[Depression in men with testosterone deficiency]. / Depressiya u muzhchin s defitsitom testosterona.

OBJECTIVE: Clinical assessment of depression in men with testosterone deficiency to improve differential diagnosis of this type of depression. MATERIAL AND METHODS: Thirty-seven men (mean age 50.1±9.08 years) with depressive episode and testosterone level ≤12.1 nmol/l were included in the main group. Depressive episode was diagnosed based on ICD-10 criteria (F-32). Additional assessment of physical and psychometrics parameters was evaluated. Forty men (mean age 42.3±10.53 years) with depression based on ICD-10 criteria (F32, F33) and testosterone level >12.1 nmol/l were included in the comparison group. RESULTS: Symptoms of depression in men with testosterone deficiency were less severe and led to less functional disturbance. There were some clinical differences in symptoms and syndromes. Single-episode course with manifestation at a later age was more typical for the main group while the comparison group was mostly characterized by recurrent episodes manifesting at an earlier age. CONCLUSION: Depression in men with testosterone deficiency has a number of differences that must be taken into account when diagnosing and choosing treatment tactics.

[Impact of alcohol abuse on suicide risk in schizophrenic patients]. / Vliyanie zloupotrebleniya alkogolem na risk suitsida u bol'nykh shizofreniei.

Suicide is one of the main causes of death among patients with mental illnesses. At the same time, alcohol consumption is associated with high risk of autoaggressive and suicidal behavior in population. On the other hand there is an opinion that alcohol may have an illusory-compensatory effect. In that case, alcohol consumption may be an attempt to decrease different symptoms such as depression, anxiety or hallucinations. An analysis of co-occurring schizophrenia and alcohol abuse is presented. Suicide statistics among patients with schizophrenia is studied. Different mechanisms contributing to suicide are highlighted. The correlations of other risk factors with suicide attempts with the assessment of the patient's social resources and environment were studied. The role of alcohol in the presence of other obvious risk factors has been assessed. Possible mechanisms of the protective role of alcohol in relation to suicides among patients with schizophrenia are presented. The authors outline topics of perspective research to clarify the risk of self-destructive behavior in patients with schizophrenia with comorbid alcohol dependence, to search for its predictors and to develop well-grounded complex preventive measures.

[An associations of possible genetic risk markers for Internet addiction with childhood trauma experience and personality traits in young adults : preliminary results]. / Svyaz' geneticheskikh markerov riska razvitiya internet-zavisimosti s detskim psikhotravmiruyushchim opytom i lichnostnymi osobennostyami u molodykh vzroslykh: predvaritel'nye rezul'taty.

OBJECTIVE: To study was to test an associations of the preliminary genetic risk markers for Internet addiction (IA) with clinical, psychological and personality characteristics, taking into account the childhood traumatic experience, in 44 IA persons compared with 120 healthy individuals. MATERIAL AND METHODS: The study included 164 participants: 44 individuals with IZ (group IZ), male and female, aged 16 to 30 years in the absence of diagnoses of mental health problems. diseases from rubrics F00-09 and F20-29 (ICD-10) and 120 healthy (control group). RESULTS AND CONCLUSION: We have found an associations of the preliminary IA genetic risk markers with some personality traits and behavioral characteristics (TCI-125, TIPI) and with the childhood trauma experience (ACE IQ, CTQ), both for healthy individuals and to a greater extent for IA individuals, that may suggests the possible effects of the gene-environment interaction on a risk of developing IA. The data obtained on the structure of associations between IA genetic risk markers and individual psychological characteristics under the significant influence of the childhood trauma experience allow us to proceed with the construction of models for IA risk prediction taking into account the "gene - environment" interactions.

[Gender dysphoria in the structure of psychosis]. / Gendernaya disforiya v strukture psikhoza.

This article describes the case of a young man diagnosed with schizoaffective disorder mixed type. The patient expressed dissatisfaction with his gender and showed a desire to change it for two years. He has applied to psychiatrists twice for permission to change his gender, having received preliminary diagnoses of «Gender dysphoria¼ and «Transsexualism¼. After treatment, which includes ECT, psychotic symptoms has disappeared, sexual identification has fully restored, and criticism of behavior and experiences has formed.

