[Psychogenic and somatic interactions in diabetes mellitus]. / Psikhogenno-somaticheskie vzaimootnosheniia pri sakharnom diabete.

As a result of 10-year follow-up study of 250 patients with diabetes mellitus, type I (58) and type II (192) 4 predictable psychological crises have been singled out: the first one was related to reaction to the diagnosis; the second--to the assignment of insulin therapy; the third--to the development of diabetes complications and the fourth--to hospitalization and a subsequent communication with other, more "experienced", patients. In the progress of the disease, an interaction of psychogenic, somatic and personality factors caused development of psycho-somatic cycles (psycho-somatic balancing according to H. Baruk), which is realized in 3 variants: predominantly psychogenic, predominantly somatic and psycho-somatic.

[Characteristics of mental disorders in patients with rheumatoid arthritis]. / Osobennosti psikhicheskikh narushenii u bol'nykh revmatoidnym artritom.

Peculiarities of mental disorders in patients with rheumatic arthritis were studied in 70 patients aged 20-60 years. The most typical mental disorders were: asthenic symptomatology, depressive phenomena with anxiety, fears, ideas of self-accusation, a peculiar variation of the syndrome of dysmorphophobia due to defects of appearance, stable disorders of sleep, psychopathic-like disorders and, quite frequently, manifestations of psycho-organic syndrome.

[Treatment of insomnia in patients with borderline mental diseases]. / Lechenie insomnii u bol'nykh s pogranichnoi psikhicheskoi patologiei.

Zolpidem, non-benzodiazipine preparation, was used for therapy of 56 patients with insomnia. 4 groups of patients were treated: a) with a prevalence of asthenic symptomatology in psychogenic disorders; b) with polymorphic neurotic symptomatology and autonomic disorders; c) with affective pathology of neurotic level; d) with nervous anorexia and bulimia. Zolpidem was quite effective in all groups of patients in terms of normalization of falling asleep, improvement of quality of sleep without changing of daily activity. A good drug tolerance was found in elderly patients.

[A role of psychosomatic cycles in genesis of psychosomatic diseases]. / Rol' psikhosomaticheskikh tsiklov v geneze psikhosomaticheskikh zabolevanii.

900 patients with different psychosomatic diseases were observed. A leading mechanism of the pathology development was found to be formation (through the period of psychosomatic reactions) of mono- and polysystemic psychosomatic cycles responsible for the development of both primary and secondary psychosomatoses in context of a single psychosomatic continuum. On the basis of neurotic depression, at first, primary psychosomatosis developed. Besides, quantitative increase of psychosomatic pathology was observed within a damaged system. As far as monosystemic psychosomatic cycle transformed into polysystemic one, secondary psychosomatosis formed including psychosomatic pathology of some other organs and systems.

[Obsessive-phobic disorders in anorexia and bulimia nervosa]. / Obsessivno-fobicheskie rasstroistva pri nervnoi anoreksii i bulimii.

The data on 1500 patients with syndrome of anorexia and bulimia nervosa were summarised in terms of clinical-psychopathological, catamnestic and experimental-psychological investigation. This syndrome was considered as one disease which presented the variation of borderline mental pathology or the manifestation of schizophrenic process. Obsessive-phobic disorders were observed in majority of patients (95%). Such disorders were characterized by prevalence of obsessive phenomena with food content. It was noted that diagnosis and prognostic significance had either obsessive-phobic disturbances or obsessions with other content which occurred on the initial stage of disease, before development of syndrome of anorexia and bulimia and in period of pronounced cachexia. The therapeutic resistance of obsessive disturbances in patients with anorexia and bulimia were emphasized as well as the necessity of prolonged ambulatory treatment of such patients.

[Borderline mental disorders in diabetes mellitus]. / Pogranichnye psikhicheskie narusheniia pri sakharnom diabete.

