PSYCHOPATHOLOGY, CLINICAL AND BIOLOGICAL PSYCHIATRY
The objective: of the study was to perform the comparative evaluation of three-year observation of cognitive dysfunction indices dynamics during conducting repeated courses of preventive treatment with choline alfoscerate (Cereton), which was assigned to first-degree relatives of patients with Alzheimer’s disease (AD). Materials and methods: first-degree relatives of patients with Alzheimer’s disease were included in the study. Changes in cognitive functioning indices were compared between the group, consisting of 30 relatives (9 subjects with mild cognitive impairment syndrome and 21 participants with signs of cognitive impairment), who had received three courses of 3-months therapy with choline alfoscerate (Cereton) at a daily dose of 1200 mg for three years, and the group, including 32 relatives, who had not received treatment with drugs. Methods. Clinical-psychological, psychometric, molecular-genetic, neurointrascopic, and statistical methods were used. Results: transition from mild cognitive impairment (MCI) syndrome was established in 28.7% of cases in therapeutic group. Significant reduction in cognitive dysfunction within the framework of MCI syndrome, as well as a decrease in cognitive dysfunction intensity were noticed in 66.7% of cases. Positive effect of treatment, assessed according to CGI (Clinical Global Impression scale) was established in 56.7% of relatives, included in the study. Statistically significant improvement of MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) indices, as well as indices of tests, differentially assessing various components of cognitive functioning, was achieved in therapeutic group, while in the group of relatives, who had not received drug treatment, significant worsening of cognitive functioning indices was revealed. Conclusion: the results of preventive course treatment with choline alfoscerate showed positive effect of the drug on the cognitive status of close relatives of patients with AD up to transition of the syndrome of mild cognitive impairment.
Background: negative mental disorders remain a poorly studied problem, especially at an early age. Violations can be considered in a wide range depending on the severity and different genesis. The treatment issues remain unclear. Purpose of work: To determine the phenomenology of negative disorders depending on the etiology and pathogenesis, to discuss the possibilities of therapy and prevention. Patients and methods: 900 clinically studied children of early and preschool age. Of these, 500 children (400 boys and 100 girls) were from the high-risk group for schizophrenia with clinical stigma disorders and a specific algorithm for psycho-speech development. 400 children didn’t have the risk of schizophrenia. 300 children (200 boys and 100 girls) made up a group with deprivation disorders and 100 children (60 boys and 40 girls) were with cerebral-organic disorders.
Results: The phenomenology of mental deficit disorders, revealed differences in the manifestation of emotions, in instinctive-volitional acts, cognitive development, social orientation in compared groups. The theoretical and practical approaches to the prevention and correction are analyzed. Conclusions: negative disorders can be detected from an early age and were observed in all patients analyzed. The etiological and pathogenetic mechanisms of negative phenomena determine the features of their clinical manifestations. The onset of negative abnormalities during early ontogenesis is largely explained by the difficulties in the treatment and prevention of these disorders.
Background: the number of elderly depressive patients hospitalized in city psychiatric hospital, essentially shortens during the last years and is limited by the most severe cases. However significant part of the moderate depressions indicates the necessity to study justification of this tendency. The goal of this study: to examine the indications for hospitalization in full day mental hospital of elderly patients suffering with moderate depression. Patientsl and methods: material of the study consists of two groups of patients who under inpatient care in geriatric departments of Mental Health Research Centre. The first group (152 patients, examined in 2015–2017), has been studied by clinical method, and the other (23 patients, simultaneously been in clinic in May 7 and 8 2019) has been interviewed using a specially developed questionnaire. The goal of both methods was to clarify the goals of hospitalization. Results: collation of the clinical and demographic characteristics of both examined groups demonstrated their real identity. It proves that both groups represent typical contingent of elderly patients suffering with depression and receiving inpatient care in Mental Health Research Centre clinic. Therefore, the results of the questioning of the second group may be considered typical for this contingent. There were revealed two main reasons of hospitalization: inefficiency of outpatient treatment and patients’ personal wish for the inpatient treatment. It is important to note, that according to literature data, considering personal patient’s wish increases the possibility for gaining remission. Conclusion: both insufficient effectiveness of outpatient care and wish to be treated in the hospital are indications for hospitalization of elderly patients suffering with moderate depression. Ignoring these indications may cause the raise of number of patients with treatment resistant depression.
