[CLINICAL AND PSYCHOLOGICAL CORRELATIONS IN FIBROMYALGIA PATIENTS].

The features of clinical symptoms, neurotic disorders and the level of subjective control were studied in patients with fibromyalgia. The analysis of relationship between the level of subjective control and neurotic symptoms (asthenia, depression, anxiety, hypochondria) depending the severity of main clinical manifestations of the disease was carried out. It was found that high intensity of fatigue, muscle pain, stiffness, insomnia, and an increase in the number of diagnostic tender points contribute to the formation of inverse correlation between the level of subjective control and neurotic disturbances. Thus, the increase of the externality of the level of subjective control allows indicating to the formation of patients' passivity in relation to their disease, the lack of adherence to prescribed course of treatment (low compliance). Although drug therapy is the main component of complex treatment of fibromyalgia patients, patients require significantly more - successful treatment requires active involvement of patients in the therapy process, as well as changes in their attitudes and lifestyle, which can be achieved by training in so-called "schools" for patients, use of psychotherapeutic methods.

[Influence of cytoflavin on symptoms of asthenia, emotional disorders and autonomic regulation in patients with organic asthenic disorder].

The present observational study addressed effects of cytoflavine on symptoms of asthenia and emotional and autonomic regulation in patients with organic emotional-labile (asthenic) disorder (F06.6). Fifty one females and 49 males (mean age 36.8±11.0 years) were included into the study during their in-patient treatment in Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department. All patients received standard antidepressant and vascular therapy, were consulted by psychologists or psychotherapists, visited physiotherapeutic procedures, massage and medical physical training. In addition, 50 patients received cytoflavin two tablets twice per day. At the psychiatric re-assessment before discharge both cytoflavin and control groups showed similar significant reduction of asthenia symptoms. At the same time, patients with cognitive deficits showed significantly larger improvement of cognitive functions after cytoflavin treatment in comparison with cognitively deficient patients after only standard therapy. Improvement of depressive symptoms was significantly larger in cytoflavin group in comparison with controls as well. These data are consistent with previous studies which showed cytoflavin to be effective as a treatment for patients with cognitive deficits and organic depression.

[The use of phototherapy and photochromotherapy in the combined treatment of the patients presenting with astheno-depressive syndrome and neurotic disorders].

The objective of the present clinical and psychopathological study was to estimate the influence of high-intensity white and yellow phototherapy on the clinical condition of 41 and 18 patients respectively presenting with astheno-depressive syndrome. The control group was comprised of 42 patients who were treated by standard pharmacotherapy. Clinical observations of the patients were supplemented by the evaluation of their conditions and characteristics using the Symptom Checklist-90 questionnaire, the Bekhterev Depression Inventory, and the Beck Depression Inventory. The patients of the three groups were surveyed before and within 20 days after the initiation of the treatment. It was shown that white light phototherapy considerably reduced the severity of asthenia and depression. Yellow light phototherapy proved more efficacious in the patients with asthenia and somatovegetative dysfunctions.

[Effect of tanakan on psychophysiological status of patients with asthenic disorders]. / Vliianie tanakana na psikhofiziologicheskoe sostoianie bol'nykh s astenicheskimi rasstroistvami.

A clinical pharmacological 56-day trial was devoted to the effect of tanakan on the psychophysiological state of 26 patients with psychogenic and post-traumatic asthenic disorders. The drug was found to produce a positive effect on the psychophysiological state, with most pronounced improvement in the attention characteristics, short-term visual memory, operational component, and integral operator performance index. The results confirmed the positive action of tanakan on the cognitive and mnestic functions, which is analogous to the effect of nootropes. The antiasthenic, anxiolytic, antiamnesic, and vegetotropic components in the pharmacological spectrum of tanakan correlate with the positive psychophysiological effects. It is shown that positive changes in the psychophysiological state play an important role in the complex therapeutic action of tanakan in the treatment of asthenic disorders.

[Neurasthenia as a variant of the asthenic syndrome: a pharmacotherapeutic analysis modelled on tanakan therapy]. / Nevrasteniia kak variant astenicheskogo sindroma: farmakoterapevticheskii analiz na modeli terapii tanakanom.

25 patients with neurasthenia were examined during 2 months of ambulatory therapy with tanakan. Taking into consideration the data of cluster analysis of symptomatology before the therapy, 2 groups of patients were selected: with hyposthenic (15 patients) and hypersthenic (10 patients) variations of the disease. The main symptom complex in both groups was an asthenic one, but symptomatology in group 1 tended to hyporeactivity and depressive range of affective spectrum, while in group 2--to hyperreactivity, hyperesthesia, irritation, anxious range of disorders. Pronounced improvement was observed in 18 cases, moderate effect--in 4 patients; in 3 cases the treatment was discontinued because of side-effects (headache, allergic reactions, etc). In group 1 efficiency of the treatment was higher and stable positive dynamics of the state was found, while in group 2 there was uneven reduction of the symptoms with partial temporary change (the exacerbation of anxious symptoms). The data obtained support correctness of the division of neurasthenia into hyposthenic and hypersthenic variations and expediency of taking into consideration such differences in therapeutic policy.

[Asthenic disorders in persons infected with HIV at the initial stages of the disease]. / Astenicheskie rasstroistva u lits, infitsirovannykh VICh, na nachal'nykh stadiiakh zabolevaniia.

Clinical psychopathological, follow-up and neuropsychological evaluation was made for 125 HIV-infected patients in stage 2B of the disease (general lymphadenopathy by V. I. Pokrovskii's classification). It is shown that seropositive subjects had asthenic syndrome for the initial 6 months of the disease. According to the manifestations, asthenia was defined as psychogenic-reactive and organic. In the former variant the treatment involved psychotherapy and occasionally drugs, the latter was treated with chemotherapy and psychopharmacological modalities as the first-line and psychotherapy as adjuvant means. The authors expect that a differential approach to HIV-infection-related asthenia at the disease onset may contribute to better life quality and prognosis in AIDS patients.

Psychosocial support for cosmonauts.

Based on a meeting with members of the Psychological Support Group for cosmonauts, along with several referenced documents, the author summarizes the Soviet experience in dealing with psychological and interpersonal factors related to long-duration space missions. Cosmonaut selection and training procedures following the principle of "neuropsychological resistance" formulated by F.D. Gorbov. Inflight monitoring uses the macroanalysis of crew speech characteristics as an indicator of psychological state. Psychosocial problems include "asthenia" and interpersonal tension. Support efforts focus on enhancing behavioral and autonomic adaptation, planning flexible work/rest schedules, improving the space station environment, arranging relevant free time activities, and helping crews readjust to Earth postflight. Attention is paid to changes in cosmonaut preferences and sensitivities as the mission progresses. The use of support activities is believed to be positively associated with the health and performance of cosmonaut space crews.