The aim was to analyze data of a therapeutic drug monitoring of quetiapine.Material: blood samples (41 samples in the whole) were received from 35 in-patients treated for various forms of schizophrenia. A method of a high performance liquid chromatography with mass-spectrometric detection was used for quantitative determination of quetiapine in the blood. Every patient got an individual outpatient card of monitoring that contained necessary clinical information. The obtained data of quetiapine level were distributed in the following way: 75,6% were in the therapeutic, 4,9% in sub-therapeutic (< 10 ng/mL) and 19,5% conditionally toxic range (> 600 ng/mL), for administration quetiapine at doses of 50 to 1200 mg per day. Two cases of alleged noncompliance were revealed. Distribution on the concentration of quetiapine-wells, normalized for dose administration, shows normal level with a slight asymmetry towards high values. During the analysis we have discovered that the average concentration of quetiapine administered in combination with clozapine was higher than with monotherapy, this should be taken into account by clinicians during correction of the therapy. There was no significant effect of co-medication haloperidol onconcentration of quetiapine.Conclusions: the type of connection between the concentration of quetiapine, concomitant therapy and dose of the drug was revealed as important element of patient-centered treatment technology.

Background: manifestations of pathological grief reactions (PGR) in late age were studied sufficiently, but their outcomes in a case of affective spectrum mental disorders were not studied enough.The aim of the study was to investigate PGR outcomes in late age in affective disorders and to determine participation of various pathogenic factors in their development.Material: as a result of blind examination of 225 patients, first hospitalized in geriatric departments of MHRC clinic due to affective illnesses, or disorders, 60 patients were chosen, who had experienced bereavement of important person in late age, with the following development of PGR.Methods of the study: during the study the following methods were used: psychopathological, clinical, psychometric, human brain MRI, EEG, neuropsychological examination, Mini Mental State Examination (MMSE). The comparative design of the study determined the comparison of the clinical specificities of the disease in different periods of ageing: in elderly age and in old age.Results: the frequency of affective disease/disorder after PGR in late age was twice as high as in a case of PGR absence after bereavement. The PGR outcome was determined by the development of endogenous affective illness, or affective disorder within the framework of prolonged depressive reaction of adaptation. Diagnostic distribution in the group of patients of the elderly age significantly differed from that one in old age. Recurrent depressive disorder developed in a case of PGR outcome exclusively in the elderly age, while the development of dysthymia was more characteristic of old age. In all the cases of PGR outcomes resulting in affective illness/disorder in late age residual reactive symptoms had special significance in the clinical picture of affective phases and states.Conclusion: clinical-psychopathological analysis revealed a high risk of PGR outcome in late age in a case of affective disorder predominantly with depressive manifestations. The predominance of endogenous affective illnesses in the elderly age and prolonged depressive adaptation reactions in old age, as well as the presence of residual PGR symptoms are important for conducting treatment and diagnostic and rehabilitation work.

The aim of the study was to determine the profile of the efficacy and safety of Kortexin in out-patient therapy of asthenic dis- orders in adolescents.Material and methods: a total of 26 patients aged 15-17 (21 youths, 5 girls) with asthenic impairments were examined using clinical-pathological method and subjective asthenia rating scale (Multidimentional Fatigue Inventory [MFI-20]). Тwo groups of patients were singled out, taking into account the nosological nature of disorders. The first group (13 cases: 10 youths and 3 girls) included adolescents with organic non-psychotic, as well as neurotic, associated with stress and somatoform impairments. The second group (13 cases: 11 youths and 2 girls) consisted of patients with schizophrenic spectrum disorders. All the patients received intramuscular injections of Kortexin (5 mg) for 10 days.Results and discussion: clinical improvement of various degrees was registered during the therapy almost in all the adolescents. By the moment of finishing the treatment a reduction in asthenic manifestations was revealed. Asthenic indices on MFI-20 decreased on the average to 52,8 scores, which confirmed psychopathological evaluation. At the same time the intensity of separate parameters of asthenia changed differently. Thus, the minimal reduction was noticed in motivation lowering, which was especially distinct in patients with schizotypal (including personality) disorders.Conclusion: the high efficacy, possibility of use in multimodal therapy, and practically complete absence of undesirable effects testifies to appropriateness of Kortexin prescription in a case of asthenic disorders in adolescents.

