[Innovative technology for assessing the level of compliance of mentally ill people]. / Innovatsionnaya tekhnologiya otsenki priverzhennosti lecheniyu psikhicheski bol'nykh.

OBJECTIVE: To develop a technology for evaluating indicators of patient's compliance, taking into account clinical, socio-demographic, psychological characteristics of the patient and characteristics of the family environment, as well as factors of psychiatric care, based on appropriate compliance algorithms and models. MATERIAL AND METHODS: The study included 107 patients (44 men and 63 women) with diagnoses of schizophrenia, schizoaffective and schizotypal disorders that met the criteria of ICD-10, as well as 105 members of their families. A set of 12 clinical and psychological questionnaires and scales was used for data collection. Clinical, statistical (correlation and regression analysis), system analysis methods, and the analytic hierarchy process were used. RESULTS: A technology for converting rank data into numerical information has been developed. The authors provide models for assessing compliance for groups of patients, which were selected based on awareness of the disease, syndromic characteristics, gender. An algorithm for evaluating the weighted, averaged prognosis (in %) of the patient's compliance level in the corresponding groups was developed. Examples of calculations for evaluating the prognosis of patient's compliance are given. CONCLUSION: The developed models for assessing the level of patient's compliance and the identified characteristics of patients, family environment and factors of psychiatric care that are important for compliance make it possible to increase the effectiveness of therapy, justify the choice of personal strategies for psychosocial and psychoeducational interventions, reduce the risk of re-hospitalization, and increase the level of social adaptation and quality of life of patients and their families.

[Processing of rank data obtained within psychometric scales using analytic hierarchy process]. / Obrabotka poluchennykh pri ispol'zovanii psikhometricheskikh shkal rangovykh dannykh na osnove metoda analiza ierarkhii.

AIM: To analyze problems of evaluation of pathological conditions using rank scales, in particular, psychometric scales, and to format the results of processing of the initial rank information on the scale of relations based on analytic hierarchy process. MATERIAL AND METHODS: A set of Russian and foreign publications on the use and processing of data presented in different scales from categorical to scales of relations were analyzed. Statistical, ranking methods, analytic hierarchy process were used. RESULTS AND CONCLUSION: The authors present the simplest examples showing the inadmissibility of rank information interpretation as numerical information. The efficiency of algorithms for conversion of initial rank information into numerical (cardinal) information based on analytic hierarchy process is demonstrated. A cardinal approach to the processing of rank information opens up prospects for obtaining integrated assessments on different scales, which is of interest for clinical practice and research.

[Problems in assessment of the effectiveness of psychosocial rehabilitation and treatment: area of psychosocial interventions, tools and evaluation criteria]. / Problemy otsenki éffektivnosti psikhosotsial'noi reabilitatsii i lecheniia: oblast' vmeshatel'stv, instrumenty i kriterii otsenki.

The literature review addresses the problems arising in assessing the effectiveness of psychosocial rehabilitation, selection of evaluation criteria and methodical tools most often used for this purpose. It is shown that for an objective assessment of the results of rehabilitation it is necessary to take into account the hierarchical structure of both the problems of evaluation and the information to be processed. This information includes both quantitative indicators (age, duration of disease, frequency of hospitalizations, results of biological study) and non-numerical (rank) indicators (severity of psychopathological symptoms, characteristics of compliance, social behavior and patient's environment). The proposed approach to assessing the results of rehabilitation of mental patients involves the development of specific criteria for the effectiveness of rehabilitation based on a multidimensional, hierarchical consideration of mental pathology with the inclusion of clinical and psychopathological, socio-environmental and personal indicators of patients in setting goals and objectives of rehabilitation.

[Population models of mental health in the Russian population: assessment of an impact of living conditions and psychiatric care resources]. / Populiatsionnye modeli psikhicheskogo zdorov'ia naseleniia Rossii: otsenka vliianiia uslovii zhizni i resursov psikhiatricheskoi pomoshchi.

ОBJECTIVE: The development and use of population models of mental health in the Russian population to analyze the relationship between indicators of mental disorders, psychiatric care resources taking into account medical/demographic and socio-economic factors in the period of 1992-2015. MATERIAL AND METHODS: The sources of information were: 1) the data of the Russian medical statistics on the main indicators of mental health of the Russian population and psychiatric care resources; 2) government statistics on the demographic and socio-economic situation of the population of Russia during this period. The study used system data analysis, correlation and regression analyses. RESULTS AND CONCLUSION: Linear and nonlinear models with a high level of significance were obtained to assess the impact of socio-economic, health and demographic (population, life expectancy, migration, mortality) factors and resources of the service (primarily, manpower) on the dynamics of the main indicators (prevalence, incidence) of mental health of the population. In recent years, a decline in the prevalence and incidence of the Russian population is a consequence of the scarcity of mental health services, in particular, personnel resources.

