[PUBLIC AWARENESS ABOUT INTELLECTUAL DISABILITY, ITS CAUSES AND EFFECTIVENESS OF INTERVENTIONS BY SPECIALISTS].

The purpose of the study is to analyze perception of the adult population about intellectual disability (ID), its causes and effectiveness of specialist interventions. MATERIAL AND METHODS: 1119 people were interviewed (men - 441, women - 678) aged 18 to 85 years (mean age - 34.3 ± 14.5 years). Urban residents - 851 people (76.1%), rural dwellers - 268 (23.9%). Each respondent was offered one vignette describing a sick child aged 8-10 with ID: typical, dyslalic, bradypsychic and dysphoric. Mathematical and statistical processing included descriptive statistics and calculation of the χ2 distribution. RESULTS: 49.1% of the respondents have correctly recognized ID in vignettes. Out of the incorrect answers, various psychological characteristics prevailed (25.3%) of the child; negative character traits with pessimistic assessments (23.2%); illness, including mental disorders (18.6%); defects in education and upbringing (15.6%). The respondents most often (38.5%) suggested assistance by psychologists, especially to patients with a bradypsychic variant of ID, a speech therapist - with a dyslalic one, teachers - with a typical one, psychiatrists - with a dysphoric one. 85.3% of the respondents expected improvement in the child's condition after the specialist intervention. The probable causes of ID included improper upbringing and disharmonious family relations, more often in case of a typical variant, hereditary burden and early childhood diseases - in dyslalic, alcohol consumption, poverty - in dysphoric, all of the above - in case of a bradypsychic variant. CONCLUSION: The study has identified an insufficient level of public awareness of ID, reflecting its delayed diagnosis in children, peculiarities of the "channels" for seeking assistance with excessively high expectations of the condition improvements.

[THE PREVALENCE OF SLEEPINESS IN THE POPULATION OF ONE OF THE REGIONS OF RUSSIA].

The aim of the study was to study excessive daytime sleepiness (EDS) among the residents of Chuvashia. 2161 residents of the republic were interviewed (men - 1007, women - 1154) aged 18 to 70 (average - 36.5 ± 13.8 years old). The Epworth Sleepiness Scale and NoSAS test were used to assess the risk of obstructive sleep apnea syndrome (OSAS). Mathematical and statistical processing included descriptive statistics, one-way analysis of variance and calculation χ2-distribution. EDS was detected in 846 people (39.2%), without any gender difference and their place of residence. The respondents with EDS were older and had a larger body mass index. With age, the number of individuals with EDS rate increased, reaching the maximum in the age group of 61-70 years. EDS was more often observed in respondents with diseases, sleep disturbances, regular alcohol consumption, smokers, as well as snoring, respiratory arrest in sleep, increased blood pressure and/or treatment for it, and tiredness during the day. The probability of OSAS by NoSAS was determined in 295 people (13.7%), in 21.4% of men and 6.9% of women; EDS was present in 45.4% of the respondents with OSAS. The spread of EDS in the population makes it possible to recommend doctors of various specialties to pay attention to this act as well as to the described risk factors in patients as highly probable grounds for qualifying OSAS, its targeted diagnosis and treatment, as well as comorbid pathology.

[Risk factors for obstructive sleep apnea in socio-demographic groups of the population of Chuvashia]. / Faktory riska sindroma obstruktivnogo apnoe sna v sotsial'no-demograficheskikh gruppakh naseleniya Chuvashii.

