[Eating behavior in children with autism spectrum disorder]. / Narusheniya pishchevogo povedeniya u detei s rasstroistvami autisticheskogo spektra.

OBJECTIVE: To study atypical eating behavior (AEB) in various variants of autism spectrum disorder (ASD) to determine the prognosis and therapeutic tactics. MATERIAL AND METHODS: One hundred and eighty patients (110 girls, 70 boys), aged 2 to 5 years (mean age 4 years), with a diagnosis of «Childhood autism¼ (F84.02), «Atypical autism¼ (F84.1), «Asperger Syndrome¼ (F84.5) and the presence of AEB were examined. RESULTS: Three clinical variants of ASD accompanied by AEB were identified: catatonic-regressive (n=75, 41%), catatonic (n=81, 45%) and hyperdynamic (n=24, 13%). The most pronounced AEB were in the catatonic-regressive variant, and the least in the hyperdynamic variant of ASD. The severity of AEB is associated with the severity of cognitive dysontogenesis. CONCLUSION: The characteristics of AEB are associated with the leading clinical syndrome of ASD. The severity of catatonia and regression affects the depth of AEB, which leads to secondary somatic disorders. Specialists of various profiles should participate in medical work for successful rehabilitation and prevention of somatic complications.

[Models of clinical and social management of patients with autism spectrum disorders]. / Kliniko-sotsial'nye modeli vedeniya patsientov s rasstroistvami autisticheskogo spektra.

OBJECTIVE: To develop clinical and social models and management routes for patients with autism spectrum disorders (ASD). MATERIAL AND METHODS: A clinical follow-up study was performed for 254 patients, aged 4-17 years (average age 7.3 years), who represented the main forms of ASD. Psychopathological, clinical-follow-up, psychological and statistical methods were used. RESULTS AND CONCLUSION: Five management models for patients with different forms of ASD are described; differentiation of routes for interagency monitoring of patients is proposed. The effectiveness of the integrated use of drug and non-drug therapeutic approaches for the management of patients with ASD in the clinical-age aspect is shown. Timely diagnosis of ASD makes it possible to develop differentiated routes of patient management within the framework of interdepartmental interaction and achieve positive results in the clinical and age aspect.

[Clinical and psychological characteristics of children and adolescents with different forms of cognitive dysontogenesis in schizophrenia]. / Klinicheskaia i psikhologicheskaia kharakteristika detei i podrostkov s raznymi vidami kognitivnogo dizontogeneza pri shizofrenii.

AIM: To perform a clinical and psychological analysis of cognitive dysontogenesis in children and adolescents with schizophrenia spectrum disorders based on the diagnosis, age at onset and disease duration. MATERIAL AND METHODS: One hundred and sixty-eight children and adolescents, aged from 7 to 16 years, with schizophrenia were studied. The pilot assessment of the individual dynamics of cognitive development (21 patients) was made to establish the form of cognitive dysontogenesis (cognitive deficit). RESULTS AND CONCLUSION: Evaluation of harmony-disharmony and deficiency of basic cognitive processes in this patient population shows persistent disturbances of thinking, memory and attention which are more pronounced in severe forms of the disease and its early onset. Age-related differences are observed as well.

[Projective method in the investigation of perception of external dangers in adolescents with mental disorders]. / Proektivnyi metod v otsenke vospriyatiya opasnosti vneshnego mira podrostkami s psikhicheskoi patologiei.

AIM: To apply projective methods in the investigation of characteristics of external danger perception in adolescents with mental disorders and their healthy peers. MATERIAL AND METHODS: The clinical sample consisted of 42 inpatients (20 girls and 22 boys), aged 11-17 years, with schizophrenia spectrum disorders (ICD-10 items F20, F21, F25). The control group included 72 adolescents (50 girls, 22 boys), aged 11-17, pupils of secondary schools and colleges of Moscow and Moscow region, who had never been referred for psychiatric treatment. A complex of specially created projective methods for assessment of danger perception and psychometric methods for personality assessment scales were used. RESULTS AND CONCLUSION: Adolescents with mental disorders tend to increase the subjective danger level. In qualitative aspect, bizarre judgments about danger which reflect disease patterns, divergence between danger estimation and its interpretation, impulsivity of estimation and poor use of previous experience have been detected. Healthy adolescents perceive danger as a source of positive emotions, new experience and a reason for communication. Common traits in danger perception, including the distribution of results of danger situation selection and interpretations of uncertain hazards, in adolescents with mental disorders and their healthy peers were found. Several correlations between personality traits and subjective level of danger were identified.

