Clinico-epidemiological research of schizophrenic students in Petrozavodsk

1. Clinico-epidemiological research of schizophrenic students in Petrozavodsk M. Burkin, A. Smirnova Department of Psychiatry Petrozavodsk State University Medical School

2. Statistics of psychic disease of students • 37 % of Russian or about 54 millions people (that is every Russian inhabitant) have problems with psychiatric health. • A particular place in the vast class of problems connected with the students health is take by mental disorders which are "most spread at the time when intension connected with the educational process coincides with transitional age changes of the youth" (WHO, 1967). • Researchers who have studied mental morbidity among students in different countries ascertain total increase of mental disorders in this group and also mention that the frequency of schizophrenia cases among other mental diseases comprises 3-25% of all cases. • The students fall ill with schizophrenia some 6-8% more than other population.

3. Material of investigation • The investigation of the clinic of the derangement and adaptation of students was carried out upon the materials got from overall investigation of personal having schizophrenia in large administrative and cultural center. Epidemiological data were gathered with the help of the programme regulated with the card of epidemiological investigation. • In the present research a complex methodical approach, is used because it is obvious that neither clinic nor epidemiological methods of investigation can give the opportunity to achive necessary results if only one of them is used. • We have investigated a group of 97 person (59 males and 38 females) at the age 17 to 27.

4. Fig. 1. Group of students

5. Fig. 2. Forms of schizophrenia in Karelian Republic

6. Analysis of the material • The investigated group of students can be considered representative enough, because it extends to the most part of people requiring psychiatric help. • The analysis of the material showed that probability of schizophrenia among male-students was higher than among female-students (1.5 times). The most of the patients are first – second years students, but it's very important to note that 64% of all the investigated schizophrenia patients entered the institutes being ill, though they confirmed that they had got ill lately – during the process of studying. However more detiled investigation of the anamnesis showed that the first symtoms had appeared during their studying at school (6-10th forms).

7. The symptomatology of disease • The symptomatology is usually defined by pshychopathic and affective disturbances, obsession, forms of reactive lability. Among the psychopathologic disorders prevailed manifestations of the schizoid circle (autism, difficult in contact with people, gross egotism, paradox in emotions and behavior), often combining with psychopatic forms of other structures: hysterical (pointed behavior, hysteric stigma, etc.), psychoastenic (anxiety, tendency to doubt and rigidity in psychic activity), and also paranoic (high self-conceit, one-sided thinking and activity, suspiciousness). • The above-mentioned symptoms often were of short duration and were so indistinctive that all the surrounding people didn't attach great importance to them. • Thus, the most of patients having got ill before entering the college were not observed.

8. Feature of students • When we tried to define more precisely the motivations of their entering the college, we found out that they usually followed their parents opinion (while, in some cases their own opinion conflicted with the parents one, but "it was beyond their strength to oppose them", "parents know better"), others were indifferent as to the place to study at, and others followed their friends or were guided by their own great success in some subjects to be examined in. • 32.5% of students had genetic burden of mental diseases. The highest number of the cases was registered among the student of physical and mathematical faculties, then come the faculties of humanities, biology and medicine, and technical ones.

9. Fig. 3. Pre-morbid of students

10. Fig. 4. Remissions

11. Clinical picture • In the clinical picture the leading place was taken by non-psychotic disorders: asthenia, neurosis, psychopathia, accompanied by the obligate schizophrenic study of symptoms. • As a rule, the appearance of psychopathological disorders provoked great lowering of productivity in the studies, and in heavy occasions made its continuation impossible. • The level of the following adaptation correlated with the character of the process course: the higher indices of adaptation were revealed in patients of borderline and recurrent schizophrenia. The carried out catamnestic investigations showed that a considerable part of the students after the endured attack managed to be a successfull in studies and only 12% of the patients could not continue the studies. It allows us to draw the conclusions that the diagnosis of schizophrenia can't be the reason to expel the student from college.

12. Problems of students with studying

13. Recommendation • As to practical application, it can be recommended to create an intercollege psychotherapeutic laboratory where early consultations of patients and rehabilitation assistance to students with neuro-psychotic disoders on the enough high level can be organised.