ĐẶC ĐIỂM LÂM SÀNG RỐI LOẠN HOẠT ĐỘNG CÓ Ý CHÍ Ở NGƯỜI BỆNH TÂM THẦN PHÂN LIỆT TẠI VIỆN SỨC KHOẺ TÂM THẦN QUỐC GIA

Abstract

Objective: To describe the clinical characteristics of volitional activity disturbances and their progression in inpatients with schizophrenia at the Institute of Mental Health. Subjects and Methods: A longitudinal study was conducted on 77 inpatients diagnosed with schizophrenia according to ICD-10 criteria at the Institute of Mental Health – Bach Mai Hospital, from July 2024 to May 2025. Results: All patients (100%) exhibited reduced volitional activity, while 94.8% demonstrated hyperactivity. Specifically, loss of creativity was observed in 100.0% of patients; academic and occupational apathy in 98.7%; diminished or lost decision-making capacity in 97.4%; episodes of impulsivity in 80.5%; social withdrawal in 66.3%; episodes of absconding in 62.3%; and episodes of aggression or property destruction in 42.9%. After two weeks of treatment, the proportion of patients with hyperactivity decreased to 36.4%, and those with reduced volitional activity declined to 80.5%. The mean total PANSS score was 36.4 ± 5.4 at admission, decreasing to 22.9 ± 2.7 after two weeks of treatment. Conclusion: The majority of patients with schizophrenia exhibited volitional hypofunction (100%), which significantly improved after two weeks of treatment, although the prevalence remained high. Hyperactivity symptoms were also common (94.8%) and showed marked improvement following treatment. The PANSS scores reflected substantial symptomatic improvement after two weeks of inpatient care.