[Mental disorders in patients with complete heart block before and after a pacemaker implantation]. / Psikhicheskie narusheniia u bol'nykh s polnoi poperechnoi blokadoi serdtsa do i posle implantatsii élektrokardiostimuliatora.

Mental disorders were studied in 52 patients with acquired complete heart block (CHB) before and after pacemaker implantation. Mental state of the patients was characterized primarily by borderline mental pathology--asthenia, affective pathology, hysteria spectrum disorders with autonomic symptoms and hypochondriac disorders. The structure and expression of mental disorders depend on premorbid personality traits of the patients, duration, severity and stage of the disease, the phase in respect to surgery intervention as well as preoperative period duration. Being the main therapy method, the operative CHB treatment, in general, positively influences the dynamics of mental disorders. However, in some cases, pacemaker implantation changes the behavior and quality of life of patients. Peculiarities of mental disorders in the CHB demand to include of psychopharmacotherapy and psychotherapy in treatment process.

[Characteristics of mental disorders in patients with rheumatoid arthritis]. / Osobennosti psikhicheskikh narushenii u bol'nykh revmatoidnym artritom.

Peculiarities of mental disorders in patients with rheumatic arthritis were studied in 70 patients aged 20-60 years. The most typical mental disorders were: asthenic symptomatology, depressive phenomena with anxiety, fears, ideas of self-accusation, a peculiar variation of the syndrome of dysmorphophobia due to defects of appearance, stable disorders of sleep, psychopathic-like disorders and, quite frequently, manifestations of psycho-organic syndrome.

[Treatment of insomnia in patients with borderline mental diseases]. / Lechenie insomnii u bol'nykh s pogranichnoi psikhicheskoi patologiei.

Zolpidem, non-benzodiazipine preparation, was used for therapy of 56 patients with insomnia. 4 groups of patients were treated: a) with a prevalence of asthenic symptomatology in psychogenic disorders; b) with polymorphic neurotic symptomatology and autonomic disorders; c) with affective pathology of neurotic level; d) with nervous anorexia and bulimia. Zolpidem was quite effective in all groups of patients in terms of normalization of falling asleep, improvement of quality of sleep without changing of daily activity. A good drug tolerance was found in elderly patients.

[Obsessive-phobic disorders in anorexia and bulimia nervosa]. / Obsessivno-fobicheskie rasstroistva pri nervnoi anoreksii i bulimii.

The data on 1500 patients with syndrome of anorexia and bulimia nervosa were summarised in terms of clinical-psychopathological, catamnestic and experimental-psychological investigation. This syndrome was considered as one disease which presented the variation of borderline mental pathology or the manifestation of schizophrenic process. Obsessive-phobic disorders were observed in majority of patients (95%). Such disorders were characterized by prevalence of obsessive phenomena with food content. It was noted that diagnosis and prognostic significance had either obsessive-phobic disturbances or obsessions with other content which occurred on the initial stage of disease, before development of syndrome of anorexia and bulimia and in period of pronounced cachexia. The therapeutic resistance of obsessive disturbances in patients with anorexia and bulimia were emphasized as well as the necessity of prolonged ambulatory treatment of such patients.

[Characteristics of families of patients with anorexia nervosa (psychocorrective measures)]. / Kharakteristika semei bol'nykh nervnoi anoreksiei (psikhokorrektsionnye meropriiatiia).

The paper is concerned with an examination of the families of patients suffering from anorexia nervosa and the role they play in rehabilitation and resocialization of patients. 103 families (103 patients and 268 persons from their family environment) were examined. 65 patients suffered from anorexia nervosa of schizophrenic etiology and 38 from anorexia nervosa as a borderline disease. Among blood relatives of patients with schizophrenia, there predominated subjects with pathology of schizophrenic nature and those with schizoid disorders. The relatives of patients with borderline disease mostly had diverse anomalies of the character, largely hysteric accentuation. The common traits characteristic of the families of anorexia nervosa patients were delineated. Based on the parents' personality traits, the nature of family relations, the type of children's education, attitude toward the sick child and preparedness for cooperation with the treating physician and medical personnel, five types of the families could be distinguished: harmonious one and 4 types of disharmonic families (non-harmonious, symbiotic, rigid pseudosolidary and destructive (conflicting]. The first two family types are more characteristic of patients suffering from borderline anorexia nervosa, the remainder three of schizophrenic patients with the syndrome of anorexia nervosa. The family types have been thus characterized; a complex of psychocorrective measures have been worked out both for patients themselves and their relatives with regard to the specific features of each family type.

