[Mental disturbances in the victims of the earthquake in Armenia (based on examination data in the medical institutions of Moscow)]. / Psikhicheskie rasstroistva u postradavshikh pri zemletriasenii v Armenii (po dannym obsledovaniia v meditsinskikh uchrezhdeniiakh Moskvy).

As a result of examining 211 persons with severe somatic pathology (the crush syndrome, multiple fractures, spinal cord injuries, and so forth) received during the earthquake, 179 (84.8%) manifested psychopathological disorders. Of these, 70 persons (33.2%) had asthenia, consciousness disturbances, insomnia which were viewed as somatogenic, 17 persons (8.1%) with craniocerebral injury had the signs of the establishment of the psycho-organic syndrome, and in 109 persons (51%), the clinical picture was determined by psychogenically conditioned depressive, anxious-phobic and psychopathic reactions. The data obtained allow one to judge the characteristics of the mental status during the subacute period (from the first to the second week) after the earthquake.

[Prospects of elaborating the scientific basis for organizing the psychiatric services]. / Perspektivy razrabotki nauchnykh osnov organizatsii psikhiatri- cheskoi pomoshchi.

It is evident that the setting up of efficient psychiatric services today is not feasible without elaborating serious theoretical concepts. In the authors' opinion, the method which would make it possible to rapidly design the system of psychiatric services for any region on the basis of the data on its geography, population and resources rather than concrete universal services is to be the final product of the theory of psychiatric services. To design such a method, it is necessary to explore a number of important problems of the epidemiological and ++medico-demographic character. The authors provide a list of the studies to be carried out according to the indicated directions as well as of the problems to be solved within the framework of the investigations of the models proper of psychiatric services.

[Clinico-epidemiological characteristics of mentally ill patients identified in the therapy department]. / Kliniko-épidemiologicheskaia kharakteristika psikhicheski bol'nykh, vyiavlennykh na terapevticheskom uchastke.

A clinico-epidemiological study was made of the incidence of mental diseases among the adult community visiting the therapeutic department of a city polyclinic. Mental patients registered at the PND (41.9 per 1000 population) underwent examinations. A large group of patients, mainly with borderline mental diseases, was additionally revealed (134.4 per 1000 population). Therefore, the total incidence of mental diseases among the adult community amounted to 176.3 per 1000 population. Both groups are compared in terms of the clinical syndromes, sex, age, and the level of social adaptation.

[Dynamics of the epidemiological characteristics of registered contingents of schizophrenia patients]. / Dinamika épidemiologicheskikh kharakteristik uchtennykh kontigentov bol'nykh shizofreniei.

Different populations of schizophrenic patients under this study were registered by three of the Moscow city outpatient psychiatric departments in 1967, 1975 and 1981. These populations' epidemiologic characteristics compared, the following could be concluded: (1) the specific quantity of patients with psychotic disorders diminished, (2) the percentage of aged patients diminished, (3) the mean observation term reduced. Some other characteristics of the tendency to worsen the medical assistance to psychiatric patients were demonstrated. Factors causing such a trend are discussed and the ways to overcome these difficulties outlined.

[Epidemiologic aspect of the problem of the disability of schizophrenic patients (incidence, chronogenic dynamics, risk factors)]. / Epidemiologicheskii aspekt problemy invalidnosti u bol'nykh shizofreniei (chastota, khronogennaia dinamika, faktory riska).

Epidemiological aspects of disability have been studied in a random sample of schizophrenics living in three Moscow districts. It has been found that 39.4% of schizophrenic patients (44.2% of the patients in the productive age) are disabled due to the underlying disease. The past 20 years have seen a trend toward a decrease in the disability rate; the difference between the number of the disabled reported 20 years ago and today is 5.5%, being fully accounted for by paroxysmal forms of schizophrenia. It has been ascertained that the decision as to the patient's disability following medical examination of his or her working ability depends not only on the severity of the patient's clinical status, but also on the patient's sex. Thus, if patients with an equally grave disease are considered, women are more frequently given the status of disability which is explained by the fact that their involvement in household chores is much greater than that of males.

[Population patterns in the dynamics of episodes and remission in patients with endogenous psychoses]. / Populiatsionnye zakonomernosti dinamiki pristupov i remissii u bol'nykh éndogennymi psikhozami.

Analyzing the data on 1770 patients with paroxysmal schizophrenia with a disease standing of 15 years and over, the authors established a statistically significant correlation between the clinical picture of remissions and attacks in the preceeding and the subsequent cycle of the disease. This correlation was expressed in the fact and from the second cycle to the third, the probability of the appearance of the same psychopathological disturbances was at least two times as that of the development of any other concrete disorders. The first three cycles of the disease were analyzed.

[Population patterns in the development and course of endogenous psychoses as a reflection of their pathogenesis]. / Populiatsionnye zakonomernosti vozniknoveniia i techeniia éndogennykh psikhozov kak otrazhenie ikh patogeneza.

