[Genetico-demographic patterns of the prevalence of various forms of endogenous psychoses]. / Genetiko-demograficheskie zakonomernosti rasprostraneniia razlichnykh form éndogennykh psikhozov.

Prevalence rates (PRs) for EFP (schizophrenic, schizoaffective and affective psychoses), with allowance for proband sex and age-of-onset data were studied in a subdivided population from the North-East of the European Region of the USSR. The population includes three subpopulations: a small old religious semi-isolate of Russians ("Rs"), aboriginal Komi people ("Ks")--an ethnic community of Ugro-Finnish lineage, and a mixed group of migrants ("Ms") from various regions of the USSR. The latter is mainly an urban population, while the "Rs" and "Ks" are, on the whole, rural populations. The total PR for EFP was found to be 0.97% for the "Rs", 0.63% for the "Ks" and 0.35% for the "Ms", whereas PRs-0.85-1.15% in other parts of the USSR, mainly for "panmixed" populations in large towns. The lower PRs for EFP in the "Ms" is caused by a backmigration flow involving certain groups of patients; consequently, the mean liability for "Ms" offsprings (as a whole) should also be lower. On the other hand, the lower PRs for EFP in the "Ks" is caused by underpresentation of clinically mild cases of the mental disease (mainly, pseudoneurotic schizophrenia), especially among female patients, probably due to that the so affected persons are sufficiently adapted to the cultural traditions of this rural population. It was shown that in the "Rs" the total PR for "nuclear" and paranoid schizophrenia is 0.68% versus 0.25% in a "panmixed" population. The increase is most likely caused by the high inbreeding level in the "Rs" semi-isolate, and if this is correct, we may suppose that at least one or two recessive genes are involved in the liability to the most heavy forms of schizophrenia. On the other hand, in the "Ms" (as in other "panmixed" populations) positive assortative mating among hereditary-predisposed persons is a more significant factor influencing family transmission of EFP, since the correlation between probands and their spouses is rpp = 0.31 (p less than 0.001) in the "Ms", as compared to rpp = 0.19 (p less than 0.1) in the "Rs". Thus, our general conclusion is that neither the place of inhabitance nor the life mode are the causal factors for EFP, but rather some genetic factors, more accurately, certain sets of specific genes.

[Dynamics of the epidemiological characteristics of registered contingents of schizophrenia patients]. / Dinamika épidemiologicheskikh kharakteristik uchtennykh kontigentov bol'nykh shizofreniei.

Different populations of schizophrenic patients under this study were registered by three of the Moscow city outpatient psychiatric departments in 1967, 1975 and 1981. These populations' epidemiologic characteristics compared, the following could be concluded: (1) the specific quantity of patients with psychotic disorders diminished, (2) the percentage of aged patients diminished, (3) the mean observation term reduced. Some other characteristics of the tendency to worsen the medical assistance to psychiatric patients were demonstrated. Factors causing such a trend are discussed and the ways to overcome these difficulties outlined.

[Epidemiologic aspect of the problem of the disability of schizophrenic patients (incidence, chronogenic dynamics, risk factors)]. / Epidemiologicheskii aspekt problemy invalidnosti u bol'nykh shizofreniei (chastota, khronogennaia dinamika, faktory riska).

Epidemiological aspects of disability have been studied in a random sample of schizophrenics living in three Moscow districts. It has been found that 39.4% of schizophrenic patients (44.2% of the patients in the productive age) are disabled due to the underlying disease. The past 20 years have seen a trend toward a decrease in the disability rate; the difference between the number of the disabled reported 20 years ago and today is 5.5%, being fully accounted for by paroxysmal forms of schizophrenia. It has been ascertained that the decision as to the patient's disability following medical examination of his or her working ability depends not only on the severity of the patient's clinical status, but also on the patient's sex. Thus, if patients with an equally grave disease are considered, women are more frequently given the status of disability which is explained by the fact that their involvement in household chores is much greater than that of males.

[Clinico-demographic characteristics and features of the social and occupational adaptation of schizophrenics in 3 population groups living in the northeastern region of the European portion of the USSR (clinico-epidemiologic study)]. / Kliniko-demograficheskaia kharakteristika i osobennosti sotsial'no-trudovoi adaptatsii bol'nykh shizofreniei trekh grupp naseleniia, prozhivaiushchikh v severo-vostochnom regione Evropeiskoi chasti SSSR (kliniko-épidemiologicheskoe issledovanie).

The authors conducted a clinico-epidemiological study of schizophrenics among the indigenous population, including that living in isolated areas and newcomers, taking into consideration forms of the disease course and employing a uniform syndromal assessment of the mental state. The authors have established general pathogenetic regularities of the course and their relationship with the age and sex. Patients from the indigenous population, particularly of geographically isolated areas, showed a higher incidence of schizophrenia, a more severe clinical picture of the disease and a lower level of social and occupational adaptation as compared to the migrated population.

[Population patterns in the dynamics of episodes and remission in patients with endogenous psychoses]. / Populiatsionnye zakonomernosti dinamiki pristupov i remissii u bol'nykh éndogennymi psikhozami.

