Vol XLVIII, No 2 (2016)

Articles
SUBSTANCE USE AND DEPRESSION AMONG PATIENTS ADHERENT AND NON-ADHERENT TO ANTIRETROVIRAL THERAPY
Ustinov A.S., Pecoraro A., Mimiaga M., O’Cleirigh C., Safren S., Blokhina E.A., Verbitskaya E.V., Yaroslavtseva T.S., Lioznov D.A., Suvorova A.V., Grinenko A.Y., Zvartau E.E., Krupitsky E.M., Woody G.E.
Abstract
The aim of the study was to determine the main predictors of leaving antiretroviral therapy by HIV-infected patients. We retrospectively assessed depression, hopelessness, substance use, viral load, and CD4+ counts of 120 patients who dropped out of antiretroviral therapy for ≥12 months (Lost-to-Care) and 120 who continued for ≥12 months (Engaged-in-Care). As expected, lost-to-care patients had higher viral load and, accordingly, fewer CD4+ lymphocytes. The level of depression, alcohol consumption, and injecting drug use in the 30 days preceding analysis was significantly higher in Lost-to-Care than in Engaged-in-Care HIV-infected patients. A binary logistic regression [χ2(4) = 64.27, p = 0.000] correctly classified 74.5% of participants as Lost-to-Care or Engaged-in-Care. The results indicate that substance use and depression are associated with antiretroviral therapy dropout. Evaluation of these factors with high degree of accuracy can predict patient’s antiretroviral therapy adherence. An integrated treatment for substance use and psychiatric disorders in HIV infected patients could reduce antiretroviral therapy dropout and improve outcomes of HIV treatment in Russia.
Neurology Bulletin. 2016;XLVIII(2):5-11
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FOLATE METABOLISM GENETIC POLYMORPHISM MTHFR 677C> T AND CATATONIC SYMPTOMS OF SCHIZOPHRENIA
Zhilyaeva T.V., Sergeeva A.V., Blagonravova A.S., Akimova E.V., Kasimova L.N.
Abstract
Folate metabolism disturbances, including the thylenetetrahydrofolatereductase (MTHFR) 677C>T genetic polymorphism, is currently being studied in relation to various aspects of schizophrenia. It has been shown that carriage of the polymorphism MTHFR 677C> T is associated with the severity of the negative and cognitive symptoms. The carriage of this polymorphism leads to hyperhomocysteinemia and methionine deficiency. According to several studies, both factors can make an independent contribution to the etiopathogenesis of schizophrenia. The relationship of folate metabolism disturbances with catatonic schizophrenia symptoms was not investigated up to date. In this regard, the aim of this study was the comparative analysis of the severity of catatonic symptoms in samples of schizophrenia patients with carriage of different MTHFR C677T genotypes based on standardized clinical assessment with rating scales. 150 patients with a diagnosis of schizophrenia were examined for the presence of polymorphisms MTHFR677C>T. A number of patients were examined using the Scale for the Assessment of Positive and Negative syndromes of schizophrenia (hereinafter PANSS, n = 52), the Scale for the Assessment of Negative symptoms of schizophrenia (hereinafter SANS, n = 64) as well as the Calgary Depression Scale for Schizophrenia (hereinafter CDSS, n = 62). Some items of PANSS and SANS reflect the presence of catatonic symptoms in patient, according to the literature. Therefore, they were used to assess the severity of catatonia. Patients with carriage of polymorphism MTHFR 677C>T (n = 77) in contrast to the normal genotype MTHFR677CC carriers (n = 73) have a greater severity of separate PANSS and SANS items, relating to catatonia, and the total score of catatonic symptoms. The differences are not related to gender, age of the patients and the duration of their disease, as well as the presence of their depressive symptoms as measured by CDSS and the factor “anxiety-depression” of PANSS. The results indicate the need for further study of the association of folate metabolism disturbances (including polymorphism MTHFR677C>T) with catatonic schizophrenia symptoms using standardized catatonia rating scales.
Neurology Bulletin. 2016;XLVIII(2):12-16
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CLINIC-PSYCHOLOGICAL CHARACTERISTICS OF SOMATIZED DISORDERS AND ORGANIC DISEASES OF THE GASTROINTESTINAL TRACT (COMPARATIVE ASPECT)
Pogosov A.V., Bogushevskaya Y.V., Maltseva A.A.
