[Associations between components of metabolic syndrome and cognitive impairment in patients with schizophrenia]. / Svyazi mezhdu komponentami metabolicheskogo sindroma i kognitivnymi narusheniyami u bol'nykh shizofreniei.

OBJECTIVE: To study the relationship between the individual components of the metabolic syndrome and cognitive dysfunction in patients with schizophrenia. MATERIAL AND METHODS: A total of 133 patients with schizophrenia were examined. To assess cognitive functioning, the Brief Assessment of Cognition in Schizophrenia (BACS) was used. The components of the metabolic syndrome were determined in accordance with the criteria of the International Diabetes Federation. RESULTS: Hyperglycemia in patients with schizophrenia led to a decrease in cognitive functioning in two domains: verbal fluency (ß=-10.67; p=0.019) and attention stability (ß=-9.519; p=0.043). Abdominal obesity was associated with lower indicators of executive functions (ß=-8.856; p=0.026). CONCLUSION: It is assumed that drug treatment of some components of the metabolic syndrome may affect cognitive functions in patients with schizophrenia.

[Prevalence and risk factors of non-suicidal self-injury behavior]. / Rasprostranennost' i faktory riska nesuitsidal'nogo samopovrezhdayushchego povedeniya.

The prevalence of non-suicidal self-injury (NSSI) behavior in adolescents has increased significantly in the early 21st century. The phenomenon of NSSI behavior has become one of the key health problems in the field of adolescent psychiatry and psychology over the past decade worldwide. However, the social characteristics and factors influencing NSSI are very different in different regions of the world. Studies of self-harming behavior indicate that the upward trend is almost equally relevant for developing and developed countries. To date, the methodological basis for the diagnosis of NSSI has not been sufficiently developed in the Russian Federation, there are only some studies of NSSI both from an empirical perspective and in the context of the search for risk factors, causes and functions, models of comorbidity with mental disorders.

[The relationship between the functional state of the brain and clinical and constitutional factors in schizophrenia]. / Svyaz' funktsional'nogo sostoyaniya golovnogo mozga s klinicheskimi i konstitutsional'nymi faktorami pri shizofrenii.

OBJECTIVE: To establish the relationships of functional changes of the brain of patients with schizophrenia with clinical manifestations of the disease and their constitutional and morphological features. MATERIAL AND METHODS: One hundred and eighteen patients with schizophrenia (64 men and 54 women), aged 33 [29; 40], years were examined. The following clinical and dynamic parameters were used: age of manifestation of the disease, duration of the disease, severity of clinical and psychopathological symptoms according to the PANSS. The anthropometric examination of patients was carried out according to V.V. Bunak's method in V.P. Chitetsov's modification for adult samples with calculation of Rees-Eysenk and Tanner indices. The EEG was recorded and analyzed in a state of calm, relaxed wakefulness with closed eyes with the calculation of the absolute spectral power for theta (4-7 Hz), alpha (8-13 Hz) and beta (14-30 Hz) rhythms. RESULTS: Significant (p<0.05) direct correlations between the age of the disease manifestation and the spectral power of the beta rhythm in the frontal leads (Fp1, Fp2, F3 and F4) were revealed. Inverse correlations (p<0.05) were found between the duration of the disease in patients with schizophrenia and the spectral power of the alpha rhythm in the left temporal (T3) and right central leads (C4), the spectral power of the beta rhythm in the parietal-occipital (P3, P4, O1,O2) and temporal leads (T3, T4, T5), the spectral power of the theta rhythm in the left occipital (O1) and posterior temporal leads (T5). Significant inverse correlations were also found between the Tanner index and the spectral power of the alpha rhythm in the frontal and temporal leads, between the Rees-Eysenk index and the spectral power of the theta rhythm in the frontal leads. CONCLUSION: The results indicate the presence of the conjugation of functional changes in the brain of patients with schizophrenia with clinical manifestations of the disease and their constitutional and morphological features. Thus, the assessment of the functional state of the central nervous system in patients with schizophrenia is an important component of the diagnostic search.

