The aim of this review was to present the current state of the BPSD problem according to the data of scientific publications.Material and methods. Analysis of the published papers, devoted to BPSD investigation in Alzheimer’s and other types of dementia oflate age was carried out.Results. The investigators of dementias unanimously acknowledge, that BPSD are important component of the clinical picture in Alzheimer’s disease. BPSD also include such non-cognitive symptomslike aggression, motor anxiety, wandering, aimless activity, desinhibition of drives, apathy, affective impairments, delusions, as well as sleep and appetite disorders. It was shown, that one, or more of these symptoms were observed in 61-92% of patients with dementia, and their frequency grew as dementia progressed. It is admitted, that BPSD are theleading reason for stress and increased workload for caregivers, and increase the risk of institutionalization of the patient with dementia. In this review the authors presented BPSD pathogenic conceptions, which at present are far from their final development. Most probably is that BPSD appear as a result of a complex interaction among psychological, social, and biological factors.Conclusion. BPSD quick and complex estimation is necessary in diagnosing the dementia and planning of corresponding treatment, aimed at achieving the relief in patients and the members of their families.

In this review the significance of personalized medicine (PM) concepts in diagnostics and treatment of mental disorders was widely discussed in various contexts in publications of the researchers.The aim of this review was to present the primary modern instruments for psychopharmacotherapy individualization and to prove the importance of PM concepts application.Material and methods. System analysis of scientific publications, devoted to the present-day methods of psychopharmacotherapy personification, was carried out. The basic effective approaches, such as genotyping, biomarkerslevels determination, and therapeutic drug monitoring (TDM), were considered. Examples of genetic tests were given, which allowed optimizing treatment of mental disorders. The conception of biomarkers as diagnostic and therapeutic indicators for personalized medicine was considered. The review emphasized the necessity of development of data base (DB), including all patients’ parameters aggregated during TDM with following nonlinear mixed effects modeling (NLME) for prediction of individual therapeutic response. Other prospective directions of psychopharmacotherapy individualization were described briefly: proteomics, metabolomics, RNAomics, transcriptomics. Problems of deployment of personalized medicine`s and translational medicine (TM) principles to routine clinical practice was given consideration.Conclusion. The presented data on the efficacy of conceptual approaches to individualization of diagnostics and therapy of mental disorders substantiate the necessity of their introduction to psychiatric practice.

The problem of enduring negative disorders in schizophrenia and approaches to their conceptualization and methods of research attracts attention of researches in the field of psychiatry for many years. One of the ways oflooking at the study of primary enduring negative symptoms (PENS) and changes in their severity is presented in this paper.The aim of study was a conceptualization of PENS and their evolution in long-term observation of patients with shift-like schizophrenia.Materials and methods. On basis of criteria of deficit syndrome in schizophrenia five signs of PENS were formed: diminishing of emotional repertoire, poverty of speech, constriction of interests, diminishing of sense of aim and decreasing of social drive. On platform of CGI-S the system of assessment instruments of PENS was developed: CGI-S-emotional deficit, CGI-S-poverty of speech, CGI-S-restricted interests, CGI-S-diminishing of purposefulness, CGI-S-diminishing of social activity and general assessment of severity of PENS as a sum of them. In addition GAF, PSP, CGI-S-compliance and the scale of autonomy were administrated. For study of compensatory recourses the list of coping-activities, activities addressing to satisfaction of patients needs, attempts to cope with the feeling of impoverishment of inner world or/and general discomfort was developed. Sixty six patients of both sex with diagnosis of episodic schizophrenia without signs of treatment resistance were included into the study. The period of observation varied from one year to ten years, 61% of patients were observed for more than 4 years. All patients were assessed twice: at the beginning and at the end of observational period.Results. All patients of the group demonstrated the signs of PENS. Severity of all signs of PENS except «constriction of interest» reduced during the study. The reduction of severity was small but significant. Severity of PENS correlated with functional scales (GAF r = -0,71; PSP r = -0,70, scale of autonomy r = -0,84). Changes of severity of PENS waslinked with changes of functional scales ( r > 0,50). Reduction of severity of PENS accompanied with improvement of functioning and capability for independentliving. 68% patients demonstrated positive changes of PENS and 32%-none or negative. The groups differed at the end of the study ( p < 0,05) but not at the beginning. The difference was seen in the indices of compliance and number of coping-activities.Conclusion. PENS are the important feature of episodic schizophrenia. This psychopathological entity has close connection with functioning of patients. In spite of significant rigidity, there is some space for reduction in certain conditions including activation of compensatory mechanisms.

