COMPARATIVE CHARACTERISTIC OF «ALCOHOL DEPRESSION¼ IN PERSONS WHO PARTICIPATED IN COMBAT OPERATIONS (COMBATANS) AND AFFECTED BY RADIATION CATASTROP. / PORIVNIaL'NA KhARAKTERYSTYKA «ALKOGOL'NYKh DEPRESII¼ V OSIB, IaKI BRALY UChAST' U BOIOVYKh DIIaKh (KOMBATANTIV) I POSTRAZhDALYKh PRY RADIATsIINII KATASTROFI.

The relevance of work is conditioned by the considerable prevalence of depressive disorders and alcohol abuseamong people who participated in combat operations (combatants) and affected by a radiation emergency, whichneeds to be optimized for providing them with a comprehensive social, psychological-psychiatric, medication andsomato-neurological help on the basis of a biopsychosocial paradigm.The objective of the study was to increase the level of medical care to combatants of the Antiterrorist Operation /Joint Forces Operation (ATO/JFO) and person affected by the catastrophe at the Chornobyl NPP (ChNPP) with depres-sion associated with alcohol abuse through theoretical substantiation, development and implementation in theinstitutions of public health and other agencies involved of new principles and algorithms for diagnosis, treatmentand prevention.The object and methods of the study were 160 ATO/JFO combatants from the age of 22 to 56 years old (M ± SD:(41.5 ± 16.5) years) with alcohol and depressive disorders the main group. The comparison groups included 81Chornobyl catastrophe clean-up workers (liquidators) with post-traumatic stress disorder and comorbid chroniccerebrovascular pathology, as well as other contingents affected by the Chornobyl catastrophe. Clinical-anamnestic,socio-demographic, clinical psychopathological, psychodiagnostic, neurophysiological and neuroimaging methodswere used. Somato-neurological clinical examinations and laboratory tests have been applied. The analysis of thedata was performed using MS Excel spreadsheets and statistical package Statistica 10.0 (StatSoft) with the Studentt-criterion, paired t-test, criterion χ2, and Fisher exact test.The study design of the main group consisted of 5 stages: 1) screening; 2) inclusion; 3) randomization; 4) treat-ment and 5) catamnestic (follow-up) observation.Results. In the main group the distribution of depressive syndromes was revealed as follows: depressive-hypochon-dric - in 68 (42.5 %) patients; 2) asthenic-depressive - in 33 (20,6 %); 3) anxiety-depressive - in 31 (19.4 %); 4)depressive-dysphoric - in 14 (8.8 %); 5) apathetic-depressive - in 7 (4,35 %); and 6) simple depressive - in7 (4,35%). The combatants after participation in the ATO/JFO had personality deformation and irritative changes of thebrain bioelectric activity, thickening of the intima-media complex and venous dyshaemia in the basal veins ofRosenthal. In liquidators there is an excess of depressive disorders, the frequency and severity of which increase inproportion to the radiation dose. These disorders are characterized by progressive course, personality changes withpsychosomatic pre-disposition, comorbidity with cerebrovascular pathology, neurocognitive deficits and high fre-quency (24 %) of secondary alcohol abuse. The relationship between depressive disorders and alcohol dependencein the examined patients is diverse. Their variants differ in certain clinical manifestations and to a large extentdetermine the differential diagnosis and differentiated approaches to treatment, prevention and medical and socialrehabilitationConclusions. The comorbidity of depressive disorders with the abuse of alcohol by combatants and person affectedby the catastrophe at the ChNPP is gaining an increasing significance first of all because of the increased risk of suicidal behavior. The proposed diagnostic complex and differentiated approaches to treatment, prevention and med-ical and social rehabilitation may increase the level of medical care for the ATO /JFO combatants and the Chernobylcatastrophe survivors with depression associated with alcohol abuse.

Ionizing radiation: brain effects and related neuropsychiatric manifestations. / IONIZUIuChA RADIATsIIa: VPLYV NA GOLOVNYY̆ MOZOK TA NEY̆ROPSYKhIATRYChNI PROIaVY.

Recently, an increasing interest has been directed towards the investigation of brain effects of ionizing radiation (IR), as it is now evident that, depending on the doses, the damages character and severity, as well as clinical man ifestations are different. They are generally considered to be the result of a blending of atherosclerotic, cardiovas cular, cerebrovascular and neurodegenerative processes. Further, an ongoing debate has been opened on the pos sible brain abnormalities following medical radiation from X ray in interventional radiology and nuclear medicine procedures that would involve both patients and medical workers. The aim of the present paper is to summarize literature data on brain effects of IR exposure, with a special focus on those gathered by some of the authors after the Chornobyl nuclear plant disaster, and how they can be related to the pathophysiology of different neuropsy chiatric disorders.

