[An effect of antipsychotic and anticholinergic treatment on cognitive function in patients with schizophrenia]. / Vliyanie antipsikhoticheskoi i antikholinergicheskoi terapii na kognitivnye funktsii u bol'nykh shizofreniei.

OBJECTIVE: To reveal the relationships between antipsychotic and anticholinergic drugs and cognitive functions in patients with schizophrenia. MATERIAL AND METHODS: The observational prospective study was conducted at the Bekhterev National Medical Center of Psychiatry and Neurology. The study involved 41 patients (22 men and 19 women) with paranoid schizophrenia, according to ICD 10 criteria, aged 30.12±8.24 years on stable antipsychotic monotherapy or in combination with anticholinergic drug (trihexiphenidyl). Cognitive functions were assessed using the «Brief Assessment of Cognitive Function in Patients with Schizophrenia¼ (BACS) scale, severity of mental state and extrapyramidal disturbances were measured using the «Positive and Negative Syndrome Scale (PANSS) and the Simpson-Angus Scale for Assessment of Extrapyramidal Side Effects (SAS). All examination procedures were performed twice at weeks 2 and 8 of therapy. Patients were divided into 2 groups according to the type of antipsychotic therapy. Twelve patients received first generation antipsychotics (FGAs) (group 1), 29 patients received second generation antipsychotics (SGAs) (group 2). RESULTS: Patients receiving SGAs had a significant decrease in the overall SAS score at week 8 of therapy compared with data at week 2, and there was an improvement in cognitive function, unlike patients receiving FGAs. There were also changes on BACS tests the digit sequencing (V=51.5, p=0.007), token motor task (V=75.5, p=0.007) and Tower of London (V=52, p=0.027) only in patients of group 2. CONCLUSION: The improved tolerance to the drug, as well as cognitive measures, was shown in patients taking SGAs by week 8. Our study confirms the importance of adhering to the minimum effective dose of antipsychotic drugs for the treatment of schizophrenia to prevent cognitive impairment, and to give preference to SGAs in the choice of treatment.

[The structure of the non-psychotic mental disorders in patients with epilepsy with and without pharmacoressistance]. / Struktura nepsikhoticheskikh psikhicheskikh rasstroistv u bol'nykh epilepsiei v zavisimosti ot nalichiya ili otsutstviya farmakorezistentnosti.

AIM: Patients with epilepsy (PE) develop persistent mental disorders identified as significant personal and affective disorders, especially of depressive and anxiety spectrum, observed in the interictal period of the disease. To study the frequency of non-psychotic mental disorders in patients with epilepsy, to specify the clinical features of non-psychotic affective disorders and to analyze the association of different variants of affective disorders with symptoms of drug-resistance in epilepsy (DRE). MATERIAL AND METHODS: One hundred and sixty patients with epilepsy, including 80 patients with DRE and 80 patients with controlled epilepsy (CE), were studied using a battery of psychometric scales. RESULTS AND CONCLUSION: The variety of depressive and anxious psychiatric condition was detected in 59.4% of PE, in 86.3% of patients with DRE and in 32.5% with CE. A clinical and psychopathological analysis of non-psychotic mental disorders showed that the frequency of affective disorders as well as great «structural complexity¼ and the depth of depressive and anxiety disorders were significantly higher in the group of patients with DRE compared to patients with CE. Patients with affective symptoms had earlier onset and the longer course of disease.