[Schizophrenia spectrum disorders (aspects of psychopathology and clinical taxonomy)]. / Rasstroistva shizofrenicheskogo spektra (aspekty psikhopatologii i klinicheskaya sistematika).

OBJECTIVE: To create a new taxonomy of schizophrenia spectrum disorders (SSD) based on the comparability of the design of SSD and borderline states. MATERIAL AND METHODS: The total sample consists of 205 patients with an established diagnosis of SSD (F21; F25; F22 according to ICD-10) collected from studies of the department of borderline mental pathology and psychosomatic disorders of the Federal State Budgetary Institution Mental Health Research Center and the Department of Psychiatry and Psychosomatics of Moscow State Medical University in the period 2014 to 2024. Clinical, psychometric, statistical methods were used. RESULTS: A new two-level model of schizotypal personality disorder (STPD) has been developed: the first level is psychopathic-like disorders of the «Ferschroben¼ type; the second level are psychopathological disorders (positive, negative, etc.), appearing under their «mask¼, constituting a «tracing paper¼ of manifestations of schizophrenia «in miniature¼. The two-level psychopathological model of STPD is a complex clinical phenotype, including independent but overlapping phenotypic formations: psychopathic-like - the «Ferschroben¼ type; and basic - schizophreniform disorders. CONCLUSION: The clinical classification of schizophrenia spectrum disorders has been developed; pseudoneuroses and stress-induced disorders of the endogenous circle are considered in the aspect of the dynamics of STPD.

[Socio-demographic and clinical-psychological characteristics of patients with residual schizophrenia and directions of their psychosocial rehabilitation]. / Sotsial'no-demograficheskie i kliniko-psikhologicheskie osobennosti patsientov s ostatochnoi shizofreniei i napravleniya ikh psikhosotsial'noi reabilitatsii.

OBJECTIVE: To analyze the socio-demographic, clinical and psychological characteristics of patients with residual schizophrenia, to identify variants of residual states and to determine measures for psychosocial rehabilitation on this basis. MATERIAL AND METHODS: At the time of investigation, 91 patients with the diagnosis of residual schizophrenia (F20.5xx according to ICD-10) were under dispensary supervision in the psychoneurological dispensary No. 18 of Moscow. A study of the medical records of all these patients was carried out. Twenty-three patients consented to face-to-face examination. The Positive and negative syndrome scale (PANSS), the Symptom Checklist-90-Revised (SCL-90-R), the Brief Assessment of Cognitive Functions in Schizophrenia (BACS) and the author's questionnaire concerning the opinion of psychiatrists on the clinical and social characteristics of patients with residual schizophrenia were used. Mathematical and statistical methods implemented in the STATISTICA 12.1 software and the Excel office suite were used. The method of stochastic nesting of neighbors («T-distributed Stochastic Neighbor Embedding¼, t-SNE) implemented in the Python program to cluster cases and identify variants of residual states was used. RESULTS: The patients with residual schizophrenia belonged to the cohort of elderly patients (mean age 66.3±13.28 years) with a predominance of females (62.22%). At the time of examination, the course of the schizophrenic process had a negative impact on the social life and professional activities of patients, which led to disability of 74.72% patients and 91.55% of them had disability due to a mental disorder. The analysis showed that patients with residual schizophrenia was a heterogeneous group with a predominant presence of negative symptoms in the clinical picture (the composite score on the PANSS negative subscale was17.79±6.67). Three variants of residual states were identified using clustering by the t-SNE method of individual PANSS indicators. Deficiency symptoms with features of pseudoorganic syndrome prevailed in the first variant. In the second variant, patients had mild positive symptoms, mainly in the form of paranoia and residual delirium, as well as a psychopathic syndrome. The third, small group, included patients with the most favorable variant of remission, having a fairly high level of social adaptation, mainly with personality changes. CONCLUSION: The obtained data were correlated with the results of a psychological examination. It was revealed that patients with residual schizophrenia were not sufficiently included in the process of psychosocial treatment and rehabilitation. Taking into account the identified variants of residual states, the directions of possible psychosocial interventions were determined.

