COGNITIVE AND HALLUCINATORY-PARANOID DISORDERS IN VASCULAR DEMENTIA (CLINICAL AND PSYCHOPATHOLOGICAL STRUCTURE AND DIAGNOSTIC CRITERIA)

The aim of the study is to investigate the clinical and psychopathological structure of cognitive and hallucinatory-paranoid disorders in patients with vascular dementia (at different stages of the pathological process).Materials and methods. The work was based on the results of the study of 75 patients with vascular dementia (VD) and hallucinatory-paranoid disorders (HPD), who made up the main group. As a control group, 63 patients with VD without predominant HPD participated in the study. The complex of research methods included clinical and psychopathological, psychometric, psychodiagnostic and mathematical statistical methods.Results. The results of the study showed that the characteristics of HPD and cognitive disorders (CD) depend on the stage of VD development. The clinical and psychopathological structure of HPD in patients with VD in the middle stage of development (MSD) was characterized by the predominance of paranoid disorders with systematic ideas of damage, robbery, theft, which occurred in the form of paranoid delusional disorder.In patients with HPD with VD in late stage of development (LSD), the in clinical picture hallucinations were dominated (visual, auditory and tactile), which occurred in the form of hallucinosis.With the transition of VD from MSD to LSD, the frequency of cognitive disorders of praxis, gnosis, attention, language, orientation increased and thinking disorders deepened.Clinical manifestations of HPD in VD were formed in the structure of cognitive disorders, the transformation of which was determined by the stage of development of the pathological process.In this work, a categorical and dimensional analysis of HPD in patients with VD of different stages of development was carried out, their clinical, psychopathological and phenomenological structure, the interaction of cognitive and non-cognitive components, and types of courses were determined. The data obtained made it possible to form diagnostic criteria for different stages of VD development, which are the basis for increasing the VD treatment effectiveness.