[The new psychopathological paradigm of schizophrenia and schizophrenia spectrum disorders]. / Novaya psikhopatologicheskaya paradigma shizofrenii i rasstroistv shizofrenicheskogo spektra.

The basis of the new paradigm, as an attempt to modernize the systematics of psychopathological disorders, is the concept of simultaneous representation of two relatively independent domains (founded by neurobiological processes) in the clinical space of schizophrenia - negative and positive disorders. The study established the spectra of functional activity of endogenous dimensions, as well as the trajectories of their development, which determine the dominance of predominantly negative or positive symptoms (negative/positive schizophrenia) during the course of the disease. The differentiated impact of endogenous domains on constitutional characterological structures accompanied by the formation of pseudopsychiopathies and subpsychotic personality disorders is observed.

[Bimodal model of delusional psychoses (on the problem of the correlation of paranoid dimensions in the psychopathological space of schizophrenia)]. / Bimodal'naya model' bredovykh psikhozov (k probleme sootnosheniya paranoidnykh dimensii v psikhopatologicheskom prostranstve shizofrenii).

OBJECTIVE: To establish clinico-pathogenetic ratios of delusional psychoses constituting the psychopathological space of paranoid schizophrenia and to determine clinical and pathogenetic validity of concepts of a single delusional psychosis (a model of chronic delusion with a staged course) and two endogenous delusional psychoses. MATERIAL AND METHODS: A sample consisted of 56 patients (19 women, 37 men; the average age 39.7±9.3 years; average duration of the disease 10.6±9.1 years) with a diagnosis of paranoid schizophrenia, continuous type of course (F20.00), developed at the age above 18 years. At the time of examination, the condition of the patients was determined by persistent delusional or hallucinatory delusional disorders. Clinical, pathopsychological, psychometric (SANS, SAPS, PANSS), immunological and statistical methods were used. RESULTS: The study substantiates a bimodal model of a single delusional psychosis with a polar arrangement of interpretive delusions and delusions of influence based on the phenomena of mental automatism, both in terms of the vector of development (toward the poles of negative/positive disorders) and in terms of the rate of progression. Psychopathological manifestations of interpretive delusions correlate with the slow evolving development of psychosis, the dimensional structure of the paranoid is limited to the limits of the delusional register; functional activity is represented by affiliation to negative changes, integration with personality anomalies ends with the transformation of positive disorders into pathocharacterological ones, corresponding to the post-processual development of the personality. Manifestation of delusional impact (syndrome of mental automatism) is manifested by the complication and maximum expansion of the spectrum of positive disorders; the dimensional structure is represented by a wide range of psychopathological disorders and is formed with the participation of processes of mental dissociation, reaching the level of delusional depersonalization; functional activity is high, which creates conditions for the formation of a «new¼ subpsychotic structure, a «psychotic character¼, which is an attenuated duplicate of delusional psychosis. In both groups of patients, a significant increase in the activity of inflammatory markers of leukocyte elastase (249.2 ((231.1-270.0); 272.2 (236.0-292.6) nmol/min∙ml) and alpha - 1 proteinase inhibitor (48.8 (46.0-55.0); 50.4 (42.1-54.8) IU/ml) was shown compared with controls (205.0 (199.8-217.3) nmol/min∙mL and 33.0 (31.0-36.0) IU/mL, p<0.01, respectively). In the group of patients with delusions of influence, an increased level of antibodies to S-100B was also observed (0.88 (0.67-1.0) opt.density units) compared with the control values (0.7 (0.65-0.77) opt.density units, p<0.05). CONCLUSION: The concept of the model is supported by the results of the immunological study, according to which interpretive delusions and delusion based on the mental automatism, indicates the different level of immunity tension, and a qualitative changes in immune reactivity (also due to different genetic burden).

[To the problem of somatic-hypochondriac paranoia]. / K probleme somaticheskoi-ipokhondricheskoi paranoii.

