[A role of progesterone and its metabolites in regulation functions of the brain]. / Rol' progesterona i ego metabolitov v reguliatsii funktsii golovnogo mozga.

The review presents literature data reflecting the nature and mechanism of the effect of progesterone and its metabolites on human and animal brain structures. Particular attention is paid to neuroprotective, anticonvulsant, anti-anxiety and sedative properties of this hormone, which determines the prospect of its use for the prevention and treatment of human neurodegenerative diseases, epilepsy, sleep disorders, and anxiety-depressive spectrum disorders, including premenstrual and climacteric syndromes.

[To the question of pathophysiological fundamentals of endocrine system functioning in patients with a first psychotic episode].

OBJECTIVE: To study the characteristics of prolactin secretion in patients with a first psychotic episode (FPE) with regard to disease severity, gender and patient's neuromediator system state. MATERIAL AND METHODS: Author studied 76 patients with schizophrenic spectrum disorders and 34 normals (control group). RESULTS AND CONCLUSION: There was a significant negative sex-related correlation between the severity of psychopathologic symptoms and plasma prolactin levels. Based on the results author attempted to explain the hormonal disbalance in the patients with FPE taking into account the state of monoaminergic mediator systems in patients.

[Eating disorders in psychiatric patients during treatment with second generation antipsychotics].

AIM: To identify the frequency and characteristics of eating disorders in patients with schizophrenia treated with second generation antipsychotics. MATERIAL AND METHODS: A sample included 56 patients (48 women and 8 men, mean age 28 ± 4.5 years) with schizophrenia and schizoaffective disorder. Patients received risperidone, quetiapine and olanzapine. The study employed clinical-anamnestic, endocrinological methods and assessment of eating behavior with DEBQ (The Dutch Eating Behavior Questionnaire). All of the patients had extra Body mass or obesity: extra Body mass of the 1st grade was found in 18 patients (BMI<30 kg/m²) and obesity grade 2-3 in 38 patients (BMI>30 kg/m²). RESULTS AND CONCLUSION: Authors identified different types of eating disorders: external, restrictive and emotiogenic as well as the relationship of their prevalence and severity with sex, drug, presence and grade of obesity. Based on these RESULTS: we developed recommendations for management of patients treated with second generation antipsychotics.

[Neuroendocrine dysfunctions during psychopharmacological treatment: clinical presentations, diagnosis, risk factors and treatment].

We present a review of the literature on clinical presentations, diagnosis, treatment and prevention of neuroendocrine dysfunctions (NED) in patients with mental disorders during psychopharmacological treatment. Prolactinemia syndrome, metabolic syndrome and dysthyreosis are considered. Risk factors for NED and practical recommendations on diagnostic and therapeutic approaches to NED minimization are presented.

[Psychological aspects of systemic approach to diagnostics of mental and immunological disorders in diffuse-nodular form of Hashimoto's thyroiditis].

Authors have studied 162 patients with the diffuse-nodular form of chronic autoimmune thyroiditis (AIT). Alexithymic personality type was found to be prevalent in patients in the euthyroid phase (51.9%). In autoimmune thyroiditis, alexithymia and certain cytokine parameters were correlated with psychopathological symptoms as asthenia, anxiety and depression which might be caused by their participation in the pathogenesis of non-psychotic mental disorders during the euthyroid phase. The linkage of alexithymia with certain emotional-personal parameters allows to regard it as one of the components of the integral personality characteristics. These findings show that alexithymia is not only an indirect risk factor of the autoimmune thyroiditis development but also a predictor of the disease course.

[Specialties of prolactin secretion and peripheral reproductive sex hormones in patients with of first episode of schizophrenia].

Levels of prolactin, estradiol and testosterone have been assessed in 50 first episode drug naive patients with schizophrenia (23 women and 27 men) and 17 mentally healthy people. All patients have been stratified into two groups by sex and into two subgroups by severity of psychopathological symptoms. The levels of prolactin and estradiol were higher in men compared to the control group. In women, the level of estradiol was lower and the level of testosterone was higher regardless of burden of psychopathologic symptoms. The decrease of testosterone level was found in males with acute psychopathologic symptoms. The increase of psychopathologic symptoms leads to lowering of prolactin level regardless of sex that confirms the dopamine theory of schizophrenia. The results of this study confirm the protective role of estrogen in the development of disease.

[Psychoendocrinological aspects of chronic autoimmune thyroiditis in women of reproductive age].

Based on the examination of 242 women, mean age 30,7+/-0,3 years, with hypertrophic form of autoimmune thyroiditis (Hashimoto disease) in the state of euthyreosis, we analyzed psychoendocrinological factors, responsible for immune reactions, taking into account the thyroid gland structure. We observed the strong correlations between the intensity of autoimmunity, morphological features, psychiatric and hormonal changes.

[Structural characteristics of asthenia in autoimmune thyroiditis].

An examination of 319 patients with hypertrophic form of autoimmune thyroiditis, including 157 patients with diffusive and 162 - with diffusive-nodule structure of the gland, has demonstrated the appearance of asthenic disorders during the euthyroid phase of the disease. Characteristics of these disorders relative to the thyroid gland structure and its diffusive or diffusive-nodule form were found. The association between changes in the immune homeostasis and characteristics of mental disorders was revealed.

[Weight gain in patients with schizophrenia and schizoaffective disorder induced by the long-term treatment with atypical antipsychotics].