Abstract
The aim of the investigation was to study clinic-psychological characteristics of somatized disorder with gastrointestinal manifestations (somatized disorder, somatoform autonomic dysfunction, in particular irritable bowel syndrome, hypochondriac disorder) and organic diseases of the gastrointestinal tract (gastric ulcer, duodenal ulcer, ulcerative colitis) and the development of differentiated psycho-corrective treatment. Results of comparative evaluation of clinical-psychological peculiarities show existence of significant differences. patients with somatized disorders with gastrointestinal symptoms and patients with organic gastrointestinal diseases. The results of the comparative assessment of clinic-psychological characteristics show the existence of significant differences. Patients with somatized disorders of gastrointestinal manifestations use such psychological defense mechanisms as regression, and intellectualization. In them there was observed high level of trait anxiety. In organic diseases of the gastrointestinal tract there were mechanisms of regression, intellectualization, and reactive formation, high levels of trait anxiety, depression, and hypochondriac and alexithimic personality traits.The data obtained are of theoretical importance, confirm the existence of clinic-psychological differences in patients with somatized disorders with gastrointestinal manifestations and organic gastrointestinal diseases. They need to be considered when developing therapeutic interventions, medical therapy along with their inclusion in differentiated psycho-corrective approaches.
Neurology Bulletin. 2016;XLVIII(2):17-22
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TYPES OF CLINICAL COURSE OF NEUROLOGICAL FORMS AT HEPATOLENTICULAR DEGENERATION
Ovchinnikov A.V., Shprakh V.V.
Abstract
The special aspects of neurological forms of hepatolenticular degeneration, based on the results of four years monitoring of 47 patients (the average age of patients is 33,4 years old, the average prolongation of the disease is 18 years) are studied in this paper. During the monitoring period: deterioration in the condition with the progress of pathological symptoms appeared in 21,27% cases; fatal cases - 4,25%; neurological defect’s stabilization - 48,9% of cases; regress of pathology - 25,5%. There are two types of development of hepatolenticular degeneration: favourable one (74,46%) and pejorative one (25,5%). The risk factors of pejorative type of decease development are: the severity of clinical aspects at the time of diagnostics in neurological stage, period of the delay of the copper-eliminate therapy prescription and the degree of mental disorder. The prognostication on hepatolenticular degeneration depended on the duration of the desiese, time of the therapy begining and the compliance to it.
Neurology Bulletin. 2016;XLVIII(2):23-29
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PSYCHOHYGIENIC DIRECTION IN REDUCING THE RISK OF ADDICTIVE BEHAVIOR FORMATION IN SCHOOLCHILDREN
Moskvitin P.N., Egorov A.Y.
Abstract
The article reveals the psycho-hygienic approach for minimizing the risk of dependence on psychoactive substances in children and adolescents. The efficiency of using the method of “Prophylactic psychodrama” has been shown. A total of 300 students of the 8th, 9th and 10th classes in the main (experimental) and control groups were studied. Students from the main group have passed a program of training by the method of “Preventive psychodrama”. Statistically significant differences were obtained in the main group of schoolchildren in dynamically reduced scores of motivation in psychoactive substances intake such as “communication”, “hedonism”, “boredom”, “change of state of consciousness”, in contrast to the control group, where these data did not change.
Neurology Bulletin. 2016;XLVIII(2):30-34
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METHODS OF OBJECTIVE CONTROL OF THE THERAPY EFFECTIVENESS IN CHILDREN WITH TICS
Zykov V.P., Kashirina E.A., Naugolnykh J.V.
Abstract
In 43 patients with tics at the age of 10-17 there was studied effectiveness of hopantenic acid usage in doses 500 mg x 3 daily during 6 weeks to correct their hyperkinesias. The therapy effectiveness was evaluated by Yale Global Tic Severity Scale (YGTSS). Hopantenic acid therapy significantly decreased the amplitude of somatosensory cortex evaluated by somatosensory evoked potentials method, normalized the situational and personal anxiety evaluated by Spielberg-Hanin scale. Therapy by hopantenic acid reliable decreased the summary severity of tics (р<0,03, p<0,02 in different groups of patients), defined by Yale scale (method of tics counting for 20 minutes), manifestations of situational anxiety (p<0,001; p<0,03), and increased volume of single aural-speech memory (p<0,01; p<0,05). Hopantenic acid therapy significantly decreased the amplitude of somatosensory cortex evaluated by somatosensory evoked potentials method (p<0,001; p<0,03). The technique of somatosensory evoked potentials using Yale scale for evaluation of the severity of tics can be used as an objective method to control the therapy.