Background: for children of preschool age, play activity is the leading type of activity, examination of its characteristics is important for the diagnosis and psychocorrection.The aim was to study the pathological forms of play activity in children of early and preschool age in cases of mental disorders. Material and methods: 160 children of early and preschool age from various nosological groups: autism spectrum disorder (ASD), schizophrenia, intellectual disability (ID) and mental retardation (MR), and a group of peers with normative psychophysicaldevelopment were clinically, psychologically and experimentally psychologically examined.Results and conclusion: the playing activity of children with ASD is monotonous, unproductive and aimed at stereotypical repetition of the physical nature of an object (obtaining a sensory effect). Children with ASD tend to play in «ordering» of the objects (alignment of items in the ranks). The playing activity of children from the schizophrenia group is characterized by confusion and senselessness, shifting to a protopathic regressive level of response. Pre-school children suffering from schizophrenia have pathological fantasies with features of transformation and withdrawal to fantasy world. Children with ASD and schizophrenia, tend to take an interest in «non-game» subjects, as well as «interlacing phenomenon». In case of ID the motivational component is not formed, the plot of playing activity is monotonous, children prefer construction games, there is no tentative plan. Children with mental retardation show a weak interest in toys, there is no need for a game, object-play actions appear in the middle of preschool age.

The purpose of the study was to compare the clinical and dynamic characteristics of depression in adolescent boys and girls.Material and methods: сlinical psychopathological, clinical and follow-up clinical-psychological methods (using a «scale of common clinical impression» of CGI, scale and Beck depression for teenagers test Boyko to study the traits of excitability and colour test of relations [TSTO]) investigated depression in 145 adolescents (56 girls and 89 boys) aged 15-17 years, observed in regional PND.Results: adolescent depression represents heterogeneous disorders in the structure of affective illness, schizophrenic disorders circle, neurotic and stress related disorders, organic disorders and in the dynamics of emerging personality disorders. The nosological distribution of depression in adolescents depends on the gender: depressions in adolescent males were more frequently found in the dynamics of personality disorders, but the depressions in adolescents girls were in the framework of affective illness. There were gender differences of frequency of depressions of varying severity and duration. The severe depressions are relatively rare in adoles- cents. A phenomenological manifestation of endogenous depression was structurally similar to those seen in adults not depending on gender. Some differences in the clinical picture of depressive disorders between boys and girls were observed in subsyndromic, mild and moderate depressive episodes.Conclusions: there is a complex of factors involved in the formation of depression in adolescence, some of which may be due to age, others are common to the depression of adulthood.

The aim was to review russian and international scientific literature sources on the prevalence and clinical features of bipolar disorder in the elderly with due regard to the age of onset.Material and methods: the search of scientific articles was carried out from MEDLINE, PUBMED databases and other reference sources with the use of the keywords «old age», «elderly», «bipolar disorder», «manic states», «depressive states», «mixed affective states».Results and conclusion: prevalence of bipolar disorder in the elderly is gradually growing due to general population aging. Differences in understanding of age-related features of psychopathological presentation, main tendencies in clinical course and the proportion of types of late-life bipolar disorder are continuing to persist. The majority of contemporary studies are directed to inves- tigation of certain separate points of the problem of bipolar disorder in aged. Lack of research is directed to investigation of clinical and psychopathological aspects of the disease in old and senile age. There is only several data about the differences in clinical course of the disease with early (before 60 years) and late (after 60 years) manifestation. In recent years research in cognitive decline during affective episodes has been becoming actual because of the risk of disease outcomes to cognitive impairment and dementia. Initial therapy and maintenance treatment of late-life bipolar disorder is still developed by halves. The questions of hereditary burden, pathogenesis and outcomes, the development of initial therapy and maintenance treatment of bipolar disorder are significantly actual for further investigations exemplified in late-life patient’s contingent.

The purpose of the review was to analyse the psychopathology manifestations of the burn-out syndrome and its clinical variant - the exhaustion disorder, proposed by Swedish psychiatrists. The results of the studies show close relations of the burn-out syndrome and depressive disorders, provoked by chronic professional stress factors. The criteria of the exhaustion disorder and the asthenic syndrome were discussed. The psychopharmacotherapy approaches to depression with comorbid exhaustion disorder also considered.

The article reports on the conference of the Mental Health Research Centre (MHRC) that took place in Moscow under the auspices of the World Psychiatric Association (WPA), co-organized by the Russian Society of Psychiatrists (ROP) and the Union for Mental Health (UMH). The article gives information about main events and reports of the conference.