КЛИНИКО-ПСИХОМЕТРИЧЕСКАЯ МОДЕЛЬ ОЦЕНКИ УСТОЙЧИВОСТИ РЕМИССИЙ ПРИ ЭНДОГЕННЫХ ПСИХИЧЕСКИХ РАССТРОЙСТВАХ
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endogen ruhiy buzilishlarAbstrak
Maqsad. Endogen ruhiy buzilishlarda remissiya barqarorligini baholash uchun psixopatologik, funksional va tipologik ko‘rsatkichlarni integratsiya etishga asoslangan kliniko-psixometrik modelni taqdim etish.
Materiallar va usullar. Tadqiqotga endogen ruhiy buzilishlarga ega (XSK-10: F20–F33) bo‘lgan, kamida 6 oy davomida remissiyada bo‘lgan 197 bemor kiritildi. Holatni baholash uchun PANSS va SOFAS shkalalari, shuningdek, M. L. Agranovskiy remissiya tipologiyasi qo‘llanildi. Risk omillarining ko‘p omilli tahlili logistika regressiyasi, ROC-tahlil va imkoniyatlar nisbati (OR, 95% IS) orqali bajarildi.
Natijalar. Remissiya barqarorligining mustaqil prediktorlari quyidagilar bo‘ldi:
- yaqqol klinik javob (ΔPANSS ≥ 15; OR = 0,42; p = 0,002),
- ijtimoiy funksionallikning yuqori darajasi (SOFAS ≥ 45; OR = 0,35; p = 0,001),
- remissiyaning qulay turlari (IIRsLIL, ATR, NTR, TTR; OR = 0,28; p < 0,001),
- davolanishga yuqori sodiqlik (OR = 0,31; p < 0,001).
Prognoz modeli yuqori aniqlikni ko‘rsatdi (AUC = 0,83; 95% IS: 0,78–0,88), sezgirlik — 91,8 %, xususiylik — 94,7 %, Hosmer–Lemeshow testi esa modelning yaxshi kalibrlanganini tasdiqladi (p > 0,05).
Xulosa. Ishlab chiqilgan kliniko-psixometrik model yuqori prognoz salohiyatiga ega bo‘lib, klinik amaliyotda bemorlarni qaytalanish xavfiga ko‘ra tabaqalashtirish va profilaktik strategiyalarni individuallashtirishda qo‘llanilishi mumkin.
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