Background: the requirements for a person at the present stage the acquisition of both academic knowledge and complex social skills in the process of growing up presuppose. Their development is impossible outside the framework of systematic training activities and mastering the function of self-control. Education of children and adolescents with mental disorders and the presence of mental disorders is an important interdisciplinary problem, including along with education (including psychoeducation), socialization, as well the quality of their functioning in society in adulthood as determining.
Purpose: to ascertain the modern tendencies in education of mental ill children and adolescents, their role in sociorehabilitative process.
Material: the data of a long standing observation, treatment and follow-up of more than 3,500 mental ill children and adolescents (male: female ratio of 2,5:1) registered in one of the Moscow psychoneurological dispensery were analyzed. 
Results and conclusion: the prevalence of outpatients with non-psychotic mental pathology was established with nosological distribution as follows: 35% — organic non-psychotic disorders, 25–30% — mental retardation, 20–25% — neurotic, affective disorders and personality pathology in total, 13–15% — schizophrenia and schizophrenic spectrum disorders. 18–20% had disablement. In the whole contingent only 1–3% proved to be completely uneducated. The majority of the patients preserved ability for learning to a certain extent but 35–40% of them could not manage in common school and were need of special conditions. The main factors associated with educational difficulties in adolescents were considered. The impact of psychoeducation and psychotherapeutic programmes were emphasized. 

The aim: was to analize the prevalence of clinical types of bipolar disorder (BD) according to bipolar spectrum concept in geriatric in-patients.
Study design: comparative study of the prevalence of different types of BD in aged patients with regard to the age of disease onset (before and after 60 years) in accordance with bipolar spectrum concept.
Methods: all the patients included to the study were examined by psychopathological, clinical and psychometrical method (Hamilton Depression Rating Scale — HAM–D, Hamilton Anxiety Rating Scale — HARS, Young Mania Rating Scale — YMRS, MiniMental State Examination — MMSE, Montreal Cognitive Assessment — MoCA and Bipolarity Index by G. Sachs). Statistical data processing was held by STATISTICA 10.0 for Windows OS. 

Results: according to bipolar spectrum concept the 1st type of BD occurred in 42,7% (n = 50) examined patients, the 2nd type — in 40,2% (n = 47), the 3rd type — in 8,5% (n = 10), the 4th type — in 3,4% (n = 4), the 5th type — in 1,7% (n = 2) and the 6th type — in 3,4% (n = 4). The 1st type of BD was more often presented in patients with disease onset in young and adult age (54,0%) and in men (45,5%). The 2nd type of BD was more common for patients with disease onset in involution period (56,0%) and with late-onset BD after 60 years (50,0%), also this type more often occurred in women (46,8%). The 3rd and the 4th types were presented rarely, although, like the 1st type of BD they occurred predominantly in patients with early-onset BD (9,2 and 3,9% consequently) and in men (10,9 and 5,5% consequently). The rarest type of BD was the 5th type. The 6th type of BD was presented only in a cohort of patients with late-onset of BD (25,0%) with the same frequency in men and women. Among approximately 1/3 of examined patients the disease had its onset in the second life half (after 50 years). New onset BD occuring in the involution period (50–59 years) was more common for women, late-onset BD at the age of 60 anf older — for men. The occurrence rate of mixed affecteive states and hypomanic states increases in case of BD onset during the involution period. For late-onset BD (age 60 and older) depressive episodes with signs of transitoral cognitive disfunction were more common.
Conclusion: every type of bipolar spectrum concept may occur in aged patients. New-onset BD in elderly has some special characteristics: during the involution period BD more ofter onsets in women, at the age of 60 and older — in men. Progressively as aging the frequency of new-onset BD with predominant depressive disturbances and cognitive performance disturbances increases. 