OBJECTIVE: To study risk factors (RF) of obstructive sleep apnea syndrome (OSAS) in the socio-demographic groups of the population of Chuvashia. MATERIALS AND METHODS: An anonymous survey included 2161 residents of Chuvashia (1007 men, 1154 women), aged from 18 to 70 years, average 36.5±13.8 years). Of all included people, 1547 (71.6%) lived in urban settlements, 614 (28.4%) in rural settlements. Exclusion criteria were those under the age of 18 and over 70. Body mass index (BMI) of more than 35 kg/m2, neck circumference of more than 43 cm for men or more than 37 cm for women, snoring, fatigue/drowsiness during the day, respiratory arrest in sleep and high blood pressure (BP) were considered as SOAS RF. The likelihood of OSAS was determined by the Lausanne NoSAS (Neck circumference, Obesity, Snoring, Age, Sex) test. RESULTS: RF OSAS were present in 63.4% of respondents. 2.4% of respondents had a BMI of more than 35 kg/m2, 162% had a large neck circumference. Snoring was detected in 24.4%, fatigue/drowsiness during the day in 42.2%, respiratory arrest in sleep in 8.1%, increased BP in 19.7%. In men, compared with women, the number of respondents with a high BMI, snoring, and respiratory failure in a dream was significantly larger; women with a large neck size and complaints of fatigue/drowsiness prevailed. The rural residents had more RF OSAS, including higher BMI, large neck circumference and snoring. The probability of OSAS according to the NoSAS score was 13.65%, including 21.35% of men and 6.93% of women, 11.38% of urban- and 19.38% of rural residents. Multivariate regression analysis showed that the OSAS prediction model included gender, age, BMI, the RF sum of four questions from the questionnaire, neck circumference and level of education with a probability of 99.99%. CONCLUSION: RF OSAS are widespread in the population of Chuvashia, which requires intensification of preventive measures to minimize them and the development of somnological service in the Republic.

[Sleep disorders as one of the indicators of postpartum depression]. / Rasstroistva sna kak odin iz pokazatelei poslerodovoi depressii.

Postpartum depression in ICD-10 refers to mild mental and behavioral disorders associated with physiological disorders of the postpartum period F53.0. Diagnosis is based on criteria, one of which is sleep disorders. The objective of the review is to characterize the postpartum sleep disorders and to reflect their predictor value in the development of postpartum depression. Presomnic, intrasomnic and postsomnic disorders with negative consequences for both the mother and her child were found in sleep disorders of women with postpartum depression. Depression with sleep disorders significantly affect the quality of life of the mother and infant. Sleep disorders are one of the predictors of postpartum depression. Improving of sleep quality is an effective way to prevent the effects of postpartum depression.

[A scientometric analysis of materials of 10 All-Russian conferences 'Modern problems of somnology' (1998-2016)]. / Naukometricheskii analiz materialov 10 vserossiiskikh konferentsii 'Aktual'nye voprosy somnologii' (1998-2016).

AIM: To analyze proceedings of the I-X Conferences 'Modern problems of somnology'. MATERIAL AND METHODS: The authors have analyzed 888 abstracts from the abstract books of the conferences held from 1998 to 2016 in Moscow and Saint-Petersburg. The territorial, sectoral and scientific indicators of the activity of participants as well as longitudinal research trends were analyzed. Mathematical and statistical data analysis was carried out using the methods of descriptive statistics (95% confidence intervals) and χ2 tests. RESULTS: On average, 300 researchers from 6 countries and 14 regions of Russia participated in each conference, most from higher education (19), research (16) and medical (12) institutions. The highest number of publications were related to clinical somnology and sleep medicine (50% to different neurological conditions), the numeral material was included in 83% and statistical analysis was performed in 32.5%. A trend towards more active participation of research and medical institutions from all the country and involvement of new regions was observed. The interest to the clinical subjects, including treatment choices in sleep disorders as well as organizing aspects of sleep medicine, has been increasing. The number of studies on different aspects of sleep apnea has increased significantly as well. CONCLUSION: The features of scientific and clinical activity in the field of somnology presented in the materials of conferences are stable in terms of the institutional and territorial representation. It complies to international trends of research and clinical development. This allows better planning of the structure and main issues of the further conferences.

[Association of sleep disorders with headache]. / Sviaz' rasstroistv sna s golovnoi bol'iu.

