[A clinico-biological study of the thrombocyte serotonin-transport complex in therapeutically resistant patients with endogenous depression undergoing combined treatment]. / Kliniko-biologicheskoe issledovanie serotonintransportnogo kompleksa trombotsitov u terapevticheski rezistentnykh bol'nykh éndogennoi depressiei pri kompleksnom lechenii.

The platelet parameters of the functional status of the serotonin-reuptake complex were studied in drug-resistant depressive patients given various regimens of complex therapy or selective serotonin re-uptake inhibitors (fluvoxamine and fluoxetine). The most persistent and marked clinical effect was seen in electroconvulsive therapy and it was due to the normalization of the serotonin-reuptake system.

[Features of the course of schizophrenia manifesting as an acute Kandinsky-Clérambault syndrome]. / Osobennosti techeniia shizofrenii, manifestiruiushchei ostrym sindromom Kandinskogo-Klerambo.

A clinical follow-up study of 57 schizophrenic patients revealed heterogeneity of the clinical role of acute Kandinsky-Clerambault syndrome in the picture of the disease. The author describes the syndrome of psychic automatism in the framework of "schizophrenic reactions" in the time-course of latent schizophrenia, in the picture of the attack in shift-like and recurrent course and in the structure of the shift resembling clinically the exacerbation of the continuously progressive process. The author also shows the correlation between the premanifest period, clinical mechanisms of the development of manifest psychosis, the structure of acute Kandinsky-Clerambault syndrome and the subsequent characteristics of the schizophrenia course. The question of prognostic significance of the differential approach to the assessment of acute Kandinsky-Clerambault syndrome and of its different clinical significance in the picture of clinical diseases is discussed.

[Clinico-psychopathologic varieties of the acute Kandinsky-Clerambault syndrome in schizophrenia]. / Kliniko-psikhopatologicheskie raznovidnosti ostrogo sindroma Kandinskogo--Klerambo pri shizofrenii.

Acute cases of the Kandinsky-Clerambault syndrome first manifested in adulthood were studied in schizophrenic patients. On the basis of the clinical mechanisms of the development of psychosis and the specific features of acute delirious disturbances in the structure of psychosis 3 clinical variants of the acute syndrome of psychic automatism were identified: developing according to the type of reaction in the structure of acute paranoid (the first variant), according to the regularities of endogenic paroxysm in the picture of acute sensory delirium (the second variant) and according to the mechanism of exacerbation of chronic delirium entering the structure of acute interpretative delirium (the third variant).

[Family background of schizophrenic patients displaying acute delusional and hallucinatory psychoses]. / Semeinyi fon bol'nykh shizofreniei, manifestiruiushchei ostrymi bredovymi i ostrymi galliutsinatornymi psikhozami.

The authors studied the characteristics of the hereditary aggravation in probands with schizophrenia first manifested with acute delirious or acute verbal hallucinosis. They also considered the incidence of manifest and latent forms of schizophrenia and the rate of personality anomalies in families of probands with the differentiation of schizoid anomalies by the predominance of sthenic and asthenic features. The frequency of coincidence of the patterns of schizophrenic process among relatives was determined and the data obtained were compared with those in probands from each group. The comparative analysis has shown that the familial background of the studied group of probands reflects the following regularities characteristic of schizophrenia; an increase in the frequency of psychoses of the schizophrenic spectrum as against that in the general population, accumulation of homonomous types of the schizophrenia course and the presence in relatives of abnormalities of the schizophrenic nature. This justifies the referral of the studied forms of psychoses to schizophrenic diseases.

[Problem of side effects of leponex on blood (multicenter inter- national study)]. / K voprosu o pobochnom deistvii leponeksa na sostoianie krovi (mnogotsentrovoe mezhdunarodnoe issledovanie).

The authors provide the data on the dynamics of the hematological parameters during continuous leponex (clozapin) treatment of two group of patients treated in 1973-1989 at the All-Union Mental Health Research Center, USSR AMS (107 patients) and at 12 Research Centers of the USSR, CSFR, Bulgaria and Poland (642 patients). The mean duration of the treatment was 4.8 and 12.4 months respectively. Moderate leukopenia (3000-4000/ml) developed in 0.5 and 1.2% of all the analyses, the neutrophil/leukocyte ratio always remained within normal (50% and higher), whereas the neutrophil count did not drop below 1600/ml, i. e. it was not pathological. Despite the relatively long treatment no cases of granulocytopenia (or agranulocytosis) were recorded. It is shown that the side hematological effect is not related to the magnitude of the diurnal dose of leponex. Recommendations are given for wide use of leponex in medical practice under constant control of the blood status, with the use of the method of a slow and progressive augmentation of the daily dose.

[Special features of autonomic regulation in patients with seasonal depression]. / Osobennosti vegetativnoi reguliatsii u bol'nykh sezonnymi depressiami.

Parameters of histograms distribution of ECG R-R intervals (the mode, mode amplitude, variation range) were compared in 60 healthy individuals and 45 patients with seasonal depressions. These ECG parameters reflect influence of sympathetic and parasympathetic parts of the autonomic nervous system on the rhythms of cardiac contractions. In the period of active development of depressive symptomatology the parameters of histograms in terms of R-R distribution were changed in comparison with the healthy individuals: mode was displaced to the region of the short intervals, the mode amplitude was increased and the variation range was reduced. All these data indicate increase of the sympathetic activity and reduction of parasympathetic activity as compared with the control individuals. In the patients with spring-summer depressions the determined parameters of autonomic nervous system were more changed than in the patients with autumn-winter depressions. Under the course of pharmacotherapy the dynamics of these parameters was less marked in patients with fall-winter depressions than in cases of spring-summer depressions.