Background: due to the high risk of development of multiple somatic and mental comorbidities in elderly and senile inpatients, — search and development of resultative and cost-efficient  organizational forms of specialized medical care for this patient population takes on great importance in the context of healthcare reform.
The aim: was to investigate the characteristics of the patient population of psychosomatic geriatric unit in multi-specialty hospital as a background for development and adoption of organizational form model of hospital care.
Material and methods: material of the study was the data from healthcare records of 463 patients, admitted to geriatric psychosomatic unit in multi-specialty hospital. Obtained data were analyzed with the use of clinical epidemiological method and further statistical processing with the purpose of unification.
Results: during hospitalization period clinical signs of confusion were presented in 92,3% patients (427 patients) of all age groups. The incidence of confusion showed statistically significant association with patient age: patients aged 50–59 years presented confusion in 78,6% cases, patients aged 60–74 years — in 81,1% cases, patients aged 75 and older — in 96,5%. Correlation between age and average daily dosage of 4 medications: chlorprothixene, risperidone, «Phenazepam» and «Mexidol» was defined. Data integration revealing multiple somatic and mental comorbidities was held. 

Conclusion: patients of tertiallypsychosomanic geriatric unit is a unique patient population determined with old age and a combination of somatic and mental comorbid disorders, requiring multidisciplinary approach in delivering specialized health care. 

Background: the ageing of the world's population is accompanied by an increase in cases of age discrimination, abuse and violence. In Russia there is no monitoring of cases of abuse of elderly people. There has been an increase in crimes against the elderly related to fraud with their property, physical violence by children. We observe a growing number of property transactions committed under the influence of fraud, deceit. There is an increasing number of elderly, deprived of legal capacity.
The aim was to identify the determinants and forms of ill-treatment we examined 235 patients of a late age who underwent forensic psychiatric examination in the criminal and civil cases. The results revealed forms of abuse and violence: physical — bodily injury; psychological — involuntary placement in a psychiatric hospital and an examination by a psychiatrist, a psychiatric hold in the hospital, the unlawful deprivation of legal capacity; financial — fraud with housing for older people, manipulation at the conclusion of civil-legal acts. Risk of abuse increases the biological determinants — sensory and motor deprivation, multimorbidity pathology, specific disorders later in life, dementia; socio-psychological — the termination of labor activity, loneliness, conflicts with children and alcohol; legal — conclusion and contestation civil legal acts, legal illiteracy, legal controversy, the lack of legal protection.
Conclusions: to prevent abuse of the elderly a complex of legislative measures is required aimed at protection of their rights, monitoring of cases of abuse, legal, psychological, educational, medical education and assistance programs, enhancing the spiritual culture of the people. 

Introduction: the predicted increase in anthropogenic, technogenic, social, military, possible space disasters and emergencies attracts the attention of health organizers, doctors of specialists and especially psychologists and psychiatrists in connection with the need to provide assistance to the victims, as well as to develop principles, strategies and tactics, methods and means of providing timely psycho-psychiatric care.
The aim of the work: was to justify the need for the psychiatrist to prepare for work in emergency situations of catastrophes, natural disasters and terrorist acts.
Materials and methods: five qualifying works of a psychiatrist of the highest category are analyzed: 1997 (analysis of work for 1994–1996); 2002 (1999–2001); 2008 (2005–2007); 2013 (2010–2012) and 2018 (2015–2017) for the work of the Medical Service of Civil Defense (MSCD) and emergency situations as an integral part of the mandatory requirements for the execution of documents when they are submitted to the Attestation Commission for the assignment of qualification medical category in psychiatry. The depth of the study was 24 years. Methodical approaches were used: system, complex, dynamic, normative, quantitative and situational. Methods of analysis included: historical, analytical and comparison. Methods were used: groupings, continuous and selective observations.
Results: the work of a psychiatrist in the structure of MSCD and ES is analyzed from the standpoint of:
1. Personal participation in the development of educational and methodological and lecture materials for the preparation of the population for action in the context of civil defense and emergencies;
2. The actions of the doctor in the workplace in a medical institution with possible «everyday» emergencies;
3. Work in the medical-nursing brigade of the civil defense system;
4. Participation in the structure of psycho-psychiatric care for the population in emergencies.
Conclusions
1. In accordance with normative legal documents and official duties, a psychiatrist must provide psychiatric assistance to the population in emergency situations and know the organization and activities of the medical service of civil defense.
2. A psychiatrist for successful work should undergo special training in the basic modules of the Psychological and Psychiatric Service of the Emergency Situations: 1) The Department of Anonymous Psychological and Psychiatric Assistance by telephone; 2) an advisory visiting team of psycho-psychiatric care; 3) Department of psychological and psychiatric care; 4) Cabinet of psychological and psychiatric care.
3. Medical workers who survived emergencies should be treated as victims, who need comprehensive psycho-psychiatric care and careful corporate support, with a gradual return to normal occupational loads.
4. The contingent of professional rescuers under conditions of emergencies is exposed to the extreme factors of the current situation and is a risk group for the development of affective spectrum disorders. They may experience psycho-pathological disorders of exogenous organic origin with a tendency to gradually formulate variants of psycho-organic syndrome and polysystemic psychosomatic disorders.
5. The multifaceted work of a psychiatrist in the MSCD system and the emergency situation should be a weighty additional argument in favor of a positive decision on awarding the qualification category declared by him.

