients diagnosed with schizophrenia were examined using clinical-psychopathological and psychometric methods using the standardized PANSS and BFCRS scales. <b>Results.</b> Three clinical variants were distinguished: one with impaired thinking and perception with a predominance of delusional disorders, one with catatonic disorders with a predominance of oneiroid clouding of consciousness, and one with impaired behavior and affect with a predominance of aggression. The earliest age of disease onset (17.1 ± 3.2 years) was noted in the clinical variant with impaired behavior (<i>p</i> = 0.022). The clinical variant with impaired thinking showed statistically significant differences (<i>p</i> &lt; 0.05) in the total score on the PANSS-P subscale (31.7 ± 3.1) and on items P1 “Delirium” (6.5 ± 0.6), P2 “Conceptual disorganization” (5.9 ± 1.6), P3 “Hallucinatory behavior” (6 ± 0.3), G4 “Tension” (5.5 ± 0.6), and G9 “Thoughts with unusual content” (5 ± 0.8). <b>Conclusions.</b> Studies of treatment-resistant schizophrenia with identification of disorders in different areas of mental activity and determination of quantitative indicators appears to be a promising area of research, as it allows at-risk groups for the development of resistance to be identified and supports the development of new strategies for overcoming resistance.</p>

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Clinical and Psychopathological Features of Treatment-Resistant Schizophrenia

  • 期刊论文

  • 发表日期：

    2025年7月1日

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  • M. A. Kaydan,
  • L. V. Bravve

摘要

Objectives. To study the psychopathological structure of refractory schizophrenia and to distinguish different clinical variants. Materials and methods. The study was conducted in the acute departments of the 24-h Alekseev Psychiatric Clinical Hospital No. 1, Moscow City Health Department. A total of 112 patients diagnosed with schizophrenia were examined using clinical-psychopathological and psychometric methods using the standardized PANSS and BFCRS scales. Results. Three clinical variants were distinguished: one with impaired thinking and perception with a predominance of delusional disorders, one with catatonic disorders with a predominance of oneiroid clouding of consciousness, and one with impaired behavior and affect with a predominance of aggression. The earliest age of disease onset (17.1 ± 3.2 years) was noted in the clinical variant with impaired behavior (p = 0.022). The clinical variant with impaired thinking showed statistically significant differences (p < 0.05) in the total score on the PANSS-P subscale (31.7 ± 3.1) and on items P1 “Delirium” (6.5 ± 0.6), P2 “Conceptual disorganization” (5.9 ± 1.6), P3 “Hallucinatory behavior” (6 ± 0.3), G4 “Tension” (5.5 ± 0.6), and G9 “Thoughts with unusual content” (5 ± 0.8). Conclusions. Studies of treatment-resistant schizophrenia with identification of disorders in different areas of mental activity and determination of quantitative indicators appears to be a promising area of research, as it allows at-risk groups for the development of resistance to be identified and supports the development of new strategies for overcoming resistance.