Hypotheses of research. The article discusses the possible negative impact of maternal depression on the emotional state of infants and young children.Material and methods. The results of clinical observation of 25 infants suffering from various depressive disorders, from mothers with depressive disorders of endogenous spectrum, and 20 children of the same age with non-endogenous emotional disorders. The severity of depression in mothers was compared by point scoring Zung Self-Rating Depression Scale and character of dyad mother-child interactions in both groups.Results and discussions. A two-year prospective study of dyads in the two groups showed that the rehabilitation and devel- opment of infants with depression was most favorable in a harmonious dyads. The child’s depression in symbiotic and indifferent dyads was more severe for children mental and speech delay and formed the dysontogenesis of deficitaire type.Conclusions. A deprivate influence of mother’s depressive state on the mental state of the child and a leading role of moth- er-child interaction in dyad was established.

Growth of mental disorders in Russia and abroad is observed, especially in children and adolescent, thatleads to the growth of child disability. Due to this fact, usefulness of early diagnostic of mental problems from the childhood is recognized. The article represents the experience of establishment of the new forms of early specialty care. Clinical and psychological checklist for parents aimed at detection of disorders of psychological development, risk of occurrence of autism spectrum disorders in early children (under 2 years), for screening in general population, is represented.

The aim of study was to investigate possibilites of therapeutical resistance prognosis on early stage treatment.Materials and methods. A total of 96 patients, who had been institutionalized in therapeutic department of Moscow Scientific Research Institute of psychiatry of Minzdrav of the Russian Federation from 1990 to 1999 in a state of acute psychotic disorder, were examined. The patients received psychopharmacotherapy with haloperidol and addition of sedative antipsychotic drugs.Results. 28 patients demonstrated cessation of psychopathological symptomatology and withdrawal from acute psychosis. In 26 observations a transition to continuous-progredient course was noticed. In 42 patients of the third group psychoemotional indifference, achieving the level of apathy, was revealed, as well as transition to protracted course of illness. The analysis of dynamics of correlation of delusional and affective disorders in reverse development of psychoses demonstrated that affect of anxiety and confusion determined favorable prognosis in a case of break of psychosis. Sensual delusion devoid of the above affective component testifies to possible protracted course of the attack, formation of apathetic depression and therapeutic resistance.Conclusion. Specificities of reverse dynamics of psychotic disorders and reduction of various components of acute endogenous psychosis have prognostic value and determine the conditions of therapeutic resistance formation.

Background. The relevance of developing differentiated therapeutic strategies in remission of recurrent depressive disorder is based on an underestimation of the problem. Since there is alot of studies devoted to depressive episodes treatment, treatment modalities in remission are underinvestigated and limited by general recommendations about stabilizing and anti-recurrence treatment.The objective of the study was a naturalistic analysis of the methods of differential therapy of remissions in recurrent depression, depending on their clinical typology (symptomatic/partial or syndromal/ complete ) and residual symptoms genesis including psychopharmacological strategies investigation (i.a. combination therapy) during a period of maximum possible duration.Material and Methods. The sample included 186 patients (130 women, 56 men; mean age 45,8 ± 15,3 years) who have had at least three episodes of recurrent depression, separated by remissionslasting atleast 6 months.Results. The basic strategies of maintenance treatment in routine clinical practice, differentiated strategies offered drug treatment depending on the typology of remission and psychopathological characteristics of residual symptoms have been established on the basis of retro- and prospective study data.

