HISTORICALLY DEVELOPED AND MODERN CONCEPTS OF NEGATIVE DISORDERS IN THE CLINIC OF SCHIZOPHRENIA AND THEIR THERAPY IN THE REPUBLIC OF KAZAKHSTAN (literature review)
Keywords:
шизофрения, негативные расстройства, Казахстан, психофармакотерапия, карипразин, социальное функционирование, дифференциальная диагностика.Abstract
Introduction. Negative disorders are considered key components in the clinical presentation of schizophrenia and remain understudied in terms of their diagnosis, classification, and treatment. This review of studies conducted in Kazakhstan addresses these issues.
This study aimed to analyze and summarize historical and current understanding of negative disorders in the clinical presentation of schizophrenia, as well as approaches to their treatment in the Republic of Kazakhstan.
Materials and Methods. This retrospective review included publications by Kazakhstani authors on negative symptoms in schizophrenia over the past 50 years, as well as Russian dissertations, articles in scientific journals, textbooks, and international guidelines (NIMH MATRICS, EPA, EMA).
Results. The scientific research on schizophrenia in Kazakhstan began in the 1970s. Although those studies focused primarily on positive (psychotic) disorders in schizophrenia, the authors also partially described negative symptoms. This review highlights the clinical characteristics of negative symptoms and reflects the evolving views on their clinical manifestations in schizophrenia, their diagnostic criteria, and therapeutic strategies. Particular attention is paid to the differential diagnosis of primary and secondary negative symptoms.
Discussion of Results and Conclusions. Until recently, scientific papers in Kazakhstan used outdated classification approaches that did not meet international standards. In recent years, Kazakhstan has been implementing modern diagnostic criteria and evidence-based treatment methods. In particular, the antipsychotic cariprazine has demonstrated high efficacy in the treatment of negative symptoms, which holds promise for its further widespread clinical use. The high clinical significance of introducing new treatment methods for negative disorders to improve social functioning and quality of life in patients with schizophrenia is noted.
References
1. Negative symptoms of schizophrenia in clinical practice / edited by I. Bitter. Oxford (USA): Oxford University Press, 2020; 125 (In Russ.). https://grdoc.ru/meropriyatiya/negativnye-simptomy-shizofrenii-v-klinicheskoy-praktike/
2. Bitter I., Mohr P., Raspopova N., et al. Assessment and treatment of negative symptoms in schizophrenia – a regional perspective // Frontiers in Psychiatry. – 2022; (12):1-8 https://doi.org/10.3389/fpsyt.2021.820801
3. Adilkhanova KA. Parafrennyi sindrom pri razlichnykh tipakh techeniia shizofrenii: avtoref. diss. ... kand. med. nauk. (Psikhiatriia: 767). [Paraphrenic syndrome in various types of schizophrenia: Abstract diss. ... Candidate of Medical Sciences. (Psychiatry – 14.00.18)]. M.: 1971. 16 p. (In Russ.)
4. Dzhamantaeva MSh. Ipokhondricheskie rasstroistva pri razlichnykh klinicheskikh variantakh shizofrenii: avtoref. dis. ... kand. med. nauk. (Psikhiatriia 14.00.18). [Hypochondriacal disorders in various clinical variants of schizophrenia: Abstract diss. ... Candidate of Medical Sciences (Psychiatry 14.00.18)]. M.: 1983. 16 p. (In Russ.)
5. Nurkatov EM. Fenomenologicheskie osobennosti sindroma Kandinskogo–Klerambo u bolnykh shizofreniei s raznym kulturnym i obrazovatelnym urovnem: avtoref. dis. ... kand. med. nauk. (Psikhiatriia 14.00.18). [Phenomenological features of Kandinsky–Clerambault syndrome in patients with schizophrenia with different cultural and educational levels: Abstract diss. ... Candidate of Medical Sciences (Psychiatry 14.00.18)]. Almaty, 2003. 25 p. (In Russ.)
6. Lyubchenko LYu. Kliniko-psikhopatologicheskaia kartina i okislitelnyi metabolizm pri shizofrenii u zhenshchin: avtoref. dis. ... kand. med. nauk (Psikhiatriia 14.00.18). [Clinical and psychopathological picture and oxidative metabolism in schizophrenia in women: Abstract diss. ... Candidate of Medical Sciences (Psychiatry 14.00.18)]. Almaty, 2002. 25 p. (In Russ.)