[Structural changes in human brain tissue during prenatal alcoholization at different stages of intrauterine development]. / Strukturnye izmeneniya v tkani golovnogo mozga cheloveka pri prenatal'noi alkogolizatsii na raznykh srokakh vnutriutrobnogo razvitiya.

OBJECTIVE: To assess the degree of influence of intrauterine alcoholization on the formation of various structural components of the brain of human embryos. MATERIAL AND METHODS: Twenty-six samples of embryonic material from 8 to 11 weeks of intrauterine development were studied. The material was divided into four subgroups in accordance with the gestational age (Control 1 - 8-9 weeks of gestation and Control 2 - 10-11 weeks of gestation) and the history of the mother (presence or absence of the diagnosis «Alcoholism stage I-II¼ in the anamnesis). Morphometry was subjected to semi-thin sections stained by Nissl. The diameter and area of each individual tissue element (neuroblasts, glioblasts, vessels of the microvasculature, as well as the determination of the specific area (the ratio of the total area of the studied structure to the area of the entire section) and the calculation of the average number of these structures per unit area of the section, were determined. The AxioVision 4.8 program (Carl Zeiss, Germany) was used for analysis, and the Mann-Whitney test was used for statistical analysis of differences between the samples (significant differences, p<0.05). RESULTS: An insufficient increase in the area of vessels of the microvasculature was revealed in combination with a compensatory increase in their number per unit area of the section in the Alcohol groups compared with intact groups (48.5 µm2 vs 83.3 µm2, p<0.05). When comparing the sizes of glioblasts in the Control and Alcohol subgroups at different stages of development, a lag in the sizes of cellular structures in the Alcohol groups at the initial stages was revealed (average area 21.3 µm2 vs 32.1 µm2; 12.9 µm2 vs 13.3 µm2). When comparing data on later periods, no significant differences were found, only an increase in the specific number of cells in subgroup Alcohol 2 was noted (p<0.05). In neuroblasts, there was also a decrease in cell size with an increase in gestational age both among the Control and among the Alcohol subgroups. However, the cell sizes in Alcohol 2 exceeded those in Control 2 and their number was smaller (p<0.05). CONCLUSION: Alcohol leads to changes in the size and number of neuroblasts, glioblasts and vessels of the microvasculature and, as a result, to a disproportionate development of the entire brain tissue. The changes progress with an increase in the development period.

[Disorders of cognitive decision-making mechanisms related to reward in alcohol use disorders]. / Narusheniya kognitivnykh mekhanizmov prinyatiya reshenii, svyazannykh s voznagrazhdeniem, pri alkogol'noi zavisimosti.

OBJECTIVE: To assess the relationship of disorders of cognitive decision-making mechanisms related to reward with clinical indicators of alcohol dependence. MATERIAL AND METHODS: Forty-five patients with alcohol dependence were studied. A control group consisted of 30 age- and sex-matched healthy individuals. To quantify cognitive functions, the Go/NoGo task, the Balloon test (BART), the Cambridge Game Task (CGT) and the Iowa Game task (IGT) were used. The age of the first alcohol sample, the age of the beginning of systematic alcohol abuse, the average amount of alcohol consumption over the past month, the number of hospitalizations, the age of the first visit to a narcologist and the duration of the last remission were used as clinical indicators. RESULTS: The indicators of executive functions are significantly reduced in patients with alcohol dependence compared with the control group. In the Go/NoGo task, patients have more errors, both on the Go signal (p=0.012) and on the NoGo signal (p=0.009). Significant differences in the group of patients with alcohol dependence from the control group were also revealed in CGT: patients had lower values of decision quality (QDM) (p=0.002), higher values of risk acceptance (OBR) (p=0.015), and they also needed more time to make decisions (DT) (p=0.012). It was also found that the age of the onset of systematic alcohol abuse directly correlates with the quality of decision-making in CGT (rs=0.407, p=0.048). CONCLUSION: The results emphasize the importance of studying cognitive impairment in patients with alcohol dependence, since the severity of these disorders is associated with the clinical course of the disease.

