Assessment of the level of rehabilitation potential in patients with psychosis associated with the use of modern synthetic psychoactive substances

Background. The clinical picture, dynamics and outcomes of psychosis associated with the use of modern synthetic psychoactive substances (PAS) are determined both by typical symptoms characteristic of disorders of the exogenous type of response, and by features determined by the type of PAS used, narcological disease, as well as the premorbid level of clinical and social functioning of patients, which must be taken into account in the diagnostic process and in the choice of therapeutic tactics. The issues of the relationship between the clinical and social characteristics of patients with the course and outcome of psychoses that developed as a result of taking modern synthetic PAS (spice, salts and butyrates), as well as their influence on the choice of treatment and rehabilitation tactics, currently remain open. Objective. To study the relationship between the clinical and dynamic characteristics of psychoses that developed against the background of the use of synthetic PAS and the clinical and social characteristics of the functioning of patients. Material and Methods. The study was conducted based on emergency drug treatment departments no. 6 of the Omsk Regional Clinical Psychiatric Hospital named after N.N. Solodnikov, male narcological department no. 3 of the Omsk Regional Narcological Dispensary, intensive care units for the treatment of acute poisoning in psychiatric patients of the Omsk Region City Clinical Emergency Hospital no. 1. Male patients (n=154) were hospitalized for psychotic disorders that developed while taking synthetic PAS. Diagnostics of psychotic conditions was carried out according to ICD-10 with additional qualification of the leading syndrome. Methods: clinical-psychopathological, laboratory, statistical. Results. A study of the level of rehabilitation potential (LRP) on the scale of T.N. Dudko (2006) was made in patients who underwent psychosis while taking synthetic PAS. The parameters of the patients’ LRP were compared depending on the stage of the narcological disease, the mechanism of the development of psychosis, the type of synthetic PAS used, the duration and outcomes of psychoses, and narcological remission. Conclusions. In patients who underwent psychosis on the background of the use of modern synthetic PAS, the indicators of LPR at different stages of the narcological disease were comparable, but differed in the groups of users of different synthetic PAS, with different mechanisms of the development of psychoses (intoxication and withdrawal), as well as in patients with different duration of psychotic disorders, variants of their outcomes and duration of narcological remission.