[Comparison of psychometric and pathopsychological approaches in the assessment of intellectual activity in children and adolescents with progressive forms of schizophrenia]. / Sopostavlenie psikhometricheskogo i patopsikhologicheskogo podkhodov v otsenke intellektual'noi deyatel'nosti u detei i podrostkov s progredientnymi formami shizofrenii.

OBJECTIVE: To study the intellectual activity of children and adolescents with progressive forms of schizophrenia using quantitative and qualitative diagnostic methods. MATERIAL AND METHODS: An experimental group consisted of 67 children and adolescents (mean age 11.1±2.8 years) with mental pathology of schizophrenia spectrum with varying severity of the disease (malignant, progressive, and low progressive course) and leading clinical syndromes (catatonic, psychopathic, neurosis-like, and hyperkinetic). A control group included 63 children and adolescents (mean age 11.1±3.0 years) without a verified psychiatric diagnosis, secondary schools' students. The Wechsler Intelligence Scale for Children (WISC) was used for assessing intelligence, the Design of objects method was used for assessing the characteristics of thinking. RESULTS: The relationship between thinking disorders and the parameters of verbal intelligence in patients with schizophrenia was shown (the Information subtest is related to all Object Construction parameters, r=0.401 to r=0.634; verbal IQ score is associated with some Object Construction scores, r=0.541 to r=0.537). In the control group, such a relationship was not noted. A decrease in the level of intelligence and severe thinking disorders is associated with such clinical factors as the malignant course of the disease (mean Full IQ score is 60.1, z-value of the coefficient of standardization in relation to the age norm is -2.1) and catatonic syndrome (mean Full IQ score is 68.1, coefficient of standardization is 60%). CONCLUSION: The use of psychometric and pathopsychological approaches in the diagnosis of intellectual activity complements each other.

Epidemiological Screening for the Risk of Mental, Behavioral and Developmental Disorders, Including Autism, in Early Childhood: Data for Russia 2017-2019.

We aimed to screen children aged 18-48 months in the general population of nine Russian regions for risk of mental, behavioral and developmental disorders (MBDDs) including autism spectrum disorders (ASD) using an original screening tool. The prevalence of the risk for MBDDs is 1307:10,000 (13.07%), the prevalence of clinically verified cases of MBDDs is 151:10,000 (1.51%), whereas the prevalence of ASD among them is 18:10,000 (0.18%). Basing on our results, the screening procedures are already integrated into the Russian primary care system since the end of 2019. Screening of the risk for MBDDs including ASD in Russia among children in the general pediatric population is a promising area of preventive medicine.

[Paired and partial correlations of immune parameters of neuro-immuno-test and coagulation parameters of thrombodynamics test in children with children's autism]. / Parnye i chastnye korrelyatsionnye svyazi immunnykh pokazatelei neiroimmunotesta i koagulyatsionnykh parametrov trombodinamiki u bol'nykh detskim autizmom.

OBJECTIVE: To reveal paired and partial correlations of values of neuro-immuno-test and thrombodynamics test in children with childhood autism and schizophrenia in childhood in a state of exacerbation. MATERIAL AND METHODS: The study used a database of children with childhood autism, obtained by us in 2028-2019. The study included 46 patients with childhood autism (CA) aged 2 to 13 years: median age [Q1; Q3] - 5 years [4; 7], 10 girls (22%) and 36 boys (78%)). The thrombodynamics test (TD) was performed on a T-2 thrombodynamics analyzer according to the manufacturer's instructions. RESULTS: It was shown that there is a statistically significant positive correlation (R=0.369, p=0.018) between the acquired immunity parameter: the level of serum antibodies to myelin basic protein (BMP): abBMP parameter, and the main parameter of platelet hemostasis - the time of appearance of spontaneous clots (Tsp). It can be assumed that autoantibodies to BMP block the procoagulant effect of myelin basic protein and thus have an anticoagulant effect. However, this analysis did not take into account the possible effects of other parameter of the neuro-immuno-test and thrombodynamics test. Therefore, when studying the correlation of specific parameters of the neuro-immuno-test and thrombodynamics, it is necessary to take into account the possible modifying effect of other parameters of these tests. It was shown that after subtracting the influence on the main correlation (abBMP & Tsp) of individual thrombodynamic parameters (Vi, V and D), as well as their total influence, the partial correlations become statistically insignificant. This indicates that these TD parameters can, individually or in total, determine the revealed correlation between the levels of antibodies to the basic myelin protein (Basic Myelin Protein) and the time of the appearance of spontaneous clots. CONCLUSION: Thus, it was shown that the correlations between the studied parameters of the neuro-immuno-test and the indicators of the thrombodynamics test mutually depend on the other indicators of these tests. This confirms the hypothesis that the immune system and the hemostatic system are two different sides of a single supersystem.

