[The state of the immune system in endogenous mental diseases with pronounced affective disorders].

Parameters of innate and adaptive immunity were studied in the blood serum of 180 patients, aged 15-25 years, with different endogenous mental diseases with depressive and mania disorders in the clinical picture (affective psychoses (29 patients), schizoaffective psychoses (106 patients) , slow-progressive schizophrenia (23 patients) and intermittent-progressive schizophrenia (22 patients)). The activation of innate immunity (the increase in the degranulation activity of leukocyte elastase (LE) and functional activity of alpha-1-proteinase inhibitor (α1-PI) were found in all the diseases. The increase in disease severity (from affective disorders to intermittent-progressive schizophrenia) was correlated with the significant elevation of LE activity. The LE activity did not depend on the polarity and severity of affective pathology in each diagnostic group. The mean levels of autoantibodies to the nerve growth factor and the myelin basic protein did not differ from the control values in all the groups of patients.

[Changes of the level of serum antibodies to neuroantigens in patients with schizophrenia during the treatment].

The level of antibodies (AT) to neuroantigens (nerve growth factor and basic myelin protein) has been studied in the serum of 80 patients with schizophrenia, attack-like type, (ICD-10 items F20.01-02) during the treatment with psychotropic drugs. Therapeutic effectiveness has been measured clinically and with the PANSS. It has been shown that the autoimmune component is present during the acute episode of schizophrenia in about 30% of cases. No statistically significant differences have been found in the mean values of AT before and after the treatment however the dynamics of their changes has been closely related with the results of therapy: the decrease of AT level during the therapy is a predictive factor for good therapeutical remission; on the contrary, the increase of this level may be considered as an unfavorable prognostic factor.

[Some indices of congenital and acquired immunity in patients with endogenous diseases of schizophrenic spectrum disorders].

Indices of congenital leukocyte elastase (LE) activity and adaptive immunity (a level of autoantiboies to nerve growth factor--AabNGF) in blood serum of patients with schizophrenia (attack-like, continuous and slow progressive types) and schizoaffective psychosis have been compared with clinical presentations of the disorders. A patient's state was assessed by clinico-psychopathological methods and with the Positive and Negative Syndromes Scale (PANSS). All schizophrenia types and schizoaffective psychosis were accompanied by LE activity elevation. An increase of AabNGF level was observed only in attack like and continuous schizophrenia. Correlations between AabNGF level and negative symptoms evaluated, using the PANSS, suggest a relation of autoimmune reactions against NGF to the progression of schizophrenic process. Differences in AabNGF level between schizoaffective psychosis and attack-like schizophrenia confirm nosologic independence of schizoaffective psychosis and demand for additional differential laboratory diagnosis of these disorders.

[The age peculiarities of nonpsychotic forms of psychogenic disorders caused by everyday stressors]. / Vozrastnye osobennosti nepsikhoticheskikh form psikhogenii, vyzvannykh povsednevnymi stressami.

Three groups of patients were examined in the period of 1994-1999: adolescent (aged 15-18 years), middle-aged (25-59 years) and elderly (60 years and older) with non-psychotic mental disorders developing under the influence of everyday stressors. The highest tolerability to stressors was detected in the middle-aged group. The dominating stressors in the groups were: social situations in the adolescences; interfamily conflicts--in the middle-aged patients and a presence of disease--in the elderly. Stressogenic affective disorders occurred most often in all the groups; anxious-phobic states prevailed in adolescents; neurotic pictures with hysteri-form symptoms, converse type--in the middle age and anxious phobic disorders with primary psychoorganic appearances--in the elderly. Risk factors for psychogenic disorders are: male sex, "organic predisposition", accentuation of the personality, "destructive" types of family bringing up in the adolescences; female sex, signs of endogenic diathesis and reactive lability for the middle-aged patients and female sex, aging factor and related changes of personality as well as somatic diseases in the elderly.

[A comparison of some indices of innate and adaptive immunity in different types of schizophrenia]. / Sopostavlenie nekotorykh pokazatelei vrozhdennogo i priobretennogo immuniteta pri raznykh formakh techeniia shizofrenii.

Leukocyte elastase (LE) blood serum activity as an index of innate immunity and autoimmune reactions to brain antigens i.e. a level of autoantiboies to nerve growth factor (NGF) as an index of adaptive immunity were studied in patients with attack-like and slow progressive schizophrenia. Compared to controls, higher LE activity accompanied by a significant increase of autoantibodies to NGF titers was found in patients with attack-like schizophrenia. In slow progressive schizophrenia, only higher LE activity was detected. Correlations between immunological parameters and some clinical appearances (positive and negative disorders) and disease course peculiarities were revealed. The results suggest an involvement of different parts of immune system in pathophysiology of attack-like and slow progressive schizophrenia.

