Structural-dynamic analysis of clinical manifestations and features of psychotic disorders therapy in users of "designer" drugs

The study involves 158 men who have developed psychosis at different stages of use of "designer" drugs. According to the clinical and psychopathological structure of psychotic disorders, taking into account the clinical-dynamic course and duration of psychosis, all patients are divided into two groups. Group 1 consists of 72 patients with acute psychosis, the psychopathological structure of which corresponds to the exogenous-toxic type of responses that can develop both into intoxication in the presence of a dependence syndrome and without a dependence syndrome, and in the abstinence state. The clinical picture of this group is determined by the delirious confusion of consciousness, acute hallucinosis and acute paranoid syndrome and is designated as intoxicating psychoses of an exogenous type of response. The second group consists of 86 patients with psychotic disorders, the clinical picture of which from the very beginning of development is characterized by the combination of affective and schizophrenic symptoms that correspond to the development of oneiroid (affective-oneiroid) attack, which has clinical similarity with schizoaffective attacks in paroxysmal (recurrent) schizophrenia. Similarity of the clinical picture with endogenous (schizophrenic) psychosis, lack of parallelism between intoxication and picture of psychotic disorders, necessity of using "interruption" therapy methods, duration exceeding one month allow one to think about the nosological affiliation of such conditions. The clinical significance of using "designer drugs" lies in their ability to cause, along with intoxication psychoses, an exogenously toxic type of response, "schizophreniform" psychoses, with the duration of more than one month, according to ICD-10, a revision of the diagnosis is possible and similar psychoses can be considered as a manifestation of an endogenous process (schizophrenia).