[Bulimic disorders in anorexia nervosa]. / Bulimicheskie rasstroistva pri nervnoi anoreksii.

As many as 108 patients with anorexia nervosa were examined. Of these, 83 patients manifested bulimic symptomatology. In all the examined patients, the formation of bulimic symptomatology was preceded by the typical dynamics of the syndrome of anorexia nervosa in the form of the stage of dysmorphophobia-dysmorphomania, of the stage of looks correction with the aid of different methods of weight reduction, and of the stage of an appreciable body weight decrease with marked secondary ++somato-endocrine abnormalities up to cachexia. Three types of bulimic disorders associated with anorexia nervosa were distinguished: bulimia as a symptom of anorexia nervosa, bulimia s a stage of anorexia nervosa, and the bulimic variety of anorexia nervosa. Each of these types of pathology is depicted clinically.

[Conditions for developing mental disorders in myocardial infarction]. / Usloviia formirovaniia psikhicheskikh narushenii pri infarkte miokarda.

Conditions for mental disorders formation at different stages of the underlying disease have been specified as a result of clinico-psychopathological, clinico-catamnestic and experimental psychological studies carried out in 55 patients with myocardial infarction. The authors show an important role of the clinical features of myocardial infarction in the formation of asthenic symptomatology and affective pathology in the acute period of myocardial infarction. In the subacute period of the illness, the premorbid characteristics and psychotraumatic factors preceding the disease exert a noticeable effect on the development of depressive and ++astheno-hypochondriac disorders. In the clinical picture of acute myocardial infarction, a less significant role is played by age-associated factor. At the outpatient stage of myocardial infarction treatment, the psychotraumatic factors due to chronic disease and related situations assume a particular significance in the formation of depressive hypochondriac symptomatology.

[Association of schizophrenia and Recklinghausen's disease]. / Sochetanie shizofrenii s bolezn'iu Reklingkhauzena.

Two cases of associated Recklinghausen's disease and different forms of schizophrenia (sluggish psychopathlike and shift-like paranoid) are described. Of special interest was the fact that such association was observed in two brothers. Based on the clinical material suggested, the conclusion was made about the modifying influence of the organism process in Recklinghausen's disease (brain gliosis) on the schizophrenic process, thereby creating certain difficulties in the diagnosis. It is also assumed that the age of the onset of Recklinghausen's disease may determine the clinical picture of the mental pathology.

[Clinico-psychological correlations of mental rigidity in anorexia nervosa]. / Kliniko-psikhologicheskie korreliatsii psikhicheskoi rigidnosti pri nervnoi anoreksii.

A study was made of mental rigidity in patients suffering from anorexia nervosa and their relatives using the Tomsk rigidity questionnaire. Based on examinations of 40 patients with anorexia nervosa, 22 of whom suffered from schizophrenia, 18 with borderline pathology (16 with an active method of weight losing, 24 with the bulimic variant of anorexia nervosa) and of 58 close relatives (mothers, fathers, sisters) the data were obtained on the level of mental rigidity. In the patients' group, it was found to depend to a greater measure on the stage of anorexia nervosa, whereas in the relatives, on the nosological appurtenance of the syndrome in their children.

[A peculiar variant of drive pathology in schizophrenia with the anorexia nervosa syndrome]. / Ob osobom variante patologii vlechenii pri shizofrenii s sindromom nervnoi anoreksii.

Detailed clinical and psychological experimental study of 103 schizophrenia patients with anorexia nervosa revealed its most characteristic correlations with a specific variant of the pathology of drive--bulimia bouts and induced vomiting. This variant of the pathology of drive appeared to be similar to narcomania.

[Disorders of self perception and feeding behavior in patients with the syndrome of anorexia nervosa (clinico-psychological analysis)]. / Narusheniia samovospriiatiia i pishchevogo povedeniia u bol'nykh s sindromom nervnoi anoreksii (kliniko-psikhologicheskii analiz).

