[A comparative study of the efficacy of personality-oriented (reconstructive) and cognitive-behavioral psychotherapy in neurotic anxiety disorders with insomnia]. / Sravnitel'noe issledovanie éffektivnosti lichnostno-orientirovannoi (rekonstruktivnoi) i kognitivno-povedencheskoi psikhoterapii pri trevozhnykh rasstroistvakh nevroticheskogo urovnia s insomniei.

AIM: To study personality-oriented (reconstructive) and cognitive-behavioral psychotherapy in patients with neurotic anxiety disorders with insomnia. MATERIAL AND METHODS: Ninety-eight patients with disorders coded in ICD-10 as F 40.0; F40.1; F41.0; F41.1; F48.0 were studied. Clinical, psychometric, experimental-psychological methods and polysomnography were used. RESULTS AND CONCLUSION: Phenomenological insomnia types characteristic of neurotic anxiety disorders and their relationship with types of intrapersonal conflicts are described. A quantitative analysis of the dynamics of symptomatic complains, anxiety level, and insomnia is presented. The efficacy of the both psychotherapeutic treatments is shown. However the personality oriented (reconstructive) psychotherapy has demonstrated better and more stable results. This can be explained first of all by its pathogenesis-oriented nature and involvement of the cognitive emotional and behavioral spheres as well as the resolution of the intrapersonal conflicts, which are the cornerstone of neurotic disorders.

[The use of spitomine (buspirone) in the combined therapy of panic disorder].

OBJECTIVE: To explore the efficacy of spitomine (buspirone) in the combined therapy of panic disorder, we studied the dynamics of clinical parameters and personality traits associated with development and maintenance of panic disorder during the treatment. MATERIAL AND METHODS: Thirty patients of a treatment setting for out-patients with panic disorder were enrolled in the study. Patients received combined treatment with spitomine (buspirone) in the dose of 30 mg/daily (10 mg three times a day) during 6 weeks and individual short-term direct cognitive-behavioral therapy. Anxiety and panic symptoms were measured with HARS, CGI, MADRS and STAI-A. RESULTS: There was a significant reduction in panic and anxiety symptoms (by 50% on the HARS) that reached on average 9.73 scores to the end of the study. This finding indicates the absence of anxiety and, therefore, therapeutic efficacy of the treatment. Scores on state anxiety of STAI-A were significantly lower compared to baseline though the level of anxiety remained relatively high. The partial decrease in trait anxiety, though its level was high as well, was noted. CONCLUSION: The combined therapy of panic disorder with spitomine (buspirone) and cognitive-behavioral therapy is an optimal treatment, though not without the limitations of short-term methods. Good tolerability of the drug allowed all patients to complete the study.

Prognostic factors for the time of occurrence and dynamics of distant metastases and local recurrences after radical treatment in patients with rectal cancer.

BACKGROUND: A remarkable increase has been noted in the rate of incidence of rectal cancer. Post- or preoperative adjuvant treatment has significantly decreased the risk of local recurrence, but still only about 50% of all patients with rectal cancer treated radically can achieve a permanent cure. The majority of failures are due to distant metastases (DM) and/or local recurrences (LR). The risk and dynamics of failure after treatment of neoplasmtic disease has been analyzed on several occasions. MATERIAL AND METHODS: This retrospective study involved 161 consecutive patients with rectal cancer treated by radical surgery between 1972 and 1989. The mean age was 57 years. All patients underwent radical abdominoperineal rectum excision. The average follow-up was 10 years. In terms of the time elapsing to failure, the entire group of patients was divided into two subgroups: 'early' (occurring within 18 months after surgery) and 'late' (more than 18 months after surgery). RESULTS: The actuarial 5-year disease-free survival rate was 61.3%. Distant metastases occurred in 42 cases (26%), of whom 50% developed 'early' relapses, whereas local recurrences (29 cases - 18%) developed 'early' in 72% of the cases. Male gender was found to be an independent factor increasing the risk of 'early' relapses, particularly in the pN2 group. The stage of the disease is an indisputable risk factor for distant metastases and 'early' local recurrences. CONCLUSIONS: The time to failure varied significantly regarding local and distant relapses, suggesting different dynamics and origin. It seems that aggressive systemic and local treatment may decrease the incidence of relapses and improve long-term results. There is an urgent need to define new prognostic factors for identifying patients threatened by early dissemination.

[The emotional assessment by test subjects of short musical fragments]. / Emotsional'naia otsenka ispytuemymi korotkikh muzykal'nykh fragmentov.

Emotional estimation of 96 short (2-5 s) musical fragments was studied in 6 healthy subjects. Fragments were scored on a 5-point scale. Statistically significant difference in estimations of specific musical fragments (positive, negative, or indifferent) was found.