[The dynamics of anxious depression under the treatment with antidepressants with different mechanisms of action].

Peculiarities of the dynamics of anxious depression under the treatment with selective serotonergic antidepressants with different mechanisms of action on the serotonin reuptake were investigated. It was examined 61 patients with anxious depression (ICD-10 F32.1, F33.1, F34.1) treated with zoloft (sertraline) or coaxil (tianeptine) as a monotherapy. The following methods were used: clinical-psychopathological, psychometric (Hamilton Rating Scales for Depression and Anxiety, the Sheehan Patient-Related Anxiety Scale) and statistical analysis. The comparative investigation has shown that both zoloft and coaxil are practically equally effective in the treatment of anxious depression with some peculiarities in the dynamics of clinical parameters.

[Somatic-autonomic disturbances in different types of depression].

To reveal correlations between the structure of somatic-autonomic disorders and types of depression - melancholic, anxious, apathic authors studied 102 patients, aged from 20 to 50 years, with depression of mild (23 patients) or moderate (79) severity; 12 patients with bipolar affective disorder, 24 - with depressive episode, 66 - with recurrent depressive disorder. Hamilton depression scale, methods for study of somatic-autonomic disturbances and predominance of sympathicotonia or parasympathicotonia were used. Somatic-autoniomic disorders were presented in all types of depression, mostly in anxious depressions, lastly - in apathic depresions, melancholic depressions were in intermediate position. For each depression, common and specific somatic-autonomic disorders were found which correlated with type of leading affect and structure of depressive syndrome.

Characteristics of albumin molecule binding centers in patients with anxious depression. Study by the fluorescence quenching method.

The state of binding centers in albumin molecule in patients with anxious depression was studied by the method of quenching of fluorescence of molecular probe (dimethyl-aminonaphthaleic acid carboxyphenylimide) with nitrate ions. Serum samples from 24 donors without somatic and mental diseases and 26 patients were analyzed. In the absence of the quenching agent, specific fluorescence of the probe (standardized by albumin concentration) was lower in patients with depression. The fluorescence quenching constant and the percentage of fluorescence available for quenching were also lower in serum samples from patients. These data indicate that the parameters of binding centers in albumin molecule in patients with anxious depression are significantly modified in comparison with normal subjects. The detected changes can play a role in the pathogenesis of depressive disorders.

[Preventive efficacy of tianeptine in recurrent depression with frequent exacerbations]. / Profilakticheskaia éffektivnost' tianeptina pri rekurrentnoi depressii s chastymi obostreniiami.

The results of the studies of 4 Russian research centers are summarized. Tianeptine (coaxil) was used in the treatment of 55 patients with ICD-10 diagnosis of recurrent depressive disorder (F32.1), 50 patients have completely finished the treatment. Tianeptine was assigned in dosage of 12.5 mg 3 times daily (patients over 65 years old received 25.0 mg daily) during 12 months. The drug was shown to have a high preventive efficacy for the disorder. Sixty-one percent of patients were full-responders. Taken together with partial responders (13%), an improvement was observed in 74% patients. The drug demonstrated a well tolerability with a rare and mild expression of side-effects.

[Clinical efficacy and tolerability of tianeptine in treatment of depression (Russian open multicenter trial)]. / Klinicheskaia éffektivnost' i perenosimost' tianeptina pri depressii (otkrytoe rossiiskoe mul'titsentrovoe issledovanie).

One hundred and forty two patients with ICD-10 diagnosis of depression from 7 research scientific were treated with tianeptine (coaxil); 124 have completed the treatment course. Moderate depression was diagnosed in 111 patients (89.5%) and severe depression--in 13 (10.5%). A duration of the last episode before treatment was 7.1 +/- 1.7 months. The mean score by Hamilton depression scale was 24.4 +/- 4.0. The patients received tianeptine as a monotherapy in dosage 12.5 mg, 3 times daily during 6 weeks (65-year olds and older were given 25 mg daily). Tianeptine proved to be an antidepressant with balanced action, i.e., exerted thymoanaleptic, anxiolytic and activating effects. The treatment was beneficial for 70.4% of the patients; remission was revealed in 58%. The medication was well tolerated with rare and weakly pronounced side effects.