AIM: The aim of the present study was to investigate the connection of sleep disorders (SD) with a headache (HA) among the representative sample of population. MATERIAL AND METHODS: 1115 inhabitants of Chuvashia (491 men and 624 women) aged from 18 to 70 years old have been interviewed (middle age 38.7±13.9 years old); respondents under 18 and over 70 years old were not included into the research. There were 690 city residents, and 425 residents of the rural areas. The questionnaire approved earlier in the research of HA, and also the questions directed to identification of SD were used. One-way ANOVA, Chi-square test were used to compare variables of the groups. RESULTS: There were 718 (64.4%) respondents with SD and HA (the main group), 366 (23.8%) with HA without SD (comparative group), 16 (1.4%) with SD without HA, and 15 (1.3%) without SD and HA. The main group of the respondents authentically differed from other groups in older age, a larger number of women and villagers, presence of concomitant diseases in them. In the respondents with SD arose more often, pain had the combined (polymorphic) character, HA were more severe, localized in several areas of the head, but were of smaller duration. Among them there were more people with short sleep duration (<5 hours of night dream) and accepting sedative-hypnotic medications. HA without SD had a pricking character more often; the respondents more often slept in the afternoon, differed in higher level of education, and a rarer occurrence of cases of the increased arterial pressure. CONCLUSION: SD are often connected with HA, with their frequency, expressiveness and localization. Development of SD from HA are influenced by existence of concomitant diseases, age, gender and the place a residence. SD make the current of HA more severe.

[The quality of research publications in psychiatry]. / Kachestvo issledovatel'skikh publikatsii v psikhiatrii.

AIM: To evaluate the quality of research articles in psychiatry and addiction medicine published in 2015. MATERIAL AND METHODS: Five experts analyzed 51 research publications from 13 psychiatric and addiction medicine journals using a standardized questionnaire, which contains 4 general questions (type or results of the study) and 21 questions on the quality of the study. RESULTS: Only 2 articles (4%) met all criteria, 64% of the articles refer to the methodologically least demonstrative (uncontrolled/one-time, series of cases, non-randomized). The most vulnerable were the characteristics which were the most important for evidence: a description of the methods, statistical analysis, accounting for systematic errors and/or side effects, the distribution of patients by group. CONCLUSION: Research publications in psychiatry and addiction medicine have a low level of evidence.

[Psychotherapy in treatment and rehabilitation of patients with multiple sclerosis]. / Psikhoterapiia v lechenii i reabilitatsii bol'nykh rasseiannym sklerozom.

Presented is a review of the use of psychotherapy and psychological intervention methods in treatment and rehabilitation of patients with multiple sclerosis (MS). Main indications for psychotherapy in MS are anxiety and depression, asthenia, movement disorders, cognitive decline or sleep disturbances. The applied methods of psychotherapy refer to behavioral, cognitive, humanistic, combined or alternative approaches. Individual and group sessions are most frequently used forms of psychotherapy. Positive effects of psychotherapy in MS patients are confirmed by data of randomized studies and neuroimaging. Psychotherapy should be included into complex multidisciplinary programs of treatment and rehabilitation of MS patients.

[Awareness on sleep hygiene rules in Russian population]. / Osobennosti predstavlenii o pravilakh gigieny sna v rossiiskoi populyatsii.

AIM: To estimate public awareness on sleep hygiene in general Russian population. MATERIAL AND METHODS: A sample consisted of 398 people (173 men, 225 women), aged from 18 to 82 years (mean age - 36.3±13.2 years), who were interviewed with the Sleep Beliefs Scale (SBS). Sociodemographic variables (gender, age, residence, education), sleep habits and disorders were recorded as well. RESULTS AND CONCLUSION: The low public awareness on sleep hygiene rules was demonstrated. Mean number of correct answers out of 20 in SBS was 8.1±3.6. Most informed were women and more educated persons, worst results were demonstrated in smoking and habitual alcohol consuming respondents. The connection between disordered sleep and awareness on sleep hygiene rules was revealed.

[The alcohol effect on natural chronobiological rhythms of suicidal activity in patients supervised by addiction treatment specialists and psychiatrists]. / Vliyanie priema alkogolya na khronobiologicheskie ritmy suitsidal'noi aktivnosti u patsientov, nakhodivshikhsya pod nablyudeniem narkologa i psikhiatra.