[Scientific bases of the organization of psychiatric care: development of a conceptual framework of modern mental health services]. / Nauchnye osnovy organizatsii psikhiatricheskoi pomoshchi: razrabotka kontseptual'noi bazy sovremennoi psikhiatricheskoi sluzhby.

AIM: Analysis and development of conceptual models of mental health organization allowing to determine the perspective directions of its further development. MATERIAL AND METHODS: The work was based on the collection of scientific publications on the problems of psychiatric care organization as well as the results of own research carried out by the authors over the last 25 years. System analysis was used for the development and analysis of the major conceptual models of mental health care. RESULTS AND CONCLUSION: The system analysis of the major conceptual models of mental health care - from the matrix model to models of the DSM-5 and RDoC, was carried out. Priorities and main AIM: of the research were specified. It has been shown that the Analytic Hierarchy Process should be used, along with traditional methods, to solve the addressed problems.

[Modelling the dynamics of suicides in the population of the Russian Federation for the period 1992-2012].

OBJECTIVE: Evaluation of the dynamics of suicides depending on the changes in medical-demographic and socio-economic factors in the Russian population in the period 1992--2012. MATERIAL AND METHODS: The research material was the data of the official medical statistics on the groups of people with mental disorders, as well as the data on the socio-economic situation of the Russian population during this period. To assess the significance of the association between suicide and these factors, correlation and regression analysis was used. RESULTS: The regression model explained 95.9% of the variance in the suicide index by two indicators: 1) life expectancy and 2) morbidity of psychotic disorders for the population of Russia during this period. The interpretation of the integral indicators used in the model, and the dynamics of suicides in the Russian population according to socio-economic changes in the country in 1992--2012 are presented. CONCLUSION: The model can be used as a tool for operational forecasting and monitoring of suicidal patients by government agencies and medical and social services.

[Scientific bases of the organization of psychiatric care: the solution of practical problems in the framework of priority research]. / Nauchnye osnovy organizatsii psikhiatricheskoi pomoshchi: reshenie prakticheskikh zadach v ramkakh prioritetnykh issledovanii.

ОBJECTIVE: a system analysis and modeling for important areas of research of the organization of psychiatric services in Russia in the study mental health of the population, identification of factors affecting the formation of the contingent of persons with mental disorders, organizational and functional structure of mental health services and mental health care. MATERIAL AND METHODS: The authors analyzed scientific publications on the problems of psychiatric care organization as well as the results of own research over the last 25 years using system analysis. RESULTS AND CONCLUSION: The approach that allows a creation of a range of population models to monitor the status of mental health based on medical, demographic and social factors (more than 60 factors) of life was suggested. The basic models and approaches for the evaluation of activity of divisions of mental health services at the macro and micro-social levels, taking into account expert information and individual characteristics of patients and relatives, were demonstrated. To improve treatment quality, the models of identification of the factors, which positively or negatively influenced the commitment to psychopharmacotherapy of patients with schizophrenia and their families, were developed.

[Psychiatric hospital: past, present and prospects].

Academic, clinical, social, economic, organizational and other aspects of psychiatric hospitals are discussed in the main sections of the article: development and current state of medical care, prospect of inpatient care. Main measures for the improvement of the activity of psychiatric hospital, their interaction with outpatient organizations are presented. The necessity of improving the image of a psychiatric hospital is emphasized.

[Actual problems of inpatient psychiatric care in Russia].

A comparative evaluation of inpatient psychiatric care in Russia and some other countries is presented. A systematic analysis of the performance of psychiatric hospitals is conducted. The process of the deinstitutionalization in Russian psychiatry is highlighted. A range of problems hindering a reform of inpatient psychiatric service of the country is singled out.

[Mental health in the Russian Federation in 1992-2010].

At the population level, the quantitative assessment of the impact of social-economic and medical-demographic factors on the dynamics of main mental health indicators (prevalence, incidence, level of suicide, disability) in the population of the Russian Federation in 1992-2010 years is presented. Regression models relating the key indicators of mental health with the health-demographic and social-economic factors have been developed. The interpretation of the dynamics of mental health in Russia according to the social changes and living conditions in the country during 1992-2010 years is suggested. Models have good predictive performance, which allows their use as a tool for real-time monitoring and planning of health and social services.

