The dissertation is devoted to the study of clinical-psychopathological, pathopsychological, neuropsychological and clinical-ethological characteristics of pathopersonalogical transformations (PpT) in patients with schizoaffective disorder (SAD), the establishment of their clinical and typological features and the development of the concept of pathogenesis, which became the basis of the algorithm for diagnostic differentiation of SAD from other endogenous psychoses with episodic course (PEC) and the program of complex therapy and rehabilitation. The study based on examination of 421 patients with PEC. After screening for compliance with the inclusion / exclusion criteria, 312 patients selected, including 102 patients with a diagnosis of SAD, 102 patients with affective disorders (AD) and 108 –with a diagnosis of paranoid schizophrenia. To achieve the goal of the study, a set of methods was used, including: clinical-psychopathological, clinical-anamnestic, clinical-follow-up, pathopsychological, clinical-ethological, as well as medical-statistical analysis. Clinical characteristics and formation factors of PpT in patients with SAD were determined, as well as their influence on the level of social adaptation. The concept of the pathogenesis of PpT in patients with SAD was developed. It reveals the multifactorial mechanisms of their occurrence because of the formation of specific constellation of clinical-psychopathological, pathopsychological, neuropsychological, clinical-ethological disorders in the context of their interaction with indicators of social adaptation / maladjustment. Four main clinical and psychopathological types of PpT identified in patients with SAD. There are “affectively labile” (20.1%), “paranoiac-dysthymic” (17.3%), “hysterical-agonistic” (25.9%), “neurocognitive -deficient "(16.9%), as well as mixed (19.8%), which differ in clinical-anamnestic, clinical-psychopathological, pathopsychological, neuropsychological and clinical-ethological characteristics and have different ratios of formation factors (among which psychogenic, endogenous and exogenous factors) and lead to social maladjustment of varying severity. Comprehensive structural and semantic analysis of signs of remission / intermission of SAD made it possible to scientifically substantiate and test the algorithm for diagnostic differentiation of SAD from other PEC. Based on the data obtained, a program of complex therapy and rehabilitation of patients with SAD scientifically substantiated, developed, tested, and introduced into practice, which takes into account the typology of PpT and clinical and anamnestic features and combines psychopharmacological, psychoeducational, psychosocial and psychotherapeutic measures. This introduction significantly improved the provision of psychiatric care, as well as improve the quality of life of patients with SAD.
