The aim of work: to study psychosomatic disorders manifesting in connection with the circumstances of pulmonary hypertension (PH), to evaluate the impact of psychosomatic pathology on the features of the internal picture of the disease formation, the level of compliance, to determine the need for psychocorrectional measures.

Material and methods: there were 40 patients with PH of the 1st and 4th groups admitted consistently from September 2017 to September 2018 in the City Clinical Hospital №51 of the Moscow City Health Department. The following parameters were evaluated: frequency, spectrum and severity of diagnosed psychiatric disorders, their duration, personality disorders and types of response to the disease using experimental psychological methods. These parameters were compared with indicators of the severity of PH at the time of the psychiatric examination.

Results: from 40 patients in 30 (75%) were diagnosed with mental disorders in the framework of psychosomatic pathology. All patients were divided into 4 groups depending on the type of registered psychosomatic diso refers. Diagnosed psychosomatic pathology differs in the mechanisms of development duration, severity of mental disorders, depends on the severity of symptoms of PH. In each group, features of the internal picture of the disease and differences in the level of compliance depending on the type of psych о somatic pat ho logy we re revealed. In addition, in the considered groups,the need for psychopharmacotherapy and psychotherapy.

Conclusion: the presence of comorbid psychosomatic pathology in patients with PH significantly influences the formation of theinternal picture of the disease and the level of compliance, which emphasizes the importance of formation the multidisciplinary team of specialists, including psychiatrists and psychotherapists in the management of this patients group.

Background: mental health саге reform and reduction of beds capacity in Russia caused shortage of beds in psychiatric hospitals. However it is known about higher need in inpatient psychiatric care among elderly patients. In this regard it became necessary to study how mentioned reform affects inpatient care for such patients.

The goal of the research: to examine the use of a shrinking bed fund for psychiatric care in elderly mental health patients.

Material and methods: the material for the study was data from the reports of Moscow psychiatric hospital #13 about treated patients older than 60 in 2016-2017. Apart from this clinic-epidemiological research of 20% sample of inpatients has been conducted.

Results: it was stated that though bed fund has shrinked in 2017, numerical and age-sex composition of group of treated patients older than 60 did not differ from the analogical group of patients treated in 2016. It was demonstrated that this appeared to be possible due to reduction of length of stay in the hospital (for 10%in average) as well as reduction in patients' re-admissions (from 43.9% in 2016 to 35.4% in 2017). It also important to mention that in 1/3 cases hospitalization of elderly patients caused with social problems. The results of clinic-epidemiological study which confirmed clinical accuracy of reported data revealed that the proportion of elderly patients admitted due to affective disorders is dramatically small which does not corresponds known data about the grows of depression prevalence in old age. Apart from this there found a significant number of schizophrenia cases with notably late onset that again raises a question about specific age of onset for schizophrenia.

Conclusion: the results of the study indicate the necessity for continued research (including economical) in order to optimize activity of the city psychiatric hospitals

Background: as it's insufficiently explored, the syndrome of possession with religious content (SPRC) in schizophrenia appears to be quite difficult problem. Severity of states that could be observed within the framework of this syndrome requests very careful research due to existing social risk and resistance to psychopharmacotherapy.

The aim of the study: was to determine clinical-and-psychopathological features of the SPRC in schizophrenia to conduct psychopathological differentiation and apply specific diagnostic criteria and prognosis of the disease.

Patients and methods: 36 patients suffering from the SPRC in schizophrenia (F20.0, F20.01, F20.02 according to ICD-10) were examined. The research methods were used in the study: psychopathological, follow-up and psychometrical (according to PANSS), statistical (Student's test).

Results and conclusion: specific feature for SPRC is persistent delusional patient's conviction in the impact on him carried out by some immaterial "spiritual creature", which involves control under his/her mind and body, and leads to destruction of personality. The syndrome of possession with religious content (SPRC) is developing according to pattern of paranoid syndrome and it's accompanied with massive mental automatisms. The obtained data contains differentiated criteria of personalized diagnostics and prognostic approaches in schizophrenia proceeded with syndrome of possession with religious content.

