Features of sexual self-consciousness in schizophrenic patients with disorders of sexual preference

The article presents the results of an empirical study of disturbances of the regulatory aspects of sexual self-consciousness in persons suffering from schizophrenia with disorders of sexual preference. Objective: to assess the dynamics of the parame-ters of sexual self-consciousness before and after combined antipsychotic and antiandrogen therapy and cognitive-behavioral psychotherapy in the process of compulsory treatment of schizophrenic patients with disorders of sexual preference. Materials and Methods. We examined 33 patients undergoing long-term treatment for up to 12 years, with ICD-10 diagnoses: “Paranoid schizophrenia” (F20.0) and “Simple schizophrenia” (F20.6) and disorders of sexual preference (F65): heterosexual sadism, homicidomania – 9 individuals; bisexual sadism, necrosadism, bisexual homicidomania – 13; sadism in relation to an undiffer-entiated object of attraction by sex and age, transient visionism – 5; homicidomania, sadism, necrosadism in relation to a geron-tophilous object – 6. Clinical-psychopathological, sexological, experimental-psychological, statistical research methods were used in the work. Results. It has been shown that disturbances of the integral structure of sexual self-consciousness with anom-alies of sexual desire do not appear in isolation from the symptom complex in schizophrenia. Patients with schizophrenia spec-trum disorders and paraphilias exhibited disturbances in the structure of sexual self-consciousness, leading to psychosexual maladjustment. Based on the complex model of antipsychotic and antiandrogenic therapy and psychotherapeutic influence, positive changes in the sphere of sexual self-consciousness of the examined patients were registered, however, there were no statistically significant differences before and after treatment. Conclusions. The complex impact and adequacy of treatment measures determine the positive dynamics in the field of sexual self-consciousness in schizophrenic patients with disorders of sexual preference. The revealed changes in personal and psychological characteristics based on the results of psychodiagnostic testing allow us to identify relevant targets for psychotherapeutic influence and can be taken into account when determining the assessment of the risk of relapse and the degree of public danger of patients.