Evaluation of the adaptive capacity of patients with schizophrenia depending on the level of hopelessness as a predictor of suicide risk

Background. Suicidal behavior in patients with schizophrenia is a prognostic factor for an unfavorable functionaloutcome, especially in paranoid form, paroxysmal course, acute polymorphic psychotic disorder, leading depressive,depressive-paranoid or anxiety-depressive syndrome, psychopathological experience of a conflict situation. At thesame time, suicidality in patients with schizophrenia may also be due to the peculiarities of adaptation (full or partialadaptability, disadaptation) in the conditions of destabilization caused by a change in the nature of interaction with theenvironment. This work is of relevance due to the need to assess the psychophysiological complex of the adaptivecapabilities of patients with schizophrenia with a tendency to suicide risk. Objective: to assess the adaptive capacityof patients with schizophrenia depending on the level of suicide risk. Materials and Methods. Clinical-psychopathological, clinical-dynamic and clinical-catamnestic methods were used to examine 116 patients with averified diagnosis of schizophrenia (F20 according to ICD-10) aged 18 to 60 years who were under therapy at theTomsk Regional Psychiatric Hospital in a round-the-clock hospital. Psychometric assessment of suicide risk inpatients was carried out using the Beck Hopelessness Scale. The assessment of the type of compensatory-adaptiveresponse and the type of socio-psychological adaptation was carried out according to the method of G.V.Logvinovich. Evaluation of adaptation and level of social functioning of patients in society was carried out using theSASS. Results and Conclusion. At the clinical evidence level, our hypothesis was confirmed: hopelessness andsuicide risk were more associated with subjective satisfaction with the existing level of functioning than with theobjective level of adaptation. According to the data obtained from psychometric testing, in the examined patients withschizophrenia, despite the frequent detection of hopelessness, favorable types of socio-psychological adaptationpredominated, and patients with a less severe level of hopelessness were characterized by higher adaptation in allareas of functioning. Social recovery might depend on the quality of life and the level of social ambitions of theindividual in the pre-illness period (which might be indirectly indicated by a higher level of education in a group ofindividuals with more severe hopelessness).