No 72 (2016)
ВОПРОСЫ ПСИХОПАТОЛОГИИ, КЛИНИЧЕСКОЙ И БИОЛОГИЧЕСКОЙ ПСИХИАТРИИ
5-19 2179
Abstract
Background: theoretical aspects of negative symptoms in schizophrenia and related disorders are among challenging research problems. Although deficit symptoms in overt schizophrenia have been intensively studied, the structure of deficit symptoms in schizophrenia spectrum disorders requires further investigation.Objective of the study is a conceptual comparative analysis of negative symptoms in overt schizophrenia and schizophrenia spectrum disorders.Results: a comparison of two kinds of negative symptoms has been performed: in schizophrenia spectrum disorders and in overt schizophrenia (including deficit type designated as «verschrobene» and subdivided in «primary deficit-syndrom» and «second-life- deficit» respectively). In schizophrenia spectrum disorders psychopathological manifestations of deficit disorder has been found to be «quasipsychopathic» (personality changes), restricted (circumscribed), monosyndromal, apparent in prodromal stage and related to premorbid personality dimensions. It has been defined that the course of negative symptoms in schizophrenia spectrum disorders is limited: they ultimate in prodromal stage and have a phasic course. Some aspects of negative symptoms treatment with modern generation medications are discussed.Conclusion: negative symptoms in schizophrenia and schizophrenia spectrum disorders should be differentiated.
20-26 667
Abstract
Background: in works, devoted to selective study of neurocognitive deficit in schizophrenia, the specificity of schizophrenic pathology as an integral psychopathological formation was not reflected.The aim of the paper was to generalize the results of long-term experience of experimental pathopsychological examination of schizophrenic patients within the framework of longitudinal studies.Material and methods: a cohort of patients with schizophrenia, hospitalized in MHRC clinic due to schizophrenia, were examined by using pathopsychological method in dynamics.Results: it seems well-grounded to consider the peculiar cognitive style characteristic of schizophrenic patients as manifestation of deficit of social orientation. The role of «paradoxic» creativity in its formation was emphasized. The problem of correlation between pathology and creation was analyzed. The question of the nature of social orientation was discussed.Conclusion: deficit of social orientation is the leading component of pathopsychological syndrome of schizophrenic defect, which should be taken into consideration during working-out of rehabilitation measures.
27-32 492
Abstract
Introduction: the study of brain functionality with neurophysiological method is one of the informative approaches to discrimination of additional diagnostic and prognostic markers of the disease. The article summarizes the findings of the initial stage of such investigation.Aims was to determine the neurophysiological profile of youth schizophrenia patients with the long-term follow-up 20-25 years. Methods: background EEG and auditory evoked potentials in oddball paradigm were recorded in 18 patients with youth schizo- phrenia (illness duration more than 20 years) and 10 age and sex matched mentally healthy subjects. Spectral power of theta, alphaand beta1 rhythms and amplitude and latencies of P300 were analyzed.Results and discussion: as compared to controls, the patients had higher spectral power of theta-rhythm but no differences by amplitude or latency of parietal P300. There were no statistically significant correlations between neurophysiological and clinical characteristics. The findings assume that pathological processes in base of tested neurophysiological characteristics are compen- sated at some extent in the patients with long-term follow-up of youth schizophrenia and do not determine the psychopathology at this illness stage.
33-40 1003
Abstract
Objective: to investigate the distinguishing features of glaucomatous optic neuropathy and damage of optic nerve and retina in patients with amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD).Methods: 34 patients with early perimetric glaucoma, 12 AD patients, 13 patients with aMCI and 19 healthy volunteers under- went comprehensive psychiatric survey and ophthalmic examinations, static perimetry, macular and peripapillary optical coherence tomography (OCT). Ganglion cell complex (GCC) protocol, specifically global loss volume (GLV), focal loss volume (FLV), peripapillary retinal nerve fiber layer (RNFL) thickness were measured.Results: AD and aMCI patients have higher in comparison with norm group GLV index. Average GCC thickness is lower in AD group. There is no significant difference in RNFL between AD and control group. Glaucoma group differ from the norm in all stud- ied parameters of OCT. Receiver operating characteristic curves were constructed for RNFL, FLV (glaucoma diagnosis) and GLV (AD diagnosis). Areas under the curves show good capability of these parameters.Conclusions: GLV index increases in patients with Alzheimer's disease. FLV index enlargement characterizes glaucomatous optic neuropathy. So ganglion cells neurodegeneration in Alzheimer's disease is diffuse, while defects of ganglion cells in glaucoma are focal.
41-48 1024
Abstract
Background: despite the presence of more than 20 antiepileptic drugs, in 30% of patients with epilepsy the control of seizures is not achieved. The basic efforts are directed at the development of drugs, oriented at new molecular mechanisms of action of anticonvulsants.The aim of the study was to investigate the efficacy of flypirtine, anticonvulsant drug with a new mechanism of action, in the form of activation of potassium channels.Material and methods: a total of 20 patients with pharmacoresistent epilepsy in adults and non-psychotic depression, associated with this disease, were included in the study. The dynamics of the frequency of seizures and the intensity of depressive disorders was studied by using the Hamilton Scale.Results: in 50% of cases treated with flupirtine therapeutic remission was achieved with cessation of seizures, in the rest observations marked reduction of seizures was noticed. At the same time a decrease of the severity of depression was registered.Conclusions: flupirtine is an effective drug in the treatment of pharmacoresistent epilepsy in adults with non-psychotic depressive disorder.
SCIENTIFIC REVIEWS
49-54 519
Abstract
Background: the link between brain aging and Alzheimer’s disease (AD) is a matter of debate. However, genetic processes hallmarking cellular and tissue senescence have been repeatedly associated with pathogenesis of AD.The aim was to review recent data concerning the incidence of low-level chromosomalаl mutations (mosaic aneuploidy) involving autosomes and sex chromosome X (a recognized feature of aging cell populations) in the prefrontal cortex and the hippocampus of the AD brain.Results: it was demonstrated that the rate of X chromosome aneuploidy in AD brain was approximately two times higher than in age and sex-matched control. Addressing X chromosome number variation in the diseased brain, we concluded that somatically acquired (post-zygotic) mosaic aneuploidy may causes the large-scale genomic alterations in neural cells of AD and, therefore, can be intimal involved in the pathogenesis of this age-associated neurodegenerative disorder. In the context of debates about pos- sible interplay between brain aging and neurodegeneration, our findings suggest that X chromosome aneuploidy can significantly contribute to both these processes.Conclusion: to this end we conclude that low-level mosaic aneuploidy in the brain is a new non-heritable genetic factor pre- disposing to AD.
55-69 1197
Abstract
Background: in development of panic disorder the accumulation of hormones of a stress - cortisol and prolactinum, as well as the cyclic changes of estrogen level plays a role.The aim was to review the results of researches on neuroendocrine bases of pathogenesis of panic disorder, access to which is got through the Pubmed and Medline databases.Results: modern views on therapy of panic disorder, in particular, efficiency of various groups of antidepressants are considered. The possible neuroendocrinological and metabolic disturbances interfaced to use of antidepressants of various mechanism of action are estimated. It is shown that practically all antidepressants influence prolactinum level, thyroid hormones, hormones of the GPA-axis and significantly increase risk of development of a metabolic syndrome and diabetes of the 2 type.
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ISSN 1683-8319 (Print)
ISSN 2618-6667 (Online)
ISSN 2618-6667 (Online)