Vol XLVIII, No 2 (2016)

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.

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.

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.

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.

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.

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.

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.

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.

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.