DYNAMICS OF INDICATORS OF SOCIAL FUNCTIONING IN CASE OF METABOLIC SYNDROME IN PATIENTS WITH PARANOID SCHIZOPHRENIA ON THE BACKGROUND OF ATYPICAL NEUROLEPTIC AGENTS APPLICA-TION AND IMPROVEMENT OF COMORBIDITY

The objective of the research was to study the features of indicators of social functioning (SF) dynamics depending on clinical and psychopathological symptoms in patients with paranoid schizophrenia (SCH-P) associated with metabolic syndrome (MS) on the background of long-term neuroleptic therapy and to study the effectiveness of concomitant corrective therapy. Materials and methods. 140 patients with SCH-P (F20.0) were examined and divided into three groups. Group I included 40 patients who received haloperidol at an average daily dose of 4.6±1.3 mg/day, Group II consisted of 40 patients who received risperidone (3.7±1.8 mg/day), Group III included 40 patients who received quetiapine (413±116 mg/day). Half of the patients in each of the presented groups continued to receive neuroleptic therapy according to the above men-tioned regimen, and the other half – received metformin hydrochloride at a dose of 500 mg/day in addition to the standard therapy. The control group consisted of 20 patients diagnosed with “SCH-P, remission”, without MS signs, who had not received neuroleptics for the past six months. The Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance (PSP) Scale were used to study the patients' mental health in detail. Results of the study and their discussion. At the time of inclusion in the study, when social functioning evaluating, the most pronounced disorders in the module "socially useful activities" were found in group haloperidol – 4.3±0.27 risperidone - 3.8±1.37; quetiapine - 3.9±0.18 and in the module "personal and social rela-tionships": 3.66±0.29 vs 4.2±1.34 vs 3.9±0.98. Less pro-nounced violations were found in “self-care” areas: 3.6±0.86 vs 3.2±0.18 vs 3.7±0.16 and "disturbing and aggressive behavior" 3.15±0.23 vs 3.4±0.21 vs 3.5±0.31. Joining metformin hydrochloride to standard complex therapy improved socially useful activity by more than in 1.5 times in the haloperidol group, in 1.43 times in the risperidone group, and in 1.14 times in the quetiapine group (p**<0.05). The indicator of the state of personal and social relationships probably improved by 39.47%, 40.6%, 37.17%, respectively, in comparison with the initial data (p*<0,05) and on the average amounted 2.47±0.18, which is on 15.6% better than in the control group (p**<0.05). Self-care among the patients in the experimental groups, where concomitant correction was performed, improved by an average of 39.18%, compared to baseline data and reaching 2.74±0.05 in the haloperidol group, 2.75±0.15 in the risperidone group, 3.01±0.09 in the quetiapine group (p*<0.05), which is on average better than the control group data (p**<0.05). Disturbing, anxious behavior in the groups where concomitant correction was performed reducing by an average of 37.9% and reaching the mark: 1.85± 0.21, 2.15±0.14, 2.08±0.27 (p*<0.05) and in compared with the control group data became lower than average on 8.7% (p**˃0.05). Conclusions. In this research, we monitored the impact of comorbidity on social functioning indices in the patients with long-lasting treatment of SCH-P by neuroleptic agents. Based on the results of the examination, we were offered and performed a concomitant correction of metabolic disorders in the treatment of SCH-P comorbid with MS. Clinical and statistical evaluation of the effectiveness of the proposed correction in the structure of complex treatment of this comorbid pathology has established its significant effect in comparison with traditional therapy.