[Dynamics of neurocognitive functioning in patients in early stages of schizophrenia and schizophrenia spectrum disorders].

The purpose of the study was to assess the dynamics of neurocognitive functioning in patients with the first episode of schizophrenia and schizophrenia spectrum disorders at baseline and in 5-year follow-up. The total number of patients was 67. The severity of symptoms was measured with the PANSS. Cognitive functioning was assessed with the Cognitive Processes Assessment Scale which is based on the methodological approaches developed by A.R. Luria. The liability of cognitive impairment with a tendency to decrease in severity was found in patients with a single psychosis or a history of few psychoses (n=25). In patients with more severe progression of disease (n=33), some labiality of cognitive impairment was observed as well, but, as opposed to the first group, its severity was increasing during the whole 5-year follow-up period. The most severely ill patients with early onset and the most progressive course of the disease (n=9) demonstrated the most severe cognitive impairment, which remained stable along the follow-up. In conclusion, the data obtained present the neurocognitive deficit in schizophrenia and schizophrenia spectrum disorders as not an unchangeable phenomenon, with its dynamics corresponding to regularities of the disease course and its progression.

[Temporal characteristics of the initial stage of the verbal information processing in healthy subjects and in schizophrenia].

The study aimed to investigate the early coding of visually presented words and pseudowords using event-related potentials (ERP). We conducted comparative analysis of the characteristics of P100 and N170 in healthy controls and in patients with the first episode of schizophrenia during passive perception of verbal stimuli as well as under conditions of relevant words and pseudowords. The latency of early ERP components P100 and N170 appeared to be shorter in comparison with healthy subjects in the temporal, parietal and occipital areas. The latency of P100 in patients was significantly shorter in the temporal, parietal and occipital areas, whereas the latency of N170 was shorter in the parietal and occipital areas than in controls. The latency of N170 in healthy subjects was significantly longer to words than to pseudowords and in patients - vice versa. The latencies of N170 in all TPO areas were equal in healthy subjects during word processing, and this equality was upset during non-word processing. In patients with schizophrenia the equality was upset, but, opposite to healthy patients, the upset of equality was more expressed during words processing. Thus, the early stage of verbal information processing in schizophrenic patients is insufficient in time. The time deficit of the automatic processes may lead to defective processing of overall information.

[The use of mGlu2/3 receptors as a new approach to treat schizophrenia: results of a randomized double-blind trial].

Glutamate neurotransmission has been considered as one of pathogenetic factors of schizophrenia though all antipsychotics widely used in modern psychiatric practice are dopamine antagonists. LY2140023 is a selective agonist for metabotropic glutamate 2/3 (mGlu2/3) receptors with antipsychotic effect. In the present study, we have assessed clinical efficacy of LY2140023 in patients with schizophrenia compared to the control group receiving olanzapine in a randomized double-blind placebo-controlled trial. The statistically significant reduction of positive and negative symptoms measured with the PANSS (p<0.001) was observed for both antipsychotics at week 4 of treatment compared to placebo. The treatment with LY2140023 was safe and well-tolerated; treated patients did not differ from the placebo group by hyperprolactinemia and extrapyramidal symptoms, and weight gain. The results suggest that the agonist for 2/3 (mGlu2/3) receptors has antipsychotic properties and provides a new, alternative to dopamine agonists, method for pharmacotherapy of schizophrenia.

[Disturbance of monoaminooxidase activity and indices of endogenous intoxication in patients with the first episode of schizophrenia].

An aim of the paper was to study some biochemical parameters of drug-naïve patients with the first episode of schizophrenia. Activities of platelet monoaminooxidase (MAO) and semicarbazide, a sensitive blood serum aminooxidase (BSA), levels of middle-sized molecules (MSM) and malonic dialdehyde (MDA), parameters of functional state of serum albumin were assessed in 16 patients. Severity of symptoms in patients with the first episode of schizophrenia was assessed as moderate (PANSS scores 73.1+/-12.5) before the treatment. The increase of MAO by 107%, reduction of BSA by 29% and increase of MSM level by 140% was found in patients compared to controls (p<0.01). The study of other biochemical (MDA level) and biophysical (effective albumin concentration) parameters did not yield unequivocal results. It has been suggested that MAO and BSA are integral components of pathogenetic mechanisms in patients with the first episode of schizophrenia.