[Effect of social-economic factors on mental health indices in the population of the Russian Federation in 1992-2008: epidemiological models].

Based on system, correlation and regression analyses of official medical and social/economic information over 1992-2008, we developed epidemiological models linking parameters of morbidity and incidence of mental disorders in the Russia Federation with main medical-demographic and social-economic factors. These models may be used for optimal planning of medical/social programs in the field of mental health protection, its operative monitoring and optimal planning of the structure and activity of the Russian system for psychiatric aid.

[Mental health of world's population: social and economic aspects (a literature review 2000-2010)].

The authors had analyzed current approaches and results of the evaluation of the economic burden of mental health in the world derived from foreign research in 2000-2010. Sources of information were publications of the WHO database and the WHO regional offices, the database of the National Library of Medicine U.S. "MedLine", archives of publications by leading foreign medical journals in the field of mental health. The burden of mental illnesses, especially depression and anxiety disorders, has been increasing in all regions of the world. It has been shown that obtaining reliable estimates of mental health in modern conditions is only possible on the basis of reliable epidemiological, clinical and social/economic data which requires the development and improvement of mental health services as well as relevant social, public and private entities.

[Mental health of the world population: epidemiological aspects (the analysis of foreign research results for 2000-2010)].

Modern approaches to studying prevalence of a mental pathology and the results received during 2000-2010 are analyzed according to a condition of mental health of the population of separate regions and countries of the world. Information sources were databases of the WHO, a database of the United States National Library of Medicine "PubMed", archives of publications of leading foreign medical magazines in the field of mental health. The growth of prevalence and incidence of mental illnesses, especially depressive and anxiety disorders, with the corresponding increasing burden of mental disorders worldwide is observed. To obtain reliable results, modern schemes of epidemiological studies should be realized with the account of social-cultural level of the population, adaptation of diagnostic tools, qualitative preparation and training of the personnel and with the precise use of statistical criteria and requirements to the selection and analysis of research information.

[The system-oriented model of psychosocial rehabilitation].

A model of psychosocial rehabilitation based on the system approach that allows taking into account both the patient-centered approach of the rehabilitation service, the development of its resource basis, the effectiveness of this care system in whole and its patterns as well has been worked out. In the framework of this model, the authors suggest to single out three basic stages of the psychosocial rehabilitation process: evaluation and planning, rehabilitation interventions per se, achievement of the result. In author's opinion, the most successful way for constructing a modern model of psychosocial rehabilitation is a method of hierarchic modeling which can reveal a complex chain of interactions between all participants of the rehabilitation process and factors involved in this process and at the same time specify the multi-level hierarchic character of these interactions and factors. An important advantage of this method is the possibility of obtaining as static as well dynamic evaluations of the rehabilitation service activity that may be used on the following levels: 1) patient; 2) his/her close environment; 3) macrosocial level. The obvious merits of the system-oriented model appear to be the possibility of application of its principles in the organization of specialized care for psychiatric patients on the local, regional and federal levels. The authors emphasize that hierarchic models have universal character and can be implemented in the elaboration of information-analytical systems aimed at solving the problems of monitoring and analysis of social-medical service activity in order to increase its effectiveness.

[Methodological bases for problem solution of monitoring and estimation of mental health services activity: national and international aspects]. / Metodologicheskie osnovy resheniia problem monitoringa i otsenki deiatel'nosti psikhiatricheskikh sluzhb: natsional'nyi i mezhdunarodnyi aspekty.

General principles and questions, concerning the problem of monitoring and evaluation of psychiatric service's work from the points of systemic and mathematic modeling, are considered. An analysis of the structure and parameters values of national psychiatric service is presented. Suggested, are recommendations on using this information and improvement as well its collection, processing and presentation of the results in the national and international aspects. Taking Russia as an example, a selective correlation analysis of the regional rows of the values of the indices for psychiatric service's work was conducted to reveal their informational excessiveness. It is shown that the sets of the indices existed and being elaborated for solution of the monitoring problem and estimation of psychiatric service's work are excessively informative and can not be used without an additional analysis in corresponding mathematic modeling. In the view of the condition of the discussing questions, a use of hierarchical modeling apparatus seems to be the most natural and adequate for the solution of the problems posited.