To specify the effect of different atypical antipsychotics on weight gain, 346 patients with schizophrenia and schizoaffective disorder have been examined. The influence of risperidone (88 patients), olanzapine (84 patients), clozapine (61 patients), quetiapine (68 patients) and amisulpiride (45 patients) used as a monotherapy has been studied during 1,5 years. Frequency of weight gain for every drug and peculiarities of the dynamics of pharmacogenic weight gain and body mass index in some stages (after 3, 6, 12 and 18 months) have been revealed. The data obtained allow to conclude that the long-term therapy with olanzapine, clozapine and risperidone exert a more marked influence on the body mass as compared to quetiapine and amisulpiride regardless of the patient's sex.

Contribution of leptin to the formation of neuroleptic obesity in patients with schizophrenia during antipsychotic therapy.

We studied the dynamics of serum leptin level and some anthropometric values in patients with schizophrenia treated with risperidone, olanzapine, and clozapine showed gender-dependent specific correlations between the studied parameters.

[Anabolic-catabolic balance in depression: an effect of coaxil].

Correlation between anabolic and catabolic process in terms of neuroendocrine changes in depression has been studied before and after coaxil therapy. The index of catabolic processes was cortisol blood level and that of anabolic processes--dehydroepiandrosterone (dehydroepiandrosterone sulfate, DHEA-S) level. The total of 39 patients of middle age were studied: 25 of the study group treated with coaxil (37.5 mg/day during 4 weeks) and 14 of the comparison group treated with sertraline (50 mg/day during 4 weeks). A mean level of cortisol was higher than normal one in patients with depression. Coaxil and sertraline decreased the mean cortisol level, no significant differences being found between these drugs. There was negative correlation between the DHEA-S level and severity of depression before the treatment. Unlike sertraline, coaxil caused an increase of this parameter in patients with decreased DHEA-S level. The ratio cortisol/ DHEA-S decreased during the treatment with either coaxil or sertraline but in the former case it was more pronounced (p = 0.003). The authors considered the data obtained in the aspect of concept of allostasis--the ability of the organism to achieve changes (stress reaction).

[Reproductive dysfunctions in female patients during therapy with atypical antipsychotics].

To specify interrelations between clinical and hormonal aspects of reproductive dysfunctions appearing during therapy with atypical antipsychotic agents (clozapine, olanzapine, quetiapine), 131 female patients with paranoid schizophrenia and schizoaffective disorder have been studied. Distinctive features of dynamics of prolactin as well as hypothalamic-pituitary-gonadal hormones levels for each medication studied and correlations between hormone indices and clinical presentations of reproductive dysfunctions (galactorrhea, disturbances of menstrual cycle and libido) were found.

Effect of therapy with atypical antipsychotic drugs on prolactin concentration in patients with schizophrenia and schizoaffective disorders.

Plasma prolactin concentration was measured in patients with schizophrenia and schizoaffective disorders receiving therapy with risperidone, olanzapine, and quetiapine and compared with the corresponding parameter in patient receiving typical neuroleptic drug haloperidol. We evaluated the specific effects of the test drugs on prolactin concentration in men and women.

[Changes in the reactivity of the sensorimotor cortex resulting from the treatment of patients with depressive disorders]. / Izmenenie reaktivnosti sensomotornoi kory v rezul'tate lecheniia bol'nykh s depressivnymi rasstroistvami.

Changes in the mu-rhythm power in response to sound (non-specific reactivity, NR) and related with the actual and imaginary movement with the right and left hand in response to sound (specific reactivity, SR) were studied in 38 right-handed patients with subdepressive psychogenic (PD) and endogenous (ED) disorders before and after successful complex treatment (pharmacotherapy and acupuncture) in comparison with 23 healthy subjects. The successful treatment was found to be accompanied by a certain extent of normalization of the disturbed SR which was different in PD and ED. The more complete recovery of the normal reactions in PD was mainly accounted for by the relative decrease in the NR and increase in the SR. The ED treatment predominantly modified the SR. Substantial reorganization of interhemispheric relations during movements in the PD patients resulted in disappearance of the abnormal ipsilateral reactions and transition to the contralateral reactions of the sensorimotor cortex.

[The reactivity of the sensorimotor rhythm in patients with depressive disorders]. / Reaktivnost' sensomotornogo ritma u bol'nykh s depressivnymi rasstroistvami.

Reactions of mu-rhythm to sound (unspecific reactivity), actual and imaged movement (specific reactivity) were studied in 30 right-handed patients with psychogenic (Pg) and endogenous (Eg, cyclophrenia and low-progredient schizophrenia) subdepressive disorders and 23 healthy subjects. Predominant derangement of specific reactivity was revealed in patients which consisted in attenuation of reactions and reorganization of interhemispheric relations. During the actual movement there was a decrease in mu-rhythm reactivity in the left hemisphere and its increase in the right one. The imaged movement was associated with some decrease in the right-hemisphere mu-rhythm reactivity. The degree of reorganization of interhemispheric relations was higher in Eg patients, especially in schizophrenic ones. Abnormal ipsilateral reactions were induced by the actual (in Eg patients) or imaged movement (in Pg patients) with the right hand. These abnormal reactions are regarded as a return to an immature (childish) form. Only in schizophrenic patients the level of unspecific reactivity is lower than in the healthy subjects. There were no hemispheric differences in the sound-induced mu-rhythm reaction both in patients and healthy subjects.