Schizophrenia spectrum disorders in persons exposed to ionizing radiation as a result of the Chernobyl accident.

We studied schizophrenia spectrum disorders in Chernobyl accident survivors by analyzing Chernobyl exclusion zone (EZ) archives (1986-1997) and by conducting a psychophysiological examination of 100 patients with acute radiation sickness (ARS) and 100 workers of the Chernobyl EZ who had worked as "liquidators-volunteers" for 5 or more years since 1986-1987. Beginning in 1990, there has been a significant increase in the incidence of schizophrenia in EZ personnel in comparison to the general population (5.4 per 10,000 in the EZ versus 1.1 per 10,000 in the Ukraine in 1990). Those irradiated by moderate to high doses (more than 0.30 Sv or 30 rem), including ARS patients, had significantly more left frontotemporal limbic and schizophreniform syndromes. We hypothesized that ionizing radiation may be an environmental trigger that can actualize a predisposition to schizophrenia or indeed cause schizophrenia-like disorders. The development of schizophrenia spectrum disorders in overirradiated Chernobyl survivors may be due to radiation-induced left frontotemporal limbic dysfunction, which may be the neurophysiological basis of schizophrenia-like symptoms. Persons exposed to 0.30 Sv or more are at higher risk of schizophrenia spectrum disorders. An integration of international efforts to discuss and organize collaborative studies in this field is of great importance for both clinical medicine and neuroscience.

EEG, cognitive and psychopathological abnormalities in children irradiated in utero.

Computerised EEG, a clinical neuropsychiatric examination, and IQ tests were examined in 50 randomly selected prenatally irradiated 9-10-year-old children and compared with 50 randomly selected non-exposed control children of the same age. In the prenatally irradiated children a disorganised EEG-pattern with slow and paroxysmal activity (acute and high-voltage delta-waves, sometimes: spike-waves) in the left fronto-temporal region was disclosed. There was also a significant predominance of delta- and beta (dominant frequency: 20 Hz)-power in the frontal lobe, particularly, in the left fronto-temporal region, together with depressed spectral theta-power. The more disorganised EEG-patterns were observed in those children exposed at 8-15 weeks of prenatal development, while left-hemisphere abnormalities were more typical for those exposed later at 16-25 weeks of gestation. There was also a significant increase of borderline and low range (70-90) IQ scores and a significant decrease of high verbal (> 110) IQ scores. Disorders of psychological development, particularly specific developmental disorders of speech, language, and scholastic skills were more common and correlated with left-sided slow- and fast-wave activity. Behavioural and emotional disorders (social estrangement, exhaustion, emotional lability, tearfulness, apathy) were also more common and associated with a L > R imbalance in arousal. We hypothesise that the cerebral basis of mental disorders in the prenatally irradiated children is the malfunction of the left hemisphere limbic-reticular structures, particularly in those exposed at the most critical period of cerebrogenesis (16-25 weeks of gestation). We propose that the left hemisphere is more vulnerable to prenatal irradiation than the right.

Psychophysiologic aftereffects of prenatal irradiation.

Prenatally irradiated children (n = 544), who were born between 26 April 1986 and 26 February 1987, in regions of the Ukraine which were radioactively contaminated as a result of the Chernobyl disaster, their mothers and teachers have been examined with psychometric tests. The control group of relevant children (n = 759), their mothers and teachers, were living at the radioecological 'clear' regions (Kharkov and Kharkov Region). Further, we randomly selected 50 prenatally irradiated children whose mothers were evacuated from the Chernobyl exclusion zone and 50 age-and-gender-matched non-exposed children. At this phase clinical examinations, psychometric tests, computerized EEG, thyroid function assessment and dosimetric reconstruction were used. We found a significant increase in mental retardation (IQ < 70) and of borderline and low range IQ, as well as emotional and behavioral disorders and a decrease in high IQ (IQ > 110) in children irradiated in utero as a result of the Chernobyl disaster, in comparison with the controls. One important biological mechanism in the genesis of mental disorders in prenatally irradiated children is the radiation-induced malfunction of the thyroid-pituitary system with the effect threshold of 0.30 Sv of thyroid exposure dose. We hypothesize that the cerebral basis of mental disorders in the prenatally irradiated children is the malfunction of the left hemisphere limbic-reticular structures, particularly in those exposed at the most critical period of cerebrogenesis (8-25 weeks of gestation). The data obtained reveal mental disorders in prenatally irradiated children and obviously reflect developmental abnormalities of brain structure and function as a result of the interaction of prenatal and post-natal factors where it is possible to assume radiation effects on the developing brain. A follow-up study of the children irradiated in utero, who may be at risk for schizophrenia, is proposed because of its particular importance to clinical medicine and neuroscience.