Objective: clinical and psychopathologicaL differentiation of manic-paraphrenic states, the analysis of the relationship and mutual influence of manic affect and delusional disorders, the development of their typological classification, which is significant for improving diagnostics and prognosis.

Patient: the study included 78 female patients aged 18 to 55 years (mean age 33.6 years). In 56 cases the condition was qualified as manic-paraphrenic, in 22 as manic-delusional, without paraphrenic delusion and change in the self-consciousness. These conditions developed as part of the attacka of endogenous psychoses. All participants were in-patients of the FSBSI «Mental Health Research Centre» in 2016-2019.

Methods: the main investigation methods were clinical-psychopathological and follow-up study. Statistical processing was carried out using the program STATISTICA 10.0 for Windows OS.

Results: Based on the psychopathological analysis found heterogeneity of manic-paraphrenic states, which dealt both with the mechanisms of formation of delusion, and features of the manic actually affect the structure and describe the 2 types of manic-paraphrenic syndromes (MPs). In the first type of MPs noted the prevalence of mixed type formation of delusion on affective dominance in his picture of acute sensory delusion and, to a lesser extent, imaginative delusion. Manic affect was characterized by the dominance of ideational excitation. In the second type of MPs was observed exclusively non-affective formation of delusion dominated interpretative delusions and episodes of delusion of perception.

Mairritable mania. In patients with manic-delusional states dominated mostly affective mechanisms formation of delusion with a high proportion of imaginative delirium and much lower representation of delusions of perception in the presence of a typical manic triad.

Conclusions: the typology of manic-paraphrenic states, based on the characteristics actually manic affect and delusional disorders, their interrelationships, carries differentiated diagnostic and prognostic information important for optimization of therapeutic intervention.

Introduction: hemostasis is one of the most important protective systems of the organism, and its deviations from the norm can lead to fatal results. Changes in hemostasis are observed in many diseases, including mental pathology. In addition, parameters of this system may also change during antipsychotic therapy.

Objective: Development and testing of a new method and device for estimating plasma hemostasis parameters in patients with mental pathologies in order to optimize treatment and eliminate fatal outcomes.

Materials and methods: in the study we used frozen (-80 °C) platelet-free blood plasma (PFP) samples from patients with schizophrenia (16 patients), taken at admission to the clinic FSBSI «Mental Health Research Centre». Plasma coagulation of patients and healthy donors was assessed with the device of our design. Hemostasis assessment is based on the determination of the clot size in proportion to the brightness of the image, which changes as a result of clot formation and lysis.

Results: optimal concentrations of coagulation and fibrinolysis activators, as well as concentrations of calcium ions were determined during the first stage of testing the method and device. The median values of all parameters of coagulation and fibrinolysis except «time before the formation of a clot» in patients upon admission to the clinic were reduced relative with combined plasma donors. The rates of clot formation and lysis in patients are significantly reduced at discharge compared with these parameters at admission. Consequently, these parameters can serve as an estimate of the change in the state of the coagulation and fibrinolysis systems during treatment.

Conclusion: during approbation of the device and method in the process of coagulation and fibrinolysis research in patients with schizophrenia, lower levels of parameters were detected compared to donors, and a decrease in the activity of plasma coagulation and fibrinolysis during treatment with antipsychotics was shown.

Introduction: abnormalities of neuronal cytoskeleton in mental disorders require to study microtubules and their proteins. Tubulin (the main protein of microtubules) has specific properties: reversibly polymerize into microtubules and bind mitotic poison colchicine in equimolar quantities.

Objective: to evaluate the process of tubulin polymerization by light scattering change and to determine the level of colchicine binding (colchicine binding activity of tubulin) in various brain structures in healthy and schizophrenia brains.

Material and methods: autopsy brain samples from patients with schizophrenia (n = 6) and from the control group (n = 9) were studied. Samples of the prefrontal (area 10), temporal (area 21), cingulate cortex (area 23/24) and thalamus were isolated (Brodmann's areas). Measurements of light scattering during tubulin polymerization and colchicine-binding activity of tubulin were determined as described earlier.