[Models of clinical and social management of patients with autism spectrum disorders]. / Kliniko-sotsial'nye modeli vedeniya patsientov s rasstroistvami autisticheskogo spektra.

OBJECTIVE: To develop clinical and social models and management routes for patients with autism spectrum disorders (ASD). MATERIAL AND METHODS: A clinical follow-up study was performed for 254 patients, aged 4-17 years (average age 7.3 years), who represented the main forms of ASD. Psychopathological, clinical-follow-up, psychological and statistical methods were used. RESULTS AND CONCLUSION: Five management models for patients with different forms of ASD are described; differentiation of routes for interagency monitoring of patients is proposed. The effectiveness of the integrated use of drug and non-drug therapeutic approaches for the management of patients with ASD in the clinical-age aspect is shown. Timely diagnosis of ASD makes it possible to develop differentiated routes of patient management within the framework of interdepartmental interaction and achieve positive results in the clinical and age aspect.

[Screening of the risk of mental and developmental disorders in children of early age in the Russian population (2017-2019)]. / Skrining riska vozniknoveniya narushenii psikhicheskogo razvitiya u detei rannego vozrasta (dannye po 9 regionam Rossii v 2017­2019 gg.).

OBJECTIVE: Screening of children 18-48 months of age at risk of mental and developmental disorders in the general population. MATERIAL AND METHODS: The survey was conducted by a continuous epidemiological method in primary health care institutions in the nine largest regions of Russia. For the period 2017-2019, 595 691 parents of children, aged 18-48 months, were surveyed. RESULTS AND CONCLUSION: The prevalence risk rate for mental and developmental disorders was determined as 1.307:10 000. The prevalence rate for mental and behavioural disorders (ICD-10) was 151:10 000. The analysis of the structure of mental and behavioural disorders was carried out. An increase in cases of pervasive developmental disorders (item F84) was detected - autism spectrum disorders (ASD) with an increase in the age of children. The prevalence of ASD under the age of 48 months was found to be 18:10 000, compared with 2015-2016 - 5:10 000 under the age of 24 months.

[A combined marker of catatonia severity including autoimmune and thrombodynamic parameters in patients with autism spectrum disorder]. / Kombinirovannyi marker tyazhesti katatonii, vklyuchayushchii immunnye i trombodinamicheskie pokazateli, u bol'nykh s rasstroistvami autisticheskogo spektra.

