[Hypochondria sine materia as a psychosomatic problem: a model of hypochondriac disorders realized in the cutaneous sphere].

Hypochondria sine materia is a disorder with physical complains corresponding to no any somatic diagnosis. Hypochondria sine materia is a more complicated psychopathological condition compared to hypochondria cum materia. Hypochondria sine materia could be diagnosed not only in psychiatry, but mainly in general medicine. It is especially prevalent in dermatology. As a result of analysis of hypochondriac disorders involving cutaneous sphere in patients without dermatological diseases, a binary model of psychodermatological syndromes presenting with hypochondria sine materia in dermatology was developed. The binary structure of the psychodermatological syndromes includes secondary psychiatric symptoms based on primary coenesthesiopathic phenomena. The heterogeneous psychodermatological syndromes (cutaneous organ neurosis, impulsive excoriations syndrome, circumscripta hypochondria, coenesthesiopathic paranoia) could be arranged in a continuum of consecutively worsening conditions from neurotic to psychotic severity register. The syndromes differ in clinical and social prognosis requiring different approach to diagnosis and treatment.

[The use of ixel in the treatment of depression in patients with chronic schizophrenia].

An open non-controlled 12-week study of 30 patients with chronic schizophrenia with mild and moderate depression has been carried out. Ixel was administered in dosage 100-200 mg daily along with the basic antipsychotic therapy (haloperidol, olanzapine, quetiapine, risperidone, paliperidone). Patient's state was assessed with the Clinical Global impression scale (CGI), the Hamilton depression scale (HAM-D-21) and the Positive and Negative Syndromes scale (PANSS). Percentage of responders on CGI was 73.3%. A significant (p

[Psychodermatology: current state of the problem]. / Psikhodermatologiia: sovremennoe sostoianie problemy.

An analysis of comorbidity of psychiatric and dermatological pathology in historical, epidemiological and clinical aspects is presented. Psychocutaneous disorders (delusional parasitosis, hypochondria circumscripta, obsessive-compulsive disorders with self-mutilations, pathomimia) play a central role in systematics elaborated in the present study. The authors suggest that delusional parasitosis is a subtype of paranoiac psychosis (paranoia, paranoiac schizophrenia). Psychiatric disorders triggered by dermatological pathology were specified as nosogenous reactions, depressive reactions with sociophobia, pathologic personality development (paranoiac, sensitive, hypochondriac). Atopic dermatitis, eczema, urticaria, psoriasis, herpes simplex, alopecia areata, rosacea, etc, are regarded among dermatological psychosomatic disorders with psychogenic manifestation/exacerbation.

[Psychological aspects of contrast obsessions]. / Psikhologicheskie aspekty kontrastnykh obsessii.

The paper presents a clinical-psychological examination of 40 patients with contrast obsessions of homicidal- and suicidal-phobic contents. The cohort of patients was divided into two groups by the prevalence of the possibility to commit either autodestructive and criminal actions (group 1-24 patients) or violence and murder (group 2-16 patients) in clinical picture of contrast phobias with anxious apprehension. It was found that in patients of group 1 pathology of personality presented with disorders of the hysteric-hyperthymic sphere together with features of overanxiety, while in patients of group 2--with disorders of the anancastic-schizoid sphere. Differences between the groups in terms of the objective direction of anxiety were associated with peculiarities of the structure of the personality: in group 1 the choice of the object of anxiety from the individuals of the nearest surrounding or the very patient himself, was determined by diffusion or widening of Ego boundaries and identification of patients with their microsocial environment; in group 2 the choice of such object of the "accidental other" was determined by the fixing, narrowing of Ego boundaries and by separation from the microsocial environment. Chronological direction of the anxiety in group 1 was conditioned by the peculiarities of the imagination function: hypertrophy of fantasy, abundance of the means of the symbolization of intrapsychic experience and emotional style of thinking determined an anticipatory anxiety; while an insufficiency of fantasy, alexythymia and the operational style of thinking in group 2 determined a retrospective anxiety.

[Clinical typology of contrast content obsessions in borderline mental diseases]. / Klinicheskaia tipologiia naviazchivostei kostrastnogo soderzhaniia pri psikhicheskikh zabolevaniiakh pogranichnogo urovnia.

40 patients were observed (16 men, 24 women, mean age 27 years) with the obsessions of the contrast contents (14-homocidophobia, 18-suicidophobia, 8-combined homo- and suicidophobia). Two types of contrast obsession (CO) were recognized: contrast phobias with anxiety about possibility to commit autodestructive or criminal actions and contrast obsessions with anxious doubts about committing either violence or murder. CO of first type were determined by the fear of lack of self-control and possibility to commit autodestructive or criminal actions. Such obsessions are accompanied by bright images, massive somato-vegetative symptomatology and rapid formation of avoidance behaviour. CO of second type are characterized by pathologic doubts about committing violence or murder and accompanied by strong desire to check again and obsessive self-analysis. CO of first type belong to the spectrum of anxious-phobic disorders and are phobic in their nature; within acute phobic fit, similar in manifestations to a panic attack; they are associated with other phobic disorders and manifest like phobic depressions. On the contrary, CO of second type are true obsessive phenomena, and isolated, combine with obsessions of the repeated control, and with different types of depressions only in half of the cases.

[Depression with obsession of contrast content]. / Depressii s naviazchivostiami kontrastnogo soderzhaniia.

Twenty depressed patients (according to ICD-10) with obsessions of contrast content (homicidophobia--4 patients, suicidophobia--12, other contrast obsessions--4 cases) were examined. The affective disorders belonged to polar areas of a depressive spectrum: anxious depressions (with a prevalence of manifestations of positive affectivity in the form of somatopsychic hyperstesia) and existential depressions (with domination of manifestations of negative affectivity in the form of alienation of the vital functions). In anxious depressions there were compulsive obsessions of contrast content (12 patients), while in existential ones impulsive obsessions (8 cases). Compulsive obsessions of contrast contents (fear of a lack of self-control pronounced in the form of the attacks of lissophobia) were formed at the height of an anxious-depressive affect. Impulsive obsessions of contrast contents (fear of self-damage with elements of an obsessive drive to its realization) were formed during depressive devitalization and were exceeded by suicidal ideas. Comorbidity of depressive and obsessive manifestations was realized by a peculiar type of interrelations with formation of "convergent" symptoms which reflected an increase of severity of depressive disorders.