[The concept of including psychiatry in insurance medicine]. / Kontseptsiia vkhozhdeniia psikhiatrii v strakhovuiu meditsinu.

Arguments for restructuring of psychiatric service on the principles of medical insurance are given. Because mental disorders are characterized by chronic development and high disability rate, the necessity of mixed budget-insurance financing of psychiatry is grounded. Obligatory state insurance must be conducted for all mentally ill persons. However, only a certain part of outpatient care and the treatment period in hospital are to be insured, while the remaining part of outpatient visits or hospital stay will be financed from the budget. The method of calculation of the incurred number of the doctor's visits and the length of hospital stay during the year is discussed.

[Sanatorium treatment of adolescents with borderline mental disorders]. / Sanatornoe lechenie podrostkov s pogranichnymi psikhicheskimi narusheniiami.

The authors review the characteristic features of group formations, work patterns and the efficacy of the new organizational form of mental assistance to adolescents--the sanatorium health centre. Special emphasis is laid on the group of patients with border-line mental abnormalities of the residual organic genesis. The dynamics of those conditions is shown as related to the characteristic features of the structure of the treatment and health process. It is concluded that sanatorium assistance to adolescents turns out effective, provided there are new approaches to the group formation and a comprehensive differentiated structure of the treatment and health process.

[Activities of the somato-psychiatric departments within the structure of multi-profile hospitals]. / O rabote somatopsikhiatricheskikh otdelenii v strukture mnogoprofil'nykh bol'nits.

Analysis of the work of the ++somato-psychiatric departments entering a multiple-discipline hospital has shown that admission to these departments of patients with concomitant mental and somatic pathologies may be viewed as an episode for such patients. The latter ones cannot be regarded as a permanent group to be treated at the above departments. The duration of the stay at hospital is largely determined by the character of somatic pathology and, in a considerable number of cases, represents a stage in the psychiatric inpatient treatment. The data indicate that the present-day bed capacities in such departments (0.65 per 10 thousand adult and adolescent population) are insufficient. It is highly advisable that the number of such departments be increased.

[The hospital and semi-inpatient clinic in the structure of psychiatric care for adolescents]. / Statsionar i polustatsionar v strukture psikhiatricheskoi pomoshchi podrostkam.

Comparative investigation of hospitalized mentally ill adolescents in two cities and an adolescent cohort under treatment in a newly created semi-inpatient unit and a dispensary resulted in a conclusion that assistance provided by hospital, semi-inpatient and dispensary units does not fully embrace the adolescents in whom borderline disorders are detected. New institutional forms are necessary to introduce in order to improve the medical aid to these patients (sanatoria, health camps, boarding schools for patients with pathologic deviations of behavior).

[Dynamics of neurosis-like disorders of residual-organic origin (according to the records of pediatric and adolescent psychiatric consulting rooms)]. / Dinamika nevrozopodobnykh rasstroistv rezidual'no-organicheskogo geneza (po materialam ucheta detskikh i podrostkovykh psikhiatricheskikh kabinetov).

On the basis of records from psychiatric rooms for adolescents at 2 outpatient centres of Moscow the authors determined the place of neurosis-like states of residual-organic genesis in the structure of the contingent on records. They also elucidated the significance of age stages in the time-course of the given pathology and outlined the most rational approaches to the organization of medical care of such patients.

[Prerequisites and new approaches toward improving the outpatient registration of mental patients]. / Predposylki i novye podkhody k sovershenstvovaniiu dispansernogo ucheta psikhicheski bol'nykh.

An increase in the registered numbers of mental outpatients, particularly at the expense of persons with borderline abnormalities, which is attendant by certain social restrictions for the latter group, is fraught with compromising the personality of these on the whole normal persons, which necessitates reorganization of the existing practice of registering patients in psychoneurological institutions. It is proposed that the existing form of registration be applied only to psychotic patients. In accordance with the level criterion patients with mental disorders of the borderline level are not liable to registration, provided their main links and relations in the social environment have remained intact. Registration should be strictly based on such time limits which can be justified on medico-social and clinico-therapeutical grounds.

