[Actual ethical problems of present-day psychiatry]. / Aktual'nye éticheskie problemy sovremennoi psikhiatrii.

Over recent years many newspapers and journals have published a lot of criticism concerning Soviet psychiatry . Partly, it is true. During a long period of time Soviet psychiatry have underestimated and sometimes ignored an important methodological principle--the principle of a personality approach to the analysis of mental diseases. The personality of patients received improper attention. Hence it followed that the elaboration of ethical problems in psychiatry was lagging behind and the introduction of psychotherapy and methods of psychological correction was slow. At present legal issues of psychiatric care are being actively elaborated. However, they cannot replace the ethical and deontological principles and norms which should be inherent in the work of psychiatrists and medical staff of psychiatric institutions. The paper addresses a number of specific ethical problems in modern psychiatry and offers ways to solve them.

[Fasting-diet therapy of elderly patients with borderline mental disorders]. / Razgruzochno-dieticheskaia terapiia bol'nykh pozhilogo vozrasta s psikhicheskimi narusheniiami pogranichnogo urovnia.

During the fasting dietetic therapy (FDT), 89 patients aged 46 to 75 years with mental disorders of nonpsychotic character (neurosis-like, neurotic and affective) were examined. The time-course of changes in the clinical status of patients with cerebral atherosclerosis, essential hypertension, slow-progredient schizophrenia, cyclothymia and manic-depressive psychosis, neuroses and lingering neurotic reactions during the FDT is described. The beneficial results in the form of considerable improvement and improvement of the mental status were attained in 83.2% of the patients. The elderly patients were found to tolerate FDT well. Side effects and somatic complications were recorded in 6 patients and were not serious. Based on the data obtained the FDT can be recommended for use on a wider basis in the management of elderly patients with borderline mental disorders.

[Reactive neurotic disorders during the clinical course of slowly-progressing hypochondriac schizophrenia]. / Reaktivnye nevroticheskie rasstroistva v klinike malo- progredientnoi ipokhondricheskoi shizofrenii.

As a result of structural-dynamic psychopathological analysis of mental states in 42 patients with slow-progressive schizophrenia in which the hypochondriac signs prevaled, the secondary reactive personality neurotic disorders were revealed. These were developed as a response to pronounced psychic traumatizing impact of the schizophrenic neurose-like symptoms: vital fear of death, cranial and cardiac senestoalgias, somato-autonomic disorders in hypochondric raptus and raptoid states.

[Complex treatment of sexual disorders in women with slowly progressive schizophrenia]. / Kompleksnaia terapiia seeksual'nykh rasstroistv u zhenshchin pri maloprogredientnoi shizofrenii.

The article describes the efficacy of combination, staged and differential therapy of sexual disorders in 90 women with slowly progressive schizophrenia. The treatment was carried out in 3 stages. At the first stage the treatment with psychotropic drugs (supplemented with some elements of rational and behavioural psychotherapy--PT) was aimed at reducing the underlying psychopathological syndrome; at the second stage the maintenance psychopharmacotherapy was combined with the maximal utilization of PT (behavioural, marital, training), whereas the third stage consisted of various types of PT and sex therapy.

[Sexual disorders in women with slowly progressing schizophrenia]. / Seksual'nye narusheniia u zhenshchin, bol'nykh maloprogredientnoi shizofreniei.

The article deals with sexual disorders in the form of lack of libido, decreased libido, anorgasmy, decreased orgasmic response, loss of the emotional element of libido, predominance of the rational element of sexual libido, manifestations of pseudovaginismus and unmotivated revulsion toward sexual intercourse in women (aged 20-47 years) with slowly progressive schizophrenia and a 2-15 year history of the endogenic process. Definite correlations between psychopathological and sexual pathological manifestations have been ascertained. Sexual disorders were of a secondary systemic nature and were undetected if the endogenic process began after the completion of all stages of normal psychosexual development.

[Effect of various extrinsic factors on the course of schizophrenia]. / O vliianii nekotorykh vneshnykh faktorov na techenie shizofrenii.

Clinical and statistical studies of 800 case histories of schizophrenia with an unfavourable (400 patients) and slow-progredient (400 patients) course with due regard for objective anamnestic data and findings of neurological examination revealed a significant and substantial difference in the occurrence of some exogenous factors. In the patients with schizophrenia running an unfavourable course, chronic otitis occurred 15 times more frequently, severe childhood infections 4.5 times, rheumatic fever 2.2 times, pathology of pregnancy and birth 2 times more frequently. The same patients demonstrated a 10-time more frequent occurrence of residual phenomena of organic brain injury. The data obtained might attest to the possibility of the effect of the factors cited on the severity of schizophrenia.

[Reflection of stable dominant states in the EEG of schizophrenic and alcoholic patients]. / Ob otrazhenii ustoichivykh dominiruiushchikh sostoianii na EEG bol'nykh shizofreniei i alkogolizmom.

EEG was used to study stable dominant states in 12 patients with sluggish forms of schizophrenia and 11 alcoholics. The control group consisted of 15 normals. The patients demonstrated the following traits : deviations in the EEG readings, reflecting the interaction of different cortical zones; a complex of signs indicative of changes in the development of a generalized, nonspecific component of the activation reaction compared to data of the control group; a certain rigidity in the dominant-subdominant relationships. In reduction of the pathological symptomatology and under the impact of unloading, dietic therapy (hunger) there were positive changes in the parameters characterizing the reaction of activators as well as differences in the EEG-correlations of 2 selected types of dominant states.