OBJECTIVE: To verify a working hypothesis that thrombodynamic parameters of hypercoagulation and neuro-immune test correlate with the severity of catatonia in patients with autism spectrum disorder (ASD), and the combination of these indicators can predict the severity of catatonia with high accuracy and precision. MATERIAL AND METHODS: Twenty-four patients with ASD (22 boys and 2 girls) with infantile psychosis in childhood autism (ICD-10 F84.02) were studied. The median age of the patients was 5,5 years. Neuro-immune and thrombodynamics tests were performed. RESULTS AND CONCLUSION: Thrombodynamic parameters of clot growth rates from the activator (V, Vi and Vst) are significantly higher than their normal values. The values of the time of spontaneous clots occurrence (Tsp) are significantly less than the lower limit values for the norm (30 min). It was also shown that the activity of leukocyte elastase (LE) and the functional activity of the α1 protein inhibitor (α1-PI) are significantly higher than their normal values. The values of the levels of autoantibodies to S100 protein (aabS100B) and the basic myelin protein (aabOBM) are within the normal range. The initial clot growth rate (Vi) and the time of spontaneous clots occurrence (Tsp) significantly correlate with the severity of catatonia: Spearman's R is 0,55 for Vi (p=0,009) and -0,61for Tsp (p=0,002). Among the parameters of the neuro-immuno-test, only aabS100B indicator significantly correlates with the severity of catatonia. To increase the informative significance and accuracy of the contribution of the studied correlates of thrombodynamics and the neuro-immuno-test to the assessment of the severity of catatonia in children with ASD, a multivariate linear regression analysis was performed to construct a linear equation for the relationship between the severity of catatonia and correlates of thrombodynamics and a neuro-immuno-test. The determination coefficient R2, which determines the informational significance of the regression model, is 0,63. The remaining 37% is explained by unaccounted and not yet known factors.

[Thrombodynamic parameters of hypercoagulation of blood in children with childhood autism and schizophrenia]. / Trombodinamicheskie pokazateli giperkoaguliatsii krovi u detei s detskim autizmom i detskoi shizofreniei.

AIM: To detect blood plasma coagulability in children with mental diseases using a thrombodynamics test. MATERIAL AND METHODS: The study included two groups of children. Group 1 included 11 patients with infantile psychosis in autism (F84.02) (4 girls and 7 boys). Group 2 included 8 patients with childhood schizophrenia (F20.8xx3) (4 girls and 14 boys). A test was performed with T-2 Thrombodynamics analyzer (LLC Hemacore, Moscow, Russia). RESULTS: Thrombodynamic parameters, such as initial, steady-state velocity and spontaneous clots adjusted velocity (Vi, Vst and V, µm/min, respectively) and clot size at 30 minute of thrombodynamics test (CS µm) were significantly increased in the total group of patients (n=29). The time of appearance of spontaneous clots (Tsp), the time of clot lag time (Tlag) and clot density (D) did not differ significantly from the normal values (p=0.98; p=0.27 and p=0.21, respectively). In the autism group (n=11), Vi, Vst and V were significantly higher than normal values, while CS, Tsp, Tlag and D did not differ from norm. In the schizophrenia group (n=18) V, Vst and CS, and Vi were significantly increased. Tsp, Tlag and D did not differ from normal values. Differences between the parameters of thrombodynamics in 1 and 2 groups were not statistical significant. CONCLUSION: It was shown for the first time that clotting (hypercoagulability) of the blood plasma in patients with autism and childhood schizophrenia was increased. This can cause thrombosis in small vessels of the brain. Early spontaneous clots appear in many patients that indicating the presence of systemic inflammation, possibly associated with an exacerbation of neuroinflammation. The thrombodynamics test allows detection of predisposition to hypercoagulability in the early stages when other methods are not sensitive enough.

[Thrombodynamic correlates of catatonia severity in children with autism]. / Trombodinamicheskie korreliaty tiazhesti katatonii u detei s autizmom.

AIM: To study a correlation between the values of thrombodynamics parameters of hypercoagulation measured by the thrombodynamics test and the severity of catatonia in children with infantile psychosis in childhood autism (F84.02). MATERIAL AND METHODS: Twenty-four patients (22 boys and 2 girls) aged from 3 to 13 years, were studied. The severity of catatonia was determined by BFCRS. A thrombodynamic test was performed in platelet-free plasma using the analyzer T-2 Thrombodynamics Device (Hemacore LLC, Russia). RESULTS: Thrombodynamic (TD) parameters of clot growth rates from the activator (V, Vi and Vst) were statistically significantly higher than normal values. Similar results were obtained for Clot Size at 30 min (CS, µm): Tlag and D values were within normal limits. The values of Time of appearance of spontaneous clots (Tsp min) were less than the lower limit values for the norm (30 min). Correlation analysis showed that the severity of catatonia is positively correlated with the initial clot growth rate (Vi) (p=0.009) and negatively with Tsp (p=0.002). With an increase in the time of appearance of spontaneous clots (due to a decrease in the procoagulant activity of platelet microparticles in the plasma of patients), the severity of catatonia in children with ASD decreases. CONCLUSION: The results suggest that normalizing plasma and platelet hemostasis is important for increasing the effectiveness of treatment of patients with ASD with catatonia.

