[Peculiarities of clinical presentations of posttraumatic stress disorder and its treatment in different types of traumatic exposures].

The authors study the exposure to different extreme events on examples of two types of stress--combat stress and the liquidation of Chernobyl accident. Thirty combatants and 33 liquidators have been examined and treated. Peculiarities of the initial study of stress reactions and posttraumatic stress disorder (PTSD) due to its main diagnostic criteria have been analyzed in each group of subjects. The authors conclude that similar pathological states, including all symptoms of PTSD, develop in response to different stressful exposures. At the same time, there are significant phenomenological differences in syndromes that are determined by the character of stressful (traumatic) event. Issues of complex treatment of patients using psychotherapy and pharmacotherapy as well as approaches to rehabilitation and social support are discussed in details.

[Posttraumatic stress disorder in different types of stressful influences].

Two types of stressful influences--the participation in combat actions and the liquidation of the Chernobyl accident consequences have been compared. Thirty combatants and 33 liquidators were followed up 5-6 and 15-17 years after the extreme situation. Clinical presentations have been analyzed using main criteria of posttraumatic stress disorder (PTSD), i.e. immersion in the experiences, avoidance, hyperactivity and social functioning. Common and peculiar presentations depending on the stress character have been found. Patients received coaxil in dosage 37.5 mg daily during 4 weeks. In both groups, the drug exerted the highest effect on symptoms of immersion and hyperactivity that improved the social adaptation. Avoidance symptoms were more resistant. It has been concluded that coaxil is an effective medication for the treatment of different PTSD types.

[Therapy of affective disorders with tianeptine in patients with essential hypertension]. / Terapiia affektivnykh rasstroistv tianeptinom u bol'nykh s éssentsial'noi formoi gipertonicheskoi bolezni.

Tianeptine was given to 30 patients aged 39-54 years with essential hypertension and masked, preclinical (n=29) or clinically evident (n=1) depression. This was associated with improvement of clinical psychiatric parameters and data of standardized questionnaire in 29 patients, and with decrease in frequency of hypertensive crises.

[Dynamics of mental adaptation disorders in chronic stress among the population after the accident at the Chernobyl nuclear power plant]. / Dinamika psikhicheskoi dezadaptatsii v usloviiakh khronicheskogo stressa u zhitelei raionov, postradavshikh posle avarii na Chernobyl'skoi AES.

A study was made of the formation and dynamics of mental disadaptation in 300 persons living permanently for 4 years in a polluted area of Byelorussia after the Chernobyl accident. The high incidence of chronic somatic diseases was marked, forming the basis for the onset of multiple forms of mental disadaptation. 38% of the examined manifested the preclinical premorbid forms of disadaptation. Description of the structure of the forms of the abnormalities observed permits forecasting their further development and developing differentiated measures of therapy.

[Mental disadaptation in emergency situations (accident at the Chernobyl nuclear power station)]. / Sostoianie psikhicheskoi dezadaptatsii v ékstrema'lnykh usloviiakh (po materialam avarii na Chernoby'lskoi AES).

Phenomenology and time course of psychic disorders in persons exposed to life-threatening emergency situations provoked by the Chernobyl accident have been analyzed. Three states could be identified according to differences in their psychogenic impact: acute, delayed and long-term. Psychic dysadaptation and disorders might be presented as results of a single process beginning with acute anxiety responses followed by asthenic disorders which backed the relatively steady neurotic and psychopathic states.

[Analysis of the activities of psychoneurological dispensaries rendering the services to patients with borderline conditions]. / Analiz deiate'lnosti psikhonevrologicheskikh dispanserov po okazaniiu pomoshchi bo'lnym s pogranichnymi sostoianiiami.

As many as 1,851 disease histories of patients belonging to the group of mental disorders of non-psychotic level (code MKB-9 300-317) were analyzed within the framework of the organizational experiment with a purpose of reorganizing the dispensary assistance. The data obtained indicate that the diagnosis and the treatment recommendations are not based enough in all the cases, with social restricting measures dominating over social and protective ones. For such a group of patients, the dispensary follow up is not justified. That is why the available dispensary services require changes in the principles and concrete patterns of their functioning.

[Dispensary registration of patients with neuropsychiatric diseases and possible methods of reorganizing it]. / Dispensernyi uchet bol'nykh nervno-psikhicheskimi zabolevaniiami i puti ego vozmozhnoi reorganizatsii.

On the basis of a clinical-statistical study of the population of psychic patients registered in the psychoneurological out-patient centers, a conclusion is drawn about the necessity of introducing special measures for the differential registration of such patients. Various types of observation to be conducted by the out-patient center over patients with border-line psychic disturbances, epilepsy and oligophrenia as well as with chronic mental diseases are proposed. The necessity of creating a unified set of regulations concerning the proper observation over mental out-patients is substantiated.