[Bimodal model of delusional psychoses (on the problem of the correlation of paranoid dimensions in the psychopathological space of schizophrenia)]. / Bimodal'naya model' bredovykh psikhozov (k probleme sootnosheniya paranoidnykh dimensii v psikhopatologicheskom prostranstve shizofrenii).

OBJECTIVE: To establish clinico-pathogenetic ratios of delusional psychoses constituting the psychopathological space of paranoid schizophrenia and to determine clinical and pathogenetic validity of concepts of a single delusional psychosis (a model of chronic delusion with a staged course) and two endogenous delusional psychoses. MATERIAL AND METHODS: A sample consisted of 56 patients (19 women, 37 men; the average age 39.7±9.3 years; average duration of the disease 10.6±9.1 years) with a diagnosis of paranoid schizophrenia, continuous type of course (F20.00), developed at the age above 18 years. At the time of examination, the condition of the patients was determined by persistent delusional or hallucinatory delusional disorders. Clinical, pathopsychological, psychometric (SANS, SAPS, PANSS), immunological and statistical methods were used. RESULTS: The study substantiates a bimodal model of a single delusional psychosis with a polar arrangement of interpretive delusions and delusions of influence based on the phenomena of mental automatism, both in terms of the vector of development (toward the poles of negative/positive disorders) and in terms of the rate of progression. Psychopathological manifestations of interpretive delusions correlate with the slow evolving development of psychosis, the dimensional structure of the paranoid is limited to the limits of the delusional register; functional activity is represented by affiliation to negative changes, integration with personality anomalies ends with the transformation of positive disorders into pathocharacterological ones, corresponding to the post-processual development of the personality. Manifestation of delusional impact (syndrome of mental automatism) is manifested by the complication and maximum expansion of the spectrum of positive disorders; the dimensional structure is represented by a wide range of psychopathological disorders and is formed with the participation of processes of mental dissociation, reaching the level of delusional depersonalization; functional activity is high, which creates conditions for the formation of a «new¼ subpsychotic structure, a «psychotic character¼, which is an attenuated duplicate of delusional psychosis. In both groups of patients, a significant increase in the activity of inflammatory markers of leukocyte elastase (249.2 ((231.1-270.0); 272.2 (236.0-292.6) nmol/min∙ml) and alpha - 1 proteinase inhibitor (48.8 (46.0-55.0); 50.4 (42.1-54.8) IU/ml) was shown compared with controls (205.0 (199.8-217.3) nmol/min∙mL and 33.0 (31.0-36.0) IU/mL, p<0.01, respectively). In the group of patients with delusions of influence, an increased level of antibodies to S-100B was also observed (0.88 (0.67-1.0) opt.density units) compared with the control values (0.7 (0.65-0.77) opt.density units, p<0.05). CONCLUSION: The concept of the model is supported by the results of the immunological study, according to which interpretive delusions and delusion based on the mental automatism, indicates the different level of immunity tension, and a qualitative changes in immune reactivity (also due to different genetic burden).

[Hypochondriasis in Graves' disease: the role of pathologic factors and clinical characteristics endocrinopathy]. / Ipokhondricheskie razvitiya pri bolezni Greivsa: rol' patokharakterologicheskikh faktorov i klinicheskikh kharakteristik endokrinopatii.

