Moral Hypochondria in the Clinical Space of Schizophrenia and Schizophrenia Spectrum Disorders

Background : the most studies of the problem of moral hypochondria (MI) in schizophrenia and schizophrenia spectrum disorders (SSD) is devoted to the study of MI in the aspects of: 1) exacerbations; 2) remissions/residual states; 3) the continuing “sluggish” course of the endogenous process. Despite the results, that have been achieved, the psychopathological structure of moral hypochondria, which forms during prolonged hypochondriacal post-psychotic states, remains insufficiently studied. The aim was to study the psychopathology of moral hypochondria, developing in the post-psychotic period of schizophrenia and SSD. Patients and Methods : the study sample consisted of 21 patients of the department for the study of borderline mental pathology and psychosomatic disorders of the FSBSI «Mental Health Research Centre». Clinical, psychometric, statistical methods are used. Results : the aspects of formation of moral hypochondria, that realizes in the post-attack period of schizophrenia and SSD, are presented: 1) premorbid personality type (cluster B personality disorder with the inclusion of dimensions of the “as-if personality”); 2) two-stage course of the disease. The first stage is an acute psychogenic debut followed by an anesthetic depression; the second stage is a prolonged hypochondriacal state with symptoms of MI. The rationale for the admissibility of interpreting MH as one of the manifestations of post-processual personality development is formulated. The psychopathological characteristics of the phenomenon of transformation of positive psychopathological disorders into pathocharacterological formations are described. Conclusions : this study presents the formation mechanism of the personalized overvalued phenomena of moral hypochondria, originating in the structure of psychopathological disorders of the depersonalization spectrum.