[Peculiarities of treatment with antidepressants in patients with schizoaffective disorder in the interictal period]. / Osobennosti terapii antidepressantami bol'nykh shizoaffektivnym rasstroistvom v mezhpristupnom periode.

OBJECTIVE: To investigate the effect of therapy with various classes of antidepressants on the quality of remission and adherence to therapy in patients with schizoaffective disorder (SAD) in remission. MATERIAL AND METHODS: We examined 87 outpatients, including 29 men (33.33%), 58 women (66.67%) diagnosed with SAD according to ICD-10 criteria (item F25), in whom 341 cases of remission were studied. The average age of the patients was 41.40±12.56 years. Cases of remission in patients receiving therapy with nonselective monoamine reuptake inhibitors (NSMRIs) were included in group 1 (n=228), cases of remission formed on therapy with selective neuronal reuptake inhibitors (SNRI) were included in group 2 (n=113). Clinical follow-up and statistical methods were used. RESULTS: In both groups, mood disorders in remission were represented by subdepression. Delusional disorders at the stage of remission were almost 7 times more common in group 1 (12.28%), compared with group 2 (1.77%). The duration of the interictal period in patients treated with NSMRIs was higher (504.0±60.67 days) compared with patients receiving SNRI (176.46±17.88 days). In group 2, residual affective-delusional symptoms in remission were significantly less common. Cases of refusal from therapy in group 2 were 12 times less frequent, which indicates a greater adherence to therapy in patients receiving SNRI. CONCLUSION: It is possible to recommend treatment with NSMRIs for patients with depressive affect in the structure of SAD to increase the duration of the interictal period. At the same time, for patients with SAD in the presence of delusional and affective-delusional symptoms, it is preferable to prescribe SNRI.

[Depression and it's treatment in patients with schizoaffective disorder]. / Depressiia i ee lechenie u bol'nykh s shizoaffektivnym rasstroistvom.

AIM: To study the influence of depression on the quality of remission in patients with schizoaffective disorder (SAD) and develop recommendations for anti-relapse therapy. MATERIAL AND METHODS: Eighty-nine outpatients with the diagnosis of SAD were examined, in whom 348 remission cases were studied. In accordance with the characteristics of the episodes, the patients were divided into 2 main groups: patients with only depressive manifestations (group 1) and patients with affective disorders of both poles (group 2). Clinical-psychopathological, clinical-anamnestic, clinical-follow-up and statistical methods were used. RESULTS AND CONCLUSION: The type of SAD did not have a significant effect on the duration of remission and the duration of subsequent hospitalization. Patients of group 2 had residual symptoms in remission almost 2 times less often and the level of affective-delusional disorders in this group was higher compared to group 1. In both groups, affective symptoms are represented by subdepression. Patients without residual symptoms had a longer remission compared to patients with subdepression. Subdepressive disorders are associated with lower treatment adherence. Prescribing anti-relapse treatment of SAD, one should consider not only the current state and features of the last episode, but also the features of previous episodes. Patients with depressive episodes are characterized by subdepressive residual symptoms in remission. For patients with different variants of affective disorders in SAD, emotional disorders in remission are as specific as elements of affective-delusional disorders. Anti-relapse therapy should include neuroleptics and normothymics. In case of residual depressive symptoms, the authors recommend the addition of antidepressants.

[Characteristics of personality and psychological aspects of suicidal behavior prevention in medical students]. / Lichnostno-psikhologicheskie aspekty profilaktiki suitsidal'nogo povedeniia studentov.

AIM: To study the formation and dynamics of development of suicidal behavior (SB) in medical students based on a personality/psychological approach. MATERIAL AND METHODS: Two hundred and seventy-two students with- (n=75) and without SB (n=197) were examined. Psychopathological and psychological methods, and several questionnaires and scales were used. RESULTS AND CONCLUSION: Personality and environmental characteristics as well as family loading were the leading factors of SB formation. Based on the results obtained, the authors developed a complex of preventive measures in the frames of three types of prevention (common, selective and indicative).

[Characteristics of the pharmacological pathomorphosis of remission in schizoaffective disorders].

OBJECTIVE: To study the effects of different types of psychopharmacotherapy on the changes in the duration and clinical symptoms of remissions in patients with schizoaffective disorders (SAD). MATERIAL AND METHODS: Authors have analyzed the therapeutic pathomorphosis of remissions in patients with SAD examined from 1980 to 2013. One hundred and there patients have been stratified into 3 groups: patients treated from 1980 to 1990 (group 1), from 1991 to 1999 (group 2) and from 2000 to 2013 (group 3). RESULTS: Main changes in the quality of remission were correlated with the reduction in the patients' commitment to anti-relapse therapy due to the reduction in the control over its timely receipt as well as decreasing of active surveillance of the mental health of patients. Social factors, together with biological factors (pharmacotherapy), are no less important to maintain the quality of remission providing not only the improvement of compliance in patients, but also increasing their social adaptation. CONCLUSION: Supporting therapy can be recommended for administration within a year after the first onset of SAD and within three years after repeated attacks. Long-term anti-relapse treatment is recommended to patients with residual symptoms or low compliance.

[The use of mood stabilizers in preventive treatment of patients with schizoaffective disorders].

OBJECTIVE: To study an effect of combination therapy consisting of mood stabilizers on the quality of remission in patients with schizoaffective disorders. MATERIAL AND METHODS: Authors examined 56 outpatients with ICD-10 diagnosis of schizoaffective disorder (F25). Patients in remission received anti-relapse therapy with antipsychotics and were not treated with mood stabilizers for at least two years, and then they received a combined anti-relapse therapy, including both antipsychotics and mood stabilizers. RESULTS AND CONCLUSION: The combined use of pharmacotherapy creates a better remission. No statistically significant differences in the effect of different groups of mood stabilizers on the average duration of remission are identified. The inclusion of mood stabilizers in the scheme of preventive treatment has no effect on the average duration of subsequent hospitalization. Mood stabilizers are effective in the prevention of suicidal behavior in patients with schizoaffective disorder, they reduce the risk of disability in patients with schizoaffective disorder and increase compliance.