THE RECURRENT DEPRESSIVE DISORDERS IN THE VIEW OF THE GENEALOGICAL COMPONENT ESTIMATION.

The objective - of the research is to study the contribution of the genealogical constituent in the genesis of the formation of recurrent depressive disorders. A group of 108 patients with RDR who were in the main group and 46 persons without mental disorders who were in the comparison group were examined. To estimate the genealogical component, 297 relatives of the main group and 167 relatives of the comparison group were evaluated. The set of research methods included: clinical-psychopathological, clinical-genealogical and methods of statistical processing of the obtained data. A substantial accumulation of psychiatric disorders in the pedigrees of the patients with RDD was established, which indicates a significant role of hereditary factors in the occurrence of clinical forms of this pathology: the rate of relatives with mental disorders was statistically higher in the pedigrees of patients with RDR than in those in the comparison group (in the main group the rates of staying under observation by a psychiatrist and presence of depression in relatives exceeded 6-8 times, the rate of suicidal behavior 2.6-5.0 times, propensity to alcohol dependence 1.5-2.0 times (p < 0.05) similar rates in the comparison group. At estimation of gender aspects of hereditary burdening it has been established, that at increase of severity of DDR course the burdening of patients' family trees with mental disorders increased: the frequency of female relatives with depression (50.00 %) and male relatives with depression (20.00 %) and alcohol addiction (41.70 %) increased. The results indicate the need to consider heredity factors in the diagnosis, risk assessment of the severity of depression and its recurrence.

CLINICAL, GENEALOGICAL AND PATHOPSYCHOLOGICAL RISK MARKERS OF RECURRENT DEPRESSION.

The goal was to determine clinical and genealogical and pathophysiological markers of the risk recurrent depression development risk. Clinical and psychopathological, genealogical, psychometric (Montgomery-Asberg Depression Rating Scale - MADRS), "Psychological Autobiography" method (Burlachuk L.F., Korzhova E.Yu., 1998), methods of mathematical statistics. A survey of 108 patients with recurrent depression (ICD10, F33.0-33.2) compared with 46 individuals in the general population, found a high level of family burden of depression, at all degrees and levels of relatedness with recurrent depressive disorder in the patients' parentage. Thus, it is shown that the patients' percentage that has been placed on a psychiatric register (18%, CI: 14.5-22.1) was 15 times higher than in the comparison group (p <0.05), patients with depression (33%, CI: 28.5-37.8) - 7.3 times higher (p <0.05), suicide (7.9%, CI: 5.6-11.0) - in 4.2 times higher (p<0.05), cases of alcohol dependence (25.6%, CI: 21.6-30.2) - 1.8 times higher (p<0.05). According to the results of the statistical analysis, it has been determined that both hereditary and sociopsychological factors act as predictors of depression, which increase the probability of depression's developing risk or anti-risk. The most informative signs of the arising depression risk were: observation by a psychiatrist (DC=-5.78, MI=1.40), the presence of depression (DC=-8.69, MI=1.24), suicidal behavior (DC=-6.15), MI=0.18) and alcohol dependence (DC=-2.53, MI=0.14) in the probands' parentage, the presence of a high level in the subjective life negative events' perception path related to health (their or relatives) (DC=-2.83, MI=0.23) in patients. The data obtained indicate the following - the formation and development of depressive pathology due to the hereditary factors influence combined with patient's psychological state negative features (high level in the subjective perception of the life path negative health events (own or loved ones).

[PSYCHO-EDUCATIONAL PROGRAM IN PREVENTION OF MENTAL HEALTH OF INTERNALLY DISPLACED PERSONS].

The goal is to develop and evaluate the effectiveness of a psychoeducational program (PP) aimed at timely detection, prevention of the formation and prevention of chronicity of mental disorders in internally displaced persons (IDPs). 414 IDPs took part in the research. A complex of clinical-psychopathological, psychometric, psychodiagnostic and statistical methods were used. It was found that the group of IDPs is heterogeneous and includes 3 categories of persons: group I - IDPs without signs of mental disorders (conditionally healthy) (53,86%), group II - IDPs with individual symptoms of mental disorders (risk group) (20,05%) and group III - IDPs with established mental disorders (26,09%). The examined IDPs of the III group were found mental disorders, predominantly of the anxiety-depressive spectrum. Factors of psychic traumatization (FPT) were assessed in a dynamic aspect: retrospectively (during of staying in the anti-terrorist operation (ATO) zone), 12 and 24 months after leaving the ATO zone and during of examination. The dynamics of FPT and their significance in time and with regard to gender specificity were shown. In order to timely identify and prevent the formation of mental disorders in IDPs and increase their adaptive capabilities, it is proposed to use PP, which had a group structured work format. The results of its approbation were presented and it were proved that the using of PP could significantly increase the level of psychological adaptation of IDPs by reducing the level of mental stress, reactive anxiety and the severity of negative perception of the future and improving the quality of life.

Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries.

