[The impact of the ones sexuality and autonomy awareness on the insomnia severity in patients with anxiety neurotic disorders]. / Vliyanie vospriyatiya sobstvennoi seksual'nosti i avtonomnosti na vyrazhennost' insomnii u patsientov s trevozhnymi rasstroistvami nevroticheskogo urovnya.

OBJECTIVE: To evaluate an impact of perception of ones sexuality and autonomy on the level of insomnia in patients with neurotic/anxiety disorders. MATERIAL AND METHODS: A sample included 123 (93 women and 30 men) patients with neurotic/anxiety disorders (F40, F41, F43, F45) in the age from 25 to 50 years old, anxiety was the main syndrome in the clinical structure of the disorder. Test battery included Pittsburgh Sleep Quality index for the subjective sleep quality evaluation, Insomnia Severity index for stratification of patients into groups with different insomnia level. Anxiety was evaluated with the Hamilton Anxiety Rating Scale. Personality traits, sexuality and sovereignty of psychological space were assessed with the G. Ammon Ego-structure test and the Sovereignty of the individual psychological space questionnaire. Multiple regression analysis was used to study the interrelationship between insomnia severity and psychological characteristics. Insomnia severity index was chosen as the dependent variable. RESULTS AND CONCLUSION: An analysis of the regression model has shown the increase in insomnia index with the simultaneous augmentation of the following scales «Physical body sovereignty¼, «Sovereignty of objects¼, «Destructive aggression¼, «Deficient aggression¼, «Constructive narcissism¼, and decrease of the scales «Territory sovereignty¼, «Deficient narcissism¼, «Constructive sexuality¼. The study results imply the importance of the use of the level of sexual functioning and autonomy as the marker of identity maturity for psychotherapeutic targets in the treatment of neurotic/anxiety disorders. The use of anxiety and insomnia as the main complaints can be explained by its societal approval and need further active evaluation by the specialist for the successful psychotherapeutic treatment.

[Comorbid posttraumatic stress disorder diagnostic improvement in oncology elderly patients after surgical treatment in relation to rehabilitation tasks.]

The cancer incidence increase in elderly patients determines the actuality of this study, because oncological illnesses are often accompanied by mental disturbances. This article considers clinical psychological risk factors of the posttraumatic stress disorder (PTSD) onset in prostate and rectal cancer elderly patients after surgical treatment. The study results showed that lack of social support, deficit of the successful stress coping experience in the past, maladaptive internal disease model, and destructive personality profile proved to be statistically significant risk factors and consequently psychotherapeutic interventions targets in PTSD treatment and prevention. Consideration of the elderly oncology patient clinical, psychological and social characteristics allows to elaborate effective personalized strategies of the complex medical-psychological care in geriatric medicine.

[A comparative study of the efficacy of personality-oriented (reconstructive) and cognitive-behavioral psychotherapy in neurotic anxiety disorders with insomnia]. / Sravnitel'noe issledovanie éffektivnosti lichnostno-orientirovannoi (rekonstruktivnoi) i kognitivno-povedencheskoi psikhoterapii pri trevozhnykh rasstroistvakh nevroticheskogo urovnia s insomniei.

AIM: To study personality-oriented (reconstructive) and cognitive-behavioral psychotherapy in patients with neurotic anxiety disorders with insomnia. MATERIAL AND METHODS: Ninety-eight patients with disorders coded in ICD-10 as F 40.0; F40.1; F41.0; F41.1; F48.0 were studied. Clinical, psychometric, experimental-psychological methods and polysomnography were used. RESULTS AND CONCLUSION: Phenomenological insomnia types characteristic of neurotic anxiety disorders and their relationship with types of intrapersonal conflicts are described. A quantitative analysis of the dynamics of symptomatic complains, anxiety level, and insomnia is presented. The efficacy of the both psychotherapeutic treatments is shown. However the personality oriented (reconstructive) psychotherapy has demonstrated better and more stable results. This can be explained first of all by its pathogenesis-oriented nature and involvement of the cognitive emotional and behavioral spheres as well as the resolution of the intrapersonal conflicts, which are the cornerstone of neurotic disorders.