[Coherence of the electroencephalogram and peripheral markers of nerve tissue damage in depressive disorders]. / Kogerentnost' elektroentsefalogrammy i perifericheskie markery povrezhdeniya nervnoi tkani pri depressivnykh rasstroistvakh.

OBJECTIVE: To evaluate the coherence parameters of the electroencephalogram and the level of peripheral markers of nerve tissue damage in patients with depressive disorders. MATERIAL AND METHODS: Thirty patients with a diagnosis from a cluster of mood disorders: affective disorder within a single depressive episode and recurrent depressive disorder were examined. A control group consisted of 30 healthy individuals, comparable in sex and age to the main group. The bioelectric activity of the brain was recorded and analyzed with the calculation of the averaged coefficients of intra- and interhemispheric coherence. The concentration of calcium-binding protein S100b, the main protein of myelin MBP and glial fibrillar acid protein GFAP was determined in blood sera by solid-phase enzyme immunoassay. RESULTS: Patients with depressive disorders showed signi cantly lower coefficients of interhemispheric coherence of alpha (p=0.003), beta (p=0.042) and theta rhythms (p=0.041), as well as intrahemispheric coherence of alpha rhythm in the left (p=0.016) and right hemispheres (p=0.026), beta rhythm in the right hemisphere (p=0.034) compared to the control group. Patients with depressive disorders showed a higher concentration of MBP compared to the control group (p=0.008). Additionally, we identified statistically significant correlations between EEG coherence coefficients and serum markers in patients with depressive disorders. CONCLUSION: The results clearly confirm the presence of inflammatory changes in the brain in patients with depression, which is reflected in structural and functional changes.

[Features of the reward-based decision-making in patients with alcohol use disorders]. / Osobennosti kognitivnogo protsessa prinyatiya reshenii, osnovannykh na voznagrazhdenii, u bol'nykh alkogol'noi zavisimost'yu.

Foreign studies increasingly emphasize the role of reward-based cognitive decision-making and its contribution to alcohol and drug abuse. Unfortunately, such studies are extremely few in Russia. Given the importance of the insufficiency of cognitive functions, primarily the decision-making process based on reward, among the risk factors of addictive pathology, increasing the severity of alcoholism, reducing the effectiveness of its therapy and rehabilitation, research in this direction is extremely relevant. This review summarizes and systematizes current data on the features of the cognitive decision-making process based on reward in patients with alcohol dependence. An analysis of the literature has shown that reward-based decision making is an important component of addictive behavior. Patients with alcohol dependence, as well as people, who abuse alcohol, demonstrate clear impairment of this cognitive function. Thus, the relative value of diagnosing disorders in decision-making in modern psychiatry is beyond doubt. It is recommended to include the above tests in the diagnostic complex of a psychiatrist, along with standard psychometric tools.

[The differential diagnosis of unipolar and bipolar depression based on EEG signals]. / Rol' elektroentsefalografii v differentsial'noi diagnostike unipolyarnoi i bipolyarnoi depressii.

The relevance of timely detection and differential diagnosis of depressive disorder and bipolar affective disorder (BD) is beyond doubt. In complex differential diagnostic cases, clinicians can come to the aid of objective research methods, such as electroencephalography. This review summarizes and systematizes modern methods of differential diagnosis of unipolar and bipolar depression based on electroencephalography data. A literature search was conducted using the search terms «depression¼, «bipolar disorder¼, «unipolar depression¼, «differential diagnosis¼, «neuromarkers¼, «electroencephalography¼, «quantitative EEG¼. The search was conducted in the databases PubMed, NCBI, ResearchGate, RSCI, Scopus and Google Scholar in the period 2000 to 2022. In general, EEG indicators at rest in patients are characterized by ambiguity and require further clarification, however, there are some important findings on the differences in the asymmetry of electric activity, spectral power and coherence between patients with BD and unipolar depression. As for event-related potentials (ERP), similar results were obtained in a number of studies. There are a longer latency of P300 and a decrease in its amplitude in patients with BD compared to unipolar depression, which makes the ERP method more promising in solving the problem of differential diagnosis.