BACKGROUND: Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. METHODS: The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. RESULTS: We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. CONCLUSIONS: We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

[Depressive disorders in Parkinson's disease: clinical presentations, diagnosis, treatment].

An aim of the study was to investigate the psychopathological structure, pathopsychological mechanisms of the formation and predictors of depressive disorders in Parkinson's disease (PD), taking into consideration the form, stage, progression rate and severity of motor symptoms, and to develop a system of differential therapy. Along with general clinical and psychopathological examination, a complex of psychometric and psychodiagnostic methods was used. Three variants of depressive disorders were singled out: adaptation disorder (59 patients), prolonged depressive reaction; recurrent depressive disorder (36 patients), organic depressive disorder (89 patients). In total, 184 PD patients with depression disorders and 76 patients without depression were studied. History of disease, results of the clinical examination and changes in scores of psychometric and psychodiagnostic measurements as well as the results of differential pharmaco- and psychotherapy were considered for all variants.

[Interferon status in the treatment of neuroleptic-resistant patients with paranoid schizophrenia].

We studied 73 patients with paranoid schizophrenia with resistance to neuroleptics. All patients were divided into two groups - basic (37 patients) and comparison (36 patients). Both groups received traditional treatment. Patients of the basic group were treated with the combination of reamberin and cycloferon. Before treatment, significant alterations in the interferon status (IFS), which were characterized by the decrease of serum interferon (SIFN) activity and blood α- and γ-interferons (IFN) levels, were identified in both group. The positive effect of the drug combination on clinical symptoms and interferon status (the normalization of SIFN activity, increase in blood α- and γ-IFN levels) was found.

[Efficacy of the combination of cycloferon and reamberin in treatment of resistant patients with paranoid schizophrenia].

The 160 patients with paranoid schizophrenia (PSH) with neuroleptic therapeutic resistance (TR) was investigated. The 90 (basic group) patients got of modern detoxic and metabolically active preparation reamberin and immunotropic facilities cycloferon combination additionally to psychotropic preparations and 70 patients (comparison group) - only the generally accepted therapy. Positive influence of reamberin and cycloferon combination was set on clinical states at the patients of PSH such as disease remission, and endogenous toxicosis syndrome liquidation. Positive influence of this preparations combination was rationed on immunological indexes, characterizing composition and functional activity of cellular immunity.

[On the improvement of everyday life behavior of chronic schizophrenic patients; from the viewpoint of "play-like behavior"].

In this study, the author examined the behavioral patterns of chronic schizophrenic inpatients to follow the process of the amelioration of abulic symptoms such as loss of interest, poverty of thought, lack of sociality, and poor communication. In everyday life in the ward, abulic patients had difficulties in accomplishing not only the basic habitual acts such as getting up or going to bed regularly, exchanging greetings, cleaning teeth, bathing, and washing clothes, but also their assigned duties on the ward. Furthermore, they were unable to behave according to the rules for inpatients, express their emotions appropriately, or build normal interpersonal relationship. The author found that five inpatients achieved some spontaneous behaviors of their own choices in the process of improvement in the above-mentioned habitual acts. As these spontaneous behaviors proceeded through several phases, obvious improvements in their behavioral patterns in everyday life were also observed. The initial phase of transient spontaneous behavior was followed by the second phase of continual spontaneous behavior. Finally, in the interview sessions, the patients became to express pleasurable emotions and physical feelings when they performed their own acts of continual spontaneous behavior. This phenomenon seemed valuable in the therapeutic context because schizophrenic patients are considered seldom capable of having positive feelings toward their own experiences. Therefore, these pleasurable continual spontaneous behaviors may be called "play-like behavior", as confirmed by comparison with the properties of "play" as defined by Caillois. In considering schizophrenic autism, Minkowski described "activité autiste" as an intrinsic quality of the way of life in schizophrenic patients. The manifestation of such quality in spontaneous behaviors can be regarded as having two meanings; an aspect of pathological acting out and a sign of recovery to realistic behaviors. Therapists should consider both aspects when conducting therapies. Although the patients regained the habits and norms of everyday life during hospitalization, the rules involved in "play-like" behavior seemed to contradict some rules in the habitual acts or assigned duties in their daily lives because within "play-like" behavior, freedom predominates over rules. The rules in "play-like" behavior are acquired mostly by mimicking other people. These rules are not fixed laws with penalties but are changeable rules depending on the circumstances of the behavioral process. From this viewpoint, "play-like" behavior allows the patients to acquire practical rules and to understand the relative nature of the rules. Most of the "play-like" behaviors originate from the preferences of the individual patients, which may be something that they have already experienced, something that they have longed for, or something that gives them self-fulfillment. These qualities contribute to the acquisition of experiences that they find pleasurable. For the patients, recalling each "play-like" behavior in the interview sessions enables them to grasp the whole picture of their behaviors, to reinforce their attachment to these behaviors as their own experiences, and to promote the dynamic process between behavior and thought. In this sense, psychotherapy incorporating the aspect of "play-like" behavior seems to prepare the schizophrenic patients to improve their way of thinking. To nurture "play-like" behavior helps the chronic schizophrenic patients to recover will power, independence and sociality, and contributes to the improvement of clinical symptoms and of daily life activities.

