ABSTRACT
The authors describe the results of the treatment of 30 patients suffering from schizophrenia with the well-defined apatho-abulic manifestations. The patients received anticholin-esterase agents (galanthamine and deoxypeganin) combined with the M-cholinolytic drug benactyzine. The treatment lasted 3 to 4 weeks. Satisfactory compensation for the deficiency manifestations was attained in 18 patients (60%). The therapeutic dynamics appeared the best in patients with predominant anergic disorders accompanied by well-defined impoverishment of motor functions. The presence of roductive psychotic disorders in the syndromal structure noticeably decreased the treatment efficacy. The deranged capacity for behavioral initiation classified by the authors with the fundamental deficiency manifestations turned out most refractory to the treatment. The polymediator model of the schizophrenic defect is reviewed, according to which the deficiency manifestations represent adaptive stability states with emergence to a lower energy level. In such a case the neuronal populations with different mediator modality become deactivated. On the one hand, this gives rise to a decrease of psychotic productive disorders, on the other one, to the occurrence of the negative manifestations.
Subject(s)
Benactyzine/administration & dosage , Emotions/drug effects , Galantamine/administration & dosage , Schizophrenia/drug therapy , Schizophrenic Psychology , Adult , Aged , Drug Therapy, Combination , Female , Humans , Male , Middle AgedABSTRACT
As many as 30 patients (18 men and 12 women) aged 17 to 47 years were examined. Use was made of A. R. Luria's method. Deficiency of both activation components of the activity and higher form of regulation was recorded in all the cases. 3 variants of the neuropsychological syndrome were distinguished. The first variant was characterized by insufficiency of the function of the nonspecific brain systems, primarily of the medial formations of the frontal lobes. The second variant was marked by dyscoordination of the ++fronto-subcortical relations associated with the weakening of the functions of the primarily prefrontal convex formations of the frontal lobes. The third variant was determined by remarkable insufficiency of the convex formations of the frontal lobes and parietotemporal and occipital parts of the brain. A high correlation was discovered (r = +0.75) between the intensity of neuropsychological disorders and the magnitude of anergy. Comparison of the results with the computer-aided tomography (CT) data did not reveal any differences between the groups. However, in the third group patients, grosser changes on the CT were found. The same group manifested significant accumulation of pre-, peri-, and postnatal harm.
Subject(s)
Cerebral Cortex/physiopathology , Schizophrenia/diagnosis , Schizophrenic Psychology , Adolescent , Adult , Cerebral Cortex/diagnostic imaging , Female , Humans , Luria-Nebraska Neuropsychological Battery , Male , Middle Aged , Psychiatric Status Rating Scales , Schizophrenia/physiopathology , Tomography, X-Ray ComputedABSTRACT
The article presents the data on 57 schizophrenic and 26 neurotic patients investigated by computerized tomography (CT). Only 4 of the neurosis patients (15.4%) displayed minor CT changes. In 45 schizophrenic patients (78.9%) CT changes were detected varying in their markedness. Most frequent were enlargement of cortical sulci (39 patients). Brain ventricles were dilated in 18 patients, cistern, retropineal and retrosellar spaces dilated in 13. Deficit disorders prevailed clinically in patients whose CT scans showed distinct signs of cortical and subcortical atrophy. These patients also had signs of organic pathology accumulated in the early childhood anamnesis. The authors suggest that this was a factor increasing the brain system' susceptibility to destructive impact of endogenous events.
Subject(s)
Brain/diagnostic imaging , Neurotic Disorders/diagnostic imaging , Schizophrenia, Paranoid/diagnostic imaging , Adolescent , Adult , Atrophy , Brain/pathology , Dilatation, Pathologic/diagnostic imaging , Dilatation, Pathologic/pathology , Female , Humans , Male , Middle Aged , Neurotic Disorders/pathology , Schizophrenia, Paranoid/pathology , Tomography, X-Ray ComputedSubject(s)
Depressive Disorder/complications , Sleep Wake Disorders/complications , Adjustment Disorders/complications , Adrenergic Fibers/physiology , Brain/physiopathology , Cholinergic Fibers/physiology , Depersonalization/complications , Depressive Disorder/physiopathology , Depressive Disorder/therapy , Disorders of Excessive Somnolence/complications , Electroencephalography , Humans , Reaction Time/physiology , Sleep/physiology , Sleep Deprivation , Sleep Initiation and Maintenance Disorders/complications , Sleep Stages/physiology , Syndrome , Time FactorsABSTRACT
Forty-six patients with various forms of endogenous depression were treated by night sleep deprivation (NSD) which was used as the cardinal method of treatment. A single session of NSD induced a considerable clinical improvement lasting 2-3 days in the majority of patients. Repetition of the procedure (3-6 times with a 2-3 day interval) led to a significant and stable clinical improvement in 32 of the 46 patients. The highest effect of treatment was observed in such symptoms as depression and suicidal tendencies, whereas in patients with vital anxiety, the efficacy of NSD was considerably lower. Individuals with the duration of the phase under one month and the greatest reduction of the symptomatology after the recovery night showed the greatest response to the treatment. Favourable prognostic signs included such symptoms as psychomotor inhibition, lassitude and apathy, although the tempo of their reduction in the process of treatment considerably lagged behind improvement in the general mood, sleep and regress of autonomous disorders. Activation of the noradrenergic system is assumed to be one of the main mechanisms of NSD action.
