Nosological structure and clinical manifestations in patients with mental disorders and comorbid addictive pathology who applied to the Yakutsk Psycho-Neurological Dispensary in 2015-2019
The study of comorbid pathology in psychiatry has always been a hot topic. However, as you know, in recent decades, the combination of an underlying mental disorder with drug dependence has become increasingly important. Taking into account the available data of ethnopsychiatry, it can be assumed that in ethnically distant peoples, mental disorders and their combinations have differences that are significant in diagnosis and therapy. The objective of the study was to compare the nosological structure and clinical features of mental disorders with comorbid substance dependence in Yakuts and Slavs who apply to the Yakut Republican Psycho-Neurological Dispensary (YaRPND) for the period from 2015 to 2019. Research Methods: clinical-psychopathological, psychometric, follow-up, statistical. Results: 89 clinical cases with combination of mental disorders and substance dependence are analyzed in patients hospitalized in the YaRPND for treatment and outpatient forensic psychiatric examination in 2015-2019. Patients of the Slavic ethnic group made up a minority (n=38, 39.3%) in comparison with patients of the Yakut ethnic group (n=51, 57.3%). The majority of patients aged 21-30 years old, are residents of the city. About half of all clinical cases are schizophrenia and schizophrenia spectrum disorders, and 1/3 were personality disorders. According to the data obtained on the PSP scale, social functioning in the compared groups does not differ significantly. The socio-adaptive level of most examined persons is low: 85.4% have a secondary or specialized secondary education, 60% are periodically unemployed; almost 70% live without a family. The results of using the PANSS scale do not reveal statistically significant differences between the groups, but the features of individual symptoms are established. In the Yakut group, affective paranoid states prevail, in Slavic patients, hallucinatory paranoid states, but no statistically significant differences in the frequency of the indicated psychoses are found. The ethnocultural content of productive symptoms is little represented. This is probably due to the disactualization of the ethnic aspects of the life of the indigenous people of Yakutia for young urban residents. The most important task of motivating the substance use is mainly to improve socialization or the desire to avoid its deterioration. Both synthetic and traditional substances were used. The predominance of the similarity of the clinical picture of the studied mental disorders comorbid with substance use in two distant ethnic groups over the distinctions has a certain practical significance: when choosing therapy and methods of rehabilitation.