[The role and place of central mediators and peptide bioregulators in the pathogenesis of emotional disorders in neurotic patients]. / Rol' i mesto tsentral'nykh mediatorov i peptidnykh bioreguliatorov v patogeneze émotsional'nykh narushenii u bol'nykh nevrozom.

The accumulated evidence on central mediators indicates that they may play an important part in the maintenance of emotional activity. Their significance is also great in the pathogenesis of affective disorders, including endogenous psychoses and borderline states. But further work in this area is needed relative to interrelation of the above mediators to a new class of bioregulators, viz peptide regulators. The results obtained suggest the existence of differentiated brain mechanisms of formation of emotional disturbances in different forms of neurosis that provide criteria for the diagnosis thereof and differential diagnosis and should be considered in conducting an adequate pathogenetically validated therapy.

[Efficacy and safety of intramuscular imipenem/cilastatin (IPM/CS) for complicated urinary tract infections].

An intramuscular preparation of imipenem/cilastatin (IPM/CS, 500 mg/500 mg) was administered to 59 patients with complicated urinary tract infections (UTI; cystitis and pyelonephritis) to evaluate its efficacy and safety. The obtained results are summarized as follows: In patients with cystitis, evaluations based on daily frequencies of administration were also performed. 1) According to the treating doctors, the drug showed an overall efficacy rate of 80% (45/56 patients). The efficacy rate was 89% in patients with cystitis treated by a u.i.d. regimen. Among patients treated by a b.i.d. regimen, the efficacy rate was 67% for cystitis cases and 84% for pyelonephritis cases. 2) When clinical efficacy was assessed according to the criteria for UTI drug efficacy evaluation, the drug was 'markedly effective' in 14 patients, 'effective' in 23, and ineffective in 11 patients, for an efficacy rate of 77% (37/48 patients). 3) The microbiological eradication rate was 88% (59/67 strains). The rate was 95% (20/21 strains) for Gram-positive bacteria and 85% (39/46 strains) for Gram-negative bacteria. The efficacy for Enterobacter faecalis and Pseudomonas aeruginosa was 100% and 73%, respectively. 4) As side effects, pain at the injection site was reported by one patient and abnormal laboratory test values were observed in 2 patients. All of these reactions were mild and resolved shortly after the completion of treatment. Based on these findings, it is concluded that this intramuscular preparation of IPM/CS is effective for treating complicated urinary tract infections.

[Study of Chlamydia trachomatis in chronic prostatitis].

To assess the pathogenetic role of Chlamydia trachomatis in non-bacterial prostatitis (NBP), aspiration biopsied specimens were examined for C. trachomatis by using in situ DNA hybridization and antibody titer to C. trachomatis was measured. An enzyme-linked immunosorbent assay (ELISA) for C. trachomatis specific IgA was employed using purified C. trachomatis type L2 EBs. The positive rates of IgA antibodies to C. trachomatis in serum, EPS and VB3 were 25.6%, 31.5% and 29.4%, respectively. They were significantly higher (p less than 0.05) in the control groups. A good correlation (0.78) of IgA antibody titer to C. trachomatis was found between EPS and VB3. In 9 husbands with positive antibodies to C. trachomatis, 5 wives showed positive serum antibodies. In the NBP patients with a high positive antibody titer, the decrease of titers was shown after treatment with drugs effective against C. trachomatis. Transrectal aspiration biopsies were performed on 7 patients with high positive IgA antibody titers to C. trachomatis, and 2 specimens showed hybrids in the cells by using in situ DNA hybridization. These findings indicate that C. trachomatis is a predominant pathogen for NBP.

[The characteristics of the emotional disorders in patients with neuroses]. / Osobennosti émotsional'nykh narushenii u bol'nykh nevrozami.

To study the structure of emotional disorders, 90 neurotic patients were examined. Analysis of the intensity and incidence of different emotions was made with the help of self-estimation cards. It has been established as a result that the structural basis of emotional disorders is formed by primary and secondary negative emotions. Different patterns of neuroses are characterized by specific structural features.

[A long-term therapeutic experience with Cernilton in chronic prostatitis].

Thirty-two patients with chronic prostatitis were given 6 tables of Cernilton daily for 12.6 weeks on the average. Improvement of subjective symptoms and objective findings was noted in 74.2% and 65.6% of the cases, respectively. The effective rate was 75.0%. No subjective symptoms or abnormal changes in laboratory data were observed in any case after Cernilton medication.

Seasonal changes of circadian pattern in human rectal temperature rhythm under semi-natural conditions.

A phase delay of the circadian rectal temperature rhythm existed in three human subjects leading normal lives under semi-natural conditions: the rectal temperature began to increase later in summer than in the other three seasons.