An analysis of a representative epidemiological sample of patients with endogenic psychoses (schizophrenia and MDP) revealed statistical distribution of some parameters of the disease (risk of the development of the disease in relation to age, a number of previous attacks, as well as distribution of patients by the duration of paroxysms and remissions). The authors believe that a collation of the tabulated data with the known mathematical models makes it possible to come to understanding some aspects of the pathogenesis of endogenic psychoses.

[Dynamics of negative disorders and the problem of differentiating paroxysmal schizophrenia (epidemiologic study)]. / Dinamika negativnykh rasstroistv i problema differentsiatsii pristupoobraznoi shizofrenii (épidemiologicheskoe issledovanie).

The task was set to elaborate, using random material, a systematics of paroxysm-like schizophrenia on the basis of the characteristics of the time-course of negative disturbances and comparison with the current systematics formed on the basis of the clinical experience. The authors analyzed the course of the disease in all registered patients with paroxysm-like schizophrenia (3928 individuals) living in four administrative districts of Moscow. Seven major variants of paroxysm-like schizophrenia have been identified. The prognosis of the disease is more favourable in cases where it first manifests itself by mild negative changes. The time-course of adverse changes determines the development of productive disturbances and their level both in paroxysms and remissions. The relationship between these phenomena indicates certain pathogenetic independence of each of the identified variants of the disease course.

[Risk of schizophrenic spectrum psychoses among the offspring of affected mothers and fathers (comparative epidemiologic study)]. / Risk zabolevaemosti psikhozami shizofrenicheskogo spektra v potomstve bol'nykh materei i ottsov (sravnitel'noe épidemiologicheskoe issledovanie).

Comparative epidemiological study in population of patients with schizophrenia in one of the Moscow regions revealed differential morbidity risk in posterity. Convincing proofs obtained showed sick children with schizophrenia prevalence in sick mothers, but not fathers' posterity. Such a conclusion on the representative populational material was made for the first time. The study showed the specificity of differential morbidity risk in control groups of patients with other disease entities analyzed. Different factors significance in so-called "maternal effect" manifestation are discussed.

[Clinico-statistical patterns in the dynamics of episodes in schizophrenia]. / Kliniko-statisticheskie zakonomernosti dinamiki poristupov v techenii schizofrenii.

An examination of schizophrenics living in three regions of Moscow and suffering from the disease for over 15 years has shown that the change of the episode form is a probability process exhibiting a tendency to retention of the form of the preceding episode in the subsequent ones. At the same time it has been shown that this tendency is more marked, if the preceding episodes were of one and the same type. When the episode form changed principal trends of that process were revealed. The patients' sex was found to exert no substantial influence on the regularities discovered. The patients getting older, the frequency of depressive episodes became greater at the expense of transformation of depressive-paranoid symptoms into depressive ones.

[Experience with a differentiated clinical approach to epidemiologic description of populations of schizophrenic patients]. / Opyt differentsirovannogo klinicheskogo podkhoda k épidemiologicheskomu opisaniiu populiatsii bol'nykh shizofreniei.

Data on the frequencies of various schizophrenia forms among the population of three districts of Moscow are presented. These data were obtained from direct examinations of each schizophrenia case, and are the most differentiated clinically, as compared with those reported in earlier publications. With regard to one district of Moscow a more detailed information is presented: such as, the frequency of admission for schizophrenia to psychiatric hospitals that was found to be 9.63 per 1,000 of population, 9.85 for males and 9.48 for females. The admission frequency for continuously-progressing cases was 2.51; for paroxismally-progressing ones 5.26; and for recurrent cases 1.80. In addition to these figures data on the admission frequency with regard to the underlying syndrome at the manifest stage of the disease (within the range of the above-mentioned basic forms of the disease course) are presented. Also the frequencies of various forms of the disease onset and the duration of the patients' stay in hospital and their observation by psychiatrists at home are analyzed with reference to the disease pattern and the frequency of each patients's hospitalization.

[Experience with epidemiologic studies of childhood schizophrenia]. / Opyt épidemiologicheskogo izucheniia detskoi shizofrenii.

An epidemiological study of the adult schizophrenic population (5039) of 3 Moscow districts has shown that 31,3% of the individuals have fallen ill before the age of 18, out of them 23,4% at the age of 12--17 years. The intensity of schizophrenia manifestation in the pubertal period was the highest. A comparison of the sex ratio at the onset of the disease at different periods of childhood and puberty has shown that the younger the boys are, the higher is the morbidity rate among them. In the initial stage of the disease at the age of 0--17 years malignant schizophrenia prevails threefold and slowly progressive schizophrenia almost twofold as compared to the patients who fell ill after 18 years of age. At the onset of the disease in adults as compared to childhood and adolescence there prevail relatively medium progressive and attack-like forms (shift-like and periodical). It was also noted that malignant schizophrenia is more common among males and periodical forms among females. A comparison of the relative frequency of forms depending upon the onset enables one to claim that the morbidity rate (all forms) undoubtedly depends upon the age, particularly upon the pubertal, while its forms are related to the sex and not to the pubertal age.