OBJECTIVE: To unite within the framework of a single clinical entity (based on the model of hypochondriacal paranoia) phenomena of the somatopsychotic and hypochondriacal range, which, in accordance with modern systematics, are classified as various categories of psychosomatic, affective disorders and personality disorders. MATERIAL AND METHODS: The sample for analysis consisted of 29 patients (with the diagnosis of delusional disorder (ICD-10; F22.0 in ICD-10), 10 men (34.5%) and 19 women (64.5%), the average age was 42.9±19.9 years; men - 10 nab. (34.5%), women - 19 nab. (64.5%). The average duration of the disease iswas 9.4±8.5 years. The psychopathological method was used as the main one. RESULTS: The article forms an alternative concept of somatic paranoia based on the model of hypochondriacal paranoia. The fundamental difference between the construct of somatic paranoia is an obligate connection between somatopsychic and ideational disorders. Somatopsychic (coenesthesiopathic) symptoms do not exist as an independent (equivalent to the structure of somatic clinical syndromes) dimensions and are formed exclusively with the participation of ideational phenomena. CONCLUSION: In accordance with the presented concept, coenesthesiopathic symptoms within the framework of somatic paranoia act as a somatic equivalent of delusional disorders.

[Hypochondriasis in Graves' disease: the role of pathologic factors and clinical characteristics endocrinopathy]. / Ipokhondricheskie razvitiya pri bolezni Greivsa: rol' patokharakterologicheskikh faktorov i klinicheskikh kharakteristik endokrinopatii.

OBJECTIVE: Clinical qualification of hypochondriasis or illness anxiety disorder (IAD) in Graves' disease (GD) and verification of associated personality and endocrinological factors. MATERIAL AND METHODS: A sample consisted of 27 patients (25 female and 2 male, mean age 48.4 years) with GD and personality disorders (PDs). The patients were examined clinically and with interviews for the assessment of PD according to DSM-IV (SCID-II-PD) and the Short Health Anxiety Inventory (SHAI). RESULTS: IAD was diagnosed in 8 cases (29.6%), of which the main study group was formed. The remaining 19 patients, who did not show signs of IAD, were assigned to the control group. In the main group, the average score on the SHAI «health anxiety¼ subscale was significantly higher (10.2 vs 4.8 points, p<0.05) corresponding to the clinical qualification of the condition as IAD. When assessing the frequency of categorical PDs, it was found that there were no affective PDs in the main group, likewise there were no anxiety cluster PDs in the control group (p<0.05). In turn, in the main group, PDs were characterized by such dimensions as the phenomena of psychopathological diathesis, reactive lability, neuropathy, which were not observed in the control group. The endocrinological factor that differed significantly in main and control groups was the frequency of recurrence of GD (75.0% vs, 40.1%, p<0.05). CONCLUSION: Despite the generally relatively favourable prognosis of GD, there is a significant frequency of IAD, the key role in the formation of which is apparently played by the parameters of the premorbid characteristics, as well as GD recurrence.

[Glossalgia as a psychodermatological syndrome]. / Glossalgiya kak sindrom psikhodermatologicheskoi patologii.

OBJECTIVE: To study clinical characteristics of burning mouth syndrome or glossalgia is a functional disorder with painful sensations in the oral cavity with verification of the psychopathological structure, typology and nosology of the syndrome within the continuum of neurotic/psychotic disorders and dermatological pathology, i.e. lichen planus (LP). MATERIAL AND METHODS: The study sample (n=30, 27 female, mean age 59.3±15.6 years) was examined by dermatologist, neurologist and psychiatrist both clinically and psychometrically. The patients met the diagnostic criteria for glossalgia according to the IASP classification and ICD-10 for glossodynia (code K14.6). In 7 subjects, there was comorbidity with LP of the oral mucosa. RESULTS: The psychopathological picture of glossalgia syndrome has a binary structure. Basic coenesthesiopathies, ranging in severity from homonomous sensations (isteralgias) to heteronomic sensopathies (senestopathies, senesthesia), are associated with secondary hypochondriacal phenomena: from health anxiety and monopatophobia to mastery of ideas and somatopsychic confusion, respectively. According to the psychopathological register (neurotic/psychotic) and the fact of objective verification of a dermatological disease (hypochondria sine materia/cum materia), there are three types of glossalgic syndrome: 1) organo-neurotic; 2) somatopsychotic; 3) dermatological (stress-induced somatic reactions). CONCLUSION: BMS is a local syndrome limited to the oral cavity, however, in fact, it covers the entire clinical spectrum of psychosomatic pathology from mental diseases to psychodermatological ones.

