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Когнитивные особенности как факторы риска несуицидальных самоповреждений у пациенток юношеского возраста, страдающих депрессиями с аттенуированной психотической симптоматикой и без нее
Background: there is evidence in research studies indicating that it is possible to establish early risk for psychosis by identifying cognitive dysfunction that precedes the development of psychotic states. The role of cognitive dysfunction as psychosis predictors in depressions with non-suicidal self-injury (NSSI) is unclear.The aim was to study the correlation between the severity of cognitive deficits and features of non-suicidal self-injury in adolescent female patients with depression with attenuated psychotic symptoms in comparison with depressed patients without these symptoms.Patients and Methods: the study included 89 female patients aged 16 to 25 years, suffering from depression of different nosology affiliation (F31.3-4; F34.0; F21.3-4 + F31.3-4; F60.X + F31.3-4 по ICD-10) with NSSI manifestations in the disease picture. Based on the presence or absence of attenuated psychotic symptomatology, the patients were divided into two groups: 46 depressed patients with attenuated psychotic symptoms (DAP) and 43 depressed patients with no attenuated psychotic symptoms and no history of psychotic disorders (DNP). Cognitive functions were assessed using the Brief Assessment of Cognitive Functions in Schizophrenia Scale (BACS), Wechsler's Similarities and Missing Details subtests, and the Interpretation of Proverbs methodology. The “Autonomy Scale” was used to assess the patients' functioning, interaction and level of social activity.Results and Conclusions: in the DAP group, the Autonomy Scale scores - Total score, Ability to build a functional social network, and Content of conversation with a doctor were significantly lower than in the DNP group. Significant differences were found in the cognitive sphere scores: in the DAP group, the scores of Total Cognitive Functioning Score, Verbal Memory, and Verbal Fluency, as well as the Similarities and Missing Details tests and the Interpretation of Proverbs technique were lower than in the DNP group of respondents, which conrms the assumption about a lower level of cognitive functioning in patients with subpsychotic attenuated symptomatology. Patients in the DAP group with suicide attempts demonstrated higher autonomy scores, but reduced cognitive sphere scores (working memory), compared to DAP patients without suicide attempts. It was noted that patients who continued NSSI after discharge demonstrated a lower level of social skills and cognitive sphere than patients with DAP who discontinued NSSI. It was shown that the variety of “Mild way of NSSI” was significantly greater in the DAP group.