[Maintenance treatment of schizophrenia with paliperidone palmitate (xeplion): a naturalistic study].

The efficacy of injectable form of paliperidone palmitate was studied in a sample of 14 schizophrenic patients (6 men and 8 women, mean age 33.8 years). Paliperidone palmitate was used as maintenance therapy in patients with remission. Duration of the study was 8 weeks. The drug was administered in doses 150 mg in the first day, 100 mg in the 8th day and 75 mg after the 4th week. Twelve (85.7%) patients responded positively to the treatment. At the end of the study, the "improvement" on CGI scale was noted in 4 patients, "minimal improvement" in 5 patients and "no change" in 3 patients. There was a significant reduction on the PANSS negative subscale. Six patients had improvement in cognitive functions. Exacerbation of positive symptoms of schizophrenia was not found. It has been concluded that injectable form of paliperidone palmitate may be recommended for maintenance treatment of schizophrenia.

["Moral mysophobia" phenomenon in schizophrenia].

Mysophobia - fear of contamination is one of the most prevalent types of the obsessive-compulsive disorder (OCD). "Moral mysophobia" is a ritual of cleanliness and avoidant behavior due to unpleasant obsessive thoughts. The presence of "moral" component in this subtype of contamination fear is supposed to cause high level of treatment resistance. The study included 16 patients with "moral mysophobia". The psychopathological structure of the phenomenon was described. Delusional symptoms and mental automatisms were found to contribute to its development. The analysis of schizophrenia course suggested that the development of "moral mysophobia" in schizophrenia was based on prominent negative symptoms.

[Affective phases in dynamics of personality disorders (on a model of borderline personality disorder)]. / Affektivnye fazy v dinamike rasstroistv lichnosti (na modeli pogranichnogo rasstroistva lichnosti).

Affective phases developing in personality disorder (index-sample--98 patients) were compared to those in cyclothymia (85 patients--control group). A preference of phase dynamics in the group of abnormalities relating to ICD-10 item "Borderline personality disorder" was confirmed. In line with a concept considering personality disorders as clinical syndromes, patients of the index-group have personality disorders with the signs of psychopathological diathesis determined by vulnerability to affective disorders. Affective phases are interpreted not only as an expression of a specific type of personality disorders dynamics but as an emergence of affective pathology, which is alternative to endogenous one both by modus of constitutional predisposition and clinical parameters (egosyntonic moderating of the phase, domination of negative affectivity in its structure, amphitymic duality of pathologically altered affect).

[Obsessive-phobic disorder typology in schizophrenia]. / Tipologiia obsessivno-fobicheskikh rasstroistv pri shizofrenii.

The study aims at clinical characteristics of obsessive-phobic disorders (OPD) in schizophrenia with regard to their modification in main disease development and interaction with basic schizophrenia symptoms (positive and negative). Eighteen patients, mean age 28.2 years, were examined. An affinity degree of schizophrenia to OPD was found to be associated with endogenous progressive process. In slowly progressive schizophrenia, an affinity is selective, concerning to one of the obsessive phobic syndrome component (phobic component proper or avoidance behavior) and realizing in either positive, or negative manifestation of schizophrenia. Two obsessive-phobic syndrome types were determined: OPD of the 1st type--panic and generalized anxiety disorder (52 patients) are modified because of overlapping by chronic endogenous anxiety, obsessive-phobic symptoms being not represented in structure of negative changes (asthenia defect); in OPD of the 2nd type (agora and social phobias, 80 patients) an overlapping of psychopathological symptoms related to avoidance behavior and negative changes (psychopathic-like defect "verschroben" type) was found. Phobic syndrome component does not tend to psychopathological transformation and undergoes reverse changes. In typical cases of progressive schizophrenia has no affinity. But exclusion is--the OPD of the 3rd type (obsessive-compulsive disorders with a fear of external threat and massive defense rituals, 49 patients). In this case, total affinity to schizophrenia is realized in overlapping of both obsessive syndrome components with positive and negative manifestation of schizophrenia.

[Clinical effect and tolerance of paxil (paroxetine) in management of panic disorders]. / Klinicheskaia éffektivnost' i perenosimost' paksila (paroksetina) pri lechenii panicheskogo rasstroistva.

AIM: To determine clinical efficiency and tolerance of paxil (paroxetin) in the treatment of panic disorders. MATERIAL AND METHODS: An open, non-comparative 7 week study entered 60 patients (mean age 36.6 +/- 3.22 years) with panic disorders and agoraphobias with panic disorders. Paroxetin was given in a single daily dose 20-60 mg/day in the morning. The results were assessed by Hamilton and Sihan scales, scale of clinical impression, by reduction of panic attacks. RESULTS: In 72.2% of patients panic attacks ceased or occurred less frequently (by 50%). Anxiety relieved by 67 +/- 4.6%. The number of the responders was greater while the effect occurred faster in patients with panic disorders. The drug was well tolerated, side effects occurred in 43.3% of cases. They were mild or moderate. CONCLUSION: Paroxetin has a prominent anxiolytic and antiphobic action, is well tolerated and is effective in panic disorders and agoraphobia with panic disorders.

[The psychopharmacotherapy of anxious-depressive states (the interrelationship of the structure of the comorbidity to the choice of drug therapy)]. / Psikhofarmakoterapiia anksiozno-depressivnykh sostoianii (vzaimosviaz' struktury komorbidnosti s vyborom medikamentoznoi terapii).

The authors examined 65 inpatients aged 20-61 admitted to the clinic with obsessional-phobic and depressive conditions (comorbidity). According to DSM-III-R, the patients suffered from panic and major depressive disorders, dysthymia, atypical depression within schizoaffective disturbance. By the response of the patients to alprazolam (anxiolytic) and fluoketin (antidepressant) given by a special scheme, 3 types of comorbidity of obsessional-phobic and affective disturbances were recognized: 1) prevalent depression, 2) combination of dysthymia with marked obsessional-phobic disorders, 3) overcoming of obsessional-phobic and affective disorders. Type 1 and 2 patients benefited more from monotherapy with antidepressants or tranquilizers. Type 3 patients did well on combined chemotherapy with tranquilizers, antidepressants, neuroleptics.