[Structure of borderline depressive conditions]. / Struktura pogranichnykh rasstroistv depressivnogo spektra.

Overall 502 workers of a scientific-industrial association were examined in order to study the prevalence and structure of affective disorders. Anxiety appeared the most frequently occurring disorder (289 subjects); depression was revealed in 175, and elements of apathy in 94 persons. In 131 cases, the conditions was assessed as depressive, with the level of depression being subclinical in the majority of them. The structure of depressive disorders, their relation to the demographic characteristics of the examined are considered in detail. The necessity of more active identification and prevention of the " pre-nosological " forms of depression is discussed.

[Significance of various enzymes of mediator metabolism for evaluation of depression and therapeutic prognosis]. / O znachenii nekotorykh fermentov mediatornogo obmena dlia otsenki depresii i terapevticheskogo prognoza.

The purpose of the work was to specify the possibilities of the use of the enzymes of mediator metabolism: monoamine oxidase (MAO) of platelets, amine oxidase (AO) of serum and acetyl cholinesterase (ACE) of red blood cells to estimate the structure of depressions and to predict their therapeutic dynamics. 32 patients in the depressive phase of MDP were examined. There were 28 women and 4 men aged 22 to 50 years. The monopolar type was recorded in 28 patients, the bipolar one in 4 (all women). The total disease duration amounts to 0.5-17 years; depression may last from 2 months to 4 years. Depending on the type of the dominant affect the patients were distributed into 2 groups (10 persons had melancholic and 22 anxious depression). It has been shown that activity of platelet MAO and serum AO was significantly higher in anxious than in melancholic depression. An interrelationship was established between activity of these enzymes before treatment and prognosis of the treatment with tricyclic antidepressants. Activation of the enzymes during therapy was parallelled by positive clinical changes. Activity of platelet MAO turned out most significant in terms of prognosis. The data obtained are analyzed from the standpoint of regarding depression as a stressful condition, with the participation of the neurohormonal axis: the hypothalamus, pituitary, and adrenal cortex.

[Risk factors of developing a continual course of manic-depressive psychosis]. / O faktorakh riska pri formirovanii kontinual'nogo techeniia maniakal'no-depressivnogo psikhoza.

To define factors contributing to formation of continual manic-depressive psychoses, 100 archival case reports were considered and 100 patients with the bipolar disease type were examined. Organic inferiority of the central nervous system and the treatment with tricyclic antidepressants were established to be of importance for the most part for the continual variety with rapid cycling. In psychoses with slow cycling, noticeable hereditary psychopathological aggravation and definite premorbid personality traits were found to be implicated.

[Psychosomatic correlations in the structure of borderline neurologic and mental disorders]. / Psikhosomaticheskie sootnosheniia v strukture pogranichnykh nervno-psikhicheskikh rasstroistv.

A total of 544 staff members of the scientific industrial association were subjected to non-randomized examination. The presentation and structure of border-line disorders were studied as correlated to the age, sex, familial status, educational level, occupation, and personality structure. Three groups have been distinguished: (1) conditional norm; (2) neurotic disorders; and (3) affective disorders. Correlations between psychopathological and somatic disorders have been traced in all the groups.

[Age and features of depressions during the 2d half of life]. / Vozrastnye osobennosti depressii vtoroi poloviny zhizni.

On the basis of a psychopathological analysis of 207 patients at the age from 45 to 80 years suffering from depressions of different nosology the authors have shown that along with common signs characteristic of the age of involution such as a considerable involvement of anxiety in the affective link, asthenic disorders, a decrease in the physiological tonus, body sensations, etc., there are significant internosological differences. These include a tendency toward the typization of depressive phases and attacks in the framework of endogenic diseases on the one hand and more classical structures of depressions characterizing psychogenic and vascular diseases corresponding to the traditional notions on the other hand.