[The epidemiologic study of the risk of autism spectrum disorders in children of 16-24 months in Russia, 2015-2016]. / Épidemiologiia riska vozniknoveniia rasstroistv autisticheskogo spektra u detei 16-24 mesiatsev zhizni (dannye po Rossii za 2015-2016 gg.).

AIM: To screen infants of the general population for the risk of autism spectrum disorders (ASD). MATERIAL AND METHODS: The survey was conducted by a total epidemiological method in primary health care facilities in the three largest regions in Russia (Volgograd, Novosibirsk, Chelyabinsk regions). For the period 2015-2016, 74191 parents of children aged 16-24 months were questioned. RESULTS AND CONCLUSION: The prevalence of risk of ASD (a condition of a pre-illness) was 103.5 cases per 1000 of children aged 16-24 months. Some of the children at ASD risk had a preventive consultation with a psychiatrist, 36 children (0.5 per 1000 peers) had severe clinical disorders classified as F84 - 'Pervasive developmental disorders' of ICD-10 (F84.0; F84.1; F84.8). From the perspective of predicative and preventive medicine, children at risk require complex measures to prevent the onset of a mental disorder or worsening of the mental state of the child.

[Autism spectrum disorders in children and adults: the experience of reserches from different countries]. / Rasstroistva autisticheskogo spektra u detei i vzroslykh: podkhody k probleme v raznykh stran.

Current studies on the development autism spectrum disorders (ASD) at different ages are reviewed. The review highlights the increasing interest to this problem and converging positions of researchers from different countries, encouraged by the development of international and other classifications of mental diseases, on the terminology, classification and prevalence of ASD in children. An important feature of the present stage is to draw attention to an understudied problem of ASD in adults, including elderly, and provision of medical and social care to these patients.

[Mercury and autism spectrum disorders]. / Vozmozhnaia rol' rtuti v razvitii rasstroistv autisticheskogo spektra u detei.

The authors present a review of literature on the involvement of perinatal and postnatal mercury exposure in the pathogenesis of autistic spectrum disorders (ASD). A number of studies have shown a reliable association between perinatal and postnatal exposure to mercury and ASD development aa well as clinical and laboratory markers of the severity of these disorders. However the association was not confirmed in other studies. Such contradictions may be explained by differences in the composition of study groups, including geographical characteristics, and the influence of the factors related to mercury neurotoxicity.

[The possibility of using immunological parameters for the evaluation of the clinical state of patients with childhood-onset schizophrenia].

OBJECTIVE: To compare clinical and immunological parameters in children with schizophrenia and to analyze the possibility of using them in the assessment of the pathological process activity. MATERIAL AND METHODS: We examined 62 patients, 39 boys and 23 girls, aged from 4 to 17 years, with childhood-onset schizophrenia. Mental state of the patients was assessed using a psychopathological method and with PANSS and CGI scales. The activity of leukocyte elastase (LE) and alpha(1)-proteinase inhibitor (α1-PI) was measured by spectrophotometric method. ELISA was used to determine the level of autoantibodies to neuroantigenes to S-100B and basic myelin protein. RESULTS AND CONCLUSION: The activation of innate immunity assessed by the activity of LE and α1-PI and adaptive immunity (levels of autoantibodies to neuroantigenes to S-100B and basic myelin protein) was identified. Significant correlations of the level of immune system activation with the severity of patient's state on СGI-S (r=0.64, p=0.000001) as well as scores on the PANSS negative symptom subscale (r=0.34, p=0.0077) were found. The results suggest the possibility of using these immunological parameters for the objectification of clinical state of children with schizophrenia.