Aim: to study the features of subpopulation composition of peripheral blood monocytes in patients with Alzheimer's disease (AD) and with amnesic mild cognitive impairment syndrome (aMCI).
Material and methods: 20 AD patients aged 73.8 ± 6.8 years, and 10 patients with aMCI aged 61.8 ± 9.6 years enrolled in the study were examined. 16 mentally and somatically healthy age- and gender-matched persons were examined as controls. The peripheral venous blood of patients and controls was the material for the study. The relative number of monocytes was determined with the help of FC-500 Flow Суtofluorometer [Beckman Coulter, USA] using the same settings for all samples.
Results: the study revealed a significant decrease of the relative number of classical subpopulations (p < 0.01) and an increase of the proinflammatory monocytes level (p < 0.01) in the group of AD patients compared with the control group. The severity of changes of the monocytes subpopulation composition depended on the dementia severity. The sharpest change of the  monocytes composition compared to controls was typical for patients with moderate dementia (p < 0.001). An increase of the subpopulation level of proinflammatory monocytes was also revealed in patients with aMCI (p < 0.05).
Conclusion: the study results have revealed the redistribution of monocyte subpopulations in AD and aMCI patients: the decrease in the classical monocytes subpopulation on the background of the increase of the monocytes subpopulation with proinflammatory activity.

The aim of the work: to study the correlations between cellular immunity indicators: the cytotoxic activity of natural killer lymphocytes and the phagocytic activity of neutrophils and to investigate the possible relationship between changes in the immune response and the clinical state of patients with schizoaffective psychosis and affective disorders.
Material and methods: 49 patients with endogenous psychosis — 23 men diagnosed with ICD-10: F25 (schizoaffective psychosis — ShAP) and 26 patients (18 men and 8 women) with affective disorders (AD) (bipolar affective disorder — F32.2, F32.3 and recurrent depressive disorder — F33.2 и F33.3) — were examined before treatment. The age of patients with ShAP and AD, enrolled in the study, was 28.6 ± 1.6 and 25.9 ± 1.5 years, respectively. 40 mentally healthy (33 men and 7 women) ageand gender-matched persons were examined as controls. Clinical assessment of the patients was performed using subscales of positive and negative disorders on the PANSS scale. The level of the cytotoxic activity of natural killer lymphocytes (NKCA) and the phagocytic activity (PA) of neutrophils isolated from the peripheral blood of patients and controls were determined in vitro using standard tests: NKCA was evaluated in a cytotoxic test; PA of neutrophils was determined according to the proportion of phagocytic cells (phagocytic index), phagocytic number and the opsonic index of absorption. The correlations between the studied indicators were investigated using parametric methods of statistics. 
Results: the values of the studied immunological parameters in the groups of patients with ShAP and AD, did not differ from the values of controls, except for opsonic index level, which was significantly reduced in all patients with ShAP compared with the control group (p < 0.01) and patients with AD (p < 0.01). The positive and negative symptoms severity was significantly increased in patients with ShAP compared with AD patients (p < 0.01). For a more detailed analysis of the studied parameters, all patients with ShAP and AD were divided by the median into equal subgroups with the level of NKCA below and above its values. A negative correlation between the level of NKCA and the value of opsonic index, as well as positive  correlations between the values of phagocytic and opsonic index and between the value of phagocytic number and the level of positive disorders were revealed in an analysis of the ShAP subgroups. Similar analysis of the subgroups of patients with AD, who had a less pronounced psychopathological disorders compared with ShAP patients, revealed only one negative correlation between the values of phagocytic index and phagocytic number. All identified correlations between the indicators were confirmed with a high degree of significance by Fisher's two-tailed exact test. 

