СЪСТОЯНИЕ НА СЪЗНАНИЕТО ПРИ ОСТРА ШИЗОФРЕНИЯ С ОГЛЕД НА ПОЗНАВАТЕЛНИТЕ ФУНКЦИИ

Abstract

A series of 50 patients with schizophrenia in the acute stage of the disease are studied clinically and by means of experimental methods, both physiological and psychological (associative experiment after A. G. Ivanov-Smo- lenskii, structural-associative experiment and method for the creation of expressive speach conditioned reflexes as proposed by VI. Ivanov, modification of the Vigotskii test for the classification of images, of TAT and according to the method for investigation of successive relationships with a series of thematically connected pictures) with the aim of determining the state of consciousness and cognitive functions. In most of the patients both direct and indirect evidence is present indicating disturbed clearness of consciousness (complete or partial allopsychic disorientation, oneiridic derangement of consciousness, amnesia or incomplete recollection of the initial phase of the disease etc.). The listed manifestations as well as the sight hallucinations, established in nearly half of the patients in the initial stage of the disease, pose the question about the relationship existing between schizophrenia and the psychoses running a course of so-called exogenous type of reaction. In a broader sense of the word, the consciousness disorders may produce also derangements in the cognition process. They include not merely the instances of manifest psychotic production, but are reflected upon the entire cognitive act, in its sensitive and logical stage as well. Under this aspect, the psychopathological production and more particularly the mental derangement very likely represent a final stage, consequence of cognitive disturbances. The pathophysiological base of the disorders just described includes attenuation of the excitation process, disorders of the cortical neurodynamics with development of inertness phenomena and inhibition of the newer and higher functions—retention of the action of the second signal system and especially of the newest and most complicated second signal relationships, with setting in the foreground of the more concrete and more essential temporary relations up to loss of logical and structural-grammatical coherency.