124 patients with diabetes mellitus were examined in hospital of endocrine profile. The borderline mental disorders were revealed in 115 cases (92,7%) in the form of neurosis-like disturbances and pathological development of personality. Asthenic, asthenohypochondriac, asthenodepressive, obsessive and hysteroformic syndromes were diagnosed in patients with neurosis-like disorders. The personal disorders included asthenic, hysteric, obsessive, explosive and psychosomatic variations of development of the personality. Besides, poor cooperation of patients with the doctor was observed in the course of "diabetic control".

[Variants of psychosomatic personality development in diseases of the gastrointestinal tract]. / Varianty psikhosomaticheskogo razvitiia lichnosti pri zabolevaniiakh zheludochno-kishechnogo trakta.

612 patients with different psychosomatic disorders of gastrointestinal tract (GIT) were examined. They included either 200 patients with organic stomach disease or with duodenal ulcer as well as 412 individuals with various functional disorders of GIT such as psychogenic vomiting, dysphagia, gastralgia and colon irritability syndrome. In 70% of all cases patientc relatives (1-3 degree of relationship) had also some psychosomatic diseases. All the patients suffered in childhood from so-called GIT-variant of children's neuropathia. Being adults they all met intensive or moderate stress and developed psychogenic depression. Two ways of psychosomatic disorders cristallization on the background of depression were observed, exactly reactivation of children's neuropathia symptomes or rapid affect somatization which were followed by psychosomatic cycles formation and by stress tolerance decrease. Several types of psychosomatic development were described: hypochondrial (78.8%), asthenic (12.4%), obsessive (2.3%), hysterical (4.4%) and paranoial (2.1%).

[Effects of carnitine and cobamamide on the dynamics of mental work capacity in patients with anorexia nervosa]. / Vliianie karnitina i kobalamina na dinamiku umstvennoi raboto- sposobnosti bol'nykh nervnoi anoreksiei.

The authors relate the results of studying intellectual work fitness in patients with anorexia nervosa (in the stage of cachexia) receiving the vitamin-like drugs carnitine and cobamamide. It has been shown that the long-term food deprivation leads to a reduction of intellectual work fitness, lability of productivity, fluctuations in the work quality, appearance of latent fatigue. In spite of the fact that standard nonspecific treatment ameliorates intellectual work fitness, it does not lead to its normalization. The use of carnitine and cobamamide in the course of nonspecific treatment results in the reduction of the time spent on task implementation, a rise of the work rate as compared to the control group. However, this does not fully remove latent fatigue and does not bring about complete recovery to normal of intellectual work fitness. The combined use of carnitine and cobamamide eliminates fluctuations in the work rate and normalizes the scope and productivity of intellectual work.

Anorexia nervosa as manifested in Russia.

The authors describe current theoretical and clinical conceptualizations and treatment of anorexia nervosa in Russia, based on their experience in the follow-up of 800 patients. Three-quarters of the patients exhibited anorexia nervosa linked with a border-line state, and one-quarter associated with schizophrenia. Different relationships to dysmorphophobic fears were observed in the different anorexic groups. In the border-line group, follow-up study indicated that the clinical symptoms of anorexia nervosa were significantly reduced. However, the disorder preserved its connection with dysmorphophobic fears even in the remote stages of the disease, and in later stages there was an occurrence of pathological personality changes. In the second group, from the very beginning, anorexia nervosa in schizophrenia was closely connected with affective disorders, pathological body sensations, hypochondriacal complaints, and a gradual personality deterioration. As the schizophrenic defect increased, anorexia nervosa was reduced to an exhausted form of vomiting behaviour, and lost its connection with dysmorphophobic experiences.

[Characteristics of families of patients with anorexia nervosa (psychocorrective measures)]. / Kharakteristika semei bol'nykh nervnoi anoreksiei (psikhokorrektsionnye meropriiatiia).