[History and current state of the problem of negative disorders (research of nosological period)]. / Istoriya i sovremennoe sostoyanie problemy negativnykh rasstroistv (issledovaniya nozologicheskogo perioda).

Pioneers of nosology in psychiatry considered mental deficit as a basic disorder obligated to all clinical forms of illness, as did E. Kraepelin in the concept of dementia praecox and E. Bleuler in the concept of schizophrenia. At the present stage of studies, this position is clearly articulated in the «deficit schizophrenia¼ concept of J. Klosterkotter. Negative disorders are considered in categorical approach to interpret psychopathological dimensions of schizophrenia as coordinated, strongly bound with positive syndromes (concept of «dialectical unity¼ of A.V. Snezhnevskiy, 1964) and classified as syndromes according to systematics of positive disorders. However, distinguished types of negative disorders are determined in terms of positive syndromes or characterological changes (asthenic, pseudopsychopathic deficit). Within a new paradigm (dimensional approach to schizophrenia), which differs from the categorical approach, negative disorders are considered as a distinct domain, primary in relation to other psychopathological phenomena of schizophrenia). A concept of primary persistent negative symptoms serves as basis of the current concept of schizophrenic deficit. Factor analysis revealed two domains of negative disorders: 1) emotional blunting: blunted affect, alogia; 2) avolition: apathy, anhedonia, asociality.

[Negative disorders: history of clinical concepts (prenosological studies)]. / Negativnye rasstroistva: istoriya razvitiya klinicheskikh kontseptsii (isledovaniya donozologicheskogo perioda).

In this review, sequential stages of the development of negative disorders doctrine are presented beginning from first description of negative symptoms (Aretaeus of Cappadocia - AD I-II) and the first deficit classification (including two polar types: congenital and acquired dementia by J.-E. Esquirol) to indigenous Russian (I.M. Balinsky, I.P. Merzheevsky, S.S. Korsakov, V.P. Serbsky and others) and foreign (B. Morel, H. Schüle, K. Kahlbaum, E. Hecker) studies of the middle 19th - beginning of 20th century. Special attention in this review of studies in prenosological period is given to the W. Griesinger's development of the main statements of deficit changes' classification and development pathways. Authors' studies created conditions not only for psychopathological construct of negative disorders to be set apart into particular category - «secondary insanity¼ (a group of psychiatric set of symptoms, which accumulate manifestations of mental deficit), but for to be subsequently clinically studied.

[Negative and positive disorders of schizophrenia (issues of co-dependence, psychopathology and pathogenesis)]. / Negativnye i pozitivnye rasstroistva pri shizofrenii (aspekty sozavisimosti, psikhopatologii, patogeneza).

The authors consider current and own conceptions about correlations of the processes underlying the pathogenesis of schizophrenia presented by negative and positive disorders. With growth of academic psychiatry, evaluation of a correlation between positive and negative dimensions has changed dramatically: on the one hand presenting in clinical unity - simultaneous psychopathologic structures, and on the other hand being clinically and pathogenetically heterogenic in dimensional structure. According to our clinical and biological findings and an analysis of fundamental neurobiological studies, positive and negative disorders present in the clinical picture of schizophrenia as two separate psychopathological and pathogenetic structures. A new paradigm of the correlation between positive and negative structures - the interaction between positive and deficit symptoms - reveals psychopathological functions differentiated for each of dimensional structures. Negative disorders act as «transformers¼ modifying characteristics of primary transnosological positive disorders to the level of psychopathological structures preferable for schizophrenia; positive disorders, in their turn, act as «moderators¼ augmenting, amplifying manifestations of negative symptoms. This psychopathological construct of the correlation between dimensional structures paves a way for the development of a new concept of psychopharmacological treatment of schizophrenic deficit: both negative symptoms and amplifying positive symptoms are considered as «target symptoms¼ for pharmacological interventions.

