Vol L, No 1 (2018)

In the article the case of Yulia Savinovskikh from whose family two adoptive juvenile children who have lived within several years with trustees and their own children and received during this time the effective help in therapy of the chronic diseases have been withdrawn, is analyzed. The surgery fact (a bilateral mastectomy) for the purpose of the further sex change which was carried out in Yu. Savinovskikh after approval of her husband and relatives, has formed the basis for withdrawal of children. Justification of the judgment was the instruction on the fact that the transsexualizm belongs to the category of mental disorders in the presence of which the person can’t adopt the child or accept him under guardianship. The described case has highlighted aspect, relevant for modern psychiatry, – the actual legal equating of behavioural disorders and deviations, to mental with distribution of rights’ deprivation of such persons.

Pharmacotherapy of depression based on a monoaminergic model in many cases is not enough effective. In this regard the ketamine treatment results of pharmacoresistant depression by subanaesthetic doses, including the patients with double diagnosis, are of interest. Method: in an open label naturalistic non-randomized trial, 12 patients with non-psychotic treatment-resistant depression (10 of whom had concomitant addictive disorder), 6 sessions of ketamine therapy (0.5 - 0.75 mg/kg intravenously) were undertaken. Clinical and psychometric (Beck scale, visual analogue scale and scale of general clinical impression) assessment were used. Statistical processing - general linear model and nonparametric criterion. Results: the effectiveness of therapy was noted in 11 of 12 respondents, and in 7 ones the improvement was qualified as significant. The total scores of the scales applied corresponded to 50% reduction of depressive symptoms (p≤0.05). Conclusions: ketamine proved to be an effective and safe method of the fast achieving therapeutic effect in patients with therapeutically-resistant depression. However insufficiently representative sample, the lack of a control group and the mechanism of randomization and the open nature of the study limit the wide extrapolation of the results.

The problem of identifying suicide risk in adolescents, especially among high-risk subgroups, requires a multifactor analysis not only of etiological factors, but also individual psychological characteristics of suicides, which could help significantly in predicting risk. The purpose of this work was to study the protective-coping strategies of adolescents prone to suicidal behavior and to analyze the effect of the level of viability on the dominance of certain protections and copings. It has been revealed that adolescents with high suicide risk are more likely to use the defense mechanisms “regression”, “projection”, and “substitution”, as well as coping “escape-avoidance”. A low level of viability increases the frequency of manifestation of coping “distancing”. The use of avoidance strategies for adolescents with high suicide risk can be seen as an attempt to improve emotional regulation.

Through the times of human culture there was a desire of using various chemical compounds, obtained from both natural plant material and artificially synthesized, for recreational purposes. These substances can cause changes in the mental state, influence the human behavior, change social activity. The review is devoted to NPS, which have only been thoroughly studied in recent years. These substances include: mitragynine (Kratom), dimethyltryptamine, a new generation of serotonergic hallucinogens, ketamine, and other dissociative substances.

The cases of syringomyelia described in the literature with spontaneous collapse of the cavity are analyzed. Differences among patients with cavity decay in childhood and adults are assessed. The basic theories of cavity shedding in syringomyelia are presented in this article.

The paper deals with the content of psychological counselling at clinic. It includes reasons of an insufficient demand for a clinical psychologist and his/her insufficient performance. Psychological counselling at clinic, unlike clinical and psychological interventions or psychotherapy, does not have an unambiguous definition and does not depend on regulatory documents. There are no specific indications and contraindications for psychological counselling, as well as application rates and standards. As a main direction of psychological counselling, the author does not only refer to coping in the social reality, but also to a patient’s adjustment to own personality and counselling to overcome a personality disorder caused by an illness. The new identity, albeit under new conditions changed by the illness, develops as far as the patient follows a trajectory of his/her life and achieves goals relevant for him/her based on significant values.

Studies of the hypothetical association between lithium in drinking water and suicide rates are considered. It is noted that some studies provide evidence of a negative association between the concentration of lithium in water and the risk of suicide, while other studies do not find convincing evidence of such association. Obviously, this issue requires further epidemiological studies that would take into account the impact of additional, primarily socioeconomic, factors.

The authors of the article express the opinion that, regardless of the ability of lithium in drinking water to reduce the mortality of the population, lithium preparations, due to their obvious and proven anti-suicidal properties in pharmacological application, should be used more often in clinical practice.