[Zharikov N.M. (The 100th anniversary of birth)]. / Nikolai Mikhailovich Zharikov. K 100-letiyu so dnya rozhdeniya.

Nikolai Mikhailovich Zharikov belongs to the galaxy of the best representatives of the Soviet and Russian psychiatric school of the 20th century, such as V.A. Gilyarovsky, E.A. Popov, O.V. Kerbikov, A.V. Snezhnevsky.

[Clinical efficacy of neurometabolic therapy of dissomical disorders in asthenic syndrome]. / Klinicheskaia éffektivnost' neirometabolicheskoi terapii dissomnicheskikh rasstroistv pri astenicheskom sindrome.

AIM: To analyze the efficacy of cytoflavin in the complex treatment of sleep disorders in asthenic syndrome. MATERIAL AND METHODS: One hundred patients with sleep disorders and asthenic syndrome of various etiology and severity were studied. The patients were divided into three groups depending on the type of therapy: the first group received intravenous infusions of cytoflavin for 10 days; the second group, in addition to cytoflavin, received per os melatonin (3 mg or 5 mg) at bedtime; the third group in addition to cytoflavin received per os zopiclone (7.5 mg) at bedtime. RESULTS: On the 14th day of the study, a decrease in severity or complete relief of asthenia manifestations (according to the SHAS scale) and, accordingly, improvement or normalization of sleep in 97% of patients was found. At the same time, during polysomnographic study, the data obtained are characteristic for improving the quality of sleep phases mainly in the first and second groups of patients and, to a lesser extent, in the third group. CONCLUSION: Cytoflavin effectively suppresses the main manifestations of asthenic syndrome, including sleep disorders.

[Depression and it's treatment in patients with schizoaffective disorder]. / Depressiia i ee lechenie u bol'nykh s shizoaffektivnym rasstroistvom.

AIM: To study the influence of depression on the quality of remission in patients with schizoaffective disorder (SAD) and develop recommendations for anti-relapse therapy. MATERIAL AND METHODS: Eighty-nine outpatients with the diagnosis of SAD were examined, in whom 348 remission cases were studied. In accordance with the characteristics of the episodes, the patients were divided into 2 main groups: patients with only depressive manifestations (group 1) and patients with affective disorders of both poles (group 2). Clinical-psychopathological, clinical-anamnestic, clinical-follow-up and statistical methods were used. RESULTS AND CONCLUSION: The type of SAD did not have a significant effect on the duration of remission and the duration of subsequent hospitalization. Patients of group 2 had residual symptoms in remission almost 2 times less often and the level of affective-delusional disorders in this group was higher compared to group 1. In both groups, affective symptoms are represented by subdepression. Patients without residual symptoms had a longer remission compared to patients with subdepression. Subdepressive disorders are associated with lower treatment adherence. Prescribing anti-relapse treatment of SAD, one should consider not only the current state and features of the last episode, but also the features of previous episodes. Patients with depressive episodes are characterized by subdepressive residual symptoms in remission. For patients with different variants of affective disorders in SAD, emotional disorders in remission are as specific as elements of affective-delusional disorders. Anti-relapse therapy should include neuroleptics and normothymics. In case of residual depressive symptoms, the authors recommend the addition of antidepressants.

[Comparative medical/social characteristics of psychiatric outpatients]. / Mediko-sotsial'naya kharakteristika vnebol'nichnogo kontingenta psikhicheski bol'nykh.

OBJECTIVE: to compare medical/social characteristics of psychiatric outpatients of rural and urban regions to optimize the activities of the regional mental health services. MATERIAL AND METHODS: Using an anonymous survey, 1042 psychiatric patients of the Orel Regional psychoneurological out-patient clinic have been examined. RESULTS AND CONCLUSION: Significant differences in the access to professional psychiatric and psychotherapeutic care between rural and urban populations of the region were shown. To overcome the imbalance, decentralization of psychiatric care and its approach to the patients are needed.

[The peculiarities of the support therapy and adherence to the treatment in psychiatric outpatients].

OBJECTIVE: To study peculiarities of the support therapy and factors hampering the compliance in psychiatric outpatients. MATERIAL AND METHODS: We questioned 1042 patients with mental diseases and 580 persons in their close social environment using the method of anonymous social questionnaire. RESULTS: The most of the respondents (78.2%) received "classic" psychotropic drugs, 21.8% - the drugs of new generations. One third of the patients (37.56%) did not take the prescribed medicine. The reasons for refusal were: polypragmasia (74.39%), poor drug tolerance (38.17%), the complex scheme of drug dosage regimen, the negative experience of the previous therapy (35.62%) and the lack of information about peculiarities of the disease (59.73%). CONCLUSION: Introduction of methods of psychosocial rehabilitation, in particular, psychoeducational and multiprofessional treatment programs, is required for psychiatric practice to improve the quality of outpatient care.