[The activity of complement system in children with autistic spectrum disorders]. / Aktivnost' sistemy komplementa u detei s rasstroistvami autisticheskogo spektra.

AIM: To evaluate the state of complement system (CS) activity in children with autistic spectrum disorders (ASD) and children with schizophrenia on the basis of development and implementation of a new method of CS determination. MATERIAL AND METHODS: A study included 249 patients, aged from 3 to 14 years. The control group consisted of 279 age-matched children. The authors developed a method for integral evaluation of CS activity based on the changes in the death of free swimming ciliata Tetrahymena pyriformis measured with the apparatus BioLat (Moscow, Russia). The integral CS activity (T50) was estimated as the time of death of 50% of ciliata in the blood serum (serum concentration was 5%). RESULTS AND CONCLUSION: A comparative analysis of CS activity showed statistical differences in median T50 values between patients and controls (p<0.005). Based on CS activity levels, three groups of patients were determined: 1) with the levels lower than the lowest value of the control group (n=112 (39%)); 2) higher than the highest level of the control group (n=103 (36%)); intermittent between low and high values of the control group (n=72 (25%)). Significant differences in T50 between the psychotic autism group and children schizophrenia group were identified (p<0.005). The CS activity was lower in patients with ASD compared to children with schizophrenia.

[Current possibilities in pharmacotherapy of anxiety disorders in children and adolescents].

OBJECTIVE: To assess the efficacy and safety of children tenoten in the treatment of children and adolescents with anxiety disorders. MATERIAL AND METHODS: It was conducted a multicenter, double-blind, placebo-controlled trial of the drug tenoten children at a dose of 1 tablet 3 times a day for 12 weeks. The study included 98 patients (boys and girls from 5 to 15 years with a confirmed diagnosis of anxiety disorder), randomized into two groups: the first included 48 patients treated tenotenom children, in the second - 50 patients receiving placebo. RESULTS AND CONCLUSION: Tenoten children has a strong anti-anxiety effect both on the results of self-assessment of patients, and on the reports of parents. This anxiolytic activity of the drug manifested most significantly in children aged 5 to 7 years. In addition, in patients 8-15 years of treatment spent tenotenom children to regress the symptoms of anxiety disorders by anxiety subscales SCAS «Separation anxiety¼, «panic attacks and agoraphobia¼ and «social phobia¼. Throughout the course of treatment tenoten children have been no adverse events.

[On the problem of psychological (psychometric) diagnosis of intelligence in children with developmental disorders]. / Psikhometricheskaia otsenka intellekta u deteĭ s narusheniiami psikhicheskogo razvitiia.

A review includes the following sections corresponded with methods of investigation and groups of patients: Wechsler test for atypical autism and schizophrenia; Psycho Educational Profile (PEP) in endogenous mental pathology, the Kaufman Test of Educational Achievement in children schizophrenia, Edinburgh Picture Test in mental dysontogenesis. The results of the studies in these fields are presented.

Speech and motor disturbances in Rett syndrome.

Rett syndrome is a severe, genetically determined disease of early childhood which produces a defined clinical phenotype in girls. The main clinical manifestations include lesions affecting speech functions, involving both expressive and receptive speech, as well as motor functions, producing apraxia of the arms and profound abnormalities of gait in the form of ataxia-apraxia. Most investigators note that patients have variability in the severity of derangement to large motor acts and in the damage to fine hand movements and speech functions. The aims of the present work were to study disturbances of speech and motor functions over 2-5 years in 50 girls aged 12 months to 14 years with Rett syndrome and to analyze the correlations between these disturbances. The results of comparing clinical data and EEG traces supported the stepwise involvement of frontal and parietal-temporal cortical structures in the pathological process. The ability to organize speech and motor activity is affected first, with subsequent development of lesions to gnostic functions, which are in turn followed by derangement of subcortical structures and the cerebellum and later by damage to structures in the spinal cord. A clear correlation was found between the severity of lesions to motor and speech functions and neurophysiological data: the higher the level of preservation of elements of speech and motor functions, the smaller were the contributions of theta activity and the greater the contributions of alpha and beta activities to the EEG. The possible pathogenetic mechanisms underlying the motor and speech disturbances in Rett syndrome are discussed.