[Cerebral hemodynamics and executive functioning in patients with alcohol use disorders]. / Tserebral'naya gemodinamika i ispolnitel'noe funktsionirovanie u bol'nykh s alkogol'noi zavisimost'yu.

OBJECTIVE: To study the cerebral hemodynamics and executive functioning in patients with alcohol use disorders. MATERIAL AND METHODS: We studied 58 patients with alcohol use disorders aged 30 to 55 years and 40 healthy controls. Rheoencephalography was used to detect cerebrovascular changes. Executive functioning was assessed using the Go-No-Go, Corsi, and Color Stroop tests. RESULTS: Patients with alcohol use disorders have higher values of the tone of resistive vessels and medium - caliber arteries, as well as lower indicators of volumetric pulse blood filling and elastic properties of the main arteries in both right and left leads compared with the controls (p≤0.003). Patients with alcohol dependence had lower rates in all studied cognitive tests compared to the norm (p≤0.011). We also found statistically significant correlations between the studied parameters in patients with alcohol use disorders: a decrease in volumetric pulse blood filling correlated with impaired psychomotor response in the Go-No-Go task (errors on the Go signal) (rs=-0.36; p=0.048), as well as cognitive flexibility in the Stroop test (rs=-0.40; p=0.024). CONCLUSION: Disturbances of the psychomotor reaction and cognitive flexibility in alcohol dependence are due to the regional changes (decrease) in cerebral blood flow, as well as to a decrease in the elasticity of the wall of cerebral vessels.

[Quantitative characteristics of the alpha-band of the electroencephalogram in people with alcohol dependence]. / Kolichestvennye kharakteristiki al'fa-ritma elektroentsefalogrammy u lits s alkogol'noi zavisimost'yu.

OBJECTIVE: To study the quantitative characteristics of the alpha-band in patients with alcoholism, depending on the main clinical and dynamic characteristics of the disease. MATERIAL AND METHODS: A total of 76 patients, aged 24 to 55 years, with alcohol dependence were examined. Forty-five healthy individuals were examined as a control group. Recording and analysis of the electric activity of the brain was carried out using a 16-channel encephalograph in a state of calm wakefulness with closed and open eyes. The values of the absolute spectral power of the alpha-band were analyzed, the microstructure of the alpha spindle and the alpha band reactivity index were evaluated. RESULTS: The values of the spectral power of the alpha-band with closed eyes were statistically significantly lower in patients with alcohol dependence in all leads (p<0.05), except for the antero-temporal and mid-temporal. The microstructure of the alpha spindle in patients with alcohol dependence was mainly represented by a flat (59.2%) or low-amplitude (28.9%) type with a predominance of an accelerated band (40.8%). The degree of alpha-band depression in the leads P3 (p=0.043), P4 (p=0.047), O2 (p=0.039), T5 (p=0.037) and T6 (p=0.002) was significantly less pronounced in patients with alcohol dependence compared to the control group. CONCLUSION: The results of the study indicate that some aspects of addictive behavior are accompanied by significant objective functional changes in the brain.

Cytokine Production in Whole Blood Cells Culture of Patients with Alcohol Dependence and Autologous Plasma Oxidative Stress Markers.

We studied spontaneous production of a spectrum of proinflammatory cytokines by cultured whole blood cells from men with alcohol dependence at the stage of withdrawal syndrome and oxidative stress markers (carbonylated proteins and TBA-reactive substances) in the plasma of these blood samples. Enhanced production of cytokines by blood cells and increased concentrations of oxidative stress markers in the autologous plasma were revealed in comparison with the corresponding parameters in the control (blood from healthy men). Direct correlations were found between the levels of spontaneous cytokine production by blood cells from subjects with alcohol dependence and the concentration of oxidized proteins and lipids in autologous plasma.