[Characteristics of the pharmacological pathomorphosis of remission in schizoaffective disorders].

OBJECTIVE: To study the effects of different types of psychopharmacotherapy on the changes in the duration and clinical symptoms of remissions in patients with schizoaffective disorders (SAD). MATERIAL AND METHODS: Authors have analyzed the therapeutic pathomorphosis of remissions in patients with SAD examined from 1980 to 2013. One hundred and there patients have been stratified into 3 groups: patients treated from 1980 to 1990 (group 1), from 1991 to 1999 (group 2) and from 2000 to 2013 (group 3). RESULTS: Main changes in the quality of remission were correlated with the reduction in the patients' commitment to anti-relapse therapy due to the reduction in the control over its timely receipt as well as decreasing of active surveillance of the mental health of patients. Social factors, together with biological factors (pharmacotherapy), are no less important to maintain the quality of remission providing not only the improvement of compliance in patients, but also increasing their social adaptation. CONCLUSION: Supporting therapy can be recommended for administration within a year after the first onset of SAD and within three years after repeated attacks. Long-term anti-relapse treatment is recommended to patients with residual symptoms or low compliance.

[The features of daily functioning of mentally ill patients: a sociological survey].

The data of a sociological survey of 1042 mentally ill patients are presented. The aim of the investigation was to study different aspects of daily functioning of patients with mental diseases. It has been shown that the negative consequences of mental disease are seen at every level (professional, family and social) of daily functioning.

[Diagnosis and treatment of metabolic syndrome combined with liver toxicity genesis in contract service officers].

In this paper is synthesized current and recent data on the problem of metabolic syndrome (MS) in combination with toxic liver injury (CCI). Statistical parameters of the last 15 years, the dynamics of alimentary-constitutional obesity (ABC) in patients from the officers contracted service of Defense Ministry of Russia are reflected. Two-year experience in the application of modern non-invasive methods of diagnosis of liver fibrosis with a reflection of its dynamics on the background of complex treatment of patients with MS in conjunction with the Chamber on the example of 57 patients is shown. Paid great attention to psychological and emotional adjustment of patients with ABC, given the complex survey design and treatment in violation of motivational and behavioral responses. High clinical efficiency of combination drug therapy of MS and CCI, the diagnostic value of modern non-invasive methods of diagnosis of hepatic fibrosis are reliably performed. Technique of elastography significantly improves the liver clinical evaluation of the effectiveness of the therapy, allows for early detect the presence of the initial degree of hepatic fibrosis, choose the optimal treatment regimen and to evaluate the results dynamically.

[Psychotherapeutic correction of affective disorders in women participating in the program of assisted reproductive technologies].

To study peculiarities of mental disorders in women during treatment of sterility using current reproductive technologies (extracorporeal fertilization), 512 women, mean age 33,6+3,7 years and sterility duration 3,1+/-2,2 years (from 1 to 5 years) have been examined. A number of attempts to treat sterility varied from 1 to 10. In 266 (52%) patients, borderline mental disorders have been found. Anxiety and depressive disorders made up 31,2%. A significant role of stress in their manifestation and a negative influence of mental disorders on treatment outcome and possibility of remission has been revealed. The use of cognitive-behavioral psychotherapy resulted in the decrease of expression of mental disorders and adequately prepared patients to the treatment thus improving its results.

[Morphology of the brain and heart in alcoholic psychoses]. / Morfologiia golovnogo mozga i serdtsa pri alkogol'nykh psikhozakh.

The authors studied the brain and heart of 40 patients (30 males and 10 females) who were hospitalized with the clinical diagnosis of alcoholic delirium, Gaye-Wernike's encephalopathy, and acute alcoholic intoxication due to chronic alcoholism. The morphological alterations in the brain and heart were as follows: compromised vascular permeability, dystrophic changes in the neurons and cardiomyocytes, proliferative reaction of microgliocytes and the development of small cardiosclerosis. Such disorders can be defined as an exacerbation of chronic alcoholic encephalopathy and cardiomyodystrophy. Alcoholic damage to the heart seems to be one of the additional factors that disrupt cerebral hemodynamics which results in hypoxia of the cerebral tissue and is accompanied by impairment of the central regulation of cardiac activity and progression of cerebral changes, i. e. the pathological process develops according to the vicious circle principle.