Analyzing the data on 1770 patients with paroxysmal schizophrenia with a disease standing of 15 years and over, the authors established a statistically significant correlation between the clinical picture of remissions and attacks in the preceeding and the subsequent cycle of the disease. This correlation was expressed in the fact and from the second cycle to the third, the probability of the appearance of the same psychopathological disturbances was at least two times as that of the development of any other concrete disorders. The first three cycles of the disease were analyzed.

[Population patterns in the development and course of endogenous psychoses as a reflection of their pathogenesis]. / Populiatsionnye zakonomernosti vozniknoveniia i techeniia éndogennykh psikhozov kak otrazhenie ikh patogeneza.

An analysis of a representative epidemiological sample of patients with endogenic psychoses (schizophrenia and MDP) revealed statistical distribution of some parameters of the disease (risk of the development of the disease in relation to age, a number of previous attacks, as well as distribution of patients by the duration of paroxysms and remissions). The authors believe that a collation of the tabulated data with the known mathematical models makes it possible to come to understanding some aspects of the pathogenesis of endogenic psychoses.

[Problem of the systematics of schizophrenia in light of current clinico-catamnestic, epidemiologic and clinico-genealogic information]. / K probleme sistematiki shizofrenii v svete sovremennykh kliniko-katamnesticheskikh, épidemiologicheskikh i kliniko-genealogicheskikh dannykh.

On the basis of the results provided by clinical follow-up, clinico-epidemiological and clinico-genealogical studies, the authors have reviewed the systematics of the major forms of schizophrenia developed at the Institute of Psychiatry of the USSR Academy of Medical Sciences and offer a statistical characteristics of these forms. The authors specifically discussed the questions associated with the characteristics of the syndrome formation and course of slowly progressive (torpid) schizophrenia and the place these forms occupy in the modern foreign classifications, including the DCM-III). The paroxysm-like form was established to run predominantly the course with a small rate of attacks or the "one-paroxysm" course. Slowly progressive and psychotic forms of continuous schizophrenia were shown to be relatively continuous, being characterized by not only the signs of tortuosity of the course but also by those of regression and subsidence of the process. Attention is drawn to the necessity of special elaboration of the notion "residual schizophrenia". All these postulates are illustrated by the appropriate statistical population characteristics.

[Dynamics of negative disorders and the problem of differentiating paroxysmal schizophrenia (epidemiologic study)]. / Dinamika negativnykh rasstroistv i problema differentsiatsii pristupoobraznoi shizofrenii (épidemiologicheskoe issledovanie).

The task was set to elaborate, using random material, a systematics of paroxysm-like schizophrenia on the basis of the characteristics of the time-course of negative disturbances and comparison with the current systematics formed on the basis of the clinical experience. The authors analyzed the course of the disease in all registered patients with paroxysm-like schizophrenia (3928 individuals) living in four administrative districts of Moscow. Seven major variants of paroxysm-like schizophrenia have been identified. The prognosis of the disease is more favourable in cases where it first manifests itself by mild negative changes. The time-course of adverse changes determines the development of productive disturbances and their level both in paroxysms and remissions. The relationship between these phenomena indicates certain pathogenetic independence of each of the identified variants of the disease course.

[Risk of schizophrenic spectrum psychoses among the offspring of affected mothers and fathers (comparative epidemiologic study)]. / Risk zabolevaemosti psikhozami shizofrenicheskogo spektra v potomstve bol'nykh materei i ottsov (sravnitel'noe épidemiologicheskoe issledovanie).

Comparative epidemiological study in population of patients with schizophrenia in one of the Moscow regions revealed differential morbidity risk in posterity. Convincing proofs obtained showed sick children with schizophrenia prevalence in sick mothers, but not fathers' posterity. Such a conclusion on the representative populational material was made for the first time. The study showed the specificity of differential morbidity risk in control groups of patients with other disease entities analyzed. Different factors significance in so-called "maternal effect" manifestation are discussed.

[Possibilities of the epidemiologic method and various results of a population study of schizophrenia]. / Vozmozhnosti épidemiologicheskogo metoda i nekotorye rezul'taty populiatsionnogo issledovaniia shizofreniia.

Some results of the epidemiological studies on schizophrenia conducted recently by the Epidemiology Department of the Psychiatry Institute, the USSR Academy of Medical Sciences, are summed up. The principal demographic data on schizophrenia, such as its prevalence and forms as well as the pathogenetic role of the sex and age are presented. Taking the paroxysmal forms as a model, the application of the epidemiological method in investigating the course and probable prognosis of schizophrenia is reviewed in greater detail. On the basis of the material from a representative group of patients with paroxysmal schizophrenia of the 15-year duration or over (1461 patients), the basic regularities of the time course of negative and positive disturbances during remission, as well as the specific features of the shift in the clinical forms of paroxysms are demonstrated. Statistical distribution shows that in most patients, the distinctive signs of a given form of the disease course tend to remain unaltered during the whole period of the illness. Apart from reflecting the stability of patterns of the disease course, these findings support the validity of the current schizophrenia differentiation.