[Autonomic regulation of the cardiovascular system in patients with schizoaffective psychosis]. / Vegetativnaia reguliatsiia serderchno-sosudistoi sistemy u bol'nykh shizoaffektivnym psikhozom.

A comparative analysis of R-R intervals distribution parameters in ECG histograms (modal value, moda amplitude, variation range) in 60 healthy individuals as well as in 35 patients with schizoaffective disorders (ICD-10: F 25.1) was performed. These ECG parameters reflected sympathic and parasympathic influences of vegetative nervous system on the cardiac rhythm. Histograms of RR-intervals distribution parameters had been significantly changed in patients during schizoaffective symptoms development as compared to control group: modal value was shifted toward short interval area, moda amplitude was rised, variation range was narrowed. It means the increasing sympathic influence and decreasing parasympathic nervous system activity. The alternation trend was the same in patients with the prevalence of affective symptoms (affectdominant form of schizoaffective psychosis) or with paranoid predominance (schizodominant form of schizoaffective psychosis). The intensity of these changes was more expressed in patients with affectdominant form of schizoaffective psychosis.

[The effect of dalargin on the opioid and immune systems in patients with a depressive syndrome]. / Vliianie dalargina na opioidnuiu i immunnuiu sistemy bol'nykh s depressivnym sindromom.

Depressed patients and healthy donors received dalargin. As shown by the radioreceptor test, the patients recovered normal quantitative and qualitative values of plasma opioid activity due to this drug which is a synthetic agonist of sigma-type opioid receptors. Lymphocyte proliferative activity (spontaneous and induced by polyclonal mitogens) was not significantly different in the test subjects versus the donors, though in vitro studies revealed multidirectional homeostatic effects of dalargin. It is shown that depressions are associated with defective relationships between functions of the immune and opioid system. Dalargin proved uneffective in the treatment of endogenic psychotic depressions, whereas in reactive neurotic depressions and psychosomatic abnormalities the drug is promising and needs further investigations.

[Specific aspects of thrombocyte system of serotonin in patients with different manifestations of schizoaffective psychosis]. / Osobennosti serotoninovoi sistemy trombotsitov bol'nykh s razlichnymi klinicheskimi proiavleniiami shizofaffektivnogo psikhoza.

45 women with different manifestations of schizoaffective psychosis (SAP) were examined. The diagnosis corresponded to ICD-10 (F25). According to the classification elaborated in Mental Health Research Centre of Russian Academy of Medical Sciences, groups of patients were identified with different variants of the psychoses course: a nuclear SAP type; a borderline SAP variation with phasic-recurrent course; SAP with progredient variation (schizoaffective variation of schizophrenia). The patients were examined both during the attack and remission. A rate of serotonine uptake (Vmax) in blood platelets, a specific imipramine binding (Bmax) and the level of serotonin in blood platelets were evaluated. It was found that dynamics of both Vmax and the level of serotonin in different SAP types were different, that was related to clinical and biological SAP heterogeneity. A tendency to decreasing of serotonin system functional activity was found in progredient SAP variations, especially during the remission, which was of low quality in these cases. On the contrary, in the borderline variations the indices of the decreased function of serotonin system corresponded well to those of acute psychosis. In nuclear type--a type with the most favourable course of psychosis--any significant changes weren't revealed as compared with the normal parameters.

[Thrombocytic serotoninergic markers in therapy-resistant patients with endogenous depression undergoing alpha-tocopherol treatment]. / Trombotsitarnye serotoninergicheskie markery u rezistentnykh k terapii bol'nykh éndogennymi depressiiami pri lechenii al'fa-tokoferolom.

The main platelet serotoninergic parameters (maximal velosity of 3H-serotonin uptake, Vmax and density of 3H-imipramine binding sites, Bmax) were measured in 17 therapy-resistant endogenously depressed patients before and after combined treatment (antidepressants and alpha-tocopherol). It was found a significant decrease of Vmax-, Vmax/Bmax- values and the increase of Bmax- values in patients before treatment. A beneficial effect of the combined therapy was found in 47% of patients. However, it was not followed by the changes of main platelet serotoninergic parameters in patients after treatment in spite of the obtained clinical improvement. There were not also observed the significant differences of measured biochemical parameters between responders and non-responders. These findings suggest that the beneficial clinical effect of the combined antidepressive therapy with alpha-tocopherol does not involve serotoninergic mechanisms.

[The thrombocytic serotoninergic markers of the efficacy of electroconvulsive therapy in endogenous depressions]. / Trombotsitarnye serotoninergicheskie markery éffektivnosti élektrosudorozhnoi terapii éndogennykh depressii.

The changes of main platelet serotonergic parameters (maximal velocity of 3H-serotonin uptake, Vmax; and density of (3)3H-imipramine binding sites, Bmax) were followed up in 25 endogenously depressed patients before and after electroconvulsive therapy (ECT). It was found a marked decrease in the velocity of 3H-serotonin uptake into platelets (Vmax) from patients before ECT (especially in non-responder group) and the significant increase of Vmax- and Bmax-values after the course of ECT in responders but not in resistant patients (non-responders). The increase of Vmax- and Bmax-values in responders was evidence of the rise of the functional activity serotonin system after treatment. The results evidence about the significance of serotonergic-mechanisms in the therapeutic efficacy of ECT.