[Some variants of premanifesting disorders in attack-like schizophrenia].

OBJECTIVE: To investigate a spectrum of disorders preceding the development of manifesting psychosis in the aspect of their topology and possible prognostic value. MATERIAL AND METHODS: Authors examined 60 outpatients, 21 women and 39 men, aged from 22 to 34 years. All patients were diagnosed with attack-like progressive schizophrenia. The retrospective evaluation of disease history and determination of the psychopathological structure and dynamics of manifesting episode and premanifesting symptom clustering were carried out. RESULTS AND CONCLUSION: It was identified 4 variants of premanifesting disorders: affective (n=15), affective with neurotic-like symptoms (n=17), affective with hallucinatory/paranoid symptoms (n=21) and affective with deficit symptoms (n=7). These disorders determine not only the transparent symptomatics but project in the manifesting episode structure and has a prognostic value thus reflecting a trend towards the continuous course of schizophrenia already at the premanifesting stage.

[Paroxysmal and paroxysmal-like conditions during schizophrenia].

The clinical picture of paroxysm-like progredient schizophrenia in 104 patients was characterized by a combination of schizophrenic symptomatology, paroxismal and paroxysm-like disorders. Investigation of their psychopathological structure showed that they differ from that of epileptic paroxysms. The data obtained provide a basis for distinguishing a special variant of endogenous process and developing criteria for typological classification of paroxismal and paroxysm-like disorders.

[Activation of kallikrein-kinin system, degranulating activity of neutrophils and blood-brain barrier in schizophrenia]. / Aktivatsiia kallikrein-kininovoi sistemy, degranuliatsionnaia aktivnost' neitrofilov i gematoéntsefalicheskii bar'er pri shizofrenii.

To evaluate permeability of blood-brain barrier (BBB) some immunological and biochemical indices were used. The levels of the activity of serum kallikrein-kinin system (KKS), compliment system, C-reactive protein (CRP) concentration, blood inhibitory potential, metabolic and degranulating activities of neutrophils, as well as functional activity of leukocytic elastase were investigated in 30 patients. Acute schizophrenic attack was accompanied by both activation of KKS and by the increase of functional activity of alfa-1-proteinase inhibitor. The increase of CRP levels, high hemolytic activity of complement as well as considerable degranulating activity of polymorphonuclear leukocytes may be the causes of the damage of BBB permeability during acute schizophrenic attack.

[The clinical evaluation of the antidepressive activity of fluoxetine]. / Klinicheskaia otsenka antidepressivnoi aktivnosti fluoksetina.

The authors studied therapeutic properties of fluoxetine in the treatment of 100 patients with endogenous depressions. The drug was introduced during 6 weeks in a daily dose 20 mg. On the basis of the analysis of its clinical action and adverse reactions, fluoxetine belonging to the class of antidepressants has been ascertained. A prevalence of thymoleptic and stimulating components in its action, equal by their degree of expressivity and a smaller degree of anxiolytic effect have been demonstrated. Differentiated indications to fluoxetine prescription, its predilection in the therapy of apatho-adynamic and melancholic depressions and the feasibility of its use in inpatient conditions are discussed.

[The psychopathology and clinical picture of schizophrenia with a course of paroxysmal and paroxysm-like disorders]. / Psikhopatologiia i klinika shizofrenii, protekaiushchei s paroksizmal'nymi i paroksizmal'nopodobnymi rasstroistvami.

Overall 70 patients suffering from attack-like progressive schizophrenia associated with paroxysmal and paroxysm-like disorders were examined. The clinico-psychopathological aspects of the disease were many and varied. The common signs of the disease included the presence of affective disorders, their considerable portion among other psychopathological manifestations. The dynamics of affective disorders specified in many respects the common character of the disease and the degree of the process progression and, in many cases, it tended to the formation of affective continuity. The common characteristics of the disease also included the presence of early disease signs which occurred long before manifest features, i.e. since the very childhood. The study of the structure of paroxysmal and paroxysm-like conditions revealed their diversity and certain specificities as compared with analogous paroxysms seen in the clinical picture of epilepsy. In addition to the clinical and psychopathological characteristics and the dynamics of personality disorders, this will provide evidence in favour of a special variant of the endogenous process.

[The psychopathological and clinical characteristics of paroxysmal and paroxysm-like states in the course of attack-like progressive schizophrenia]. / Psikhopatologicheskie i klinicheskie osobennosti paroksizmal'nykh i paroksizmal'nopodobnykh sostoianii v techenii pristupoobrazno-progredientnoi shizofrenii.

The author presents the results of examining 70 patients with attack-like progressive schizophrenia. The clinical picture of the disease was characterized by the combination of endogenous disorders and paroxysmal and paroxysm-like disturbances. The study of the structure of paroxysmal and paroxysm-like conditions revealed their diversity and certain specific features as compared to analogous paroxysms seen in the clinical picture of epilepsy. In addition to the clinical and psychopathological characteristics, the dynamics of personality disorders, this study may provide evidence in favour of a special variant of the endogenous process and will make it possible to provide more well-defined criteria, on the basis of which one can differentiate the character of paroxysmal and paroxysm-like conditions.