Clinical Features and Social Behavior of Patients with Schizophrenia

Background: currently schizophrenia remains one of the most disabling diseases. Its clinical manifestations, course and outcome are extremely diverse. At the same time, there is no strict parallelism between the formal severity of illness and behavioral disorders. The aim of review is to analyze the available data on the relationship between clinical symptoms and cognitive deficits in patients with schizophrenia and behavioral disorders identified in them. Material and Method: the narrative review systematizes the data about influence of various clinical symptoms and their course on the behavior of patients with schizophrenia during the prodromal period, active course of the disease and during remission. Special attention is paid to the role of cognitive impairment, as well as the prevention of socially dangerous actions of mentally ill patients. An original typology of behavior of patients with schizophrenia in remission is considered. Conclusion: the analysis of the reviewed studies determines the possibilities of targeted psychosocial influence in order to form socially adaptive behavior in patients with schizophrenia.

1. Bleuler E. Dementia praecox oder Gruppe der Schizophrenien. Leipzig, 1911. 420 s.

2. Krepelin E. Psikhiatriia: uchebnik dlia studentov i vrachei / perevod vrachei bol’nitsy sv. Nikolaia chudotvortsa: M.V. Ignat’eva, L.G. Orshanskogo, P.I. Pavlovskogo [i dr.], s soglasiia i s predisloviem avtora s nemetskogo piatogo, sovershenno pererabotannogo izdaniia: [v 2 chastiakh]. Sankt-Peterburg: Gos. tip., 1898. (In Russ.).

3. Morel B. Traité des maladies mentales. Paris: Masson, 1860.

4. Magnan V. Leçons cliniques sur les maladies mentales. Paris: Bureaux du Progre ́s Me ́dical, 1893.

5. Kahlbaum KL. Die Katatonie oder das Spannungsirresein. Eine klinische Form psychischer Krankheit. Berlin, 1874.

6. Hecker E. Die Hebephrenie Ein Beitrag zur klinischen Psychiatrie. Von Dr Ewald Hecker in Görlitz. Archiv für pathologische Anatomie und Physiologie und für klinische Medizin, 1871;25:394-429.

7. Diem O. Die einfach demente Form der Dementia praecox (Dementia simplex). Arch Psychiatr Nervenk. 1903;37:111-187.

8. Bleuler M. Die Schizophrenen Geistesstorungen im Lichte Inaggahriger Kranken und Familiengeschichten. Stuttgart. 1972. 673 s.

9. Bleuler M. Schizophrenic disorders, long-term patients and family study. Yale University Press, 1978. 529 p.

10. Снежневский АВ. Шизофрения. Мультидисциплинарное исследование. М.: Медицина, 1972. 403 с. Sneznevsky AV. Schizophrenia. Multidisciplinarnoye issledovanie. M.: Medicina, 1972. 403 p. (In Russ.).

11. Nadzharov RA. Klinika, osnovnye etapy uchenia o schizophrenii i eyo klinicheskich raznovidnostyach. V kn.: Schizophrenia. Klinika i patogenez. Pod redakciei AV. Sneznevskogo. M.: Medicina:29-119. (In Russ.).

12. Serieux P, Capgras J. Les Folies raisonnantes, le délire d’interprétation. Paris. J.-F. Alcan, 1909. 387 p.

13. Zhislin SG. Ob ostrych paranoidach. Nauchno-issledovatelskii nevro-psichiatricheskii institute imeni prof. P.B. Gannushkina. M., 1940. 116 s. (In Russ.).

14. Andreasen NC, Carpenter WT Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005 Mar;162(3):441-449. doi: 10.1176/appi.ajp.162.3.441 PMID: 15741458.

15. Gurovich IYa, Shmukler AB, Storozhakova YaA. Remissions and personal and social recovery in schizophrenia: proposals for ICD-11. Social and Clinical Psychiatry. 2008;28(4):34-39. (In Russ.).

16. Vovin RYa. Kompleksnoe kliniko-eksperimentalnoye issledovanie struktury paranoyalnogo i paranoidnogo sindromov. V kn.: Materialy 5-go Vsesoyuznogo s’ezda nevropatologov i psichiatrov. M., 1969;(1):293. (In Russ.).

17. Lemke R, Rennnert H. Neurologie und Psychiatrie. Leipzig, 1966. 412 s.

18. Kronfeld AS. Problemy sindromologii i nosologii v sovremennoi psichiatrii. V kn.: Trudy instituta im. P.B. Gannushkina. M., 1940;(5):5-147. (In Russ.).

19. Petrilowisch N. Psychiatriche Krankheitslehre und psychiatriche Pharmakotherapie. Basel; New York, 1966. 114 s.

20. Mauz F. Die Prognostik der endogenen Psychosen. Leipzig, 1930. 121 s.

21. Vie J. Queques terminaisons der délires chroniques. Ann méd-psychol. 1939;(4):461-494.

22. Weitbrecht HJ. Was heist multikonditionale Betrachtungweise bei den Schizophrenien. Fortschr Neurol Psychiat. 1972;40(6):287-307.

23. Wetzel A. Die soziale Bedeutung. In: K. Beringer, H. Bürger-Prinz, Hans W. Gruhle, A. Homburger, W. Mayer-Gross, G. Steiner, A. Strauss, A. Wetzel Spezieller Teil. Fünfter Teil die Schizophrenie Springer, Berlin, Heidelberg. 1932: 612–667. doi: 10.1007/978-3-642-92501-6_8

24. Muller M. Uber Heilungsmechanismen in der Schizophrenie. 1930. 143 s.

25. Пападопулос ТФ. Острые эндогенные психозы (психопатология и систематика). М.: Медицина,1975:192 с. Papadopulos TF. Ostrye endogennye psikhozy (psikhopatologiia i sistematika). М.: Medicina, 1975:192 s. (In Russ.).