The purpose of the study: a description of psychocorrectional options for the rehabilitation of patients with schizophrenic disorder. The article shows some private examples from clinical practice that are only part of the real theoretical and experimental studies. The tasks were to describe and discuss the conditions of the psychocorrectional approach in dasein-analysis and psychoanalysis, which would not exclude each other, but on the contrary would expand psychotherapeutic tools when dealing with people suffering from Schizophrenia. Patients and methods: in the course of psychotherapeutic work, complex group and individual psychocorrectional activities were carried out with persons suffering from schizophrenia on the basis of the Novosibirsk Psychiatric Hospital (GNPCB No.3). A set of methods was used: dasein-analytical, psychoanalytic, cognitive behavioral therapy.
The principles of Integrated Psychological Therapy (IPT) to identify the surviving cognitive resources and social skills of a schizophrenic patient were used as a binder (or structuring) approach. Results and сonclusions: during the psychocorrections, internal and external coordination conflicts were developed in patients with schizophrenia, who lived part of their personal experience. Attempts have been made to develop a pattern of behaviour that would create an acceptable social microclimate in the life of a schizophrenic patient while maintaining his individual values. Productive intrarapsiic activity was also stimulated, which would help to establish links with society.
SCIENTIFIC REVIEWS
Objective: to present a review of domestic and foreign modern studies highlighting the features of the pathogenesis of depressive disorders in late age. Material and method: using the keywords «depression», «late age», «pathogenesis», scientific articles were searched in the MEDLINE/PubMed databases for the period 2000–2020. Conclusion: Despite the large number of hypotheses regarding the pathogenesis of depression, they are not mutually exclusive, but rather complementary, which reflects the systemic multifactorial nature of depressive disorders, primarily late-age depression. However, many of these hypotheses are closely related. It is likely to suggest that late-life depression is a heterogeneous clinical syndrome with multiple etiologies of depressive disorders, and the involvement of various pathogenetic mechanisms. The study of the pathogenesis of depressive disorders in late life reveals important and promising areas for further research in order to develop personalized therapeutic approaches and identify predictors of therapeutic response. Selection of adequate psychopharmacotherapy in this age group is especially relevant in relation to often recurrent and therapy-resistant depressions, which are factors of unfavorable prognosis of the disease as a whole.
The aim of the review: to analyze up-to-date domestic and foreign literature dedicated to the problem of chronic depression in youth. Material and method: according to the keywords «juvenile depression», «chronic depression», «prolonged depression», «atypical depression», «dysthymia» papers were selected and analyzed from 2009 till 2019 in databases of MEDLINE/PubMed as well as relevant references in the literature of the analyzed papers. Conclusion: the results of the analysis of scientific publications, the records demonstrate high prevalence of chronic juvenile depression, which contributes to a pronounced decrease in labor and social functioning. Questions of features of psychopathological structure of depression were studied according the specificity of the course of the disorder and dynamic aspects. It is shown that such depressions are nosologically nonspecific and can appear in isolation or in combination with other psychopathological features, which cause difficulty in studying of the pathogenesis and prognosis of these states. The importance of timely and correct nosological assessment of chronic juvenile depression is highlighted.
The aim: to overview changes in diagnostic criteria for mental disorders in old adults in modern classifications. Material and methods: DSM-5 and publications describing process of development and empirical background and articles cited in them. Focus was made on facts and discussions concerning diagnostics of mental disorders in older adults. Results: the review highlights principles of development of DSM-5, main changes compared with previous classification (the most essential for depressive, anxiety and neurocognitive disorders) and also its consequences for diagnostics of psychic disorders in elderly patients. Conclusions: changes in modern classifications can facilitate studies of several psychopathological syndromes in the elderly, in particular catotonia, hoardierline disorders, separation anxiety, insomnias, neurocognitive disorders. However there are some problems of implication of some criteria in geriatric patients.
Background. In an increasingly complex information society, demands for cognitive functioning are growing steadily. In recent years, many strategies have been proposed to enhance brain function. Attempts to improve cognitive function in patients with brain disorders have become the focus of intensive research efforts. A recent emerging trend is the use of so-called cognitive enhancers by healthy individuals. The aim was to present and to discuss a wide spectrum of scientific research directions on the problem. Material and method. Using keywords «cognitive functions», «memory», «cognitive enhancers» in the databases (PubMed/Medline and others) it was selected scientific publications on the problem in past 5 years. Conclusions. The analysis of selected articles showed an actuality of this problem elaboration. The main focus is on pharmacological methods of influencing the cognitive functions of a healthy individual. Non-pharmacological interventions, such as cognitive remediation and noninvasive brain stimulation techniques, seem promising, but their role has not yet been properly explored.
INFORMATION
In September 2019, the 30th World Congress of the International Association of Suicide Prevention took place in Derry, Londonderry, Northern Ireland, UK. It was a very thought-provoking and engaging event. Here is the account of some of the keynote lectures and the symposia with references to the recent publications of the speakers on the presented reports.
ISSN 2618-6667 (Online)