OBJECTIVE: Clinical qualification of hypochondriasis or illness anxiety disorder (IAD) in Graves' disease (GD) and verification of associated personality and endocrinological factors. MATERIAL AND METHODS: A sample consisted of 27 patients (25 female and 2 male, mean age 48.4 years) with GD and personality disorders (PDs). The patients were examined clinically and with interviews for the assessment of PD according to DSM-IV (SCID-II-PD) and the Short Health Anxiety Inventory (SHAI). RESULTS: IAD was diagnosed in 8 cases (29.6%), of which the main study group was formed. The remaining 19 patients, who did not show signs of IAD, were assigned to the control group. In the main group, the average score on the SHAI «health anxiety¼ subscale was significantly higher (10.2 vs 4.8 points, p<0.05) corresponding to the clinical qualification of the condition as IAD. When assessing the frequency of categorical PDs, it was found that there were no affective PDs in the main group, likewise there were no anxiety cluster PDs in the control group (p<0.05). In turn, in the main group, PDs were characterized by such dimensions as the phenomena of psychopathological diathesis, reactive lability, neuropathy, which were not observed in the control group. The endocrinological factor that differed significantly in main and control groups was the frequency of recurrence of GD (75.0% vs, 40.1%, p<0.05). CONCLUSION: Despite the generally relatively favourable prognosis of GD, there is a significant frequency of IAD, the key role in the formation of which is apparently played by the parameters of the premorbid characteristics, as well as GD recurrence.

[The newer antipsychotic cariprazine (reagila): perspectives for use in different stages of schizophrenia therapy]. / Noveishii antipsikhotik Kariprazin (Reagila): vozmozhnosti primeneniya na raznykh etapakh terapii shizofrenii.

Cariprazine is a newer 3rd generation antipsychotic acting as partial agonist for dopamine receptors with unique higher affinity for D3 than D2 receptors. This review article summarizes key data from preclinical and clinical studies of cariprazine including pharmacodynamics, pharmacokinetics, clinical efficacy and safety/acceptability in acute short-term and long-term maintenance and relapse prevention therapy in patients with schizophrenia. Efficacy and safety of cariprazine in patients schizophrenia with predominantly negative symptoms resistant to previous antipsychotic therapy is discussed as well.

[Glossalgia as a psychodermatological syndrome]. / Glossalgiya kak sindrom psikhodermatologicheskoi patologii.

OBJECTIVE: To study clinical characteristics of burning mouth syndrome or glossalgia is a functional disorder with painful sensations in the oral cavity with verification of the psychopathological structure, typology and nosology of the syndrome within the continuum of neurotic/psychotic disorders and dermatological pathology, i.e. lichen planus (LP). MATERIAL AND METHODS: The study sample (n=30, 27 female, mean age 59.3±15.6 years) was examined by dermatologist, neurologist and psychiatrist both clinically and psychometrically. The patients met the diagnostic criteria for glossalgia according to the IASP classification and ICD-10 for glossodynia (code K14.6). In 7 subjects, there was comorbidity with LP of the oral mucosa. RESULTS: The psychopathological picture of glossalgia syndrome has a binary structure. Basic coenesthesiopathies, ranging in severity from homonomous sensations (isteralgias) to heteronomic sensopathies (senestopathies, senesthesia), are associated with secondary hypochondriacal phenomena: from health anxiety and monopatophobia to mastery of ideas and somatopsychic confusion, respectively. According to the psychopathological register (neurotic/psychotic) and the fact of objective verification of a dermatological disease (hypochondria sine materia/cum materia), there are three types of glossalgic syndrome: 1) organo-neurotic; 2) somatopsychotic; 3) dermatological (stress-induced somatic reactions). CONCLUSION: BMS is a local syndrome limited to the oral cavity, however, in fact, it covers the entire clinical spectrum of psychosomatic pathology from mental diseases to psychodermatological ones.

[Depression therapy for somatic diseases]. / Terapiya depressii pri somaticheskikh zabolevaniyakh.

A review of works devoted to the problem of psychopharmacotherapy of depression in general medical practice is presented. The issues of its comorbidity with somatic and neurological diseases, as well as multimorbidity are discussed. Both direct and side-effects of antidepressants, which are important for effective therapy of not only affective disorders proper, but also the symptoms of the leading pathology, are considered in detail for individual organs and systems. The analysis of the preferred pharmacological classes of antidepressants, which are drugs of first choice, taking into account the somatic condition of the patient, is carried out, and drugs are indicated, the appointment of which is undesirable for the treatment of a patient with a certain disease. The presented results are aimed both at increasing the efficiency of therapy for patients with general medical level of health care, and at increasing the safety of treatment of psychiatric patients with concomitant somatic disorders.

