Aim of the study: comparative evaluation of effectiveness and safety of monotherapy with one of the new-generation antidepressants and a complex treatment with the same antidepressants in combination with infusions of Astrox® (ethylmethylhydroxypyridine succinate) in depressive geriatric in-patients. Material and methods: both compared groups included 25 in-patients aged from 60 to 79 years with mild and moderate depression (according to ICD-10) and were treated with mono- or complex (in combination with Astrox®) antidepressant therapy. Treatment effectiveness was assessed with the use of HAM-D, HARS, CGI-S and CGI-I rating scales; cognitive function was assesses with MMSE scale, «Memorizing 10 words» test and clock drawing test.Results: obtained data showed that complex antidepressant treatment in combination with antioxidant medication Astrox® leads to more rapid therapeutic response and significant effectiveness of treatment in comparison with antidepressant monotherapy. The data were confirmed with significant reduction of depression and anxiety rates and improvement of patients’ cognitive function.Conclusion: obtained results allow us to recommend a complex antidepressant treatment of geriatric in-patients in order to reach more rapid and effective treatment response and to shorten hospitalization period.

The aim of study was to investigate psychopathological features, ways of formation and dynamics of postpartum depressions.Material and methods: by clinical-psychopathological method 148 females were examined, who had developed depressions during 6 months after uncomplicated labor. Depressions corresponded to diagnostics criteria for postpartum depressions according (F53 to ICD-10).Results and discussion: three types of postpartum depressions were described. They differed in its psychopathological structure and conditions of formation. Typologically postpartum depressions were correspondingly specified as endogenous, endoreactive, and endosomatoendocrine ones. It was shown, that the formation of postpartum depressions and psychopathological specificities of each type took place under the impact of pathoplastic factors. Autochthonous evolution as well as the impact of psychogenic, or neuroendocrine factors, determined peculiarity and type of syndromal clinical picture. The role of hormonal disorders during the period of labor is considered as one of the significant factors, determining the picture of neuroendocrine syndrome and conditioning peculiarity and development of endosomatoendocrine type of postpartum depression. The legitimacy of its diagnostics is discussed as postpartum depressions proper, which are the most clinically specific and corresponding to postpartum depression (F53.0 to ICD-10).

The problem on the analysis of the relationships between different anatomical-morphological brain anomalies in mental disorders is still far from solution.The aim of the present study was to determine the peculiarities of cortex thickness and microstructural characteristics of main tracts of white matter in patients with schizophrenia, as well as the analysis of their intercorrelations.Methods: brain images were obtained at 3Т Philips Achieva (Holland). The data analysis was done with FreeSurfer 5.3.0, and FSL 5.0.7.Results: in patients, cortical thickness reduction in multiply loci and radial diffusion reduction in anterior thalamic radiation of both hemispheres, as well as an increase of axial diffusion of the cingular-angular bundle of the right hemisphere were found. The white and grey matter abnormalities did not correlate with each others and also with the PANSS scores.Conclusion: the findings point to the role of the structural and functional anomalies as trait markers of schizophrenia and also to the possible existence of different pathogenetic processes with impact to the different brain tissues.

The aim of study was to compare brain structures, first of all hippocampus, in patients with depression and healthy volunteers.Material and methods: MRI examination were made to 101 healthy volunteers and 47 patients with depression. Postprocessing conducted using FreeSurfer software with the implementation of voxel morphometry of brain structures and DISPLAY programme for calculation of different subregions of hippocampus.Results: the volume decrease of the thalamus and the hippocampus and the volume increase of the right amygdala in patients with depression compared with the control group was noted. The most difference was found in volume of right hippocampus.

The aim was to study neuroimaging changes of the brain in depression and addictive disorders.Results: research shows that depressive patients with various etiologies have the structural and metabolic differences. Drug- dependent patients have alterations in the structures of the limbic system in which dopamine and opioid receptors localized. These patients have atrophic processes in the brain (cortex thickness have reduced, the amount of gray and white matter lowered in sections that realize the emotional and cognitive functions). New information on the pathogenesis of drug-resistant depression have received by investigators.Conclusion: brain imaging with MRI and DTI are high informative for diagnostics of brain pathology in addiction and for evidences of brain lesion because addictive agents action.

The aim was to review recent publications on functional MRI of brain.Results: it was shown a transition from methods of functional localization to methods revealing functional connectivity gives rise to a progress in application of functional MRI to research on the nature of mental diseases. Although resting state fMRI remains more popular in connectivity studies, task-based fMRI may be more prospective. Particularly, it provides more objective information than the resting state, and helps to understand the functional systems of the brain underlying specific behavioral tests that proved their validity for specific mental and neurological conditions.Conclusion: method of task-based fMRI contributes to the view of many mental and neurological diseases as a disorder of connectome.

The aim was to the study neuroimaging of neural correlates of emotions in patients with paranoid schizophrenia in acute psychosis.Material and methods: fMRI was used to reveal the difference in activation of cortical and limbic structures of the brain in patients compared to healthy control. The stimuli were visual (neutral and threatening) in passive perception paradigm.Results: the activation of cortical and limbic structures in schizophrenic patients in general is greater than in the healthy group, on both types of stimuli evidently due to anomalous detection of emotionality and disturbance of the excitation/inhibition processes balance.

