[Conceptualization of comorbid anxiety and depressive disorders and approaches to their managing]. / Kontseptualizatsiya komorbidnykh trevozhnykh i depressivnykh rasstroistv i podkhody k ikh vedeniyu.

Anxiety and depressive disorders are characterized with frequent co-occurance. Depression comorbid to anxiety disorder increases severity of main disorder, aggravates it`s clinical course, worsens social functioning of the patients and decreases life quality, results resistance to therapy and increases the probability of suicidal attempts. In patients with depressive disorders onset of anxiety disorder results increased severity of disorder and decrease in quality of remission. There are different opinions on nature and phenomenology of comorbidity of anxiety and depressive disorders. There are biological and psychological factors of risk of comorbidity. Some scientists consider comorbid disorders to be independent and not to effect each other; others pay attention at common anatomic basis of comorbid disorders, which explains manifestation of comorbid disorder. Hierarchical analysis of clinical features of comorbid disorders favors nosological approach to understanding of comorbidity, and implicates the need for inclusion of transdiagnostic elements. Some authors consider comorbid disorders to be separate type of disorder, characterized with special dynamics of syndromes which reveals transformation of one disorder into another. Phenomenon of comorbidity can be described as part of concept of disease spread which estimates important role of bridge psychic states. Considering clinical features of comorbid disorders, difficulties of their therapy based on concepts of phenomenology of comorbid depressive and anxiety disorders recommendations on prevention, early diagnosing and managing of comorbid disorders were elaborated. Psychotherapy (including CBT, which demonstrated high efficiency) is an essential element of treatment of comorbid depressive and anxiety disorders. Psychotherapy is supposed to be correcting personality traits, cognitive mistakes and maladaptive strategies of coping with disorder, which support the comorbidity.

[Premorbid self-medication and its factors in patients with depressive and neurotic disorders]. / Samomedikatsiia i faktory ee formirovaniia u patsientov s depressivnymi i nevroticheskimi rasstroistvami v domanifestnom periode.

AIM: To study self-medication and its factors in patients with depressive and neurotic disorders at premorbid stage. MATERIAL AND METHODS: The sample included 131 first-time admitted patients and 85 recurrent patients with depressive or neurotic disorders, who reported taking medication to cope with the symptoms during preadmission period. Lazarus coping strategies test, Shmishek personality test, test on disease attitude and patient activation were used. Social and demographic characteristics, subjective characteristics of disease, medical literacy and behavioral coping strategies were studied. RESULTS AND CONCLUSION: Over 50% of the patients used self-medication to cope with the symptoms during the preadmission period. Coping anxiety and insomnia was a key motivation to self-medication. Most frequently used medications included tranquilizers and herbal anxiolytics. Misunderstanding of origin of their state, searching for information about treatment of disease via internet, increased emotiveness and tension, lack of their correction with psychotherapy were the factors of self-medication.

[Influence of psychopathological factors and personality traits on the results of the study of quality of life in patients with multiple sclerosis]. / Vliianie psikhopatologicheskikh faktorov i osobennostei lichnosti na rezul'taty issledovaniia kachestva zhizni bol'nykh rasseiannym sklerozom.

AIM: To study the influence of psychopathological factors and personality traits on the results of the study of quality of life (QoL) in patients with multiple sclerosis (MS). MATERIAL AND METHODS: Forty-three patients with relapsing MS were included in the study (74.4% female; mean age 33.1 years). SF-36 was used to evaluate QoL. Effects of psychopathological factors, cognitive regulation of emotions and personality traits on QoL were studied. Statistical analysis was performed using multiple linear model. RESULTS AND DISCUSSION: A wide number of strategies of cognitive regulation of emotions has conflicting effects on the physical component of QoL; subscales of anhedonic depression and anxious arousal (MASQ), which probably represent depressive and anxiety disorders, decrease the physical component of QoL. The key factors of the mental component of QoL include psychopathological factors (mostly obsessive-compulsive symptoms) and personality traits (the more intense they are the lower is QoL). Strategies of cognitive regulation of emotions have low impact on the mental component of QoL.

[Anxiety and depressive psychopathological characteristics of patients with multiple sclerosis at different stages of disease]. / Osobennosti trevozhnykh i depressivnykh rasstroistv u bol'nykh rasseiannym sklerozom na razlichnykh étapakh bolezni.

AIM: To study the development of anxiety and depressive disorders in patients with exacerbated multiple sclerosis (MS). MATERIAL AND METHODS: Forty-three patients with MS were included in the study (women 74.4%, mean age 33.1 years old). SCL-90-R and MASQ questionnaire were used to evaluate psychopathological symptoms. RESULTS AND CONCLUSION: There is the high prevalence of symptoms of anxiety and depression in patients with MS. Other symptoms, including interpersonal sensitivity, hostility and decrease of stress response, are observed as well.

[A multiple linear model of help-seeking behavior in patients with depressive and neurotic disorders]. / Mnogofaktornaia model' povedeniia patsientov po obrashchaemosti za meditsinskoi pomoshch'iu pri depressivnykh i nevroticheskikh rasstroistvakh.