[Clinical and genetic studies of Alzheimer-type dementia]. / Kliniko-geneticheskie issledovaniia dementsii al'tsgeimerovskogo tipa.

The families of 128 probands with Alzheimer's disease (AD) and senile dementia (SD) were studied. Genetical and mathematical analyses were employed to estimate the clinico-genealogical findings. The genetic factors were found to be likely to make some contribution to the origin of Alzheimer-type dementia (ATD). The proportion of afflicted relatives considerably exceeded that of the above dementia patients. Two genetic models (monogenic and multifactorial) were tested. The limit estimations of genetic similarity between AD and SD manifestations both in the monogenic and multifactorial models denied the fact that there is a common major gene responsible for liability to Alzheimer-type dementias. The common gene modifiers were assumed to exist in AD and SD. In addition to the differences found between the types of inheritance in patients with these disease, the following features are: an oligogenic type of inheritance in SD and a quasi-dominant one with incomplete manifestations of homo- and heterozygotes in AD. Studies into the clinical polymorphism of Alzheimer-type dementias in hereditary cases enabled the authors to establish the genetically determined signs and the environmentally induced signs. The predisposing features (premorbid characteristic traits and specific features of mnemic and intelligence) were identified, which allowed the development of Alzheimer-type dementias to be predicted in 80% of women from hereditarily aggravated families.

[Comparative clinico-genetic studies of senile dementia and Alzheimer's disease]. / Sravnitel'noe kliniko-geneticheskoe izuchenie senil'noi dementsii i bolezni Al'tsgeimera.

The families of 128 probands with senile dementia (SD) and Alzheimer's disease (AD) were entered into the study. The correlation between the familial and sporadic cases of the disease was established. A geneticomathematic analysis was employed to estimate the clinicogenealogical findings. Two genetic models (monogenous and multifactorial) were tested. The contribution of the genetic factors to SD and AD liability was assessed. As a result of a comparative clinicogenetic study of SD and AD it was found that there is no doubt about the contribution made by the genetic factors to the origin of the Alzheimer type dementia (ATD). The rate of the afflicted relatives considerably exceeded the population rates of the investigated patterns of dementia. The limit estimations of the genetic similarity between the manifestations of AD and SD, both in the monogenous and multifactorial models, were obtained, which rejects the presence of the common major gene responsible for liability to these patterns of the ATD. It was assumed that AD and SD are characterized by the presence of the common genes modifiers. In addition, the difference was established between the types of inheritance in persons afflicted with these diseases: an oligogenic type of inheritance in SD, a quasidominant type with incomplete penetrance of homo- and heterozygotes in AD.

[Clinico-psychopathological characteristics of the mental disorders at a neurotic level detected in patients at a general polyclinic]. / Kliniko-psikhopatologicheskaia kharakteristika psikhicheskikh rasstroistv nevroticheskogo urovnia, vyiavliaemykh u bol'nykh obshchesomaticheskoi polikliniki.

Examination of patients observed at a general somatic outpatient centre showed that 31.2% of the patients had mental disorders of the borderline level. Most commonly occurring among the psychopathological syndromes were atypical affective conditions with definite somatization of mental disturbances, which was expressed in massive somatic sensations (senestopathies), vegetative irregularities, and somatic pathology of the functional character. Such conditions made up 62.7%. The given syndromologic type is defined as senestopathic-hypochondriac depression which is subdivided into two variants depending on the nature of the symptomatology. The study has shown that the revealed psychopathological syndromes of the borderline level predominantly refer to the endogenic process of low intensity and less frequently to personality pathology at the stage of decompensation.

[Endogenous subdepressions among late middle-aged patients at a general-somatic polyclinic]. / Endogennye subdepressii u pozhilykh patsientov obshchesomaticheskoi polikliniki.

Endogenic subdepressions were studied in psychogeriatric rooms at three territorial polyclinics. They constituted a considerable portion of all mental abnormalities of the borderline level among all the patients treated in these rooms. The psychopathologic structure of these states was similar to the picture of masked depressions of the elderly age. Such peculiarities explain the erroneous diagnosis of these conditions as vascular (atherosclerotic) psychoorganic syndromes. The authors consider the data about a pathoplastic influence of the "age factor" reflected in both form and essence of the psychopathologic picture.