[Age identity disorders (infantilism/ puerilism) in the psychopathological space of endogenous diseases]. / Rasstroistva vozrastnoi identichnosti (infantilizm/puérilizm) v prostranstve psikhicheskikh zabolevanii éndogennogo kruga.

AIM: A comparative psychopathological and psychometric analysis of age identity disorders (AID) - infantilism and puerilism - on the model of schizophrenia proceeding with hysterical symptoms. MATERIAL AND METHODS: Results of the psychopathological study of 42 patients with schizophrenia and schizophrenia spectrum disorders (SSD), with well-marked signs of AID in the course of the disease (22 sub. - infantilism; 20 sub. - puerilism), are summarized. Psychometric evaluation was carried out using a standardized block of pathopsychological methods; scales for assessing negative and positive psychopathological symptoms (SANS, PANSS, MFI-20); personality assessment instruments (SPQ-A; Personality Traits Questionnaire (V. Rusalova); Methods for diagnostics of personal maturity (V. Ruzhenkova)). RESULTS: The differentiation between infantilism and puerilism, forming in the psychopathological space of schizophrenia and SSD, is not limited by differences in the indicators of age-related immaturity. Infantilism shows an affinity to the dimensional structures of the negative symptoms, acting as primary psychopathological formations - apathoabulic disorders. Conversely, puerilism is derived from the positive symptoms - psychopathological formations related to the dissociative disorders. CONCLUSION: From the perspective of the modern concept of schizophrenia, infantilism and puerilism are associated with polar dimensional structures (positive-negative symptoms) and, accordingly, can be regarded as psychopathologically heterogeneous formations.

[Cariprazine in schizophrenia with predominantly negative symptoms: early effects of therapy (observational study)]. / Kariprazin v terapii shizofrenii s preobladaniem negativnykh simptomov: initsial'nye effekty lecheniya (observatsionnoe issledovanie).

BACKGROUND: Currently available antipsychotics have limited efficacy in the treatment of negative symptoms in schizophrenia and new drugs with wider spectrums of clinical efficacy are very desirable. Cariprazine is a newer antipsychotic acting as dopamine D3- and in lesser extent D2-receptor partial agonist found to be effective in the treatment of negative symptoms in schizophrenia. OBJECTIVES: To evaluate cariprazine early effects at the first stage of therapy of schizophrenia patients with predominantly negative symptoms. DESIGN AND PATIENTS: Open-lable observational assessment of 60 adult schizophrenia patients (F20 on ICD-10, 49% males) with predominantly negative symptoms (PANSS-FSNS ≥15, PANSS-FSPS <19) treated by cariprazine (starting daily dose 1.5 mg followed by upward titration by 1.5 mg weekly up to 6 mg if needed) were assessed with PANSS, CAINS, CDSS and SAS scales at baseline and on week 1, 2, and 4. Efficacy criteria were. RESULTS: Most patients (75%) improved during 28 days of cariprazine treatment. Negative symptoms mean total scores on PANSS-NS and CAINS significantly (p<0.05) reduced by 4.3 and 4.9 respectively at the end of assessment (day 28). Cariprazine tolerability was good, only 4 patients discontinued because of TEAEs (akathisia, insomnia). CONCLUSIONS: The study results preliminary suggest initial effect of cariprazine on negative symptoms at least in some schizophrenia patients with predominantly negative symptoms starting from 1-2 weeks of treatment and available for observation and assessment and could be useful for determination of early clinical predictors for efficacy. Considering limitations of observational open-lable design with no control groups these data need to be confirmed.