7. Saduakassova KZ. Kliniko-geneticheskie osobennosti shizofrenii detsko-podrostkovogo vozrasta v kazakhskoi populiatsii: avtoref. dis. ... d-ra med. nauk (Psikhiatriia 14.00.18). [Clinical and genetic features of schizophrenia in childhood and adolescence in the Kazakh population: Abstract of diss. … Doctor Medical Sciences (Psychiatry 14.00.18)]. Almaty, 2006. 30 p. (In Russ.)
8. Izmailova N.T. Shizofreniia, oslozhnennaia upotrebleniem gashisha: avtoref. dis. ... d-ra med. nauk (Psikhiatriia 14.00.18). [Schizophrenia complicated by hashish use: Abstract of diss. … Doctor of Medical Sciences Medicine thesis (Psychiatry 14.00.18)]. Tashkent, 1998. 48 p. (In Russ.)
9. Malysheva NV. Vnutrenniaia kartina bolezni u bolnykh shizofreniei v period remissii: avtoref. dis. ... kand. med. nauk (Psikhiatriia 14.00.18). [The Internal Picture of the Disease in Patients with Schizophrenia during Remission: Abstract of diss. … Cand. Med. Sci. (Psychiatry 14.00.18)]. Almaty, 2001. 20 p. (In Russ.)
10. Gubashev MSh. Kliniko-sotsialnaia kharakteristika bolnykh shizofreniei, sovershivshikh ubiistvo: avtoref. dis. ... kand. med. nauk (Psikhiatriia 14.00.18). [Clinical and Social Characteristics of Patients with Schizophrenia Who Committed Murder: Abstract of of diss. … Cand. Medical Sciences. (Psychiatry 14.00.18)]. Almaty, 1999. 30 p. (In Russ.)
11. Bazarbaeva LE. Sudebno-psikhiatricheskii aspekt obshchestvenno opasnykh deistvii u bolnykh shizofreniei: avtoref. dis. ... d-ra med. nauk (Psikhiatriia 14.00.18). [Forensic Psychiatric Aspect of Socially Dangerous Acts in Patients with Schizophrenia: Abstract diss. … Doctor of Medical Sciences (Psychiatry 14.00.18)]. Almaty, 2010. 46 p. (In Russ.)
12. Kokshinova OYu. Deviantnoe povedenie bolnykh shizofreniei v period prinuditelnogo lecheniia: avtoref. dis. ... kand. med. nauk (Psikhiatriia 14.00.18). [Deviant behavior of patients with schizophrenia during compulsory treatment: Abstract diss. ... Candidate of Medical Sciences (Psychiatry 14.00.18)]. Almaty, 2010. 26 p. (In Russ.)
13. Raspopova NI. Mekhanizmy formirovaniia i profilaktika suitsidalnogo povedeniia u bolnykh s psikhicheskimi rasstroistvami: avtoref. dis. ... d-ra med. nauk. (Psikhiatriia 14.01.06). [Mechanisms of formation and prevention of suicidal behavior in patients with mental disorders: Abstract diss. … Doctor of Medical Sciences (Psychiatry 14.01.06)]. M.: 2012. 37 p. (In Russ.)
14. Altynbekov KS. Optimizatsiia psikhiatricheskoi pomoshchi bolnym shizofreniei v usloviiakh statsionara: avtoref. dis. ... d-ra med. nauk (Psikhiatriia 14.01.06). [Optimization of psychiatric care for patients with schizophrenia in a hospital setting: Abstract diss. … Doctor of Medical Sciences (Psychiatry 14.01.06)]. St. Petersburg, 2017. 43 p. (In Russ.)
