[Characteristics of arterial hypertension clinical course in patients with obesity and anxiety-depressive disorders].

This article covers an important subject clinical course of arterial hypertension in patients with metabolic abnormalities with obesity and anxiety-depressive disorders. Relevance of this topic is defined with high incidence of each aforementioned conditions and their influence on quality of life and social functioning of patients. Review of literature covers subjects of comorbidity and multimorbidity. Relevant data are presented which are focusing on complex management of arterial hypertension co-existing with obesity and anxiety-depressive disorders.

[Mental disorders and personality characteristics of patients with polycystic ovary syndrome]. / Psikhicheskie rasstroistva i lichnostnye osobennosti u patsientok s sindromom polikistoznykh yaichnikov.

OBJECTIVE: To study the frequency and clinical manifestations of mental disorders in women with polycystic ovary syndrome (PCOS), to describe the personality characteristics and basic behavioral styles of these patients. MATERIAL AND METHODS: One hundred and sixteen women with PCOS were examined, the average age was 26.9±4.1 years. The diagnosis of PCOS was verified by a gynecologist based on the ESHRE/ASRM criteria, the qualification of the mental state was carried out by a psychiatrist based on the ICD-10 criteria. MMPI and 16-PF were used to assess personality characteristics. RESULTS: Mental disorders were diagnosed in 76 (65.5%) patients. Generalized anxiety disorder (26.7%), recurrent depression (19.8%) and bipolar affective disorder (14.7%) were prevailed. A psychological study of the PCOS patients identified four main behavioral styles: anxiety-depressive (n=18, 22.5%), masculine (n=18, 22.5%), hyperthymic (n=25, 31.3%) and sensitive (n=19, 23.7%). Anxiety-depressive and sensitive styles were most frequently combined with mental disorders. CONCLUSION: Women with PCOS have an increased risk of developing mental disorders, which indicates the need to connect psychological and psychiatric support to their medical management.

[Affective disorders in acute myocardial infarction and possibilities of their correction with tianeptin].

AIM: to study the prevalence, pattern of and trends in affective disorders (AD) in patients with acute myocardial infarction (AMI) and to assess whether they might be corrected with the antidepressant tianeptin. SUBJECTS AND METHODS: The study enrolled 108 patients with AMI. To detect and evaluate affective spectrum disorders, all the enrolled patients were interviewed on days 2-3 of AMI, by using the screening questionnaire developed at the Moscow Research Institute of Psychiatry (MRIP), Russian Agency for Health Care, and 4-5 days and 2 and 6 months after the onset of AMI they underwent an in-depth psychopathological examination by a psychiatrist who applied the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). To correct affective symptomatology in some patients with verified depression, the antidepressant tianeptin was added to the conventional therapy for AMI on its days 5-7. RESULTS: The screening questionnaire study revealed depressive spectrum disorders in 45.4% of the patients with AMI. The in-depth psychopathological examination confirmed the presence of AD in 40.7%. Mild and moderate depressive episodes were observed in 26.9% of the patients and adjustment disorders were seen in 13.8%. The sensitivity and specificity of the MRIP screening questionnaire for the diagnosis of depressive spectrum disorders in patients with AIM was 86.2 and 69.6%, respectively. The concomitant symptoms of anxiety were detected in 27.8% of the patients with AMI. The duration of a course of antidepressant therapy with tianeptin averaged 3.9 +/- 1.1 months. Six moths after AMI, the tianeptin group a showed significant reduction in HDRS scores by 50% (p = 0.0013) and in HARS scores by 52.7% (p = 0.0004) versus the baseline values. During a follow-up, there was no significant decrease in HDRS and HARS scores in a group of patients who refused antidepressant therapy. CONCLUSION: Affective spectrum disorders are most common in myocardial infarction (MI). The use of the MRIP screening questionnaire favors a more adequate diagnosis of depressive spectrum disorders in patients with AMI. Tianeptin therapy for AD concurrent with MI causes an evident reduction in psychopathological symptomatology and a statistically significant decrease in HDRS and HARS scores.

[The clinical picture and treatment of depression spectrum disorders in patients with cardiovascular disease].

AIM: To study the impact of depressive and anxious disorders on the course of cardiovascular disease (CVD) and the specific features of clinical changes during combined pharmacotherapy (with cardiovascular agents and antidepressants). SUBJECTS AND METHODS: Seventy-eight patients with arterial hypertension (AH), acute myocardial infarction (AMI), chronic heart failures (CHF), or concomitant affective spectrum disorders were examined. Clinicopsychopathological and clinicofunctional studies were conducted. RESULTS: Statistically significantly higher degrees of anxiety and depression were revealed in patients with AH and in those with CHF than in patients with prior AMI. After AMI, the degree of psychopathological symptomatology reduced during treatment more rapidly than that in patients with AH and in those with CHF. In all three groups, combined therapy using the antidepressant tianeptine (coaxil) improved intracardiac hemodynamics and left ventricular structural and geometric parameters. CONCLUSION: Anxious and depressive disorders substantially affect the formation of a clinical picture in CVD. Inclusion of tianeptine (coaxil), that has antidepressive and anxiolytic activities, into the combined therapy of patients with CVD and depression spectrum disorders leads to a reduction in affective symptomatology, contributing to the positive impact on intracardiac hemodynamic and left ventricular structural and geometric parameters.