[Anhedonia as target symptom in personalized therapy of patients with mood disorders and alcohol use disorder comorbidity]. / Angedoniya kak tselevoi simptom personalizirovannoi antidepressivnoi psikhofarmakoterapii u patsientov s komorbidnymi affektivnymi rasstroistvami i alkogol'noi zavisimost'yu.

OBJECTIVE: To estimate the efficacy of antidepressants in the treatment of anhedonia in mood disorders (MD) comorbid with alcohol use disorder (AUD), considering melatonin concentration in the patient's blood serum. MATERIAL AND METHODS: Seventy patients, aged 18-65 years old, with MD, including patients with- (group F3+F10, n=36) or without comorbid AUD (group F3, n=34), were examined. Control group consisted of 26 healthy volunteers. Clinical-dynamic evaluation was carried out using SIGH-SAD and SHAPS-C. Melatonin concentration was measured with MAGPIX analyzer (Luminex, USA). The statistical analysis was carried out using the SPSS (V. 23.0) standard package. RESULTS: In the case of MD/AUD comorbidity anhedonia symptom does not respond well to psychopharmacotherapy during four weeks (p=0.192, Wilcoxon test) whereas anhedonia in «pure¼ MD does (p=0.007, Wilcoxon test). At the same time, only patients with «pure¼ MD have a statistically significant decrease in melatonin concentration in blood serum compared with the control group (p=0.025, p=0.031, Mann-Whitney test), on the contrary, in the case of MD/AUD comorbidity, a relative increase in melatonin concentration (p>0.05 Mann-Whitney test) was demonstrated. CONCLUSION: The relatively low response of anhedonia symptom in the case of MD/AUD comorbidity compared with the «pure¼ MD, makes perspective using antidepressants with prodophaminergic mechanism of action in this cohort of patients. Furthermore, in MD/AUD comorbidity, contrary to «pure¼ MD, a relative increase in melatonin concentration in blood serum was detected, therefore it could be a limitation to prescribing antidepressants directly or indirectly modulating melatoninergic system.

[Current methods for predicting therapeutic response in patients with depressive disorders]. / Sovremennye metody prognoza terapevticheskogo otveta u patsientov s depressivnymi rasstroistvami.

Depressive disorder is the most common mental illness, which is also one of the leading causes of disability worldwide. In addition, most suicides are associated with depression. Despite all modern achievements in the treatment of depressive disorders, up to 60% of patients did not adequately respond to psychopharmacotherapy (non-responders). Current guidelines and studies characterize non-responders as patients who have an inadequate response to taking two or more antidepressants from different classes within 4 weeks. However, in some cases, such a long wait for a therapeutic response can lead to adverse consequences. Thus, there is a need to develop prognostic methods of therapeutic resistance in patients with depressive disorders. The purpose of this review is to summarize current methods used to predict therapeutic response in patients with depressive disorders. A literature search was conducted using the search terms «depression¼, «antidepressant¼, «outcome¼, «predictor¼, «(bio) marker¼, «treatment-resistant depression¼ and «chronic depression¼. The search was conducted in the PubMed, Scopus, and Google Scholar databases for the time period from 2005 to 2020.

[The role of functional brain activity in the impairment of inhibitory control in alcohol dependence]. / Rol' funktsional'noi aktivnosti mozga v narushenii ingibitornogo kontrolya pri alkogol'noi zavisimosti.

OBJECTIVE: Determination of differences in brain function in alcohol-dependent patients with varying degrees of inhibitory control impairment. MATERIAL AND METHODS: Seventy-five patients with alcohol dependence were examined. The level of inhibitory control was assessed using the Go/No-go test. The background electric activity of the brain was recorded, and the values of spectral power and coherence of theta, alpha, and beta rhythms were analyzed. Two groups of patients - 24 with- and 51 without inhibitory control impairment - were determined. RESULTS: According to the spectral analysis, high values of alpha rhythm in the frontal-central-parietal-occipital and beta rhythm in the central and left occipital cortex, low values of theta rhythm in the posterior-temporal regions were common for patients with inhibitory control impairment. Visual analysis of the EEG in patients with inhibitory control impairment shows a smoothing of zonal differences in the alpha rhythm, which is not found in patients without the disturbance of inhibitory control. Patients with inhibitory control impairment were characterized by an increase in interhemispheric connections in the alpha and beta frequency ranges and a weakening of intrahemispheric connections on the right in the theta rhythm range. CONCLUSION: There are significant differences in the functioning of the brain in patients with alcoholism, depending on the presence / absence of inhibitory control impairment.