[Typology of affective disorders on the neurotic level in essential hypertension]. / Tipologiia affektivnykh rasstroistv nevroticheskogo urovnia pri gipertonicheskoi bolezni.

A study of 123 hypertensive patients in conditions of a specialized department of a cardiological Institute has shown the predominance of depressive disorders with a certain prevalence of the anxiety affect at the first stages and the melancholical affect at the subsequent stages. States with the leading affects of dysphoria and hyperthymia are observed less frequently and only at advanced stages of the disease. The authors outline the role of personality and situational-psychological characteristics as well as the stage and the course of the vascular process itself in the formation of affective disturbances.

[Analysis of the structure of the depressive triad as a diagnostic and prognostic indicator]. / Analiz struktury depressivnoi triady kak diagnosticheskogo i prognositcheskogo priznaka.

In order to ascertain the diagnostic and prognostic importance of the structure of the depressive triad, the authors conducted a clinical psychopathologic study of 173 patients (88 males and 85 females) with depressions (manic-depressive psychosis, schizophrenia, residual-organic and vascular cerebral impairments, psychogenic depression). An analysis of the structure of the depressive triad was made based on the concept of heterogeneity of the depressive affect, with such acknowledged major components as melancholy, anxiety, and apathy. Depending on the nature of the leading elementary affect, three types of the depressive triad were identified, namely, melancholy, anxiety and apathy depressive triads. According to the criterion of qualitative and quantitative correlation between the triad components (ideational and motor) and the leading affect, harmonic, disharmonic and dissociated variants were identified within every type. The regular features of the time-course of the triad were established: from the initial stages to the over picture and then to the reduction of depression. These regularities were characterized by definite nosological preference, and may be helpful in the differential diagnosis and also be used as predictors of a protracted course of depression.

[Changes in the levels of adrenergic and serotoninergic indices in patients with depressive states]. / Nekotorye osobennosti izmeneniia urovnia adrenergicheskikh i serotoninergicheskikh pokazatelei u bol'nykh s depressivnymi sostoianiiami.

The blood and urine levels of biogenic amines and their metabolites were examined in 37 males with depressions chiefly of schizophrenic nature. The content of almost all catecholamines in the urine, as well as the level of serotonin in the blood were found to be lowered, however, the excretion of 5-hydroxyindolacetic acid with the urine remained unchanged. A rise of the noradrenaline blood level and of the homovanillic acid: dopamine ratio were noted. In patients with agitated depression, the noradrenaline content in the urine was higher than in patients with melancholic depression. A positive therapeutic effect and, even to a greater extent, egress from the depression were accompanied with a rise of the urine levels of almost all the agents examined.

[Certain patterns in the formation of optical illusions]. / O nekotorykh zakonomernostiakh formirovaniia obmanov zreniia.

A structural dynamic analysis of productive disorders in visual perception was attempted on the basis of psychological study of 344 patients. These disorders were studied according to the increasing degree of inadequacy (anisomorphia) of pathological images in respect to real stimula. Considering the differences of such phenomena according to the degree of discrepancy of their perceptive characteristics with the traits of real objects, some successively complicated pathological images were examined, including traditional false recognition, illusions and hallucinations, as well as interlapping intermediate structures. Some pathogenetical mechanisms in the formations of visual illusions are suggested. Clinico-psychopathological parallels are made between disorders of visual perception and disease entities.

[Psychopathologic structure of protracted endogenous depressions]. / Psikhopatologicheskaia struktura zatiazhnykh éndogennykh depressii.

The psychopathological structure of protracted endogenous depressions was studied. An attempt was made to eliminate the main components of the depressive syndrome (variants of the depressive affect - anguish, anxiety, apathy, ideator and motor inhibition and "supplementary" symptoms). The results of the study demonstrated some general psychopathological regularities in the interrelationship of components of the depressive triade and some nozological differences. The assumption is made of the heterogenity in the mechanisms of "delayed" depressions. The most significant appeared to be such factors as the character of the main affect, the degree of intensity and concord of the triade elements and the existence of "supplementary" psychopathological phenomens.