[Methodological bases of early psychosocial rehabilitation of poststroke patients in neurological hospital].

Based on the principles of rehabilitation elaborated by M.M. Kabanov (partnership, multidirectional nature and intergrity of psychosocial efforts), the authors have worked out a model of a complex team (neurologist, psychiatrist, psychotherapist and all medical personnel of the neurological unit) biopsychosocial approach to early psychosocial rehabilitation of patients who survived acute) ischemc attack. During the period of 2001-2004, comorbid mental disorders of psychotic (36%) and neurosis-like (64%) types were found in 356 patients (132 male, 224 female aged 40-59 years, 60-79 years and over 80 years. The model of organization of psychiatric/psychotherapeutic care ("interaction-attachment") is presented. Using combined psychopharmacotherapy (sonapax, neuleptil, haloperidol, coaxil, cipramil, phenazepam, xanax, mexidol, nootropil, etc) and an adequate psychotherapy basing on the principle of simultaneous biological and social action on poststroke patients (or persons socially significant for them and unit personnel), it was possible to raise quality of neurological as well as psychopharmacological and psychotherapeutic, in case of comorbid mental disorders, care that proved to be a main factor of early inpatient stage of psychosocial rehabilitation. As a result, there was an improvement of quality of life of poststroke patients in disease-modified conditions of their further biopsychosocial being.

[Psychiatric service in general hospital]. / Psikhiatricheskaia sluzhba v mnogoprofil'noi somaticheskoi bol'nitse.

The article summarizes the 3-year (1998-2000) consulting and treatment experience of a psychotherapeutic unit in one Moscow general hospital. Psychiatrists realized emergent and planned consultations of the mentally-ill patients in all hospital departments, conducted, in addition to general treatment, psychopharmacotherapy and psychotherapy or directed them, on demand, to psychiatric hospitals. For the 3-year period, the psychiatrists have consulted 4685 somatic patients with comorbid mental diseases (5% of the total amount of the patients admitted to the hospital at that period), 1360 patients (29%) being affected with psychotic disorders. One hundred eighty two patients were diagnosed to have schizophrenia, 784--arteriosclerosis and old-age psychosis and dementia, 45--reactive psychosis, 16--epilepsy (disphoria and psychotic episodes), 67--mental retardation with inadequate behavior, 266--delirium of alcoholic and drug addiction genesis. In some cases, usage of psychotropics, in combination with psychotherapy, has resulted in recovery or considerable psychic state improvement in 9.1% of the patients, improvement in 52% ones, insignificant improvement in 36%. In 2.9% of the cases, the effect of treatment has not been achieved.

[Psychotherapeutic service in general somatic hospital]. / Psikhoterapevticheskaia sluzhba v mnogoprofil'noi somaticheskoi bol'nitse.

The paper presents the experience of the activity of psychotherapeutic department in general somatic hospital during 3 years. For this period specialists of this department (psychotherapist, psychiatrist, medical psychologist and a nurses) were consulted 4528 patients. Some disorders of nonpsychotic level were found in 2915 cases. Different methods of psychotherapy resulted in either "recovery" or "significant improvement" in 1065 (39.5%) patients; in the "improvement"--in 1157 (39.7%) cases, in the "insignificant improvement"--in 604 (20.7%) patients; there wasn't observed any effect in 89 (3.1%) cases. Psychotherapeutic service in general somatic hospital is thought useful.

[Halcion (triazolam) in the treatment of insomnia]. / Khal'tsion (triazolam) v lechenii insomnii.

A hypnotic effect of chalcion (triazolam) was studied in 24 outpatients suffering from insomnia. It was found high and beneficial in pre-, intra- and post-insomniac disorders. Side effects were mild. Characteristics of chalcion-induced sleep reached to those of physiological sleep. Chalcion was found superior to other drugs used against insomnia.

[Clinical dynamics of cenesto-hypochondriacal neurosis-like disorders in schizophrenia with onset in adolescence (clinico-catamnestic study)]. / Klinicheskaia dinamika senestoipokhondricheskikh nevrozopodobnykh rasstroistv pri shizofrenii, nachavsaheisia v podrostkovom vozraste (kliniko-katamnesticheskoe issledovanie).

For 10-15 years the authors studied the time-course of neurosis-like disturbances in 46 patients with schizophrenia manifested in adolescence with cenesthopathic symptomatology (23 patients presented the cenesthopathic-hypochondriac syndrome, in 17 cenesthopathia was attended by phobias, in 6 it was combined with manifestations of derealization and depersonalization). The study showed that in 87% of the observations the disease ran continuously (torpidly in 29, by the type of the simple form in 5 and by the type of the paranoid form in 6 patients), in 13% of the patients the disease ran a paroxysm-progressive course. In 10-15 years the clinical picture in half of the patients continued to be characterized by the leading cenestho-hypochondriac symptomatology, in one-fourth of patients cenestho-hypochondriac disturbances were transformed into hallucinational-paranoid, in another one-fourth of patients into either psychosis-like or apathoabulic (by the type of the simple form) symptomatology. The authors discuss the degree of progression of the disease in different variants of its course, the social and marital status of patients, the specificity of personality changes and peculiarities of disease relapses.

[Epidemiologic analysis of a contingent of patients with psychoses who applied for emergency psychiatric services in Ethiopia]. / Epidemiologicheskii analiz kontingenta bol'nykh psikhozami, obrativshikhsia za neotlozhnoi psikhiatricheskoi pomosh'iu v Efiopii.

A clinico-statistical analysis covers 825 psychotic patients who applied to the Amanuel mental hospital in Addis-Abeba over the first 3 months of 1983. The population of patients had the following characteristics associated with cultural factors: a considerable predominance of males, a dramatic reduction in the number of both male and female patients with an increasing distance between their place of residence and the hospital, a large percentage of non-working individuals, single men and divorced women. Among the entire number of mental patients primary patients constituted 67.1%; 42.9% of all patients were hospitalized. A total of 6.7% of patients could not be hospitalized because of overcrowding in the hospital. As regards diagnoses, the patients were distributed in the following way: schizophrenia 46.1%, reactive psychoses 19%, intoxicational 15.6%, organic 3.9%, involutional 2.8%, senile 2.5%, epileptic 2.3%, manic-depressive 2.1%, unspecified psychoses 4.8%. The identified characteristics of the local psychopathology in Ethiopia are discussed.