[Quantitative EEG correlates of the human frontal lobe dysfunction]. / Kolichestvennye EEG-korreliaty disfunktsii lobnykh dolei kory golovnogo mozga cheloveka.

Increased central-parietal EEG theta-2 activity (about 6.5 per sec) was found in children with cognitive disorders (in Rett's syndrome, fragile X-syndrome, infantile autism) and in elderly patients with Alzheimer-type dementia (with prevalence of neuropsychological "frontal" disorders) in the presence of suppressed alpha rhythm. This theta-activity was closely associated with cognitive deficits and possessed a specific functional topography, namely it focused in the parietal region and suppressed by both visual stimulation and motor tests. The similar EEG pattern was observed in some patients treated with neuroleptics and/or during hyperventilation. By taking into account the data available in the literature on motor, oculomotor, regional cerebral blood flow and the probability prediction in frontal lobar dysfunction, it is suggested that the theta-activity described appears in the visuomanual coordination system and is a physiological correlate of decreased functional status of frontal lobes.

[Clinico-catamnestic study of the development of remissions in adolescents suffering recurrent schizophrenia]. / Kliniko-katamnesticheskoe izuchenie stanovleniia remissii u podrostkov, bol'nykh rekurrentnoi shizofreniei.

The formation of remissions of recurrent schizophrenia was studied over time in 32 adolescents (12-17 years of age). Over the period of follow-up (4-8 years) the author analyzed 23 affective-oneiric and 50 affective-delirious attacks of schizophrenia and traced the history of patients at the age of 18-23 years. Following attacks of recurrent schizophrenia all patients presented a gradual formation of remissions. At the first stages continuous affective disturbances were well pronounced. In the course of their subsidence, 1.5-2 years after the end of attacks the patients were characterized by mild personality changes and a slight decrease in the energy potential as compared to its high premorbid level. A number of therapeutic-adaptational recommendations has been developed for the management of patients with recurrent schizophrenia in the period of remission formation.

[Clinical features of acute polymorphic paroxysms of puberal schizophrenia]. / Klinicheskie osobennosti ostrykh polimorfnykh pristupov pubertatnoi shizofrenii.

Forty-five patients aged 12 to 17 years suffering from acute pubertal schizophrenia characterized by polymorphic paroxysms were studied. This group was heterogeneous and included recurrent schizophrenia with affective-oneiroid and affective-delusional disturbances in paroxysms and paroxysmal progressive schizophrenia with catatono-oneiroid and paranoid disorders. An extensive description of psychopathologic disturbances in affective-oneiroid and acute affective-delusional paroxysms of pubertal schizophrenia is presented. Acute pubertal schizophrenia with affective-oneiroid disturbances in paroxysms is often characterised by a serial course (42%). Diseases of this sub-group displayed a tendency toward a regressive course and resembled schizoaffective psychoses most closely.

[Features of remissions in adolescents with paroxysmal schizophrenia who have suffered catatono-oneiroid episodes]. / Osobennosti remissii u podrostkov, bol'nykh shuboobraznoi shizofreniei, perenesshikh katatonooneiroidnye pristupy.

The article is devoted to a clinical dynamic study of the formation of remissions, the specification of the structure of the defect, social prognosis and localization of asthenic disturbances in 33 adolescents with shift-like juvenile schizophrenia who suffered from catatono-oneiroid attacks. The duration of the follow-up was 4-8 years. The fate of patients was traced at the age of 17-23 years. A total of 54 catatono-oneiroid attacks were analyzed. Psychopathological characteristics of asthenic disturbances in the structure of the defect were compared in remission, in the premorbid period and in premanifest period of the disease. A number of therapeutic and adaptational recommendations on the management of patients with shift-like juvenile schizophrenia in the period of remission formation are provided.