[The use of the concentrate of nucleus containing cells of umbilical cord blood for treatment of asthenic disorders (schizoasthenia) in patients with schizophrenia with negative symptoms]. / Primenenie kontsentrata iadrosoderzhashchikh kletok pupovinnoi krovi u bol'nykh s astenicheskimi rasstroistvami (shizoasteniia) v ramkakh shizofrenii, protekaiushchei s preobladaniem negativnykh rasstroistv.

AIM: To assess the safety and efficacy of umbilical cord blood (UCB) cells in the treatment of schizoasthenia and comorbid negative disorders. MATERIAL AND METHODS: The study was conducted in men (n=15) with remission of schizophrenia with a predominance of asthenic disorders (ICD-10 items F20.6 and F21.5). Patients received intravenous infusions of UCB cells at the average dose of 250 mln viable cells per infusion (4 injections at 2 week intervals). The efficacy and safety were assessed using the Positive and Negative Symptoms of Schizophrenia (PANSS), the General Clinical Impression Scale (CGI), Asthenia Scale MFI-20 3, the MATRIX Consensus Cognitive Battery (MCCB), the Clinical evaluation of adverse events (side effects). RESULTS AND CONCLUSION: The infusions of UCB cells have a positive effect on asthenic disorders, increase the level of general activity and minimize cognitive impairments. The authors assume that UCB cells potentiate the activity of typical and atypical antipsychotics.

[Asthenia in the psychopathological space of schizophrenia and schizophrenia spectrum disorders (The concept of asthenic deficit in aspect of the modern model of negative symptoms)]. / Asteniia v psikhopatologicheskom prostranstve shizofrenii i rasstroistv shizofrenicheskogo spektra (kontseptsiia astenicheskogo defekta v aspekte sovremennykh modelei negativnykh rasstroistv).

At the modern level of knowledge, classification of asthenic deficit as an independent psychopathological category and, in general terms, as the classification of asthenic symptomatic complexes of negative symptoms within schizophrenia and schizophrenia spectrum disorders is the subject of discussion. Studies of recent decades have shown that asthenia cannot be considered as a separate deficient monosyndrome, does not fit into the framework of negative disorders and is excluded from the block of scales of negative symptoms (SANS, PANSS, BNSS, CAINS). The authors suggest a working hypothesis that asthenia symptomatic complexes within schizophrenia are not comparable either in nature or in their psychopathological structure with primary deficiency disorders determined by the disease process. However, at the same time schizoasthenia, acting as a manifestation of the coenesthesiopathic hypochondriacal register, i.e. essentially in the space of positive disorders, is formed in close dependence on negative symptoms and is thus one of the markers of the already formed defect.

[Personality disorders and schizophrenic defect (problem of comorbidity)]. / Rasstroistva lichnosti i shizofrenicheskii defekt (problema komorbidnosti).

AIM: To test the main hypothesis that the deficit phenomena in schizophrenia act not in the 'pure' form, but in the form of aggravating personality characteristics, forming so-called 'common' syndromes with personality disorders (PD). MATERIAL AND METHODS: The results of the psychopathological study (with the use of psychometric methods) of deficit disorders in a sample of 170 patients with schizophrenia and schizophrenia spectrum disorders (63 men, 107 women) are presented in relation to the abnormal structure of premorbid personality (PD of clusters A, B, C). An analysis of negative symptoms according to the comparability of defect to the profile of premorbid personality made it possible to distinguish three groups of deficit states associated with PD - 'common syndromes': defensive schizoidy by the type of deficit schizoid and expansive schizoidy by the type of 'verschroben' (cluster A); pathological hysterical infantilism, malignant hysteria and defective erotomania (cluster B); pseudo-psychasthenia and pathological rationalism (cluster C). RESULTS: It has been found that the symptomatology of 'common syndromes' is subject to patterns reflecting the dichotomy of the basic defect. This pattern is valid not only for one single cluster of PD, but extends to all psychopathy-like disorders, regardless of their affiliation with a particular cluster. The pathocharacterological component of the 'common syndromes' coexisting with the deficit symptom complexes is subject to the basic deficit component of the defect and is separated into polar dimensions (defensive-expansive) within specific clusters of PD, and then unified in accordance with the dichotomy of schizophrenic defect in categories with the predominance of emotional or apathoabulic disorders. CONCLUSION: Psychopathy-like symptom complexes in the space of 'common syndromes' can be qualified as a psychopathological construct secondary to basic deficit disorders, and their isolation as an independent entity of negative disorders appears to be unjustified.