[Clinico-statistical patterns in the dynamics of episodes in schizophrenia]. / Kliniko-statisticheskie zakonomernosti dinamiki poristupov v techenii schizofrenii.

An examination of schizophrenics living in three regions of Moscow and suffering from the disease for over 15 years has shown that the change of the episode form is a probability process exhibiting a tendency to retention of the form of the preceding episode in the subsequent ones. At the same time it has been shown that this tendency is more marked, if the preceding episodes were of one and the same type. When the episode form changed principal trends of that process were revealed. The patients' sex was found to exert no substantial influence on the regularities discovered. The patients getting older, the frequency of depressive episodes became greater at the expense of transformation of depressive-paranoid symptoms into depressive ones.

[Experience with a differentiated clinical approach to epidemiologic description of populations of schizophrenic patients]. / Opyt differentsirovannogo klinicheskogo podkhoda k épidemiologicheskomu opisaniiu populiatsii bol'nykh shizofreniei.

Data on the frequencies of various schizophrenia forms among the population of three districts of Moscow are presented. These data were obtained from direct examinations of each schizophrenia case, and are the most differentiated clinically, as compared with those reported in earlier publications. With regard to one district of Moscow a more detailed information is presented: such as, the frequency of admission for schizophrenia to psychiatric hospitals that was found to be 9.63 per 1,000 of population, 9.85 for males and 9.48 for females. The admission frequency for continuously-progressing cases was 2.51; for paroxismally-progressing ones 5.26; and for recurrent cases 1.80. In addition to these figures data on the admission frequency with regard to the underlying syndrome at the manifest stage of the disease (within the range of the above-mentioned basic forms of the disease course) are presented. Also the frequencies of various forms of the disease onset and the duration of the patients' stay in hospital and their observation by psychiatrists at home are analyzed with reference to the disease pattern and the frequency of each patients's hospitalization.

[Experience with epidemiologic studies of childhood schizophrenia]. / Opyt épidemiologicheskogo izucheniia detskoi shizofrenii.

An epidemiological study of the adult schizophrenic population (5039) of 3 Moscow districts has shown that 31,3% of the individuals have fallen ill before the age of 18, out of them 23,4% at the age of 12--17 years. The intensity of schizophrenia manifestation in the pubertal period was the highest. A comparison of the sex ratio at the onset of the disease at different periods of childhood and puberty has shown that the younger the boys are, the higher is the morbidity rate among them. In the initial stage of the disease at the age of 0--17 years malignant schizophrenia prevails threefold and slowly progressive schizophrenia almost twofold as compared to the patients who fell ill after 18 years of age. At the onset of the disease in adults as compared to childhood and adolescence there prevail relatively medium progressive and attack-like forms (shift-like and periodical). It was also noted that malignant schizophrenia is more common among males and periodical forms among females. A comparison of the relative frequency of forms depending upon the onset enables one to claim that the morbidity rate (all forms) undoubtedly depends upon the age, particularly upon the pubertal, while its forms are related to the sex and not to the pubertal age.

[Several features of the course of attack-like schizophrenia (according to the findings of an epidemiologic study)]. / O nekotorykh osobennostiakh techeniia pristupoobraznoi shizofrenii (po dannym épidemiologicheskogo izucheniia).

The authors studied patients with an attack-like course and a "cliche" type course (i.e. the psychopathological structure of attacks does not change within the disease). In spite of the differences in the clinical picture of the attacks, the studied patients slightly differed in age, onset of the 1st attack, number of sick male- and female patients, correlation between the age at the onset of the 1st attack and sex, number of previous attacks and continuation of remissions. A direct correlational dependance between the character of productive disturbances and the depth of negative changes in remissions and the clinical picture of psychotic attacks was observed.

[Role of sex and age in the occurrence and course of attack-like schizophrenia (based on epidemiological study data)]. / Rol' pola i vozrasta v vozniknovenii i techenii pristupo-obraznoi shizofrenii (po dannym épidemiologicheskogo izucheniia).

On the basis of an over-all investigation of 2 districts of Moscow (1548 patients) the authors studied correlations between clinical traits of attack-like schizophrenia and factors of sex and age. It was demonstrated that the disease most frequently (irrespective of the sex and duration) manifests itself by affective-delusional attacks, then go depressive states, acute-delusional oneiroid and manic attacks. The statistical processing of these results demonstrates the existence of a common regularity in the development of clinical traits of attack-like schizophrenia. Factors of sex and age contribute only to conditions of a predilectiveness in an occurrence of different syndromes.

[Family formation by schizophrenic and manic-depressive patients according to an epidemiologic study (birth rate)]. / Formirovanie sem'i u bol'nykh shizofreniei i maniakal'no-depressivnym psikhozom po dannym épidemiologicheskogo obsledovaniia (rozhdaemost')

The birth rate among patients with endogenous disorders is considered as an index of the degree of their social adaptation. It was established that in all forms of such disorders the level of birth rates and the rate of family formation is lower than that in the general population. However, in all endogenous disorders (except the malignant schizophrenia) there are some patients the adaptation of whom is not disturbed.