[Asthenic disorders in schizophrenia (schizoasthenia) on the model of hypochondriac schizophrenia]. / Astenicheskie rasstroistva pri shizofrenii (shizoasteniya) na modeli ipokhondricheskoi shizofrenii.

OBJECTIVE: To determine the structure and mechanisms of interaction of asthenic disorders with negative and positive psychopathological symptoms in hypochondriac schizophrenia. MATERIAL AND METHODS: The study included male and female patients, aged 17-69 years, with a diagnosis of hypochondriac schizophrenia (F20.80 according to ICD-10) and asthenia symptoms. The main research method was clinical, which was supplemented by pathopsychological examination and the use of psychometric scales (PANSS, SANS, MFI-20,VAS asthenia). RESULTS AND CONCLUSION: Asthenia in case of hypochondriac schizophrenia (schizoasthenia) integrates two unrelated phenomena: «weakness¼ and «exhaustion¼ (intolerance to stress), and also acts within the framework of three psychopathological syndromes: neurotic, senestopathic/hypochondriac and overvalued hypochondria. Asthenia with hypochondriac schizophrenia is a predictor of an unfavorable social and clinical prognosis. Integrating into the structure of the clinical manifestations of hypochondriac schizophrenia, asthenia forms close relationships with positive and negative disorders of the type of «general syndromes¼, but remains outside the categories of both positive and negative symptoms of the disease, thus forming a separate «dimension¼ in the psychopathological space of schizophrenia.

[History and current state of the problem of negative disorders (research of nosological period)]. / Istoriya i sovremennoe sostoyanie problemy negativnykh rasstroistv (issledovaniya nozologicheskogo perioda).

Pioneers of nosology in psychiatry considered mental deficit as a basic disorder obligated to all clinical forms of illness, as did E. Kraepelin in the concept of dementia praecox and E. Bleuler in the concept of schizophrenia. At the present stage of studies, this position is clearly articulated in the «deficit schizophrenia¼ concept of J. Klosterkotter. Negative disorders are considered in categorical approach to interpret psychopathological dimensions of schizophrenia as coordinated, strongly bound with positive syndromes (concept of «dialectical unity¼ of A.V. Snezhnevskiy, 1964) and classified as syndromes according to systematics of positive disorders. However, distinguished types of negative disorders are determined in terms of positive syndromes or characterological changes (asthenic, pseudopsychopathic deficit). Within a new paradigm (dimensional approach to schizophrenia), which differs from the categorical approach, negative disorders are considered as a distinct domain, primary in relation to other psychopathological phenomena of schizophrenia). A concept of primary persistent negative symptoms serves as basis of the current concept of schizophrenic deficit. Factor analysis revealed two domains of negative disorders: 1) emotional blunting: blunted affect, alogia; 2) avolition: apathy, anhedonia, asociality.

[Negative disorders: history of clinical concepts (prenosological studies)]. / Negativnye rasstroistva: istoriya razvitiya klinicheskikh kontseptsii (isledovaniya donozologicheskogo perioda).

In this review, sequential stages of the development of negative disorders doctrine are presented beginning from first description of negative symptoms (Aretaeus of Cappadocia - AD I-II) and the first deficit classification (including two polar types: congenital and acquired dementia by J.-E. Esquirol) to indigenous Russian (I.M. Balinsky, I.P. Merzheevsky, S.S. Korsakov, V.P. Serbsky and others) and foreign (B. Morel, H. Schüle, K. Kahlbaum, E. Hecker) studies of the middle 19th - beginning of 20th century. Special attention in this review of studies in prenosological period is given to the W. Griesinger's development of the main statements of deficit changes' classification and development pathways. Authors' studies created conditions not only for psychopathological construct of negative disorders to be set apart into particular category - «secondary insanity¼ (a group of psychiatric set of symptoms, which accumulate manifestations of mental deficit), but for to be subsequently clinically studied.

