[Open randomized comparative twelve-week study of lithium and valproate in manic episode].

One hundred and twenty-five patients (49 men and 76 women, mean age 38,0+/-12,5 years) were randomized in two groups. One group (64 patients) was treated with valproate sodium and another group (61 patients) received lithium carbonate. Monotherapy was administered with the mean dose of valproate 20 mg/kg/day (serum valproate concentration between 70 and 125 ?g/ml) and the mean dose of lithium 800 mg/day (between 600 and 900 mg/day; serum lithium concentration 0,8-1,2 mmol/L) during 12 weeks. Clinical effectiveness was assessed using YMRS, CGI-BP and MADRS at 0, 5th, 10th, 21st , 84th days of treatment. The number of responders (50% reduction in YMRS scores) was 51,7% (30 patients) in lithium group and 56,7% (34 patients) in valproate group by the 21st day (p=0,59).The mean reduction in YMRS scores was 11,6 in patients treated with lithium and 12,3 in patients treated with valproate. By the 84th day (LOCF), the number of responders reached 85% (51 patients) in lithium group and 90,3% (56 patients) in valproate group (p=0,37). The mean reduction in YMRS scores was 19,4 in patients treated with lithium and 19,6 in patients treated with valproate. The average reduction in MADRS scores was -1,4 (p=0,08) and -2,2 (p=0,001) in lithium group; -1,6 (p=0,002) and -1,4 (p=0,019) in valproate group on the 21st and 84th days. Adverse effects were observed in 8 (13,1%) patients who received lithium and 3 patients (4,7%) who received valproate (p=0,12). The most common of them were tremor, nausea, dry mouth. There were no clinically significant abnormalities in laboratory values, vital functions and EEG. In conclusion, the results demonstrated equal therapeutic efficacy, tolerability and safety of valproate and lithium in the treatment of manic episodes in patients with bipolar disorder.

[Clinical and psychological criteria of early detection of hazardous effects of components of synthetic hydrocarbon fuel]. / Klinicheskie i psikhologicheskie kriterii rannego vyiavleniia vrednogo deistviia komponentov sinteticheskikh uglevodorodnykh topliv.

The article shows increasing degree of psychic disorders in workers exposed to highly toxic chemicals. The symptoms develop from mild emotional disturbances in apparently healthy individuals then through premorbid psychotic manifestations to complete psychiatric syndrome of chronic occupational poisoning. The authors necessitate early diagnosis of the chronic occupational poisoning.

[Psychophysiological changes in occupational diseases of chemical etiology]. / Psikhofiziologicheskie izmeneniia pri professional'nykh zabolevaniiakh khimicheskoi étiologii.

Use of various psychophysiologic methods enabled to specify psychic response of workers exposed to chemicals and chronic poisoning patients. Chronic poisonings with 1,1-dimethylhydrazine, hydrocarbons, Trichlorfon, mercury, nitroesters have specific traits, and the patients could be grouped by means of cluster analysis. Handy techniques evaluating attention and memory could be recommended for everyday practical needs.

[Characteristics of affect in chronic intoxication by non-symmetrical dimethylhydrazine, hydrocarbons and nitroglycols]. / Osobennosti émotsional'noi sfery pri khronicheskikh intoksikatsiiakh nesimmetrichnym dimetilgidrazinom, uglevodorodami i nitroglikoliami.

The authors analyze emotional features in workers with occupational exposure to hydrazines, hydrocarbons and nitroglycols. Chronic occupational poisoning with those chemicals induce numerous emotional symptoms that are specific and varying in severity. The materials presented by authors could be interesting for occupational therapist, internist and psychiatrist for early diagnosis of chronic occupational intoxications, treatment of emotional disorders in workers and better occupational safety.

[Reactive suicide attempts in children, adolescents and young adults]. / O reaktivno obuslovlennykh suitsidal'nykh popytkakh v detskom, podrostkovom i iunosheskom vozraste.

The paper is concerned with the study of 86 patients from 9--18 years who suffered from hysterical, affective-shock reactions and reactive depressions, accompanied by suicidal acts. Suicidal tendencies in these conditions appeared following acute psychic traumas. Their formation was facilitated by different unfavourable factors. As the children become older there is a complication not only of the clinical picture of the psychogenic disorder, but of the suicidal syndrome. The suicidal act in children proceeds impulsively, while in adolescency there is a presuicidal period. The stability of suicidal tendencies depends upon the depth of depressions; repeated suicides from the expressiveness of psychopathical personality traits and the existence of unsolved psychotraumatizing situations.

[Dynamics of mental disorders in poisoning with hypnotic and sedative preparations]. / Dinamika psikhicheskikh rasstroistv pri otravlenii snotvornymi i sedativnymi preparatami

In order to study some mental disorders due to poisoning by sleeping and sedative drugs 258 patients with mental and boderline conditions (who had taken these drugs in toxic doses) were studied in the Sklifosovskiy Moscow Research Institute of Emergency Medical Aid. The revealed mental disorders on different stages of poisoning were less differentiated in the acute period (clouded consciousness, coma) and most diverse in pre- and postcomatose stages, where they were characterized by disturbed consciousness, hallucinatory and delusional experiences, epileptiformal syndromes, emotional, motor and other disturbances. The symptomatology depended upon the type of medical drug, intensity of medical procedures, the mental or boderline disease itself which influences the clinical picture of every stage of the intoxication.

[Mental disorder in strangulation asphyxia]. / Psikhicheskie narusheniia pri stranguliatsionnoi asfiksii

In order to study the mental, neurological and EEG changes due to strangulative asphyxia, the authors studied 163 patients who attempted suicide by selfhanging. In the poststrangulative period there was changed consciousness, disorders of memory, emotions, as well as neurological symptoms which eventually had a reversible course. All these data were confirmed by EEG studies. The convened investigation demonstrated a high therapeutical effect of modern resuscitative measures which can be rendered to this contingent of patients.

[Suicide attempts in the involutional and aged periods]. / O suitsidal'nykh popytkakh v involiutsionnom i starcheskom periodakh

The authors studied 76 patients from 51-87 years who attempted to commit suicide. The main diagnostic categories were involutional, senile and reactive psychoses, alcoholism, and schizophrenia. The main syndromes during which such acts were attempted were anxious-depressive, depressive-hypochondriacal and depressive-delusional. The formation of suicidal tendency was precipitated by age involution, somatical disorders, psychogenic traumas. In most of the patients following the suicidal attempt, there were mental disorders, conditioned both by the main psychic disturbance and by the personality reaction to the suicidal act, due to which special psychiatric treatment was necessary.