[Evolution of the schizophrenic deficit concept]. / Évoliutsiia ucheniia o shizofrenicheskom defekte.

The relevance of this study is the high prevalence and clinical heterogeneity of deficit states in chronic schizophrenia and schizophrenia spectrum disorders. The study aimed at analyzing negative symptoms in schizophrenia and schizophrenia spectrum disorders from historical and modern perspectives. An analysis of available literature, along with own observations, has been performed. It was found that negative symptoms comprise 3 clinical types: 1) 'pseudopsychopathic' type (overlapping personality dimensions and premorbid/initial negative symptoms), 2) pseudoorganic/asthenic/pseudobradiphrenic type (pseudoorganic states), developing at different stages of schizophrenia), 3) 'new'-life pseudopsychopathic type (not associated with premorbid personality traits), developing at late stages in schizophrenia. The trajectory heterogeneity of negative symptoms in their relation to positive symptoms has been defined: simultaneous-continuous course (synchronous course of positive and negative symptoms), polar course (alternative development of predominantly positive or negative symptoms), simultaneous-phasic course (pseudopsychopathic negative symptoms, attracting depressive symptoms, or depression that exacerbates latent deficit). The authors discuss some aspects of psychopharmacological treatment of negative symptoms. Negative symptoms in schizophrenia and schizophrenia spectrum disorders differ clinically, have heterogeneous trajectory course, and require differentiated approach with regard to psychopathological qualification, prognosis and treatment.

[Nooklerin (deanoli aceglumas) in the treatment of astenic and cognitive disorders in patients with borderline psychopatological conditions]. / Opyt primeneniia nooklerina (deanola atseglumat) pri terapii kognitivnykh i astenicheskikh rasstroistv u bol'nykh s pogranichnoi psikhicheskoi patologiei.

BACKGROUND: This work is devoted to the combined therapy of asthenic syndrome in psychiatric patients due to the importanmce of studies of clinical signs of asthenic disorders and their comorbidity with psychiatric and somatic diseases. AIM: To evaluate the efficacy and safety of deanoli aceglumas (nooklerin) in treatment of asthenic and cognitive disorders in patients with borderline psychopathological conditions. MATERIAL AND METHODS: Sixty patients were enrolled in the study (30 patients of the main group and 30 patients of the control group). All patients received psychopharmacological treatment. Nooklerin was administered as add-on in the daily dose of 1000 mg in the main group. Psychopathological and psychometric examinations were conducted. The duration of treatment with nooklerin was 30 days. RESULTS: There was a significant reduction of asthenic and cognitive disorders in the main group compared to the controls. The good tolerability of nooklerin in the absence of a negative effect on the main disease was shown. CONCLUSION: The possibility of using deanoli aceglumas (nooklerin) as a drug of choice in combined treatment of asthenic and cognitive disorders in patients with borderline psychopathological conditions is confirmed.

[The optimization of management of chronic daily headache patients]. / Optimizatsiya vedeniya patsientov s khronicheskoi ezhednevnoi golovnoi bol'yu.

AIM: To optimize the management of chronic daily headache (CDH) using cognitive-behavioral therapy (CBT). MATERIAL AND METHODS: The study included 90 patients (76 women and 14 men), aged from 23 to 78 years (mean age 46.71±11.99) with primary forms of CDH. The patients were followed-up by the neurologist during 12 months, psychological characteristics were studied together with the psychiatrist. Patients received combined treatment, including optimized pharmacotherapy, educational program, relaxation training, CBT and exercise therapy. RESULTS: The diagnosis of CDH has not been previously established in 86.7% of the patients. All patients received unnecessary additional diagnostic examinations, ineffective treatment (86.7%) that resulted in the formation of wrong conceptions about their state (90%). Three months after combined treatment, a significant positive effect has been achieved in 62.2% of the patients and after 12 months in 72.2%. CONCLUSION: The combined treatment program that included CBT can relatively rapidly help patients with CDH and exerts a stable positive effect during 12 months of the follow-up.