[Migration of mental patients due to disease-related motives]. / Migratsiia psikhicheski bol'nykh, obuslovlennaia boleznennymi motivami.

The authors have studied a group of mental patients who have migrated to Moscow from various administrative areas of the Russian Federation. It has been established that the number of such patients over the last ten years has decreased by 11.6 per cent only. The authors present data on the nosological composition of the group of migrants and mental disturbances in each nosological group with which the migrational behaviour is associated. It has been demonstrated that the number of migrants from variable areas diminishes with a greater distance from Moscow; it is lower in those areas where the outpatient care is better exercised. The ways of preventing the migrational behaviour of mental patients have been outlined.

[System of dynamic observation of children with mental disorders at a psychoneurologic department at a pediatric polyclinic]. / Sistema dinamicheskogo nabliudeniia detei s psikhicheskimi narusheniiami v psikhonevrologicheskom kabinete detskoi polikliniki.

On the basis of analysis of the characteristics of patients registered in child psychoneurological rooms and in view of the necessity to ensure continuity in the work of children's and adolescents' psychiatrists the authors propose a system of follow-up of children with mental disorders which helps to ensure consecutive provision of the entire complex of therapeutic and roborant measures to such patients.

[Non-dispensary division of psychiatric services]. / O vnedispansernom razdele psikhiatricheskoi pomoshchi.

A complex of the developing organizational forms integrated with institutions of the general medical network and providing psychotherapeutic, psychohygienic and suicidological help to patients of polyclinics, to students, industrial workers and other individuals suffering from mental deviations of the borderline level is considered as a non-dispensary sector of psychiatric help. Its appearance is assessed as a qualitatively new stage in the improvement of psychiatric help in the USSR.

[Evaluation of changes in a contingent of day hospital patients according to the results of a follow-up study]. / Otsenka izmenenii kontingenta bol'nykh dnevnogo statsionara po dannym katamnesticheskogo issledovaniia.

A comparative study of the mentally ill patients admitted to the hospital for the first time annually over five years (1975-1979) made it possible to establish some tendencies in changes in this population. The follow-up data obtained within a period of 3-5 years were studied. The analysis showed that the inpatient treatment proved to be effective both in controlling the disease in various groups of patients and in altering the composition of the inpatients over the last five years.

[System of therapeutic-health-improving measures in the screening of adolescents with mental disorders]. / Sistema lechebno-ozdorovitel'nykh meropriiatii pri dispanserizatsii podrostkov s psikhicheskimi narusheniiami.

The authors present a system of the screening of adolescents with mental aberrations which involves the identification of five groups of follow-up depending on the status of the patient on the one hand and the types of necessary therapeutic and roborant help on the other.

[Analysis of a population of adolescents with mental disorders]. / K analizu populiatsii podrostkov s psikhicheskimi zabolevaniiami.

A study of patients registered in the adolescent rooms of the psychoneurological outpatient centres of two districts of Moscow showed that the structure of psychic pathology of this population is characterized by a greater proportion, as compared with children, of psychotic forms, with non-psychotic psychic diseases and mental retardation still occupying the leading place. Almost one-third of patients (largely those with non-psychotic forms of psychogenic and exogenous-organic nature and a superficial level of disturbances observed) have good prognosis in terms of their cure including the discarding off the record in the relevant dispensary. Activation of extrahospital forms of care including improvement of the microsocial environment is required.

[Effect of moditen-depot therapy on the duration and quality of remissions in schizophrenia patients]. / Vliianie terapii moditenom-depo na dlitel'nost' i kachestvo remissii u bol'nykh schizofreniei.

The authors studied the effectiveness of out-patient treatment by Moditen-Deppt of 128 schizophrenic patients. A comparison of the previous remissions appearing during usual pharmacotherapy and remissions seen during Moditen-Depot treatment depicted statistically significant differences, indicating a distinct prevention of exacerbations due to this preparation, an increase in the duration and improved quality of remissions. Such improved remissions were expressed in lesser severity, in a decrease of psychopathological disturbances, changes qualified as a "mollification of a defect" and an improvement of some socio-clinical indices.