Background. The demographic phenomenon of «ageing» of the population resulted in the growth of late age dementias frequency, which brought about the development of new organizational forms of assistance for the patients with dementia.The aim of the study was to investigate the structure of the contingent of MHRC Alzheimer's Disease Center patients and to determine the parameters of the Center work efficacy.The materials of the study were demographic and medical data on the patients, who had consulted Alzheimer's Disease Center specialists from 2004 to 2013.Methods were used as follows: the clinical method, neuroimaging (CT/MRI), and psychometric method.Results. The number of initial consultations made up 2620 (68% females), average age of the patients was 70.4 years. As regards the diagnostic distribution, Alzheimer’s type dementias (65,3%) of various degrees of severity were the most frequent, in 42% cases the presence of psychopathological and behavioral symptoms was revealed. In 21% of patients with cognitive impairments the disorders came to nothing more than the syndrome of mild cognitive decline. Over the decade from 2004 to 2013 the data on the dynamics of medical aid appealability to Alzheimer's Disease Center were obtained. The growth of appealability on the whole was shown. The number of initial consultations increased twofold, the number of repeated consultations increased threefold. During the studied period significant growth of the part of patients with mild dementia (from 28.8% to 41.2%) and with the syndrome of mild cognitive decline (from 13,4% to 15,1%) was noticed, which demonstrated distinct tendency towards making a diagnosis at the initial stages of the disease.Conclusion. The complex of tasks and the total volume of the effective activity of Alzheimer’s Disease Center afford a basis for singling it out as an independent link of specialized outpatient gerontopsychiatric assistance for the patients with cognitive disorders and dementia.

Background and Objectives. The inferior parietal and the prefrontal cortex are an essential part of the heteromodal associative cortex involved in the pathophysiology of schizophrenia. Neuroimaging studies demonstrated that abnormalities in the parietal cortex in schizophrenia are associated with early onset of disease that coincides with a key time point in myelination. The deficits of oligodendrocytes have been reported in the prefrontal cortex in schizophrenia.Methods. The morphometric study of the numerical density of oligodendrocytes and oligodendrocyte clusters was performed in the inferior parietal cortex (layer 3 of Brodmann’s area 40) in the normal controls and in the schizophrenia subjects. The autopsy section collection from the Stanley Medical Research Institute (USA) and optical disector method were used for the study.Results. No significant group difference was found in the numerical density of oligodendrocytes. However, the numerical density of oligodendrocyte clusters was 30% lower in the schizophrenia group compared to the control group ( p < 0,01). A significant deficit in the numerical density of oligodendrocyte clusters (- 40%, p < 0,01) was revealed only in the subgroup with early onset of disease (9-18 y.о.) as compared to the controls.Conclusions. The data suggests that the deficit of oligodendrocyte clusters might be associated with altered proliferation and/ or maturation of oligodendrocyte progenitors in schizophrenia.

Background. Epilepsy is associated with the development of a wide range of mental disorders, requiring direct participation of the psychiatrist in their recognition, diagnostics, and therapy. Among all psychopathological disorders affective and anxiety disorders are the most important.The aim of the paper was to present clinical characteristics of depressive and anxiety disorders in epilepsy and to substantiate current psychopharmacology of these impairments. Based on the literature data and our own studies specificities of the affective symptomatology characteristic of epilepsy were demonstrated. Significance of cognitive impairments with impairments of executive functioning was emphasized. Comparison of clinical manifestations of depressive and anxiety disorders was carried out with localization and lateralization of epileptic focus, the leading arm factor, and the presence of alexithymia. The impact of pharmacological mechanisms of action of (GABA-ergic and antiglumatergic) antiepileptic drugs on affective disorders was discussed, as well as possibility of decrease in frequency of seizures and reduction of seizure disorders during treatment with antidepressants from SSRI group.Conclusion was made, emphasizing individualized approach to the choice of antiepileptic and antidepressive drugs for the treatment of patients with epilepsy with affective and anxiety disorders.

Modern consumers demand for tranquillisers includes safety, absence of side effects, behavioral toxicity and favorable influence on working efficiency.The aim of paper is to substantiate Mebicar compliance with the consumer’s demand, to range its pharmacotherapeutic effects and mechanisms of action. The article outlines effect of Mebicar on water structure explaining wide range of its therapeutic activity. Results. The possibility of drug administration by mentally healthy patients under intense working conditions as a day tranquilliser with the effects of adaptogens, nootropics, antidepressants, correctors, mood stabilizers, antioxidants and immunomodulators lackingside effects is justified.