Out-patient care to schizophrenic patients having antisocial records

Abstract

The objective of the study were the problems of out-patient care to schizophrenic patients having antisocial records.

Materials and methods:

The forensic psychiatric assessment of 98 schizophrenic patients (according to ICD-10) has been carried out. During our assessment psychopathic-like, neurotic-like disorders, depressive and psychotic symptoms were prevalent.

Methods:

Structured and semistructured clinical interviwes and medical and criminal records investigation.

Results:

The outpatient care of observed patients must be strictly deontologically consistent. Most of the patients and their relatives have a certain psychological ideas about antisocial behaviour and causes of the disease. The doctor's attempts to make alterations may break his contact with a patient and increase the dissimulating tendences. Some patients were sure that relatives “dream” to get rid of them. Continuation of multifactor pathomorphosis in schizophrenia was determined.

The main causes of errors in diagnosis and therapy in schizophrenic patients were the previous treatment for combat related PTSD; alcohol and drug abuse or all of them as comorbid. Many patients and relatives were not prepared for necessary inpatient treatment and were unaware about new psychopharmacological therapy. Aggressive behaviour was the result of delirious protection which forces a patient to change his former social attitude or manifested as a postpsychotic condition as a form of adjustment to a “new health”.

Conclusion:

The carried out research is helpful to formulate changed diagnostic criteria and aggressive behaviour rick/protective (clinical and social) factors system in schizophrenia patients. Out-patient care to schizophrenic patients seems to remain an object of discussion.