15. Kirkpatrick B, Fenton WS, Carpenter WT, Marder SR. The NIMH MATRICS consensus statement on negative symptoms. Schizophrenia Bulletin. 2006; (32): 214–219. doi: 10.1093/schbul/sbj053. Epub 2006 Feb 15. PMID: 16481659; PMCID: PMC2632223
16. Carpenter WT Jr, Heinrichs DW, Wagman AM. Deficit and nondeficit forms of schizophrenia: the concept. Am J Psychiatry. 1988 May;145(5):578-83. doi: 10.1176/ajp.145.5.578. PMID: 3358462
Carpenter WT Jr, Arango C, Buchanan RW, Kirkpatrick B. Deficit psychopathology and a paradigm shift in schizophrenia research. Biol Psychiatry. 1999 Aug 1;46(3):352-60. doi: 10.1016/s0006-3223(99)00088-8. PMID: 10435200
18. Goldberg S.C. Negative and deficit symptoms in schizophrenia do respond to neuroleptics. Schizophrenia Bulletin. 1985;(11):453–456. doi: 10.1093/schbul/11.3.453
19. Goldberg TE, Hyde TM, Kleinman JE, Weinberger DR. Course of schizophrenia: neuropsychological evidence for a static encephalopathy. Schizophr Bull. 1993;19(4):797-804. doi: 10.1093/schbul/19.4.797. PMID: 8303228
20. Petrova NN. On the issue of heterogeneity of negative symptoms in schizophrenia. Sotsialnaia i klinicheskaia psikhiatriia = Social and Clinical Psychiatry. 2020; 30(1): 81–87. (In Russ.)
21. Raspopova NI, Dzhamantaeva MSh, Bastasova UA, et al. On the issue of differential diagnostics of pseudoneurotic schizophrenia and neuroses. Vestnik KazNMU = Bulletin of KazNMU. 2020; (4): 253–258. (In Russ.)
22. Bleuler E. Lehrbuch der Psychiatrie. – Berlin: Verlag von Julius Springer, 1916; 518
23. Raspopova NI, Dzhamantaeva MSh, Bastasova UA. Negative disorders as the main differential diagnostic sign of schizophrenia. Psikhiatriia, psikhoterapiia i narkologiia = Psychiatry, psychotherapy and narcology. 2021; (1): 37–41. (In Russ.)
24. Galderisi S, Kaiser S, Bitter I, Nordentoft M, Mucci A, Sabé M, Giordano GM, Nielsen MØ, Glenthøj LB, Pezzella P, Falkai P, Dollfus S, Gaebel W. EPA guidance on treatment of negative symptoms in schizophrenia. Eur Psychiatry. 2021 Mar 17;64(1):e21. doi: 10.1192/j.eurpsy.2021.13. PMID: 33726883; PMCID: PMC8057437
25. Raspopova NI, Yeshimbetova SZ. Current Possibilities of Psychopharmacotherapy of Negative Disorders in the Clinic of Schizophrenia. Meditsina (Almaty) = Medicine (Almaty). 2020; 217-218 (7–8):53–61. (In Russ.). doi: 10.31082/1728-452X-2020-217-218-7-8-53-61
26. Yeshimbetova SZ, Altynbekov KS, Bespalova LYu, et al. Experience of Using the New Antipsychotic Cariprazine (Reagila) in the Treatment of Patients with Schizophrenia. Vestnik KazNMU = Bulletin of KazNMU. 2021; (4): 202–211. (In Russ.)
27. Raspopova NI, Bastasova UA, Yeshimbetova SZ. Negativnye rasstroistva v klinike shizofrenii. [Negative Disorders in the Clinic of Schizophrenia]. Saarbrücken: Lambert Academic Publishing, 2021; 60. (In Russ.)
28. Snezhnevsky AV. Shizofreniia: tsikl lektsii. [Schizophrenia: Lecture Series] 1964. 2010; 160. (In Russ.)
29. Rukovodstvo po psikhiatrii: v 2 t. / pod red. A.S. Tiganova. [Handbook of Psychiatry: in 2 volumes / edited by A.S. Tiganov]. 1999; (1):712. (In Russ.)
30. Bukashov TS, Nurkatov EB. Vyrabotka professionalnogo myshleniia vracha-psikhiatra i novye formy psikhiatricheskoi pomoshchi: kliniko-prakticheskoe rukovodstvo. [Development of Professional Thinking of a Psychiatrist and New Forms of Psychiatric Care: Clinical and Practical Guide]. 2013; 46. (In Russ.)