[A study of the duration of the disease as a risk factor for the development of hospitalization in elderly psychiatric patients.]

Phenomenon of hospitalism in elderly patients with mental disorders is an extremely important clinical, social and economic problem. 155 patients of the gerontopsychiatric hospital were examined, 75 of them showed signs of hospitalism, and 80 made up a control group. A subgroup of patients with signs and short duration of the disease was isolated, the duration of treatment in the hospital of these patients was 133,5±42,24 days (in the corresponding control subgroup 72,11±37,11 days, p<0,05). This subgroup was characterized by greater impulsiveness as a personality trait and less adaptive coping strategies. A subgroup of patients with signs of hospitalism and a longer duration of the disease also had a longer stay in the hospital compared to patients with a similar experience of illness without hospitalism (249,67±63,56 and 79,58±39,52 days, respectively, p<0,05). For this subgroup of patients, the factors associated with the development of hospitalism were higher anxiety and depression in the current psychoemotional state, a smaller representation of adaptive cognitive coping and less sensitivity to the disease, all differences are significant at p<0,05.

[Anxiety disorders diagnostic algorithm in cancer patients].

The article defines the basic principles of anxiety disorders diagnosis (anxious-phobic disorders, panic disorder, generalized anxiety disorder) in cancer patients in accordance with the evidence-based medicine. There are provided typical clinical manifestations, features and variants of courses of disease. There is proposed the anxiety-phobic disorders diagnosis algorithm. There are characterized clinical, experimental, psychological, laboratory methods and are highlighted stages of diagnostic process.

[Etiology, epidemiology and psychotherapy of comorbid psychiatric disorders in cancer patients].

The scientific review reflects the prevalence of psychiatric disorders in oncological and hematological diseases. The ratio of occurrence of anxiety and depressive disorders in different nosological forms of cancer was considered. There were described clinical presentation and particular manifestations of depressive and post-traumatic stress disorder in patients with malignant tumors. Pathogenetic mechanisms and risk factors of mentioned disorders in cancer were determined. The basic models and targets of psychotherapy for comorbid psychiatric disorders in cancer patients were considered as well.

[The use of spitomine (buspirone) in the combined therapy of panic disorder].

OBJECTIVE: To explore the efficacy of spitomine (buspirone) in the combined therapy of panic disorder, we studied the dynamics of clinical parameters and personality traits associated with development and maintenance of panic disorder during the treatment. MATERIAL AND METHODS: Thirty patients of a treatment setting for out-patients with panic disorder were enrolled in the study. Patients received combined treatment with spitomine (buspirone) in the dose of 30 mg/daily (10 mg three times a day) during 6 weeks and individual short-term direct cognitive-behavioral therapy. Anxiety and panic symptoms were measured with HARS, CGI, MADRS and STAI-A. RESULTS: There was a significant reduction in panic and anxiety symptoms (by 50% on the HARS) that reached on average 9.73 scores to the end of the study. This finding indicates the absence of anxiety and, therefore, therapeutic efficacy of the treatment. Scores on state anxiety of STAI-A were significantly lower compared to baseline though the level of anxiety remained relatively high. The partial decrease in trait anxiety, though its level was high as well, was noted. CONCLUSION: The combined therapy of panic disorder with spitomine (buspirone) and cognitive-behavioral therapy is an optimal treatment, though not without the limitations of short-term methods. Good tolerability of the drug allowed all patients to complete the study.

[Features of fractal dynamics EEG of alpha-rhythm in patients with neurotic and neurosis-like disorders].

Fifty-five patients with neurotic and neurosis-like disorders and 20 healthy controls, aged 17-64 years, have been examined. The basic research method was electroencephalography (EEG) with the fractal analysis of alpha power fluctuations. In patients, the changes in the fractal structure were of the same direction: the decrease of fractal indexes of low-frequency fluctuations and the increase of fractal indexes of mid-frequency fluctuations. Patients with neurosis-like disorders, in comparison to those with neurotic disorders, were characterized by more expressed (quantitative) changes in fractal structures of more extended character. It suggests the presence of deeper pathological changes in patients with neurosis-like disorders.