Neurology Bulletin. 2016;XLVIII(2):35-41
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ABOUT PROBLEMS OF NARCOLOGICAL STATISTICS
Kuznetsov V.V.
Abstract
In Russian addiction medicine, a paradoxical situation has emerged; diagnosis formulation and encoding in primary medical documentation (outpatient and inpatient medical records) is performed in full accordance to ICD-10 whereas statistic processing of this data is performed according to slightly adapted ICD-9. All the statistical information concerning addiction care is based on methodology of primary statistical data collection that is hopelessly out of date and is totally unsuitable for evaluation of treatment efficacy, planning of narcological service development, evaluation of efficacy of its modernization, and for development of State Guarantees Program.
Neurology Bulletin. 2016;XLVIII(2):42-46
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USING THE EXISTENTIAL CRITERION OF NORMAL AND ABNORMAL PERSONALITY FOR THE PSYCHOLOGICAL ANALYSIS OF THE PETER PAVLENSKY’S CASE
Kapustin S.A.
Abstract
The article presents the results of using existential criterion of normal and abnormal personality for psychological analysis of the case of Peter Pavlensky. It is shown that it is possible to diagnose abnormal type of personality with a high probability «oriented on protest against compliance of own behaviour with other people requirements», which is common for people seeking psychological consultation. However, this conclusion does not indicate mental pathology of Peter Pavlensky, but the fact that his personality is in conflict with a human essence, and this conflict can provoke life psychological problems and psychiatric disorders.
Neurology Bulletin. 2016;XLVIII(2):47-50
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BILATERAL IDIOPATHIC PHRENIC NEUROPATHY: A CLINICAL OBSERVATION AND REVIEW OF LITERATURE
Khaiatova Z.G., Bogdanov E.I., Anisimov V.I., Ilyinsky V.I., Kabirov A.R., Fazliakhmetova A.G., Khayrullov M.A.
Abstract
The causes of diaphragmatic paralysis according to the level of a lesion, particularly phrenic nerve palsies of different etiology are observed. Clinical observation of bilateral idiopathic phrenic neuropathy and review of the literature concerning this problem is presented.
Neurology Bulletin. 2016;XLVIII(2):51-56
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PRIMARY (FAHR DISEASE) AND SECONDARY CALCIFICATION OF THE BASAL GANGLIA (CLINICAL OBSERVATION)
Matveeva T.V., Ovsyannikova K.S.
Abstract
The description of the clinical observations and clinical cases of patients with primary (Fahr disease) and secondary calcification of the basal ganglia (CBG) is given. Both patients had thyroid dysfunction. It is emphasized the uniqueness of the neurological manifestations of the CBG, the need for their early diagnosis for timely initiation of therapy, which is fundamental in relation to prognosis.
Neurology Bulletin. 2016;XLVIII(2):57-62
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MEDICAL CASE OF INTRAVENOUS INJECTION OF METHYLENEDIOXYPYROVALERONE IN A PATIENT DIAGNOSED WITH SYNTHETIC DRUG ADDICTION SYNDROME
Asadullin A.R., Yuldashev V.L., Akhmetova E.A.
Abstract
In recent years, consumption of synthetic drugs has been increasing worldwide. In addition to the above, intravenous administration of synthetic drugs has overtaken pulmonary administration due to tolerance affect and side effects. Methylenedioxypyrovalerone is a common type of synthetic drugs. The study describes a medical case of developing physical and psychological addiction to the drugs classified as stimulants and administered parenterally.
Neurology Bulletin. 2016;XLVIII(2):63-66
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CHARACTERISTICS OF PARENTAL FAMILIES OF SECONDARY SCHOOL STUDENTS AND PREVALENCE OF SUBSTANCE USE AMONG ADOLESCENTS
Belokrylov I.I.
Abstract
The aim of this research was studying of substances consumption among students of secondary schools, and studying of the microsocial factors’ influence on this process. It was revealed that 8,7% of secondary school students have experience of drug use. The analysis of microsocial risk factors has shown that preventive measures are needed both for schoolchildren from families with obvious problems (such as low material welfare, conflict, alcohol abuse) and teenagers from families which appear to be secured at first sight.
Neurology Bulletin. 2016;XLVIII(2):67-69
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CLINICAL-PSYCHOPATHOLOGICAL CHARACTERISTIC OF PATIENTS WITH SUICIDAL DISADAPTATION IN A PSYCHIATRIC HOSPITAL AND AT EARLY TERMS AFTER DISCHARGE FROM THE HOSPITAL
Morenec T.V.
