[The problem of multiple somatic and/or psychiatric pathology basic concepts and prevalence]. / Problema mnozhestvennoi somaticheskoi i/ili psikhicheskoi patologii.

The literature of the last decades shows the growing interest to multiple pathologies in medicine including psychiatry and neurology. Multiple pathology is often determined as multimorbidity or comorbidity. Multiple pathology is a common phenomenon, which is the rule rather than the exception. In the medical care system, it is burden for the patient and for the physician in clinical, organizational and economic aspects. The review addresses all these issues in the aspect of terminology and prevalence.

[Suicidality in epilepsy: epidemiology and clinical risk factors]. / Suitsidal'nost' pri épilepsii: épidemiologicheskie aspekty i faktory riska.

The results of studies on the prevalence of suicidal behavior in patients with epilepsy are discussed in the article. The reasons for the high incidence of suicides among patients with epilepsy are given, with special attention paid to social, demographic, clinical and pathopsychological risk factors. Existing gaps in our knowledge about suicidal behavior in patients with epilepsy are analyzed.

[Subcortical laminar heterotopia 'double cortex syndrome']. / Podkorkovaia laminarnaia geterotopiia (sindrom 'dvoinoi kory').

This article presents a clinical case of a 29-year-old patient with 'Double cortex syndrome' with epilepsy, intellectual and mental disorders. Subcortical band heterotopia is a rare disorder of neuronal migration. Such patients typically present with epilepsy and variable degrees of mental retardation and behavioral and intellectual disturbances. The main diagnostic method is magnetic resonance imaging (MRI).

[The «Dialogue¼ or the «Conflict of interests¼ between psychiatrists and neurologists: results of a focus group interview]. / «Dialog¼ ili «konflikt interesov¼ psikhiatrov i nevrologov (rezul'taty fokusirovannogo gruppovogo interv'yu).

OBJECTIVE: To determine the characteristics of interdisciplinary interactions between neurologists and psychiatrists in treatment of anxiety and depressive disorders, including prognostic aspects, and the responsibility of the doctor. MATERIAL AND METHODS: A scenario of an interview included similar questions related to diagnosis, examination and the treatment of patients with anxiety and depressive disorders. Ten neurologists and 10 psychiatrists have completed the interview. RESULTS: The characteristics of the management of patients, the absence of the joint management and interactions, subjective adherence to definite drugs and methods were shown. CONCLUSION: The intersection of professional interests for both specialties because of the similarities of the groups of patients in the conditions of concurrent interdisciplinary interactions makes up the reason for the conflict between them. An introduction of an interdisciplinary model of interactions between the physicians and specified continual education in adjacent fields of medicine will resolve this situation.

[The role of autonomic dysfunction in pathogenesis of irritable bowel syndrome].

This article presents the results of a comparative study of autonomic disorders in patients with differernt types of irritable bowel syndrome (IBS). We used several clinical and instrumental methods, including the Veyn questionnaire, Kerdo autonomic index, skin sympathetic response and heart rate variability analysis. The results show a prevalence of sympathetic tone in all groups of patients (more pronounced in IBS with constipation), as well as an elevated stress index and decreased arterial baroreflex sensitivity. In the IBS with diarrhea group there was a reliable increase of power spectral density alvery low frequency and a lowered respiratory sinus arrhythmia.

[A feedback method in clinical practice].

The authors reviewed a history of development of a feedback method, its physiological basis, essence, methodological aspects of its practical application and factors related to its effectiveness. This method may be used in studies of basic functional disorders, syndromes and diseases. Perspectives of its using in restorative and preventive health care are considered.

[The role of neurobioregulation in the combined treatment of subjective tympanophonia and dizziness].

The objective of the present study was to evaluate the effectiveness of the biological control technologies applied in the framework of the combined treatment of the patients complaining of subjective tympanophonia and dizziness with concomitant changes in the psychoemotional status. It was shown that the disturbances in the psychoemotional sphere associated with complaints of subjective tympanophonia and dizziness took place in 81.4% of the patients included in the study although 17.2% of them had no signs of organic pathology in the central and peripheral regions of the auditory and vestibular apparatuses. It is concluded that the proposed therapeutic strategy can be recommended in the case of poor effectiveness of the medicamnetal treatment in the patients presenting with subjective tympanophonia and dizziness with concomitant changes in the psychoemotional status because it permits to eliminate clinical manifestations of the disease or reduce their severity.

[Akatinol memantine in patients with vascular cognitive disorders].

Treatment of cognitive disorders developed in cerebrovascular pathology is an actual medical problem. Of great importance is the timed diagnosis of these changes in the earlier phases of the development of cognitive deficit as well as adequate therapy that can delay and prevent the development of such complication as dementia. Pathogenetic mechanisms of cognitive disorders are associated with brain vascular and neurodegenerative changes that determine using drugs with vasoactive, metabolic and/or neuromediator effects. Memantine (the active component of akatinol memantine) is a drug that exerts an effect on the glutamatergic system, a non competitive antagonist of NMDA-receptors. The results of studies on the efficacy of this drug in moderate cognitive disorders are inconsistent and the amount of research is small. The present study aimed at the evaluation of changes of neuropsychological parameters in patients with moderate cognitive impairment caused by cerebrovascular pathology who were treated with memantine compared to the control group. Results of randomized open study suggested a significant clinical efficacy of akatinol memantine in the treatment of patients with vascular cognitive disorders. The treatment with akatinol memantine in dose 20 mg/day (10 mg twice a day) during six months significantly reduced cognitive deficit. The most distinct dynamics was related with ideation praxis, visual-spatial and speech functions, word selection, storage of instructions, increasing of volume of audio-speech and visual memory.

[Experience with ixel (milnacipran hydrochloride) use in the treatment of patients with post-stroke depression]. / Opyt primeneniia iksela (milnatsiprana gidrokhlorida) u bol'nykh s postinsul'tnoi depressiei.

AIM: To evaluate antidepressive efficacy of ixel in patients with poststroke depression (PSD). MATERIAL AND METHODS: The study included 59 PSD patients aged 43-79 years divided into two groups: the test group (31 patients) treated with antidepressive drugs and the control group (28 patients) was not treated with such drugs. The test group took a two-month treatment with oral ixel in a dose 100 mg/day. The neurological status was assessed by Lindmark scale (LS), severity of depression-by Hamilton scale (HS). RESULTS: On ixel treatment day 10-14 the patients felt better, by the treatment day 60 depression disappeared in 60.9%, only borderline conditions were seen in 39.1%. Mean score by HS fell from 15.8 to 5.7. The controls showed moderate reduction of some symptoms of depression, mean score by HS decreased insignificantly (from 14.5 to 13.4). By LS, significant differences between the groups were not registered. Side effects arose in 10 patients, 6 of them withdrew. CONCLUSION: Ixel is an effective drug against depression in stroke survivors.