[Current possibilities in pharmacotherapy of anxiety disorders in children and adolescents].

OBJECTIVE: To assess the efficacy and safety of children tenoten in the treatment of children and adolescents with anxiety disorders. MATERIAL AND METHODS: It was conducted a multicenter, double-blind, placebo-controlled trial of the drug tenoten children at a dose of 1 tablet 3 times a day for 12 weeks. The study included 98 patients (boys and girls from 5 to 15 years with a confirmed diagnosis of anxiety disorder), randomized into two groups: the first included 48 patients treated tenotenom children, in the second - 50 patients receiving placebo. RESULTS AND CONCLUSION: Tenoten children has a strong anti-anxiety effect both on the results of self-assessment of patients, and on the reports of parents. This anxiolytic activity of the drug manifested most significantly in children aged 5 to 7 years. In addition, in patients 8-15 years of treatment spent tenotenom children to regress the symptoms of anxiety disorders by anxiety subscales SCAS «Separation anxiety¼, «panic attacks and agoraphobia¼ and «social phobia¼. Throughout the course of treatment tenoten children have been no adverse events.

[A therapy of eating disorders in children and adolescents]. / Terapiia pri narushenii pishchevogo povedeniia u detei i podrostkov.

Eighty patients with anorexia nervosa, 66 girls and 14 boys, aged 6-16 years, illness duration 6-44 months, were examined and treated. Sixty-seven patients were follow-up studied during 3-10 years. In 30 cases, anorexia nervosa emerged in the frame of pathological course of the age crisis in children and adolescences with accentuated personality features; in 50 cases--as syndrome in the frame of schizotypal personality disorder. The treatment was realized stage-by-stage and included "nonspecific" therapy directed to ceasing of weight deficit and stopping the increase of cahexia; "specific" psychotropic therapy conducted with taking into account a nosologic affiliation of syndrome and combined with psychotherapy and family therapy. An implication of the complex therapy allowed to increase a patient's body mass and to reduce motivational, autonomic, emotionally-affective disorders. A combination of "nonspecific" and "specific" treatment stages with psychotherapy made it possible to form and reinforce a stable right style of eating behavior in patients with syndrome of anorexia nervosa that was supported by positive dynamics and favorable follow-up results.

[Typology of disordered eating behaviour (anorexia nervosa with bulimia and vomitomanic disturbances) in children and adolescents]. / Tipologiia narushenii pishchevogo povedeniia (nervnaia anoreksiia s bulimiei i vomitomanicheskimi rasstroistvami) u detei i podrostkov.

Eighty children (66 girls and 14 boys), aged 6-16 years, with syndrome of anorexia nervosa (AN) have been studied. Two nosologic groups: pathological age crisis of childhood and adolescence (F50.0-F50.2 in ICD-10)--30 patients and slow-progressive schizophrenia (schizotypical disorder, F21.3-F21.4)--50 patients are determined. The latter group was divided according to syndrome types: syndrome of AN (28 patients); AN syndrome with predominant bulimia (11 patients); AN syndrome with dominating bulimia and vomitomanic disturbances (11 patients). Syndrome structure was determined by the stages of the course, syntropy character with other psychopathological disorders and process of their reduction. Psychotic disorders in patients of the third type were most pronounced. In each group, statistically significant EEG features, comparing to control age-matched group, were revealed. The severer were psychopathological symptoms, the less was an amount of organized and the more--desynchronized "flat" EEG.