[«Verschroben¼-phenomenon in schizophrenia and schizophrenia spectrum disorders: aspects of systematics]. / Fenomen «fershroben¼ pri shizofrenii i rasstroistvakh shizofrenicheskogo spektra (tipologicheskaia differentsiatsiia).

AIM: Psychopathological analysis and typological differentiation of «verschroben¼-phenomenon as the full-blown syndrome of defect in schizophrenia and schizophrenia spectrum disorders. MATERIAL AND METHODS: Fifty patients, 33 female and 17 male, mean age 44.8±8.5 years, with ICD-10 diagnosis of schizotypal disorder (F21) and residual schizophrenia (F20.5) were included in the study. Patients were examined using psychopathological and psychometric (SPQ-74) methods. RESULTS AND CONCLUSION: There was clinical heterogeneity of the «verschroben¼ type defect: the differentiation of primary defect syndrome and the «second life¼ defect was confirmed. This typological classification is based not only on the differences in psychopathological symptoms and impaired social functioning but on the trajectory of the development of deficit syndromes related with the features of the course of endogenous disease. The typology would be useful for future studies of deficit changes in view of clinical prognosis, social context of schizophrenia spectrum disorders with negative «verschroben¼ type changes.

[Psychogenic depression and endogenous process (to the problem of reactive schizophrenia)].

OBJECTIVE: To conduct clinical differentiation of stress-induced conditions in schizophrenia and schizophrenia spectrum disorders according to the concept of so-called "Reactive schizophrenia" (J. Berze). MATERIAL AND METHODS: A sample consisted of 40 patients (14 male, 26 female, mean age 38.6±12.5. 17 years), including 17 (42%) patients with schizophrenia, 16 (40%) patients with ICD-10 schizotypal disorder and 7 (18%) patients with DSM-V schizotypal personality disorder. RESULTS AND CONCLUSION: All clinical cases were divided into two groups according to the discrepancy of endogenous/psychogenic factor interaction, clinical aspects and disease course. In the first group, the onset of stress-induced depression is due to psychogenic provocations of endogenous (schizophreniform) disorders. In the second group, the development of depression is based on the endogenous provocation of psychogenias (an increased affinity to stressful factors associated with the exacerbation of the endogenous process).

[Schizophrenia spectrum disorders in general medical practice].

Based on the conception of correlations between independent endogenous factors (positive and negative disorders), the author present a psychopathological model of psychosomatic (hypochondriac) symptoms in deficit disturbances, comorbid with the changes of «verschroben¼ type, observed in general medical practice. The psychosomatic symptoms are represented by a wide range of symptom complexes (from idiopathic pain and conversions to restricted hypochondria, organ neuroses, encapsulated organ psychosis) and defined as a syndrome of endoform of somaticized disorders. The syndrome is interpreted beyond schizophrenia as «the second disease¼, a type of schizophrenia spectrum disorders, in which negative process changes have stopped while the other component (positive psychopathological symptoms) continues to develop.

Efficiency of Umbilical Cord Blood Cells in Patients with Treatment-Resistant Depressions.

We studied the efficacy of umbilical cord blood cells in the therapy of treatment-resistant depressive states in women. Concentrated umbilical cord blood cells were administered in a dose of 250 millions cells (4 injections at 1-week intervals). The control group received placebo. In both groups, reduction of depressive disorders and the decrease in hypothymia severity were observed. Infusions of cell concentrate contributed to delayed correction of treatment resistance and reduced the severity of depression to moderate. In the main group, significant, persistent, and long-term positive dynamics was observed in the cognitive sphere. The therapeutic potential of umbilical cord blood cell concentrate can be used to overcome treatment resistance formed in depressive patients.