AIM: To study the alcohol effect on chronological rhythms of suicidal activity in patients supervised by addiction treatment specialists and psychiatrists. MATERIAL AND METHODS: We have analyzed 1094 cases of suicides committed by men who lived in Cheboksary and Novocheboksarsk. The suicide committers were divided into two groups by presence or absence of blood and/or urine alcohol; each group was subdivided into three subgroups: a) mentally healthy suicide committers (MHSC), b) those who were under the supervision of the psychiatrist (PS), c) those who were supervised by addiction treatment specialists (ATS). Chronobiological rhythms were assessed using z-scores, frequency biological rhythms were evaluated with Kolmogorov-Smirnov's test with the Lilliefors correction and rank correlation. The trends of each chronobiological number were computed, the differences of obliquing angle of the trend were evaluated using 2×2 contingency tables (c2 with Mac-Namara's amendment). RESULTS: All suicide committers of the 1st group showed daily rising suicide trend, which had highs in the active wakefulness period. In the 2nd group, the trend did not change in MHSC and ATS, but in PS it significantly changed to descending with two peaks at 6-8:59 and 18-20:59. Upward weekly trend in PS in both groups was almost the same (in the 1st group the obliquing angle of the trend was 19° and in the 2nd group - 21°), the maximum was observed on Saturday and Sunday. In MHSC of the 1st group, the trend was moving downward, and in the 2nd group it was low. Both MHSC and ATS had the maximum on Monday. Annual trend in the 1st group in all samples was low. In the 2nd group, the trend remained low at MHSC and ATS and changed up in PS (16°) with the maximum in November-December. CONCLUSION: Chronobiological characteristics of deaths confirmed by peaks exceeding the average proportion of suicides from 1.5 to 2.5 times were noted in all groups of suicide committers. Alcohol intake significantly changed the suicidal chronobiological rhythm in PS.

[Parametabolism as Non-Specific Modifier of Supramolecular Interactions in Living Systems].

As it became known recently, in addition to the enzyme (enzymes and/or ribozymes) in living organisms occur a large number of ordinary chemical reactions without the participation of biological catalysts. These reactions are distinguished by low speed and, as a rule, the irreversibility. For example, along with diabetes mellitus, glycation and fructosilation of proteins are observed resulted in posttranslational modification with the low- or nonfunctioning protein formation which is poorly exposed to enzymatic proteolysis and therefore accumulates in the body. In addition, the known processes such as the nonenzymatic carbomoylation, pyridoxylation and thiamiation proteins. There is a reasonable basis to believe that alcoholic injury also realized through parametabolic secondary metabolites synthesis such as acetaldehyde. At the same time, the progress in supramolecular chemistry proves that in biological objects there is another large group ofparametabolic reactions caused by the formation of supramolecular complexes. Obviously, known parameterizes interactions can modify the formation of supramolecular complexes in living objects. These processes are of considerable interest for fundamental biology and fundamental and practical medicine, but they remain unexplored due to a lack of awareness of a wide range of researchers.

[The influence of alcohol consumption on the chronological patterns of sudden cardiac death].

The objective of the present study was the retrospective analysis of the materials collected by the Republican Bureau of Forensic Medical Expertise, Ministry of Health and Social Development of Chuvash Republic, during the period from 1997 till 2002 for the elucidation of the chronological patterns of sudden cardiac death (SCD) associated with alcohol consumption depending on the sex and age of the victims, days of the week and months of the year as well as weather conditions. It was shown that the peak of mortality among men and women taking no alcohol fell on Monday. It was highest in May and decreased by February. The alcohol consumption significantly changes the chronological patterns of mortality from cardiovascular pathology. It was highest among the women abusing alcohol in August and October. The study has demonstrated a weak negative correlation between the frequency of sudden cardiac death among non-consumers of alcohol and dew-point temperature among the persons having alcohol in blood.

[A clinical and psychological study of tobacco dependence in patients with alcoholism]. / Kliniko-psikhologicheskoe issledovanie tabachnoi zavisimosti u bol'nykh alkogolizmom.