Conclusion: based on the results obtained, it can be assumed that the number of identified correlations between the studied clinical and immunological parameters in patients with ShAP and AD indicates the degree of violation and the level of adaptation of innate cellular immunity functions associated with different severity of  psychopathological disorders in these patients. 

The aim of the work: is to analyze the prospects of the study of «social cognition» for solving diagnostic questions of geriatric psychiatry.
Materials and methods: combining the key words «social cognition», «theory of mind» and «neurodegenerative diseases», «mild cognitive impairment», etc., in PubMed, ScienceDirect, PsycARTICLES databases, there were chosen and analyzed publications of the last decade in form of reviews, meta-analyzes and longitudinal studies.
Results: today the evaluation of social cognition has been included as a necessary requirement in the diagnosis of «Dementia», «Neurocognitive Disorder» or «Mild Cognitive Decline» in the modern diagnostic manuals (DSM-V and the preliminary version of ICD-11). In foreign psychiatry and clinical psychology, the study of social cognition in the elderly has become a new research
trend of the last decade. In the first part of the article, the  conceptual basis and methods of this research area are considered.
Conclusion: the most common conceptual basis for studying social cognition in the elderly patients is the concept of the «theory of mind». Today the brain correlates of the theory of mind have been identified, a stable set of psychodiagnostic methods for its evaluation with validated indicators of validity and reliability has been formed.

Summary: Chronic fatigue is a persistent state of extreme weakness, exhaustion, loss of strength (physical and/or mental), which occurs spontaneously or as a result of a previous activity and makes it impossible to perform a new activity. Chronic fatigue syndrome – a condition with an unclearly defined status, the main manifestation of which is rapid fatigue, persisting for at least several months, which cannot be explained by another disease or syndrome within a specific disease, current physical exertion. It is often referred to somatoform disorders due to psychopathological symptoms. However, the pathogenesis of this syndrome is largely determined by immunopathological, neurotransmitter, neuroendocrine mechanisms, which are involved in varying degrees in the primary and secondary forms of the syndrome. Treatment continues to be primarily empirical and includes methods of cognitive behavioral therapy, measured physical activity, normalization of sleep, the use of antidepressants, anxiolytics, and neurometabolic agents. 

Summary: A charitable institution first established the Christian Church in the early fourth century in the Roman Empire, they are inextricably linked with the historical development. The psychiatric Department at Simferopol charitable institutions, which was opened in 1807, is among the first houses of the insane in Russia. Psychiatric unit in Simferopol, God-pleasing establishments start successfully development 77 years after its launch. This was facilitated by the construction of a modern psychiatric building under the project of Professor A.W. Frese, due to productive work of psychiatrists, doctors of medicine B.S. Freedenberg and J.A. Bodkin. Their scientific researches are presented. In 1916 this psychiatric Department was reorganized into a psychiatric hospital.