Results: tubulin polymerization was not disturbed in schizophrenia as compared to controls, except for the cingulate cortex that showed slight but significant decrease in light scattering. At the same time, the binding of colchicine in schizophrenia was reduced in all examined areas of the cortex. This decrease was not associated with age, sex, and postmortem interval since the groups were matched by these factors. The tubulin colchicine-binding activity in thalamus remained at the same level both in control and schizophrenia, but it was lower than in the areas of the cortex.

Conclusion: Decreased activity and hence decreased amount of tubulin in the cerebral cortical areas without changes of the tubulin polymerization in microtubules have been shown in schizophrenia. The results confirm the literature data on the changes in the cytoskeleton in cortical areas in schizophrenia.

The aim: was to present the evolution of the views of Russian and foreign researchers on gender identity disorder, problems and controversial issues of its classification and, as such, attribution to mental disorders.

Material and method keywords «gender identity disorder», «gender dysphoria» were used to find the publications in MEDLINE/PubMed.

Results: this review highlights the following areas: (1) the prevalence and epidemiology of the problem at present; (2) the views of scientists throughout the entire period of studying the issue; (3) variants of classifications of gender identity disorder; (4) the current state of the problem; (5) current issues of pathogenesis.

Purpose: to present an analysis of scientific publications on psychosocial rehabilitation and psychosocial treatment with an emphasis on its targets, stages of implementation, effectiveness of the interventions and criteria of the effectiveness.

Material and method: a set of domestic and foreign publications on the problem of psychosocial rehabilitation and psychosocial treatment over the past two decades.

Results: the goals and stages of psychosocial rehabilitation are analyzed, the results of the evaluation of the effectiveness of different types of psychosocial treatment and comprehensive rehabilitation programs are presented. Analysis of scientific publications shows that the targets of pathogenetic psychosocial therapy and psychosocial rehabilitation of patients with schizophrenia are neurocognitive deficit, impaired social cognition, motivation, emotional sphere, social functioning, as well as negative symptoms, social and psychological vulnerability, family disadaptation. The use of specific psychosocial interventions, comprehensive rehabilitation programs and modules helps to reduce recurrence of the disease and the number of hospitalizations, reduce cognitive and socio-cognitive impairment, increase social competence, social functioning and quality of life that can transform into more adaptive social functioning in a community of schizophrenic patients.

Conclusion: psychosocial interventions with scientific evidence of effectiveness should be implemented in practical activities and are available to most patients with schizophrenia.

Aim of study: analyze recent publications, related to the incidence, clinical signs and treatment of antipsychotic-induced movement disorders.

Material and methods: articles published in the last 10 years were searched in Scopus, Pubmed and Cochrane Library using following keywords: neurological side-effects, dyskinesia, antipsychotics.

Results: current review summarizes the data on epidemiology, diagnosis, and treatment of neurological complications of antipsychotics were found. Provides information on risk factors and clinical features of parkinsonism, dystonia and tardive dyskinesia, as well as possible treatment options.

Conclusion: early differential diagnosis of neurological complications and taking into account risk factors will reduce frequency and increase compliance.

Objective: to provide an overview of domestic and foreign contemporary studies concerning the problem of old age depressions: their prevalence, clinical features, course and outcomes.

Material and methods: the keywords «depressive states», «late age» were used to search for scientific articles in the MEDLINE, PUBMED databases, as well as among other bibliographic sources.

Results and conclusions: the prevalence of depressive disorders at a later age is steadily increasing due to the general aging of the population. Discrepancies in ideas about the characteristics of psychopathological manifestations, main trends in the course and outcomes of depressive disorders at a later age persist. In recent years, the study of cognitive dysfunctions in the structure of depressive episodes and incomplete remissions in late age has been actualized due to the risk of the outcome of the disease in cognitive decline and dementia. The problem of the treatment of late depressions is still not fully developed, which is associated with an increased risk of developing adverse events, a slow development of a therapeutic response, a high recurrence rate and «incomplete» exits from depression.

Conclusion: the clinical and pathogenesis features of late depressions determine the need for further scientific development of personalized approaches to the treatment and prevention of relapse of depressive disorders in the current contingent of late age patients.