[A role of traumatic brain injury in the dynamics of combat posttraumatic stress disorder].

OBJECTIVES: To explore dynamics of clinical signs of posttraumatic stress disorder (PTSD) and their causal relationship with organic brain changes. MATERIALS AND METHODS: A longitudinal observational study of 87 combatants of the Karabakh war (1992-1994) was conducted in 2009-2011. Two groups of patients were singled out. The first group included 45 veterans with mild combat cranial/brain injury with the following development of PTSD; the second group consisted of 42 veterans with organic brain lesions of traumatic origin. Somatic and neurological examination of patients and evaluation of their status using psychometric and other scales (CAPS, the Mississippi Scale for Combat-Related PTSD) were performed. RESULTS AND CONCLUSIONS: The analysis of patient's status at examination period and at the moment of injury demonstrated that PTSD patients, despite the relative reduction of posttraumatic symptoms, had higher level of all PTSD symptoms during the whole period of the disease (15-18 years) with the simultaneous aggravation of organic mental symptoms. In patients with organic brain lesions, the symptoms were more pronounced immediately after the traumatic event compared to the period of observation.

[The involvement of abnormal apoptosis in the disturbance of synaptic plasticity in posttraumatic stress disorder].

Authors determined the levels of marker proteins for apoptosis and synaptic plasticity - annexin-А5 and complexin-2, correspondingly, as well as the proinflammatory cytokine tumor necrosis factor-α (TNF-α) in the blood serum of patients with posttraumatic stress disorder (PTSD) in comparison to healthy controls using the enzyme-linked immunosorbent assay. An analysis of correlations between these parameters was performed. According to the results obtained, the levels of annexin-А5 and complexin-2 were significantly lower, and the levels of TNF-α were significantly higher in PTSD patients. In addition, a positive correlation between the levels of annexin-А5 and complexin-2, on the one hand, and a negative correlation between the levels of annexin-А5 and TNF-α, on the other hand, were detected in PTSD. It has been concluded that PTSD is characterized by the lower apoptosis rate associated with the defects in synaptic plasticity. It is proposed that abnormal apoptosis may be also one of the factors responsible for development of PTSD-associated chronic inflammation.

[General diagnostic center as a indicator of the problems of psychiatric service in Armenia]. / Diagnosticheskii tsentr kak indikator problem, sushchestvuiushchikh v psikhiatricheskoi sluzhbe Armenii.

The efforts directed to understanding of the role of genetic factors in both etiology and risk to develop Alzheimer's disease (AD) become more active. The results of such investigations should be used in genetic counseling with a caution. This counseling should be individual for each family. In respect to molecular genetic testing (and to some extent to diagnostic testing) we can't now do this work in most cases with sufficient accuracy, taking into consideration social, juridical, psychological, ethic and moral potential significance of such information. However, the data accumulated now about the role of a genetic factor in AD allow to perform a genetic assessment in certain cases by geneticists and the clinicians in specialized AD clinics.

[The characteristics of mental disorders in older persons who were earthquake victims]. / Nekotorye osobennosti psikhicheskikh rasstroistv u lits pozdnego vozrasta, postradavshikh pri zemletriasenii.

To investigate mental disorders in elderly patients, victims to the earthquake, 30 patients aged 50 to 68 years were examined. Somatic complaints played the leading part in the disease clinical picture. The basic group comprised 14 patients, victims to the earthquake, and the control group was made up of 16 patients with analogous disorders but they had not been exposed to the earthquake. The disease lasted 6 and more months. It has been shown that the basic group patients seen over time manifest depressive forms of reaction to the extreme situation whereas in the control group patients, somatic disorders turned out dominant.

[The characteristics of the development and course of somatization mental disorders in older persons]. / Osobennosti formirovaniia i techeniia somatizirovannykh psikhicheskikh rasstroistv u lits pozdnego vozrasta.

As many as 33 patients aged 50 to 74 years with different mental disorders (mild organic syndrome, slow progredient schizophrenia, cyclothymia, neurotic development of personality) were examined. In all cases somatic-like conditions dominated: vegetative-vascular, somatoform and cenestopathic disorders. They formed as the reaction, phases and development of personality.

[The clinical types of somatization mental disorders in elderly people]. / Klinicheskie tipy somatizirovannykh psikhicheskikh rasstroistv u lits pozhilogo vozrasta.

A study is presented of 33 patients suffering of borderline neuropsychic disorders of neurotic and affective levels with somatized course. One should distinguish in these patients mental disorders per se (asthenia, depression and hypochondria) and different functional-somatic, vegetative-vascular and senestopathic disorders and their combinations. Somatized disorders characteristic of this age group were singled out: cutaneous-muscular, abdominal, cerebral and cardiovascular. Cutaneous-muscular were most frequent. The problem is discussed of distinguishing peculiar "senestovegetoses" and "senestosomatoses" in the borders of somatized depressive states.

[Protracted reactive states in the general hospital: the clinico-psychopathological aspects]. / Zatiazhnye reaktivnye sostoianiia v obshchesomaticheskoi bol'nitse: kliniko-psikhopatologicheskie aspekty.

A study was made of earthquake-induced mental disorders which did not lead to the patients' admission to psychiatric hospitals. 40 patients were examined at the general somatic hospital 6-7 months after the earthquake. The signs of mental disorders of the neurotic and affective level were revealed in 70% of the patients with lingering reactive conditions. They manifested in asthenic, depressive hypochondriac and conversion syndromes. All the cases were characterized by asthenic disorders and somatized nature of the disorders.

[Clinico-tomographic study of atherosclerotic dementia]. / Kliniko-tomograficheskoe izuchenie ateroskleroticheskogo slaboumiia.

On the basis of the results obtained in the examination of 61 patients with atherosclerotic dementia, the author has established general clinical peculiarities of dementia: asthenia, rigidity and the fluctuations in the patients' status. The main types of dementia (general organic, torpid, pseudoparalytic, and amnestic) reflecting the characteristics of cerebrovascular pathology detected by computer tomography of the brain, as well as patterns of the disease (stroke, mixed and stroke-free) have been defined. The main types of structural changes in the patients' brain (foci of lower density, expansion of the CSF spaces and diffuse decrease in the bran density) have been identified. The aggregate of tomographic signs preferable for each type of atherosclerotic dementia and the correlation between the severity of dementia and elicited structural alterations in the brain have been ascertained.