[The suicidal activity and comorbid mental pathology in persons with gender dystrophia].

According to foreign publications, 58% of patients with gender disorders had additional psychiatric diagnosis, 39.3% had at least one suicide attempt. The data of suicidal activity and mental comorbidity in Russian population of transgenders are absent.Purpose of the study is to assess suicidal activity and mental comorbidity in persons with gender disorders.The retrospective analysis of records of patients applied with complains on gender disorders from January 2014 to April 2021 was applied. The demographic characteristics, life anamnesis, comorbid mental pathology at time of appliance, frequency of suicidal attempts, suicidal thoughts and auto-aggressive behavior were examined. The data of 926 patients with gender disorders were included: FtM 515 (55.7%), MtF 411 (44.3%). The median age of patients applied for care appliance was 24 years (13-65 years). In group of transgender patients 75.2% had no mental illness, except gender disorders. At that, there was high prevalence of comorbid mental pathology (24.8% on average). Usually, it was background mental illnesses and reversible mental disorders, which were not causes of gender disorders. The suicide rate in transgender group was 12.5%. For 1 patient with suicidal experience, there were 1.3 suicidal attempts (from 1 to 5). The significant dependence of increased suicidal activity, depression, auto-aggressive behavior and rate of comorbid mental pathology on age of debut of gender disorders was established. The transgender patients with debut of gender dysphoria in puberty age are most vulnerable to development of any mental pathology. The suicidal activity of patients with gender disorders depends on both social causes and presence of comorbid mental pathology. A number of modifiable risk factors for suicidal behavior were identified: support of relatives, external correspondence to associated gender, early steps to "change gender", earlier apply for medical care, background compensated mental illnesses.

[The problem of the use of hormonal therapy aimed for sex correction by transgender persons on their own initiative].

BACKGROUND: In recent years, the demand for feminizing and masculinizing hormone therapy has increased significantly among transgender people around the world. There are no such studies in Russia and the amount of medical information on the transgender population is limited. AIM: to assess the number of transgender patients who take hormone therapy without a doctor's prescription and to characterize the medicines they use. MATERIALS AND METHODS: data from 1117 transgender patients were included in to analysis: 44.01% (n=515) of them were trans women, 55.99% (n=630) were trans men. Patients applied to the "Scientific Center for Personalized Medicine" in order to receive medical care. RESULTS: Half of transgender people (53.6%) are already taking hormonal drugs. More often transgender women (76.7%), less often transgender men (32.3%). In this case, only 8.6% turned to endocrinologists for the therapy prescription. Many patients used unlicensed drugs, use irrational schemes and combinations, often overdose. CONCLUSION: A significant number of transgender people start using hormone replacement therapy on their own initiative, without the doctor's supervision. The solution to this problem could be incensement of knowledge level in doctors and patients to create a friendly environment and productive interaction between therapists, endocrinologists and transgender people, as well as the organization of consulting centers within public medical institutions.

[Dichotomous classification of autism spectrum disorders: syndromal and non-syndromal forms]. / Dikhotomicheskaia klassifikatsiia rasstroistv autisticheskogo spektra: sindromal'nye i nesindromal'nye formy.

In foreign literature on research into the etiopathogenesis of autism spectrum disorders (ASDs), the division of this group of diseases into two forms is getting more and more frequent. These two forms are 'syndromal' and 'non-syndromal' forms of autistic disorders. The literature review aims to cover the issues of the dichotomous classification of ASDs based on the genetic and molecular psychiatric views on the etiopathogenesis of this group of diseases. It also covers the purpose of this classification, the opportunities of its usage in routine clinical practice and the network resources, which allow classifying a form of ASD correctly. Special attention is paid to the multidisciplinary approach to dichotomous classification and its difference from the clinical view on the systematization of autism and the importance of this method for selection of target therapy.

[The efficacy of sulpiride in patients with anxiety disorders depending on the serum serotonin concentrations].

OBJECTIVE: The efficacy of sulpiride in patients with anxiety disorders depending on the serum serotonin concentrations was evaluated. MATERIAL AND METHODS: We examined 132 patients with anxiety disorders. The higher levels of serotonin were found in 81 (61.3%) of patients, normal levels in 24 (25.8%) and lower levels in 27 (20.5%). Sulpiride was used in doses from 50 to 400 mg. Average treatment duration was >90 days. RESULTS: The positive effect of sulpiride monotherapy was identified in patients with higher and normal levels of serotonin. No clinical effect of sulpiride was noted in patients with lower serotonin concentrations. CONCLUSION: The efficacy of sulpiride depends on serum concentrations of serotonin. It can be assumed that serotonin concentration is a marker of sulpiride treatment efficacy in patients with anxiety disorders.