Correlation of Antibodies to Neurotransmitters in the Sera of Women with Alcohol Dependence and Depressive Disorders.

Comparative analysis of blood sera from women with alcohol dependence and depressive disorders or from conditionally healthy women revealed reduced level of antibodies to dopamine, norepinephrine, serotonin, glutamate, and GABA in blood serum in women with dysthymic disorder and a depressive episode and their increased content in women with alcohol dependence in combination with depressive disorders.

[A screening study of non-suicidal forms self-injurious behavior in persons of draft age]. / Skriningovoe issledovanie nesuitsidal'nykh form samopovrezhdayushchego povedeniya u lits prizyvnogo vozrasta.

A screening study on non-suicidal self-injurious behavior in men of military age was conducted. OBJECTIVE: Study was aimed to determine the prevalence, structure and causes of non-suicidal self-injuries in 193 men aged 19.68±2.07. METHOD: Assessment of non-suicidal self-injury (NSSI) was performed with clinical interview and the scale on self-harm behavior (Polskaya, 2014). RESULTS: The study revealed that 38.7% (75 persons) in the sample committed an act of self-harm at least once in their life. The most common acts of instrumental self-harm were striking with a fist, leg, head or body by hard surfaces and self-cutting. Among somatic self-harm, nail biting, lip, cheeks and tongue biting, as well as skin combing and creating obstacles for wound healing were founded. CONCLUSION: Non-suicidal self-injurious behavior of persons of military age presented by the tools and somatic self-harm and caused by the factors of «regaining control over emotions¼, «impact on others¼, «stress relief¼.

[Executive functions and their role in predicting therapeutic response in patients with depressive disorders]. / Upravlyayushchie kognitivnye funktsii i ikh rol' v prognozirovanii terapevticheskogo otveta u patsientov s depressivnymi rasstroistvami.

OBJECTIVE: To identify differences in executive functions in patients with depressive disorders depending on their sensitivity to antidepressants. MATERIAL AND METHODS: The study included 70 patients with depressive disorder. All patients received syndrome-induced psychopharmacotherapy, which included antidepressants and normotimics. The severity of depressive disorder was assessed using the Hamilton Depression Rating Scale (HDRS). The criterion for the effectiveness of therapy (sensitivity) was an improvement in clinical symptoms by 50% or more, as measured with HDRS. The study was performed in two stages (points): at the first point, patients were examined upon admission to the Department before taking medications, and the second point was performed after a 4-week treatment of patients in the hospital. The assessment of executive functions was performed using computer tests Go/Nogo, Corsi and Stroop. RESULTS AND CONCLUSION: Patients with depressive disorders who were not sensitive to therapy were characterized by low performance in executive functions compared to patients with a positive therapeutic response. Based on the data obtained, a multiple linear regression equation was constructed to predict the therapeutic response based on individual differences in the results of cognitive tests, regardless of potential clinical and demographic factors.

[Lithium in the psychopharmacology of affective disorders and mechanisms of its effects on cellular physiology]. / Litii v psikhofarmakologii affektivnykh rasstroistv i mekhanizmy ego effektov na kletochnuyu fiziologiyu.

However, despite successful use of lithium in the treatment of affective disorders for almost 40 years, the mechanisms of its therapeutic action are still poorly understood. This review presents and summarizes the current literature about the use of lithium in treatment of affective disorders, as well as its effects on cellular physiology, with a separate description of the effect of this ion on the functioning of nerve tissue and ion-molecular mechanisms.

[Clinical and electrophysiological parameters of alcohol dependence and its comorbidity with affective disorders]. / Klinicheskie i neirofiziologicheskie osobennosti pri alkogol'noi zavisimosti i pri ee komorbidnosti s affektivnymi rasstroistvami.