[Combat-related posttraumatic stress disorder: from «irritable heart syndrome¼ to «psycho-organic disorder¼. Contemporary approach]. / Boevoe posttravmaticheskoe stressovoe rasstroistvo: ot «sindroma razdrazhennogo serdtsa¼ do «psikhogenno-organicheskogo rasstroistva¼. Sovremennye podkhody.

The authors consider current views on and approaches to trauma and posttraumatic stress disorder (PTSD). There are doubts about the correctness and validity of allocation of PTSD entirely according to psychogenesis of the disease. The authors consider the «post-traumatic¼ as a type of response to extreme stress. PTSD is characterized as a nonspecific pathological form of disease, which can occur in the structure of different mental disorders. Based on considering two approaches (cerebrotraumatic and psychosomatic) in solving the current issue, the authors suggest that PTSD is a psychogenic-organic disorder.

[Combat-related posttraumatic stress disorder: the historical evolution of concept from «irritable heart syndrome¼ to «psycho-organic disorder¼. Biological aspect]. / Boevoe posttravmaticheskoe stressovoe rasstroistvo: ot «sindroma razdrazhennogo serdtsa¼ do «psikhogenno-organicheskogo rasstroistva¼. Biologicheskii aspekt.

OBJECTIVE: To study a role of traumatic brain injury (TBI) in the development of posttraumatic stress disorder (PTSD) in ex combatants. MATERIAL AND METHODS: Eighty-seven ex combatants were studied. The duration of follow-up was 15-18 years. The diagnosis was established in accordance with ICD-10 criteria. Patients were stratified by diagnosis into main group (PTSD) and comparison group (organic brain injury with reduced symptoms of PTSD). A psychopathological method and a battery of questionnaires and scales, including those adapted for assessment of consequences of combat trauma, were administered. RESULTS AND CONCLUSION: Clinical presentations of both groups in posttraumatic period show the similarity and homogeneity of posttraumatic disorders in these groups. In the future, the pathogenetic role of TBI severity appears more clearly, which, depending on the severity, leads to the formation of an organic lesion of the brain or performs only a pathoplastic role, giving some features to the clinical picture of PTSD. It was found that the more severe the injury, the greater the likelihood of PTSD transition to organic brain damage. It is emphasized that PTSD treatment is a continuous, long-term, complex and graded process that includes pharmacotherapy, psychopharmacotherapy, psychotherapy, psychosocial interventions.

[Clinical and psychological features of people with internet dependence: experience of a pilot study]. / Kliniko-psikhopatologicheskie osobennosti lits s internet-zavisimost'yu: opyt pilotnogo issledovaniya.

OBJECTIVE: The prevalence of Internet addiction (IA) is growing steadily, especially among the younger generation. The purpose of this multicenter study was to investigate the socio-demographic characteristics, clinical varieties, and profile of psychopathological symptoms of mental disorders in patients with IA. MATERIAL AND METHODS: The study included 2 groups: the main group consisted of 44 people, aged 16 to 34 years, average age 22.00±0.66 years, 33 (75%) men, 11 (25%) women; the control group included 120 people, aged 19 to 30 years, average age 23.13±0.18 years, 90 (74.3%) men, 30 (26.7%) women. Groups were identified at the testing stage based on the total score on the Chen Internet Addiction Scale (CIAS). The main group included individuals who scored CIAS 65 points or higher. The specially developed Unified Study Card, The Mini international neuropsychiatric interview (MINI), the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Questionnaire (BDI), the Prodromal Questionnaire-16 (PQ-16), the Symptom Checklist-90-Questionnaire Revised (SCL-90-R). RESULTS AND CONCLUSION: There were more people with secondary specialized education and unemployed in the main group. The family burden of addiction and psychiatric disorders did not differ in both groups, and the heredity of somatic diseases was lower in the IA group. In the IA group, a psychiatric diagnosis was made 9 times more often. The severity of affective and anxiety disorders was higher in the IA group, while the risk of psychosis was low that allows considering the symptoms of IA outside the framework of subpsychotic mental disorders. The features of the psychopathological symptoms of IA were: total «tension¼ of the psychopathological profile; a relatively uniform and slightly specific profile of psychopathological symptoms with a certain tendency to the prevalence of personality-related stress manifestations.

[Does alcohol influence the cognitive functions of schizophrenic patients?] / Vliiaet li alkogolizatsiia na kognitivnye funktsii bol'nykh shizofreniei?