AIM: To find out the factors effecting time from onset of symptoms of psychiatric disorders to help-seeking. MATERIAL AND METHODS: The sample included 166 inpatients with affective or neurotic, stress-related and somatoform disorders. Clinical, psychometric, anamnestic methods were used. RESULTS AND CONCLUSION: The multiple regression model of help-seeking by inpatients with depressive and neurotic disorders is characterized by the high level of multiple correlation (r=0.85). This model allows the prediction of the time of help-seeking in the group of inpatients or individually, which can be used as a basis for programs of prevention of delayed help-seeking behavior.

[Gambling addiction: the psychopathological structure of game-circle].

Thirty-two pathological gamblers were examined. The SCL-90-R, the LSI (Life Style Index) and the CSW questionnaires were used to evaluate psychopathological disorders. Based on the data obtained and the analysis of the development of pathological behavior, authors singled out 6 periods of the game-circle: 1) distress that directly followed the game (anxiety-depressive, obsessive-compulsive and paranoia disorders); 2) moderate anxiety-depressive disorders; 3) subdepressive disorders with predominance of asthenia and apathy; 4) anxiety and dysphoria comorbid with subdepression; 5) the narrow state of consciousness (game trans) preceding the relapse; 6) the return to game.

[Emotional burn-out in narcologists].

To study the prevalence, structure and risk factors of emotional burn-out in narcologists, 90 practitioners in the field of narcology were studied. Emotional burn-out syndrome was found in 37.7% of narcologists. The stage of "resistance" characterized by the lowered interest in professional duties, sparing of emotions and feeling of being tired from interpersonal contacts was observed most frequently. Emotions were totally removed from the professional activity at the stage of "exhaustion". The emotional burn-out syndrome was most prevalent within the first 10 years of professional activity. The personality factors increasing the risk of burn-out were increased impulsiveness, lowered control of motivations and incentives, increased rigidity, inertness of mental processes, inability to exclude the traumatic experiences. The ability to plan the problem solving process and act in a logic and consistent way decreased the risk of the burn-out syndrome while the increased self-control produced the increased level of anxiety and contributed to the burn-out syndrome.

[Mental disorders in pathological gamblers].

The study aimed at investigating mental disorders in pathological gamblers. A sample included 73 pathological gamblers (PG) and 77 age- and sex-matched controls. Severity of mental disorders was assessed using the SCL-90-R questionnaire. Most of PG were male (89%), mean age 26,8 +/- 6,3 years. Divorced were 27,4% and never married--20,5%. Most of PG (71,1%) had secondary school education. Alcohol-related problems were observed in 35,6% of PG and 52,1% had positive family history of alcohol-dependence. Mental disorders, mostly of anxiety-depressive and asthenia character, as well as obsessive-compulsive, paranoiac and phobic symptoms were found in 66 (90,4%) PG. In 92,4% cases, severity of disturbances reached the level of symptomatic stress disorder.

[Psychological aspects of systemic approach to intra-nosological diagnosis in arterial hypertension]. / Psikhologicheskie aspekty sistemnogo podkhoda k vnytrinozologicheskoi diagnostike pri arterial'noi gipertonii.

AIM: To evaluate significance of the program of psychological examination of patients with essential hypertension (EH) for clinicians and characterize the patients psychologically. MATERIAL AND METHODS: 46 EH patients were examined for time of trouble, stress liability, psychological reaction to the disease, factors of vitality. 24-h blood pressure (BP) monitoring was made in 40 patients. RESULTS: It is shown that in EH more frequent are hypochondriac and anxiodepressive psychological types. "White coat" hypertensive reactions (primarily, a rise of systolic blood pressure by 12.5%, on the average) were observed in any psychological types but more in the hypochondriac type. Time of trouble and stress liability were high and correlated. Cluster analysis has identified patients with the highest mean BP. Their psychological analysis is presented. CONCLUSION: The proposed program of evaluation of psychological features of somatic patients allow to define main psychological factors influencing BP. This program is available for clinicians who are not professional psychologists.

[Psychophysiological health aspects of population living in radiation-contaminated territories]. / Psikhofiziologicheskie aspekty zdorov'ia naseleniia radiatsionno zagriaznennykh territorii.

A combined psychophysiologic study of 100 individuals living in territories contaminated by radionuclides and 60 people from ecologically clean region. There were no significant differences in the incidence of neurotic disorders between people from these regions (61.2 and 65.3%, respectively). The highest sensitivity to small radiation doses was observed at rather young age (20-40 years). It was found that a considerable role in the development of borderline psychic disorders belongs to both somatic disturbances due to low-dose radiation and psychogenic effects. A combined action of psychogenic and somatogenic factors aggravated symptoms of neurotic disorders and promoted widening of a range of psychic disturbances. Some part of the population from the contaminated territories tended to the development of cerebro-vascular psychoorganic pathology resultant from a breakdown of the reserves of the adaptation. Now the stress factor of radionuclides exposure is not so important as social and economic problems.