Cognitive Risk Factors for Relapse in Chronic Schizophrenia

摘要

Cognitive risk factors and maladaptive coping mechanisms are important elements for the prognosis and evolution of schizophrenic patients, their manifestations being observed during psychotic episodes but, often, even during apparently asymptomatic, inter-episodic, intervals. Patients diagnosed with chronic schizophrenia have perceptual and thought distorsions that invalidate their representation of reality, therefore coping with these disorder manifestations stands as a difficult challenge. We assessed 51 patients diagnosed with chronic schizophrenia in order to establish a correlation between main categories of coping mechanisms and specific type of schizophrenia. Patients with paranoid schizophrenia associated maladaptive coping strategies like alcoholism (36.3%) and aggression (27.2%), those with residual type presented more social withdrawal (71.4%) and self-harming (35.7%), while catatonic and disorganised schizophrenia cases had a high incidence of thought blocking (60% and 40%, respectively) and social isolation (60% in both groups). There are more frequent types of coping mechanisms in each form of schizophrenia. This is an important fact for focusing the psychotherapy approach on conversion to adaptative coping strategies, using techniques like verbal challenge and reality testing or reattribution- enhancing techniques.