[Negative and positive disorders of schizophrenia (issues of co-dependence, psychopathology and pathogenesis)]. / Negativnye i pozitivnye rasstroistva pri shizofrenii (aspekty sozavisimosti, psikhopatologii, patogeneza).

The authors consider current and own conceptions about correlations of the processes underlying the pathogenesis of schizophrenia presented by negative and positive disorders. With growth of academic psychiatry, evaluation of a correlation between positive and negative dimensions has changed dramatically: on the one hand presenting in clinical unity - simultaneous psychopathologic structures, and on the other hand being clinically and pathogenetically heterogenic in dimensional structure. According to our clinical and biological findings and an analysis of fundamental neurobiological studies, positive and negative disorders present in the clinical picture of schizophrenia as two separate psychopathological and pathogenetic structures. A new paradigm of the correlation between positive and negative structures - the interaction between positive and deficit symptoms - reveals psychopathological functions differentiated for each of dimensional structures. Negative disorders act as «transformers¼ modifying characteristics of primary transnosological positive disorders to the level of psychopathological structures preferable for schizophrenia; positive disorders, in their turn, act as «moderators¼ augmenting, amplifying manifestations of negative symptoms. This psychopathological construct of the correlation between dimensional structures paves a way for the development of a new concept of psychopharmacological treatment of schizophrenic deficit: both negative symptoms and amplifying positive symptoms are considered as «target symptoms¼ for pharmacological interventions.

[Age identity disorders (infantilism/ puerilism) in the psychopathological space of endogenous diseases]. / Rasstroistva vozrastnoi identichnosti (infantilizm/puérilizm) v prostranstve psikhicheskikh zabolevanii éndogennogo kruga.

AIM: A comparative psychopathological and psychometric analysis of age identity disorders (AID) - infantilism and puerilism - on the model of schizophrenia proceeding with hysterical symptoms. MATERIAL AND METHODS: Results of the psychopathological study of 42 patients with schizophrenia and schizophrenia spectrum disorders (SSD), with well-marked signs of AID in the course of the disease (22 sub. - infantilism; 20 sub. - puerilism), are summarized. Psychometric evaluation was carried out using a standardized block of pathopsychological methods; scales for assessing negative and positive psychopathological symptoms (SANS, PANSS, MFI-20); personality assessment instruments (SPQ-A; Personality Traits Questionnaire (V. Rusalova); Methods for diagnostics of personal maturity (V. Ruzhenkova)). RESULTS: The differentiation between infantilism and puerilism, forming in the psychopathological space of schizophrenia and SSD, is not limited by differences in the indicators of age-related immaturity. Infantilism shows an affinity to the dimensional structures of the negative symptoms, acting as primary psychopathological formations - apathoabulic disorders. Conversely, puerilism is derived from the positive symptoms - psychopathological formations related to the dissociative disorders. CONCLUSION: From the perspective of the modern concept of schizophrenia, infantilism and puerilism are associated with polar dimensional structures (positive-negative symptoms) and, accordingly, can be regarded as psychopathologically heterogeneous formations.

[Cariprazine in schizophrenia with predominantly negative symptoms: early effects of therapy (observational study)]. / Kariprazin v terapii shizofrenii s preobladaniem negativnykh simptomov: initsial'nye effekty lecheniya (observatsionnoe issledovanie).