[Psychosomatic correlations in the structure of borderline neurologic and mental disorders]. / Psikhosomaticheskie sootnosheniia v strukture pogranichnykh nervno-psikhicheskikh rasstroistv.

A total of 544 staff members of the scientific industrial association were subjected to non-randomized examination. The presentation and structure of border-line disorders were studied as correlated to the age, sex, familial status, educational level, occupation, and personality structure. Three groups have been distinguished: (1) conditional norm; (2) neurotic disorders; and (3) affective disorders. Correlations between psychopathological and somatic disorders have been traced in all the groups.

[Modern antidepressants in complex management of patients with hypertension and concomitant affective disorders]. / Sovremennye antidepressanty v kompleksnom lechenii bol'nykh s arterial'noi gipertenziei s soputstvuiushchimi affektivnymi rasstroistvami.

According to results of multiple studies depression and anxiety are found in more than 50% of patients with hypertension. Presence of affective disorders elevates risk of progression of hypertension. That is why complex therapy comprising antihypertensive drugs from various groups and antidepressants takes on higher and higher significance. Modern antidepressants produce no substantial cardiotoxic effects. Combination of an antihypertensive drug (angiotensin converting enzyme inhibitor captopril or beta-adrenoblocker metoprolol) with an antidepressant affects favorably clinical course of hypertension, 24-hour blood pressure profile, characteristics of intracardiac hemodynamics, structural and geometric left ventricular parameters, allows to achieve sufficient antihypertensive effect with acceptable tolerability.

[Diagnosis and approaches to therapy of emotional disorders in patients with infectious diseases]. / Diagnostika i podkhody k terapii émotsional'nykh narushenii u bol'nykh s infektsionnoi patologiei.

AIM: To examine psychological and emotional disorders in patients with infectious diseases, to specify indications for their pharmacological correction. MATERIAL AND METHODS: Clinicopsychological, clinicofunctional and laboratory tests were made to examine 30 patients with infectious mononucleosis (19 females and 11 males) and 30 patients with serous meningitis (16 females and 14 males) aged 16-35 admitted to hospital on the disease day 2-14. RESULTS: Shmishek's questionnaire revealed various types of personality accentuations with dominating hyperthymic (30%) and cyclothymic (20%). According to the data of the clinical scale SCL-90, the greatest number of cases with values over normal was in patients with serous meningitis. Beck's questionnaire revealed clinical depression in 12 patients (40%) with acute serous meningitis, subdepression in 14(46.7%) patients, severe depression in 6(20%) patients with infectious mononucleosis. In convalescence, emotional disorders persisted in 4 patients with serous meningitis. CONCLUSION: Affective disorders in the above patients require consultation of the psychiatrist to decide on psychopharmacotherapy inclusion in combined treatment of infectious diseases to prevent lingering course.

[Emotional disturbances in patients with infectious mononucleosis and serous meningitis]. / Emotsional'nye narusheniia u bol'nykh infektsionnym mononukleozom i seroznymi meningitami.

30 patients with infectious mononucleosis (19 females and 11 males) and 30 ones with serous meningitis (16 females and 14 males) aged 16-35 years admitted to hospital on the disease day 2-14 were examined clinicopsychologically, clinicofunctionally and using laboratory tests. The examination has revealed emotional disturbances in 40% of patients with serous meningitis and 20% of those with infectious mononucleosis. Clinical manifestations were characterized by polymorphism, combination of somatovegetative and anxiodepressive disorders. Personality accentuations in the patients are described.

[Anxiety-depressive disorders and cognitive impairment in patients of the primary level of health care].

An objective of the study was to compare cognitive and anxiety-depressive disorders in patients of the primary level of health care. Authors studied 103 patients, mean age 51.2±15.9 years, of a psychotherapeutic setting in a polyclinic. Patients were stratified into three groups: patients with anxiety-depressive disorders (ADD), with mild organic mental disorders (MOMD) and with the combination of ADD and MOMD. Patients were assessed using a form for assessment of anxiety and depressive symptoms and psychometric scales HADS, MMSE, FAB, ACE-R. High positive correlations between the total score on the subscale "depression" of the HADS and some ACE-R items (total score, orientation/attention, verbal fluency) and total score on the FAB were identified in patients with ADD and MOMD compared to other groups. In patients with ADD, the correlations between some measures of cognitive style and language disturbances measured with the ACE-R were found. The results indicate that it is necessary to evaluate cognitive impairment (deficit symptoms and distortions in cognitive styles) in patients with anxiety-depressive disorders at the primary level of health care and to take it in account in choosing treatment options and predicting outcome.

[Diagnosis and treatment of anxiety-depressive disorders in patients with myocardial infarction].

The results of the study of psychopathological, somatic and functional characteristics of anxiety-depressive disorders in patients with acute myocardial infarction are presented. The authors confirmed the wide prevalence of these disorders in acute myocardial infarction and described the features of their diagnostics, dynamics and response to complex treatment. The impact of anxiety-depressive disorders on the clinical and functional state of the cardiovascular system and the dynamics of the patient's status due the concomitant anxiety-depressive disorder are considered.