Abstract
The cases of suicidal behavior in psychiatric hospitals and in the early terms after discharge from the hospital were analyzed. The article presents a comparison of patients with repeated suicide attempts and patients who committed suicide based on the peculiarities and objectives of suicidal acts, characteristics of suicidal conflict. There were identified clinical-social characteristics and risk factors of suicidal disadaptation in a psychiatric hospital.
Neurology Bulletin. 2016;XLVIII(2):70-72
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PREVALENCE OF SOCIAL STIGMATIZATION IN PSYCHIATRIC PATIENTS AND ITS CORRELATION WITH MOTIVATION FOR TREATMENT
Sorokin M.Y.
Abstract
The phenomenon of social stigmatization of psychiatric patients was evaluated in 108 people: 49 psychiatric inpatients and 59 healthy individuals. Correlation between stigma and motivation for treatment was also assessed. Patients and volunteers perceive social discrimination of people with psychiatric disorders in different ways. Level of stigmatization in psychiatric patients is connected with their motivation for treatment and changes in motivation structure. Predominance of external motivation for treatment causes the opinion: “psychiatric patients are losers” and “people with personal failure”. High levels of motivation with good insight on disease and active role of patient in treatment lead to decrease of external stigmatization.
Neurology Bulletin. 2016;XLVIII(2):73-77
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LIFE QUALITY, COPING BEHAVIOR AND MECHANISMS OF PERSONALITY DEFENSES IN ALCOHOL AND OPIOIDS ADDICTION PERSONS
Kolpakov Y.V.
Abstract
The article presents the main results of study of life quality parameters and related indicators of coping behavior and mechanisms of personality defenses in alcohol and opioids addiction persons. In a study of 40 patients undergoing in-patient treatment, there were revealed differences in the structure of the life quality parameters and their relation to coping behavior and mechanisms of personality defenses among alcohol addiction men and opioids addiction men.
Neurology Bulletin. 2016;XLVIII(2):78-80
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CLINICO-PSYCHOPATHOLOGICAL AND PSYCHOLOGICAL CHARACTERISTICS OF ADJUSTMENT DISORDER AMONG POLICE OFFICERS
Pogosov A.V., Shibaev P.V.
Abstract
We examined police officers after detached duties to the North Caucasus region; there were revealed 119 patients with a diagnosis of adjustment disorder. There was established that prolonged detached duties were psychotraumatic situations and had caused adjustment disorders with depressed mood or with mixed anxiety and depressed mood. It was found that the accentuations of personality traits were predisposing factor for manifestation of adjustment disorder. Adjustment disorder was the cause of decreasing quality of life.
Neurology Bulletin. 2016;XLVIII(2):81-83
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CLINICAL-PSYCHOLOGICAL AND SOCIO-DEMOGRAPHIC CHARACTERISTICS OF COMBATANTS WITH COMBINED FORMS OF MENTAL PATHOLOGY
Streminskiy S.Y.
Abstract
Particular qualities of 102 patients with exogenous-organic brain disease were analyzed to study the clinical-psychological and socio-demographic characteristics of combatants with combined forms of mental pathology. And 45 of them were identified as having neurotic disorders. We used clinical, psychopathological, clinical and anamnestic methods. Two groups were identified with a statistically significant difference of clinical-psychological and socio-demographic characteristics. Results of the study demonstrate a high level of neuroticism and introversion in patients with combined forms of pathology, a direct correlation was found between moderate introverts with family problems (r = 0,31) and the problems of the financial difficulties (r = 0,32), indicating difficulties in social adaptation of these patients.
Neurology Bulletin. 2016;XLVIII(2):84-87
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TO THE QUESTION OF RECOVERY AT ACUTE POLYMORPHIC DISORDER
Kuleshova E.O.
Abstract
In order to study the course and prognosis for acute polymorphic disorder, the author has analyzed the features of post-psychotic period in 146 patients with these mental disorders. The clinical-dynamic, clinical and follow-up methods and psychometric methods were applied. Statistically significant differences in clinical and social structures of post-psychotic period in individuals with the investigated diseases have been identified. The results of this investigation point to a variety of possible outcomes: along with severe and disabling variants, a part of patients show a rather positive prognosis after the manifestation of disease, i.e. it could be a single episode without noticeable social consequences and with good functioning in the community.
Neurology Bulletin. 2016;XLVIII(2):99-91
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