Clinical prognosis criteria of resistance to psychopharmacological therapy in acute endogenous psychoses

Abstract

The aim of study was to investigate possibilites of therapeutical resistance prognosis on early stage treatment.Materials and methods. A total of 96 patients, who had been institutionalized in therapeutic department of Moscow Scientific Research Institute of psychiatry of Minzdrav of the Russian Federation from 1990 to 1999 in a state of acute psychotic disorder, were examined. The patients received psychopharmacotherapy with haloperidol and addition of sedative antipsychotic drugs.Results. 28 patients demonstrated cessation of psychopathological symptomatology and withdrawal from acute psychosis. In 26 observations a transition to continuous-progredient course was noticed. In 42 patients of the third group psychoemotional indifference, achieving the level of apathy, was revealed, as well as transition to protracted course of illness. The analysis of dynamics of correlation of delusional and affective disorders in reverse development of psychoses demonstrated that affect of anxiety and confusion determined favorable prognosis in a case of break of psychosis. Sensual delusion devoid of the above affective component testifies to possible protracted course of the attack, formation of apathetic depression and therapeutic resistance.Conclusion. Specificities of reverse dynamics of psychotic disorders and reduction of various components of acute endogenous psychosis have prognostic value and determine the conditions of therapeutic resistance formation.