[Borderline personality disorder in clinical outpatient practice]. / Pogranichnoe rasstroistvo lichnosti v klinicheskoi vnebol'nichnoi praktike.

OBJECTIVE: To investigate Borderline Personality Disorder (BPD) and associated psychiatric disorders in real clinical practice. MATERIAL AND METHODS: Fifty patients (72% female; n=36; 28% male; n=14, aged 22.4±4.3 years) with ICD-10 diagnosis F60.31 «Emotionally Unstable Personality Disorder, Borderline Type¼ were examined. Research methods included a clinical follow-up method and psychometric assessment. RESULTS: The majority of patients were female (72%). Asocial environment and low social status were typical for the patients with BPD. The vast majority of patients (86%; n=43) were not diagnosed with BPD when they first consulted a psychiatrist. In 24% of patients comorbid psychiatric disorders were diagnosed, of which affective spectrum disorders were predominant. Depressive (94%) and anxiety (80%) syndromes were leading in the clinical presentation. BPD patients were characterized by the absence of somatic components of depression, vitality of affect. CONCLUSIONS: Women are predominant among patients with BPD in outpatient practice. Impairment of interpersonal interaction and antisocial environment were typical for them. Comorbidity of BPD and affective disorders, mostly anxious-depressive, was confirmed. Low diagnosability of BPD at the initial psychiatric examination was established.

[Cognitive impairment in remitted patients with bipolar disorder]. / Kognitivnye narusheniya u patsientov s bipolyarnym affektivnym rasstroistvom v remissii.

OBJECTIVE: To assess the frequency and severity of cognitive impairment as well as its correlations with clinical characteristics in remitted patients with bipolar disorder (BD). MATERIAL AND METHODS: Eighty-five patients with BD type I (64 patients) and BD type II (21 patients) in remission were examined (average age 36.6±5.7). Affective symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and Young's Mania Rating Scale (YMRS). Cognitive impairment was assessed using the Brief Neuropsychological Cognitive Examination (BNCE). RESULTS: Cognitive impairment was revealed in 43.5% of the patients. The frequency and structure of cognitive impairment in patients with BD type I and type II did not differ. The patients with cognitive impairment were characterized by decreased speed of mental processes, decreased working memory and attention deficit. The correlation of the total BNCE score with the age of the patients, duration of the disease, total HDRS and YMRS scores was revealed. CONCLUSION: The results demonstrate the affective nature of cognitive deficit in the patients. Cognitive impairment in remitted patients with BD is a significant therapeutic target.

Effects of CYP2D6 activity on the efficacy and safety of mirtazapine in patients with depressive disorders and comorbid alcohol use disorder.

The objective of the study was to investigate the effects of CYP2D6 activity on the efficacy and safety of mirtazapine in patients with depressive disorders and comorbid alcohol use disorder who received mirtazapine. The study included 109 Russian patients who received mirtazapine at a dose of 30.0 [15.0; 45.0] mg per day. Genotyping of CYP2D6*4 (1846G > A, rs3892097) was performed using real-time polymerase chain reaction with allele-specific hybridization. The activity of CYP2D6 was evaluated by determining the concentration of endogenous substrate of the enzyme and its urinary metabolite - pinoline to 6-hydroxy-1,2,3,4-tetrahydro-beta-carboline ratio, using high-performance liquid chromatography - mass spectrometry. The statistically significant differences between the scores on the Hamilton Depression Rating Scale (HAMD) in patients with different genotypes were revealed by day 16: (GG) 5.0 [3.0; 6.0], (GA) 1.5 [1.0; 3.2] (p < 0.001), and for the The UKU Side Effects Rating Scale (UKU): (GG) 6.0 [6.0; 7.0], (GA) 8.5 [8.0; 10.0] (p < 0.001). The calculation of correlation coefficients between the differences in scale scores and metabolic rate showed the presence of statistically significant weak inverse correlation with the efficacy indicator evaluated by HAMD (r = -0.278, p < 0.05), but not by UKU (r = 0.274, p > 0.05). This study demonstrated that an increased CYP2D6 activity reduces the efficacy of treatment with mirtazapine.

[Dependence of antimicrobial effect of micelle-capsulated therapeutics on the micelle size].

With the method of dynamic light scattering it was shown that the average size of micelles in the series of formulations based on various clindamycin salts, i. e. ClindHCl+Tween-20, ClindBz+Tween-20, ClindHCl+Cremafor-EL and ClindBz+Cremafor-EL increased from 6 to 20 nm. Investigations with the agar diffusion method revealed that the bactericidic action of the micelle-capsulated therapeutics did not depend on the micelle size within 6 to 20 mn. The concentration of the micellar clindamycin or gentamicin equal to 0.05 mcg/ml was bacteriostatic with respect to Micrococcus (Sarsina) luteus.