Background: previously we have found significant decrease in the level of natural killer cytotoxic lymphocyte activity (NKCA) in patients with schizophrenia and juvenile depression in comparison with the healthy controls. In the culture of mononuclear cells, separated from schizophrenic patients’ peripheral blood (in vitro system), possibility of NKCA restoration by means of immuno- modulator Encad up to its level in healthy persons was established. Participation of monocytes in the stimulating effect of the drug was also revealed.The aim of the study was to investigate the influence of immunomodulator Encad in vitro system on the decreased NKCA level in patients with juvenile depression at early stages of the disease, and also to study the role of monocytes in Encad effects in these patients.Material and methods: venous blood samples of 24 males aged 17-23 with juvenile depression with attenuated psychotic symp- toms in their structure were examined. Their mental status was assesses on Hamilton Depression Rating Scale (HDRS) and The Scale of Prodromal Symptoms (SOPS). 15 mentally healthy persons of age and gender-matched were examined as controls. The level of NKCA-lymphocytes, separated from peripheral blood of the patients and healthy, was determined in cytotoxic test in Multisizer MS-4 (USA) multiunction counter and particle size analyzer, and evaluated in the form of cytotoxicity index in percentage terms (CI, %). The influence of immunomodulator of nuclear nature Encad on NKCA level and the participation of monocytes in effects of the drug on NKCA was investigated in vitro system.Results: NKCA level in blood samples, taken before and after treatment of patients, was significantly reduced in comparison with the control group ( p < 0,001) independent of the presence, or absence of monocytes in cells culture. The study of Encad effect on NKCA level showed that the drug increased the index value up to the control value ( p < 0,05) in its concentration of 10-5 mg/ml. At the same time the stimulating Encad effect on NKCA was only revealed in the presence of monocytes.Conclusions: the results confirm NK-limphocytes and monocytes participation in the pathogenetic component of the develop- ment of mental disorders. The Encad effect on NKCA may be of interest for further research of the efficacy of its use in combination with psychotropic medication.

The aim of the study was to compare statistical conclusions, based on confidence intervals (CI) and p-value by the example of assessment of efficacy of psychopharmacotherapy in two groups of schizophrenic patients according to the results of evaluation of PANSS indices in dynamics.Material and methods: а total of 46 patients with schizophrenia (27 subjects with shift-like course of the disease and 19 subjects with continuous type of paranoid schizophrenia), who were admitted to hospital in acute psychotic state, received amisulpride at the average dose of 765,5 mg/day. The evaluation of mental status was carried out every week using PANSS scale. As comparable indices of efficacy of treatment, change in the mean PANSS total score was used, which was calculated weekly each time of 9 visits. The hypothesis of statistical significance of differences in the use of Student’s t-test was checked by mathematical method, taking into account p-value and CI.Results and discussion: it was established, that during pharmacotherapy statistically significant differences of PANSS mean total score values between the two examined groups appeared since visit 6, on the 35th day of observation ( p ≤ 0,05). Since that very day 95% CI did not include zero value. This testifies to the fact, that mean values of the mean total score in the two studied groups in dynamics have statistically significant differences.Conclusions: the obtained results demonstrate consistency of statistical conclusions on the basis of p-values and 95% CI, which indicates appropriateness of adduction not only p-values, but first of all 95% CI in scientific publications.

The aim of the work is to analyze the literature data on the possible role of apoptosis activation in the pathogenesis of schizophrenia.Material and methods: the review of the literature is based on data on the mechanism of apoptosis development and its role in maintaining the constancy of the internal environment of the organism. The possible role of apoptosis in the development of pathological disorders in mental illness, in particular, in schizophrenia, has been explored. The effect of drug therapy used for the treatment of patients on the development of apoptosis and, as a consequence, on the patient’s condition was analyzed.Conclusion: analysis of literature data indicates the need to further elucidate the causes of activation-induced apoptosis and to investigate factors that may prevent the development of abnormal apoptosis.

The aim of the review was to evaluate the historical importance of nootropics introduction into psychiatric practice and their place in perfecting of pharmacotherapy of mental disorders.Method: systematic review.The contents of the review: pharmacological and clinical properties of the last generation nootropic drug Pantogam active (group name: D-, L-hopantenic acid, Active ingredient: rac-hopantenic acid) were discussed; the results of clinical studies of Pantogam active efficacy in complex prescription with antipsychotics in patients with psychotic forms of schizophrenia were analyzed in detail. Recommendations were considered for Pantogam active prescription with orientation at various aspects of its clinical effect, showing in mild activating action, improving neurons metabolism, in combination with mild anxiolytic, anticonvulsive, and neuroprotective effect, an ability to correct and to prevent the development of undesirable side effects of psychotropic psychotherapy (among them neuroleptic extrapyramidal symptoms).Conclusion: recommendations were substantiated for Pantogam active prescription as drug of choice for broad introduction into the practice of antipsychotic treatment of patients with schizophrenia, for rising its tolerance and improvement of quality of life of patients.

The notion of «nervous constitution» with transtypological mental signs of individual predisposition to mental disorders and considered byW. Griesinger separatedly the second type of predisposition to mental disorders with emotional «coldness» are analyzed. The doctrine of unitary illness process according to which the different forms of mental disorders are only its stages that was supported by W. Griesinger is discussed. Afterwards this doctrine was defined as «unitary psychosis».

The main stages of scientific and creative activity of professor R.A. Nadzharov, the famous Russian psychiatrist, a prominent scientist, corresponding member of the Russian Academy of Medical Sciences are given. His contribution to the development of scientific and practical psychiatry, to the teaching of schizophrenia is noted. It gives a brief description of his main publications, performed during the period of his work at the Department of Psychiatry of the Institute for Advanced Training of Physicians, at the Institute of Psychiatry, later in the Scientific Center for Mental Health of the Academy of Medical Sciences. An integrated approach to the study of the type of flow and the clinical characteristics of schizophrenia is emphasized, the interdisciplinary nature of the studies conducted on this issue, the results of which served as the basis for the domestic and international classification of diseases.