BACKGROUND: Currently available antipsychotics have limited efficacy in the treatment of negative symptoms in schizophrenia and new drugs with wider spectrums of clinical efficacy are very desirable. Cariprazine is a newer antipsychotic acting as dopamine D3- and in lesser extent D2-receptor partial agonist found to be effective in the treatment of negative symptoms in schizophrenia. OBJECTIVES: To evaluate cariprazine early effects at the first stage of therapy of schizophrenia patients with predominantly negative symptoms. DESIGN AND PATIENTS: Open-lable observational assessment of 60 adult schizophrenia patients (F20 on ICD-10, 49% males) with predominantly negative symptoms (PANSS-FSNS ≥15, PANSS-FSPS <19) treated by cariprazine (starting daily dose 1.5 mg followed by upward titration by 1.5 mg weekly up to 6 mg if needed) were assessed with PANSS, CAINS, CDSS and SAS scales at baseline and on week 1, 2, and 4. Efficacy criteria were. RESULTS: Most patients (75%) improved during 28 days of cariprazine treatment. Negative symptoms mean total scores on PANSS-NS and CAINS significantly (p<0.05) reduced by 4.3 and 4.9 respectively at the end of assessment (day 28). Cariprazine tolerability was good, only 4 patients discontinued because of TEAEs (akathisia, insomnia). CONCLUSIONS: The study results preliminary suggest initial effect of cariprazine on negative symptoms at least in some schizophrenia patients with predominantly negative symptoms starting from 1-2 weeks of treatment and available for observation and assessment and could be useful for determination of early clinical predictors for efficacy. Considering limitations of observational open-lable design with no control groups these data need to be confirmed.

[Asthenia in the psychopathological space of schizophrenia and schizophrenia spectrum disorders (The concept of asthenic deficit in aspect of the modern model of negative symptoms)]. / Asteniia v psikhopatologicheskom prostranstve shizofrenii i rasstroistv shizofrenicheskogo spektra (kontseptsiia astenicheskogo defekta v aspekte sovremennykh modelei negativnykh rasstroistv).

At the modern level of knowledge, classification of asthenic deficit as an independent psychopathological category and, in general terms, as the classification of asthenic symptomatic complexes of negative symptoms within schizophrenia and schizophrenia spectrum disorders is the subject of discussion. Studies of recent decades have shown that asthenia cannot be considered as a separate deficient monosyndrome, does not fit into the framework of negative disorders and is excluded from the block of scales of negative symptoms (SANS, PANSS, BNSS, CAINS). The authors suggest a working hypothesis that asthenia symptomatic complexes within schizophrenia are not comparable either in nature or in their psychopathological structure with primary deficiency disorders determined by the disease process. However, at the same time schizoasthenia, acting as a manifestation of the coenesthesiopathic hypochondriacal register, i.e. essentially in the space of positive disorders, is formed in close dependence on negative symptoms and is thus one of the markers of the already formed defect.

[Personality disorders and schizophrenic defect (problem of comorbidity)]. / Rasstroistva lichnosti i shizofrenicheskii defekt (problema komorbidnosti).

AIM: To test the main hypothesis that the deficit phenomena in schizophrenia act not in the 'pure' form, but in the form of aggravating personality characteristics, forming so-called 'common' syndromes with personality disorders (PD). MATERIAL AND METHODS: The results of the psychopathological study (with the use of psychometric methods) of deficit disorders in a sample of 170 patients with schizophrenia and schizophrenia spectrum disorders (63 men, 107 women) are presented in relation to the abnormal structure of premorbid personality (PD of clusters A, B, C). An analysis of negative symptoms according to the comparability of defect to the profile of premorbid personality made it possible to distinguish three groups of deficit states associated with PD - 'common syndromes': defensive schizoidy by the type of deficit schizoid and expansive schizoidy by the type of 'verschroben' (cluster A); pathological hysterical infantilism, malignant hysteria and defective erotomania (cluster B); pseudo-psychasthenia and pathological rationalism (cluster C). RESULTS: It has been found that the symptomatology of 'common syndromes' is subject to patterns reflecting the dichotomy of the basic defect. This pattern is valid not only for one single cluster of PD, but extends to all psychopathy-like disorders, regardless of their affiliation with a particular cluster. The pathocharacterological component of the 'common syndromes' coexisting with the deficit symptom complexes is subject to the basic deficit component of the defect and is separated into polar dimensions (defensive-expansive) within specific clusters of PD, and then unified in accordance with the dichotomy of schizophrenic defect in categories with the predominance of emotional or apathoabulic disorders. CONCLUSION: Psychopathy-like symptom complexes in the space of 'common syndromes' can be qualified as a psychopathological construct secondary to basic deficit disorders, and their isolation as an independent entity of negative disorders appears to be unjustified.