The paper is concerned with an examination of the families of patients suffering from anorexia nervosa and the role they play in rehabilitation and resocialization of patients. 103 families (103 patients and 268 persons from their family environment) were examined. 65 patients suffered from anorexia nervosa of schizophrenic etiology and 38 from anorexia nervosa as a borderline disease. Among blood relatives of patients with schizophrenia, there predominated subjects with pathology of schizophrenic nature and those with schizoid disorders. The relatives of patients with borderline disease mostly had diverse anomalies of the character, largely hysteric accentuation. The common traits characteristic of the families of anorexia nervosa patients were delineated. Based on the parents' personality traits, the nature of family relations, the type of children's education, attitude toward the sick child and preparedness for cooperation with the treating physician and medical personnel, five types of the families could be distinguished: harmonious one and 4 types of disharmonic families (non-harmonious, symbiotic, rigid pseudosolidary and destructive (conflicting]. The first two family types are more characteristic of patients suffering from borderline anorexia nervosa, the remainder three of schizophrenic patients with the syndrome of anorexia nervosa. The family types have been thus characterized; a complex of psychocorrective measures have been worked out both for patients themselves and their relatives with regard to the specific features of each family type.

[Bulimic disorders in anorexia nervosa]. / Bulimicheskie rasstroistva pri nervnoi anoreksii.

As many as 108 patients with anorexia nervosa were examined. Of these, 83 patients manifested bulimic symptomatology. In all the examined patients, the formation of bulimic symptomatology was preceded by the typical dynamics of the syndrome of anorexia nervosa in the form of the stage of dysmorphophobia-dysmorphomania, of the stage of looks correction with the aid of different methods of weight reduction, and of the stage of an appreciable body weight decrease with marked secondary ++somato-endocrine abnormalities up to cachexia. Three types of bulimic disorders associated with anorexia nervosa were distinguished: bulimia as a symptom of anorexia nervosa, bulimia s a stage of anorexia nervosa, and the bulimic variety of anorexia nervosa. Each of these types of pathology is depicted clinically.

[Conditions for developing mental disorders in myocardial infarction]. / Usloviia formirovaniia psikhicheskikh narushenii pri infarkte miokarda.

Conditions for mental disorders formation at different stages of the underlying disease have been specified as a result of clinico-psychopathological, clinico-catamnestic and experimental psychological studies carried out in 55 patients with myocardial infarction. The authors show an important role of the clinical features of myocardial infarction in the formation of asthenic symptomatology and affective pathology in the acute period of myocardial infarction. In the subacute period of the illness, the premorbid characteristics and psychotraumatic factors preceding the disease exert a noticeable effect on the development of depressive and ++astheno-hypochondriac disorders. In the clinical picture of acute myocardial infarction, a less significant role is played by age-associated factor. At the outpatient stage of myocardial infarction treatment, the psychotraumatic factors due to chronic disease and related situations assume a particular significance in the formation of depressive hypochondriac symptomatology.

[Association of schizophrenia and Recklinghausen's disease]. / Sochetanie shizofrenii s bolezn'iu Reklingkhauzena.

Two cases of associated Recklinghausen's disease and different forms of schizophrenia (sluggish psychopathlike and shift-like paranoid) are described. Of special interest was the fact that such association was observed in two brothers. Based on the clinical material suggested, the conclusion was made about the modifying influence of the organism process in Recklinghausen's disease (brain gliosis) on the schizophrenic process, thereby creating certain difficulties in the diagnosis. It is also assumed that the age of the onset of Recklinghausen's disease may determine the clinical picture of the mental pathology.

[Clinico-psychological correlations of mental rigidity in anorexia nervosa]. / Kliniko-psikhologicheskie korreliatsii psikhicheskoi rigidnosti pri nervnoi anoreksii.

A study was made of mental rigidity in patients suffering from anorexia nervosa and their relatives using the Tomsk rigidity questionnaire. Based on examinations of 40 patients with anorexia nervosa, 22 of whom suffered from schizophrenia, 18 with borderline pathology (16 with an active method of weight losing, 24 with the bulimic variant of anorexia nervosa) and of 58 close relatives (mothers, fathers, sisters) the data were obtained on the level of mental rigidity. In the patients' group, it was found to depend to a greater measure on the stage of anorexia nervosa, whereas in the relatives, on the nosological appurtenance of the syndrome in their children.