AIM: To establish an effect of alcohol dependence on the cognitive functions of patients with schizophrenia. MATERIAL AND METHODS: One hundred patients with paranoid schizophrenia were examined. Half of them had a co-occurring diagnosis of alcohol dependence syndrome. Memory, attention, thinking were studied. Comparisons were made between groups, depending on the presence of the addictive disorder. RESULTS: Attention and short-term memory are at the low border of normal values in both groups. No significant between-group differences were found. In Benton test, errors characteristic of schizophrenia were more frequent in the main group. 'Organic' errors were prevalent in the control group. Mild thinking disorders of organic type were significantly more frequent in the main group. CONCLUSION: Co-occurring alcohol dependence does not significantly influence intelligence but significant organic stigmas contribute to the structure of the cognitive profile of patients. The prevalence of organic disturbances in the structure of thinking in patients with co-occurring alcohol abuse was revealed. The best indicators of attention were demonstrated by patients with attack-like schizophrenia without substance abuse. This suggests that the influence of the alcohol factor differs in continuous and attack-like progressive schizophrenia.

[Combat-related posttraumatic stress disorder: the historical evolution of concept from 'irritable heart syndrome' to 'psycho-organic disorder']. / Boevoe posttravmaticheskoe stressovoe rasstroistvo: évoliutsiia poniatiia ot 'sindroma razdrazhennogo serdtsa' do 'psikhogenno-organicheskogo rasstroistva'.

Nowadays PTSD is the most urgent problem in the field of world psychiatry due to its academic, practical, epidemiological significance and other aspects. The authors present a historical review of different conteptions explaining the development of posttraumatic stress disorder. Attention is drawn to the description of evolution of PTSD from psychogenic to complex forms, with the formation of bio-psycho-social approach to the problem. The dynamics of the development of PTSD diagnostic crireria according to the current international classifications is analyzed.

[Is syndrome of embodied presence a rare psychopathological phenomenon?] / Sindrom voploshchennogo prisutstviia - redkoe psikhopatologicheskoe obrazovanie?

The literature review addresses the history, clinical presentations, prevalence, differentiation with similar conditions and concepts explaining the development of a rare phenomenon named embodied presence. The authors state that this syndrome is not exclusively rare though it is rarely diagnosed in clinical practice due to the lack of the unified approach to its clinical identification.

[The use of pregabalin without prescription]. / Primenenie pregabalina bez naznacheniia vracha.

Objective. Interest to pregabalin can be explained by the fact that the drug is purchased without prescription and used in nonmedical purposes. Authors performed the identification of pregabalin in the biological material (urine) of 16 364 patients. Material and methods. Psychoactive substances were identified in a chemical-toxicological laboratory of a narcological dispensary in the Krasnodar region. Results and conclusion. Pregabalin was identified only in 0.1% of the patients. In all cases it was not used for the first time. Most often pregabalin was used to relieve abstinent syndrome in different types of addictions. The mechanisms of its action in these cases and potential danger of using without prescription are considered.

[A study of the efficacy and safety of valdoxan in the treatment of a depressive episode].

An open non-randomized controlled prospective study was conducted to investigate the efficacy and safety of valdoxan in the treatment of depression as monotherapy and in the combination with other drugs. Based on the clinical and psychometric measures, author confirmed the high efficacy of valdoxan. The drug can be combined with other antidepressants, no adverse effects are observed in these cases. Positive changes in sleep patterns during the treatment with valdoxan were found. The high tolerability and minimal risk of serious adverse effects were observed. Preliminary data revealed that the age of the patient and scores on some HAMD items were predictors of treatment efficacy. The authors developed a computer program for express-assessment of probability of remission and response to treatment.

[Factors predisposing to pathological gambling].

An examination of 150 patients suffering from pathological gambling (PG) has shown that a PG predisposition includes 3 components: personal, morphofunctional and gender. The personal component is a combination of lability and hyperthymia, higher extraversion, easy communication, riskiness, low empathic ability, inclination to emotional satiation. The morphofunctional component embraces structural (a pathology of cortical and subcortical areas, localized mainly in the frontal region and limbic structure of brain) and functional (abnormalities of regulatory processes, signs of cerebral immaturity) peculiarities of the central nervous system. The gender component is reflected in the notable predominance of males, weak and medium-weak sexual constitution, psychosexual development peculiarities manifested as a reduced romantic stage. This complex predisposition, though non-fatal, raises the risk of the disorder.