OBJECTIVE: To identify characteristics of and possible differences in clinical and electroencephalographic parameters in patients with alcohol dependence with- and without comorbid affective disorders. MATERIALS AND METHODS: Ninety-five patients, including 74 with an established diagnosis of alcohol dependence and 21 with alcohol dependence and affective disorders, were examined. Duration of alcohol dependence and affective disorder (years), number of hospitalizations and suicidal attempts were analyzed as anamnestic data. Hamilton's anxiety and depression scale (HDRS), the Alcohol Use Disorders Identification Test (AUDIT), the General clinical impression scale (CGI-s) were used as psychometric tools. The study of bioelectric activity of the brain was carried out using a 16-channel encephalograph. The background electroencephalogram was recorded, the values of absolute spectral power and coherence of theta, alpha and beta rhythms were analyzed. RESULTS AND CONCLUSION: Patients with comorbidity of alcohol dependence and affective disorders have a significantly higher risk of suicidal behavior, a greater frequency of hospitalizations, higher levels of anxiety compared with patients without affective disorders. Electrophysiological data have shown that patients with comorbidity of alcohol dependence and affective disorders have higher values of spectral power of alpha-rhythm in all parts of the cerebral cortex (except for temporal lobes) and beta-rhythm in the occipital cortex, as well as an increase in interhemispheric coherence in all frequency ranges.

[Hormones of stress-response system in alcohol dependence: the ability to predict duration of remission]. / Gormony stress-realizuyushchei sistemy pri alkogol'noi zavisimosti: vozmozhnost' prognozirovaniya dlitel'nosti remissii.

OBJECTIVE: To determine the spectrum of hormones of the stress-realizing system in the time course of therapy of withdrawal syndrome and post-withdrawal state and analyze their possible relationships with the duration of therapeutic remission in patients with alcohol dependence. MATERIAL AND METHODS: The examination included 74 men admitted in the clinic at Mental Health Research Institute NRMC diagnosed as having «Mental and behavioral disorders due to use of alcohol¼ (dependence syndrome F10.21 and withdrawal state - F10.30) according to ICD-10. The control group included 35 men matched in age with patients. Concentration of cortisol, testosterone, and thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) were determined by immunoenzyme method (IEM), in patients - at two points: point 1 - by day 3-5 of the admission in the clinic in the withdrawal syndrome state after alcohol detoxification; point 2 - by day 15-17 of the anti-alcohol therapy. RESULTS: In the general group of patients with alcohol dependence the elevation of the level of cortisol in comparison with control was established (pc<0,0001 at both points) and increase of concentration at point 2 (p=0,0253 to point 1). Concentration of testosterone at point 1 exceeded the level of control (pc=0,0203), at point 2 decreased up to control values and in relation to point 1 (p=0,0004). In relation to control the level of TSH in patients was decreased at point 1 (pc=0,0077); the concentration of fT3 and fT4 was reliably decreased at both points; concentration of fT4 decreased further in the process of the therapy of the post-withdrawal state (p=0,0003 to point 1). According to the duration of the last therapeutic remission, two groups of patients were formed: those with unstable remission (up to 6 months) and with the formed stable remission (1 year or more). A comparative analysis of the concentration of cortisol and testosterone in blood serum taken in patients at point 1 revealed a significant excess of testosterone in the group with unstable remission, both in relation to the control (pc=0,0239) and to the indicator in the group of patients with stable remission (p=0,0159). CONCLUSION: Dysfunctions in the spectrum of stress-realizing hormones in patients with alcohol dependence in the time course of the therapy for withdrawal syndrome and post-withdrawal state were revealed, the main of which are high level of cortisol, testosterone, reduction of secretion of free thyroxine and free triiodothyronine. Patients with unstable therapeutic remission are characterized by a high concentration of testosterone after alcohol detoxification, which allows us to consider testosterone as a biological criterion that can increase the accuracy of prediction of the duration of remission after anti-alcohol therapy.