Patologìâ (Jun 2020)
An algorithm for the diagnostic differentiation of schizoaffective disorder and other endogenous psychoses with episodic course (schizophrenia and affective disorders)
Abstract
At present, it is difficult to carry out differential diagnosis between schizophrenia, schizoaffective disorder (SAD) and affective disorders (AD), which is caused by a similarity of the clinical features of psychosis exacerbation. A promising direction of improving the quality of differential diagnosis is the study of nosospecific pathopersonological transformations (PpT). Studying of these changes and identifying their clinical differences from the pathopersonology of schizophrenia and AD will allow differential diagnosis with a high level of confidence. The aim of the study was to develop an algorithm for the diagnostic differentiation of SAD and other endogenous psychoses with episodic course (schizophrenia and AD) based on the analysis of clinical-psychopathological, medical- psychological and clinical-ethological features of remission. Contingents and methods. 312 patients were examined at the Municipal Non-Commercial Enterprise “Regional Clinical Institution for Provision of Psychiatric Care” of Zaporizhzhia Regional Council, including 102 patients suffering from AD, 102 persons with SAD and 108 patients diagnosed with “Schizophrenia. Paranoid type. Episodical course”. The main methods of the study were clinical-psychopathological, psychodiagnostical, pathopsychological, clinical-anamnestical, clinical-ethological, as well as medical-statistical analysis. Results. The study developed an algorithm for the diagnostic differentiation of SAD and other endogenous psychoses with episodic course (schizophrenia and AD) based on the analysis of clinical-psychopathological, medical-psychological and clinical-ethological features of remissions / intermissions. The algorithm involves the sequential use of 2 tables (differentiation for the pair of SAD – schizophrenia and SAD – AD), which included features, sorted by decreasing total informative index. Conclusions. The results obtained can be used in the differential diagnosis of endogenous psychosis with the determination of nosological affiliation of the clinical case to the SAD and for use of individually required medico-rehabilitative interventions.
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