An experimental psychological examination involved 87 patients with anorexia nervosa of different nosological origin. Patients with anorexia nervosa as part of borderline disease and schizophrenia presented specific characteristics of perception of their own appearance and of feeding habits. Patients with anorexia nervosa combined with borderline mental diseases showed close relationship between the orientation and degree of distortion of perception of the size of their own body and the nature of emotional value judgements. In schizophrenic patients with symptoms of anorexia nervosa this interrelationship was either absent or paradoxical in nature. All patients presented marked changes in the structure of feeding habits which were specific in each nosological group (lack of substitution effect, etc.). The results obtained served as a basis for appropriate psycho-corrective measures.

[Dynamics and mental disorders in patients with portal hypertension after surgical treatment]. / Dinamika psikhicheskikh narushenii u bol'nykh portal'noi gipertenziei pri operativnom lechenii.

On the basis of the clinical, experimental-psychological and electroencephalographic examinations of 173 patients with portal hypertension (intrahepatic--110 and extrahepatic--63) the authors elucidated the regularities of the formation of mental disorders, their clinical characteristics and the course following surgical treatment. The asthenic syndrome with marked vegetative disturbances was the most prominent feature in the clinical picture. Patients with hepatic cirrhosis were characterized by a more severe asthenia and greater intensity of vegetative symptomatology as compared to patients with an extrahepatic form of portal hypertension. Characteristic of psychotic disorders in liver cirrhosis was severity of the psychoorganic syndrome. Personality shifts with the predominance of explosiveness, epilepsy- and paranoia-like tendencies grow with disease progression. Surgical treatment by constructing vascular anastomoses occasionally leads to intensification of the psychoorganic syndrome in cirrhosis patients and to its appearance in patients with extrahepatic portal hypertension, which calls for the development of more clear-cut indications for such surgery.

[Clinical features of asthenic conditions in young persons]. / Klinicheskie osobennosti astenicheskikh sostoianii u lits molodogo vozrasta.

On the basis of examining 293 young patients (predominantly individuals with intelectual occupations) with asthenia the authors have established the clinical characteristics of asthenic states of various genesis. Psychogenic asthenias, asthenias in patients with a history of a craniocerebral injury and so-called adaptation asthenias are described in greater detail. The data obtained are important for the diagnosis, treatment and prophylaxis of the asthenic syndrome of variable genesis.

[Features of catatono-oneiroid paroxysms of schizophrenia manifesting in the puerperal period]. / Ob osobennostiakh katatonooneiroidnykh pristupov shizofrenii, manifestiruiushchei v poslerodovom periode.

A total of 131 puerperas with manifest paroxysms of schizophrenia were examined to correlate the time- course of their psychic and somatic state (puerperal characteristics and complications). Specific features of schizophrenia in the postpartum period were disclosed. The authors analyzed the course of manifest paroxysms (patients with predominant catatono-oneiroidal symptomatology) accompanied by pyrexia associated with acute endometritis, the subclinical forms of schizophrenia and also its course during an uncomplicated puerperium and correlated the clinical picture of psychoses in the presence of fever and without it. On the basis of the results obtained a suggestion is made that the febrile reaction accompanying manifest paroxysms of schizophrenia with predominant catatono-oneiroidal symptomatology cannot be considered as a manifestation of infection or as a manifestation of the toxic course of schizophrenia, inasmuch it reflects a particular state of the whole body and the CNS in the puerperium giving rise to the manifestations of schizophrenic process.

[Dynamics of the mental disturbances in primary biliary liver cirrhosis with allowance for a hemosorption procedure]. / Dinamika psikhicheskikh narushenii pri pervichnom biliarnom tsirroze pecheni s uchetom provedeniia gemosorbtsii.

The authors followed the time course of the psychic disturbances in 37 patients with primary biliary liver cirrhosis who received hemosorption as part of the combined therapy. The peculiarities of the psychic disturbances and their time course before and after the hemosorption were specified. It was found that after the hemosorption a regression of asthenoneurotic disturbances took place. However, the characteristic changes and elements of the psychoorganic syndrome developed in the course of the disease showed no positive dynamics.