[Evolution of the schizophrenic deficit concept]. / Évoliutsiia ucheniia o shizofrenicheskom defekte.

The relevance of this study is the high prevalence and clinical heterogeneity of deficit states in chronic schizophrenia and schizophrenia spectrum disorders. The study aimed at analyzing negative symptoms in schizophrenia and schizophrenia spectrum disorders from historical and modern perspectives. An analysis of available literature, along with own observations, has been performed. It was found that negative symptoms comprise 3 clinical types: 1) 'pseudopsychopathic' type (overlapping personality dimensions and premorbid/initial negative symptoms), 2) pseudoorganic/asthenic/pseudobradiphrenic type (pseudoorganic states), developing at different stages of schizophrenia), 3) 'new'-life pseudopsychopathic type (not associated with premorbid personality traits), developing at late stages in schizophrenia. The trajectory heterogeneity of negative symptoms in their relation to positive symptoms has been defined: simultaneous-continuous course (synchronous course of positive and negative symptoms), polar course (alternative development of predominantly positive or negative symptoms), simultaneous-phasic course (pseudopsychopathic negative symptoms, attracting depressive symptoms, or depression that exacerbates latent deficit). The authors discuss some aspects of psychopharmacological treatment of negative symptoms. Negative symptoms in schizophrenia and schizophrenia spectrum disorders differ clinically, have heterogeneous trajectory course, and require differentiated approach with regard to psychopathological qualification, prognosis and treatment.

Efficiency of Umbilical Cord Blood Cells in Patients with Treatment-Resistant Depressions.

We studied the efficacy of umbilical cord blood cells in the therapy of treatment-resistant depressive states in women. Concentrated umbilical cord blood cells were administered in a dose of 250 millions cells (4 injections at 1-week intervals). The control group received placebo. In both groups, reduction of depressive disorders and the decrease in hypothymia severity were observed. Infusions of cell concentrate contributed to delayed correction of treatment resistance and reduced the severity of depression to moderate. In the main group, significant, persistent, and long-term positive dynamics was observed in the cognitive sphere. The therapeutic potential of umbilical cord blood cell concentrate can be used to overcome treatment resistance formed in depressive patients.

[Reactive (psychogenic) depressions].

In this literature review, authors analyzed the history of studies on psychogenic (stress-included) depressions and the current state of the problem. The status of these diseases in classification systems, main directions of current research, proposed conceptions and perspectives of future studies in the filed are considered.

[The systematics of psychogenic depressions (reactions of complicated grief)].

OBJECTIVE: Reactive depression provoked by the loss of loved ones is a controversial problem of modern psychiatry based on the diametrically opposite conceptions. The author suggests a clinical typology of these depressions based on a psychopathological analysis of trigger mechanisms and constitutional predisposition. MATERIAL AND METHODS: Fifty-five patients, aged from 31 to 65 years (mean age 46.9±13.9 years), were examined. The course of depression, including previous psychogenia, was followed up for 5-15 years (mean 11.5±3.6 years). RESULTS AND CONCLUSION: Three types of catathymic complexes (affective dissonance, affective resonance and affective imbalance) can be considered as a significant parameter responsible for trigger mechanisms of these psychogenias and their further dynamics. Each type determines not only the psychopathological structure of psychogenic depression but has a predictive validity thus allowing to predict the dynamics of depression and its nosological attribution.

[The use of ixel in the treatment of depression in patients with chronic schizophrenia].

An open non-controlled 12-week study of 30 patients with chronic schizophrenia with mild and moderate depression has been carried out. Ixel was administered in dosage 100-200 mg daily along with the basic antipsychotic therapy (haloperidol, olanzapine, quetiapine, risperidone, paliperidone). Patient's state was assessed with the Clinical Global impression scale (CGI), the Hamilton depression scale (HAM-D-21) and the Positive and Negative Syndromes scale (PANSS). Percentage of responders on CGI was 73.3%. A significant (p