AIM: To study the effect of sex- and age-related features, social aspects and progression of alcoholism on tobacco smoking (TS), tobacco dependence (TD) and alcohol dependence (AD) in the Chuvash Republic. MATERIAL AND METHODS: Authors questioned 769 inpatients with AD and then performed detailed examination and questioning of 390 patients. RESULTS AND CONCLUSION: 74.4% patients with AD (82.2% men and 41.6% women) were cigarette smokers. According to the Fagerström's test, 79.2% had Nicotine Dependence (ND), 80.3% smoked more than 10 cigarettes per day. ND was diagnosed much more often in men, TS in them was more intense in comparison with women. There were highly significant correlations between alcoholism progression and TS or TD. Patients with AD had more significant ND compared to total population. They started TS much earlier, more often didn't prefer a particular brand of cigarettes, smoked high pitch cigarettes. Rejuvenation of TS onset with the fast formation of ND and AD is noted.

[The comparative analysis of various amyloid models].

Considered natural and experimental amyloidosis models in the existing theories context and known amyloidogenesis mechanisms. Available clinical and experimental observations indicate that the opinion of a fatal incurable amyloidosis wrong. It is shown that there is a significant amount of experimental easily replicable amyloidosis models, which may be used for practicing the treatment methods of this pathology. We offer an amyloidosis models classification: natural (animal models with generic amyloidosis), cell clones, artificial (infectious, protein, etc.). Based on the analysis of amyloidosis existing models concluded--none of the accepted in the scientific the theories community for amyloid building does not combine or explains all known facts about the amyloidogenesis mechanisms. It is assumed that there is a proteins group, the beta-sheet structure, which are potentially capable of amyloid conformation building. It is assumed that beta-sheets of these proteins have similar amino acid composition. The condition for the amyloid building conformation is getting too much protein in sufficient quantities in an uncharacteristic place where the ionic strength of the tissue fluid is such that it promotes the amyloid building conformation. It is assumed that an unfortunate amount of ionic strength environment amyloid protein is provided by polysaccharides, tubulins proteins and ionized silicon.

[Recognition and awareness about stages of Alzheimer's disease]. / Raspoznavanie i osvedomlennost' naseleniia o stadiiakh bolezni Al'tsgeimera.

Objective. To estimate the level of recognition of Alzheimer disease (AD) and awareness about its causes, medical help and its efficacy in general population. Material and methods. Authors questioned 1043 Chuvashia residents (391 men and 652 women), aged from 18 to 81 years (mean age - 41.5±16.3 years ), using vignettes (a clinical "picture" of disease). A vignette describes the stages of AD (subclinical, mild, moderate and severe). Results. AD was determined correctly by 13.6% of respondents. Most difficulties were associated with definition of subclinical stage of disease (6.1% of correct answers). Good AD recognition depended on the level of education, including medical knowledge, age of respondents and previous experience with such cases. Visit to doctor was recommended by 83.1% (in most cases it was neurologist - 33%). The improvement of mental condition in illustrated cases was supposed by 60%, no improvement - 28.9%, deterioration - 1.7%, without answer - 9.4% of respondents. Conclusion. These data indicates the low level of mental health literacy in the general population, especially on preclinical stage of AD. That needs to be corrected by psychiatric education at a general level.

[Experience of teaching the questions of alcoholism to medical students].

The experience of teaching alcoholism to undergraduate students of a medical school at lectures and practical trainings on narcology (psychiatry), at the organization of independent, educational and research work is described. Aprioristic ideas of students of alcoholism and alcohol abuse are analyzed. Possibilities of use movies for narcology teaching are discussed. It is offered to strengthen intercathedral integration of teaching in higher education institution the questions of alcoholic intoxication and dependence, to direct educational process on development of bases of preservation and correction of health of future doctors and patients, to increase educational motivation of students by introduction of active methods of training (clinical games), educational multimedia modules and work intensification with patients.

[Correction of apathetic-abulic manifestations of schizophrenia with cholinotropic drugs]. / Korrektsiia apatoabulicheskikh proiavlenii protsessual'nogo defekta kholinotropnymi preparatami.

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.

[Neuropsychological study of the schizophrenic defect]. / Neiropsikhologicheskoe izuchenie shizofrenicheskogo defekta.

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.