26. Konrad K. Nachinaiushchaiasia shizofreniia: opyt geshtal’t-analiza breda / Nezavisimaia psikhiatricheskaia assots. Rossii; per. s nem. P.Iu. Zavitaeva. M.: Grifon, 2015. 315 s. (In Russ.).

27. Huber G. Psychiatrie. Stuttgart, 1974. 398 s.

28. Мелехов ДЕ. Клинические основы прогноза трудоспособности при шизофрении. М., 1963. 198 с. Melechov DE. Klinicheskie osnovy prognosa trudosposobnosti pri schizophrenii. M., 1963. 198 s. (In Russ.).

29. Гурович ИЯ, Любов ЕБ, Сторожакова ЯА. Выздоровление при шизофрении. Концепция «recovery». Социальная и клиническая психиатрия. 2008;28(2):7-14. Gurovich IYa, Lyubov EB, Storozhakova YaA. The concept of recovery in schizophrenia. Social and Clinical Psychiatry. 2008;28(2):7-14. (In Russ.).

30. Jääskeläinen E, Juola P, Hirvonen N, McGrath JJ, Saha S, Isohanni M, Veijola J, Miettunen J. A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull. 2013;39(6):1296-1306. doi: 10.1093/schbul/sbs130 Epub 2012 Nov 20. PMID: 23172003; PMCID: PMC3796077.

31. Smulevich AB, Voronova EI, Solokhina TA, Lobanova VM, Ilyina NA. Some Aspects of Psychopathology of Residual States in Schizophrenia (A “New Life” Type Remissions - Modern Models). Psychiatry (Moscow) (Psikhiatriya). 2022;20(1):46-57. (In Russ.). doi: 10.30629/2618-6667-2022-20-1-46-57

32. Green MF, Penn DL, Bentall R, Carpenter WT, Gaebel W, Gur RC, Kring AM, Park S, Silverstein SM, Heinssen R. Social cognition in schizophrenia: an NIMH workshop on definitions, assessment, and research opportunities. Schizophr Bull. 2008;34(6):1211-1220. doi: 10.1093/schbul/sbm145 Epub 2008 Jan 8. PMID: 18184635; PMCID: PMC2632490.

33. Pervyi psichotocheskii epizod / pod red. IYa Gurovicha, AB Shmuklera. M.: Medpraktika. 2011. 492 s. (In Russ.).

34. Gurovich IIa, Shmukler AB, Zaitseva IuS. Dynamics of neurocognitive functioning in patients in early stages of schizophrenia and schizophrenia spectrum disorders. S.S. Korsakov Journal of Neurology and Psychiatry. 2012;112(8):7-14. (In Russ.).

35. Lepage M, Bodnar M, Bowie CR. Neurocognition: clinical and functional outcomes in schizophrenia. Can J Psychiatry. 2014;59(1):5-12.

36. Шмуклер АБ. Шизофрения. М: Гэотар-Медиа. 2021. 176 с. Shmukler AB. Schizophreniya. M.: Geotar-Media. 2021. 176 s. (In Russ.).

37. Abdullina EG, Savina MA, Rupchev GE, Morozova MA, Pochueva VV, Sheshenin VS. Independent living skills and cognition in early-onset and late-onset of schizophrenia patients: a pilot study. Neurology Bulletin. 2020. LII(1):34-37. (In Russ.). doi: 10.17816/nb16461

38. Karyakina MV, Ponizovskiy PA, Shmukler AB. Problem of social behaviour in patients with schizophrenia. The concept of recovery in schizophrenia. Social and Clinical Psychiatry. 2023;33(2):59-68. (In Russ.).

39. Shmukler AB, Karyakina MV. Typology of behavioral disorders in patients with schizophrenia without acute psychopathological symptoms. Social and Clinical Psychiatry. 2023;33(3):5-13. (In Russ.).

40. Makushkina OA. Risk assessment of socially dangerous behavior of persons with mental disorders. Social and Clinical Psychiatry. 2017;27(3):49-55. (In Russ.).

41. Makushkina OA, Leurda EV. Structured professional psychological judgment for assessing the risk of public danger in persons with mental disorders. V.M. Bekhterev review of psychiatry and medical psychology. 2023;57(4):66-74. (In Russ.).

42. Kholmogorova AB, Garanyan NG, Dolnykova AA, Shmukler AB. The program for cognitive and social skills training in schizophrenic patients. Social and Clinical Psychiatry. 2007;17(4):67-77. (In Russ.).

43. Kuznetsov SYu, Afyan MV, Kozhevnikova MYu, Movina LG. Metacognitive training: theory, practics, efficacy. Social and Clinical Psychiatry. 2020;30(1):97-101. (In Russ.).

44. Papsuev OO, Movina LG, Kiryanova EM, Salnikova LI, Shahkova NG, Murashko AA, Spektor VA. To the concept of the reform of institutional social care for individuals with psychiatric disabilities. Social and Clinical Psychiatry. 2022;32(4):75-87. (In Russ.).

45. Rychkova OV Disturbances of social skills and social behavior in schizophrenia (an analysis of approaches to justify interventions). Social and Clinical Psychiatry. 2023;33(2):101-108. (In Russ.).

46. Solokhina TA, Oshevsky DS, Kuzminova MV, Tyumenkova GV, Voronova EI, Alieva LM, Tyulkina OY, Ibragimova AR. Socio-demographic and clinical-psychological characteristics of patients with residual schizophrenia and directions of their psychosocial rehabilitation. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(11):82–89. (In Russ.). doi: 10.17116/jnevro202312311182.