[Periodic catatonia in schizophrenia spectrum disorders]. / Periodicheskaya katatoniya pri rasstroistvakh shizofrenicheskogo spektra.

OBJECTIVE: Typological differentiation of periodic catatonia in schizophrenia and schizophrenia spectrum disorders (SSD), in particular, schizoaffective disorder. MATERIAL AND METHODS: Seventy-four patients with the verified diagnosis of schizophrenia and SSD (ICD-10 items F20, F21) were studied. The clinical, psychometric (BFCRS, SANS) and statistical methods were used. Clinical and psychometric study of seizures of periodic catatonia was carried out at the following stages: 1) manifestation of a seizure; 2) the maximum severity of psychopathological disorders. Also, at the end of the seizure, an additional assessment of the severity of negative symptoms was carried out using the SANS. RESULTS: Three forms of periodic catatonia have been identified: hypokinetic, parakinetic, multikinetic. Clinical distinguishing indicators of periodic catatonia seizurs have been established (protracted - two-stage - form of seizures; the phenomenon of «secondary catatonia¼). The psychometric study revealed significant differences between the variants of periodic catatonia seizures in terms of the severity of motor phenomena (at both stages of the seizure) and negative disorders. BFCRS scores at the first stage of seizures were as follows: hypokinetic - 9.7±0.4; parakinetic - 12.8±0.9; multikinetic - 32.3±1.6 (the differences were found between 1 and 2 (p<0.05); between 1 and 3, as well as 2 and 3 (p<0.01)). BFCRS scores at the second stage of seizures were 12.1±0.8; 19.9±1.2 and 47.7±1.9, respectively,with the differences between 1 and 2 (p<0.05); between 1 and 3, and also 2 and 3 (p<0.01). The scores on the SANS anhedonia-asociality subscale were 1.9±0.2 for hypokinetic; 2.3±0.3 for parakinetic and 3.2±0.2 for multikinetic with the differences between 1 and 2, 1 and 3, 2 and 3 (p<0.01). CONCLUSION: Periodic catatonia is the clinical entity that includes a complex of progressively worsening seizures, the psychopathological systematics of which takes into account the clinical structure of motor disorders, their affiliations with positive and negative dimensions, and functional activity.

[Chemotherapy-associated clinical dynamics of nosogenic reactions in breast and ovarian cancer model]. / Assotsiirovannaya s khimioterapiei klinicheskaya dinamika nozogennykh reaktsii na modeli raka molochnoi zhelezy i yaichnikov.

OBJECTIVE: To study the clinical features, dynamics and factors of nosogenic reactions (NR) development in patients with breast and ovarian cancers at the stage of chemotherapy. MATERIAL AND METHODS: The study involved 35 patients who underwent chemotherapy. Clinical-psychopathological and psychometric methods were used to assess the mental state. RESULTS: We distinguished 3 clinical types of nosogenic reactions: anxiety-phobic (n=14, 40%), anxiety-depression (n=13, 37%) and dissociative reaction (n=8, 23%). It was discovered that nosogenic reactions reflect the dynamics of psychopathological disorders associated with chemotherapy and they are connected with premorbid personality structure of the patients. When compared on the Mini-mult scales, differences were found between patients of the anxiety-phobic and dissociative groups: the score on the Anxiety and Depressive Tendencies scale was significantly higher in the group of patients with anxious-phobic NR (p<0.01), as was the score on the scale «Anxiety fixation and restrictive behavior¼, which was correlated with such personality traits as sensitivity, self-doubt, low self-esteem, obsessive fears (p<0.05). According to the results of the Spielberger-Khanin anxiety scale, in general, the sample was characterized by an increased level of anxiety compared to the norm: the average scores were 49.7 for trait anxiety and 47.7 for state anxiety. CONCLUSION: Nosogenic reactions can undergo dynamic changes at various stages of treatment. The proposed typology of nosogenies in a more detailed study can have not only scientific, but also practical significance for determining the personalized tactics of psychiatric care for cancer patients at different stages of the disease.

Processes of homeostatic proliferation in the pathogenesis of autoimmune glomerulonephritis induced by chronic graft-versus-host reaction.

Lymphopenia developing at the early stage of chronic graft-versus-host reaction is associated with increased content of IL-7 in the peripheral blood and leads to an increase of the CD4(+)and CD8(+)cell subpopulations in the spleen of the recipient. After 3 months, some animals develop autoimmune glomerulonephritis (lupus recipients). High levels of IL-7 and T-cells with the memory cell phenotype (CD4(+)CD45RB(low)and CD8(+)CD45RB(low)) persist in these animals, in contrast to nonlupus recipients without signs of autoimmune disease. This can attest to the involvement of homeostatic proliferation processes in the formation of autoimmune disease in this model.