[Several features of the course of attack-like schizophrenia (according to the findings of an epidemiologic study)]. / O nekotorykh osobennostiakh techeniia pristupoobraznoi shizofrenii (po dannym épidemiologicheskogo izucheniia).

The authors studied patients with an attack-like course and a "cliche" type course (i.e. the psychopathological structure of attacks does not change within the disease). In spite of the differences in the clinical picture of the attacks, the studied patients slightly differed in age, onset of the 1st attack, number of sick male- and female patients, correlation between the age at the onset of the 1st attack and sex, number of previous attacks and continuation of remissions. A direct correlational dependance between the character of productive disturbances and the depth of negative changes in remissions and the clinical picture of psychotic attacks was observed.

[Role of sex and age in the occurrence and course of attack-like schizophrenia (based on epidemiological study data)]. / Rol' pola i vozrasta v vozniknovenii i techenii pristupo-obraznoi shizofrenii (po dannym épidemiologicheskogo izucheniia).

On the basis of an over-all investigation of 2 districts of Moscow (1548 patients) the authors studied correlations between clinical traits of attack-like schizophrenia and factors of sex and age. It was demonstrated that the disease most frequently (irrespective of the sex and duration) manifests itself by affective-delusional attacks, then go depressive states, acute-delusional oneiroid and manic attacks. The statistical processing of these results demonstrates the existence of a common regularity in the development of clinical traits of attack-like schizophrenia. Factors of sex and age contribute only to conditions of a predilectiveness in an occurrence of different syndromes.

Prognosis of the duration of the remissions in attack-like schizophrenia. / K voprosu o prognoze prodolzhitel'nosti remissii pri pristupoobraznoi shizofrenii.

On the basis of a clinico-epidemiological study of patients with attack-like developing schizophrenia and duration of the disease of 15 years and more the authors report of some results of the prevalence of remissions of different duration. The paper contains data concerning correlations between different duration intra-attack intervals, the type of the sustained attacks, number of sustained attacks and the patient's age at the onset of the disease. The study demonstrated direct correlations between the duration and the type of the attack on the one hand and the character of negative changes--on the other. The formation of protracted remissions is more characteristic of shift-like attacks, i. e. attacks possessing more destructive qualities than in attacks characteristic of recurrent schizophrenia.

[Family conditions of patients with schizophrenia and manic-depressive psychosis according to epidemiologic findings (marriage)]. / Semeinoe sostoianie bol'nykh shizofreniei i manikal'no-depressivnym psikhozom po dannym épidemiologicheskogo izucheniia (brachnost').

The authors studied the familial (marital) state in schizophrenia and manic-depressive psychosis. The marital level in these patients is considered as one of the indices of social adaptation. It was demonstrated that the marital level differs significantly from the general populations in malignant schizophrenia where most of the patients do not marry at all. In other forms of schizophrenia these differences appear to be much less, while some people being not married by 50 years do not differ significantly from the respective indices for the population. In manic-depressive psychosis the differences are less. Among the patients who did get married the age at the time of marriage and the duration of the marriage is comparable with the data on the population and consequently these indices are determined to a large extent by general demographic regularities rather than by the disease.

[Variants in the course of circular schizophrenia (an epidemiologic study)]. / K probleme variantov techniia tsirkuliarnoi shizofrenii (épidemiologischeskoe issledovanie)

The authors report of the clinico-statistical characteristics in the development of circular schizophrenia in 645 patients. An analysis of the course of the disease was convened in respect to the correlation of the affective disorders, the clinical structure of the attacks and remission, their duration, the amount of attacks in the past, sex and age. It was demonstrated that all of these parameters are closely connected with the type of the manifest attack. This circumstance may be used for the prognosis of the disease and for clarifying the problem of the typology of circular schizophrenia.

[Prognosis of the frequency of attacks of schizophrenia (according to findings from an epidemiologic study)]. / K prognozu chastotnosti pristupov shizofrenii (po dannym épidemiologicheskogo issledovaniia)

In 915 patients with attack-like schizophrenia with a duration of the disorder not less than 15 years, the authors studied some clinical and endogenous factors in order to determine the criteria of prognosis of the attacks. It was displayed that in most of the cases schizophrenia proceeded with a small amount of attacks. Manifestation at young age (irrespective of the duration of the disorder), its affinity to the periodical pole of the disorder and concomitance of subsequent attacks of manic disturbances correlated with a large amount of attacks.

[Family formation by schizophrenic and manic-depressive patients according to an epidemiologic study (birth rate)]. / Formirovanie sem'i u bol'nykh shizofreniei i maniakal'no-depressivnym psikhozom po dannym épidemiologicheskogo obsledovaniia (rozhdaemost')

The birth rate among patients with endogenous disorders is considered as an index of the degree of their social adaptation. It was established that in all forms of such disorders the level of birth rates and the rate of family formation is lower than that in the general population. However, in all endogenous disorders (except the malignant schizophrenia) there are some patients the adaptation of whom is not disturbed.