The article considers modern evidence based approaches to the treatment of neurotic level anxiety disorders (social phobia, anxiety and panic disorders, generalized anxiety disorder). The main treatment issues for this category of patients are presented such as principles of differentiation, integration, complexity, integrity and short-temness).Specific psychopharmacological algorithms of each kind of anxiety disorder are elaborated on the main principles of eviedence based medicine.

Article is devoted to the analysis of validity of changes of classifications of mental and behavioural disorders due to inclusion of deviant forms of behavior and a medicalization of ordinary life. The conclusion that the problem of differentiation of psychopathological symptoms from behavioural pathology is insufficiently worked is drawn. It is noted that in modern psychiatry there is no unambiguous definition of behavioural disorders that complicates their differentiation, on the one hand, with psychopathological symptoms, with another, with deviations of behavior. New systematization of behavioural pathology with allocation of primary, secondary and tertiary disorders is offered.

The substance use disorders Diseases of substance dependence (SAW) represent the «pharmacogenetic» diseases caused by abnormal and genetically determined response of the CNS to use of the substance of abuse (SA), conscious and regulated by person itself. Genetic differences in the pharmacodynamics of SA can shape the individual level of genetic risk for disease, which can be calculated, provided valid identification of genetic markers that distinguish the «responders» (ill) from «non-responders» (healthy). Further genetic studies in addiction using strict evidence-based design and pathogenetic panel with dopamine and opioid genes will help to assess: 1) the genetic influence on the effects of SA, depending on the level of genetic risk; 2) to assess the level of genetic risk itself; 3) the effect of genetic variants on the effectiveness of pharmacotherapy of the disease. It is necessary to consider the impact of ethnicity, gender and age of patients, concomitant somatic and mental illness, combined administration of other medicines and variety of substances of abuse, tolerance, poor compliance in the absence of objective laboratory tests.

In this article the modern research directions of the distress specific for parents of children with life-threatening diseases (oncological/hematological/immunological) is reviewed. The connections of parental distress level with parents’ socio-psychological characteristics, coping strategies and resources, children’s adaptation characteristics, special aspects of children illness and treatment process organization as well as with a presence of psychological services are analyzed.

There are researched psychosocial components of hospitalism in elderly patients with affective disorders. We were using clinical and psychological semi-structured interview as a method focused on the investigation of relations in the parent and the relevant families of patients. In addition there were being used personality and family relationships questionnaires, locus of control personality research. According to the survey, there have been found out signs indicating de-emphasis of family, reducing of emotional involvement in family relationships and distancing from relatives in patients with hospitalism compared with the control group.

This paper considers two forms of self-destructive behaviour in groups of young highly educated patients with dependencies (F1) and neurotic disorders (F4). The prevalence of suicidal ideation was 25.5% and risk-taking behaviour 18.2%. These symptoms are negatively correlated with each other, characterized by different pathopsychological and psychopathological relationships. Suicidality is detected mainly in neurotic disorders and characterized by a reduced adaptation, low frustration tolerance, and maladaptive coping. Risk-taking behaviour is more related to addictive disorders, irrational cognition of self-imposed obligation, and a fairly high level of adaptation. Accordingly, there were proposed differentiated programs of cognitive-behavioural coping prevention of self-destructive behaviour.

Objective: to study the association polimorfizma-G308A gene tumor necrosis factor TNF-α and sleep disturbances in the male population aged 25-64 in metropolis of Western Siberia (Novosibirsk). Methods: Under the III screening of the WHO program «MONICA-psychosocial» a representative sample of men 25-64 years were surveyed (n = 657 men, mean age - 44, 3 ± 0,4 years responsum - 82.1%) in 1994 in Novosibirsk. For assessment of sleep levels scale Jenkins was used. Procedures have been standardized and strictly comply with the requirements of the protocol of the «MONICA». Genotyping of polymorphisms studied gene-G308A tumor necrosis factor TNF-α was conducted in the laboratory of molecular genetic in Research Internal Medicine and Preventive Medicine. Statistical analysis was performed using the software package «SPSS-11,5». Results: The level of sleep disorders in the male population aged 25-64 was 48.3%: evaluation of sleep as «fair» was 39.6%, «bad» - 7.6%, «very bad» - 1.1%. Genotype G/G gene TNF-α was in 79.1% of individuals, the genotype A/G - 19% of cases and genotype A/A was in 1.9% of men. Men carrying the genotype G/G of TNF-α gene are more likely to assess their sleep as «good» (98.3%), compared to those carrying other genotypes. In contrast subjects with heterozygous genotype A/G of TNF-α gene are more likely to estimate their sleep as «fair» (30%) than «good» (15.2%) in all groups. Conclusion: It was determined a heterozygous genotype A/G of TNF-a gene is most frequently associated with sleep disorders.

The longitudinal study examined continuity of child mental health problems (n = 70) using parent reported Child Behavior Checklist (CBCL /1 /½-5) in early childhood and the Strengths and Difficulties Questionnaire (SDQ) in preschool and school age. Longitudinal correlations and multiple regression indicated that sleep problems predicted higher levels of mental health problems, emotional symptoms showed homotypic continuity, and impact of psychiatric problems was predicted by earlier total problems, particularly externalizing and attention problems; the models explained from 10 to 12% of the variance in subsequent child mental health problems.

The article presents the results of transcultural adaptation and assessment of psychometric properties of Russian Version of Leahy Emotional Schema Scale II. Emotional schemas present the totality of implicit interpretations, beliefs regarding persons emotions and the emotions of other people. By emotional schemas in cognitive-behavioral therapy we understand what people think about their own emotions and the emotions of others, which behavior, and interpersonal strategy they use in response to their emotions. The sample comprises 200. The mean age was 20,1 ± 3,3. Russian Version of Leahy Emotional Schema Scale II has comparable test-retest reliability and internal consistency to original version of Leahy Emotional Schema Scale II. External validity technique confirms that emotional schemes are linked with the severity of psychopathological symptoms, early maladaptive schemes and maladaptive cognitive emotional regulation strategies. Results of stepwise regression (forward selection) analysis revealed that the emotional schemas have an important role in the development of some psychopathological symptom.

In order to identify the psychosocial characteristics of patients with chronic cerebral ischemia there were examined 280 patients of the organized population of Petrozavodsk (the median age 53,9±8,1 years; gender index 1:1). The control group consisted of persons (n=32) without signs of cerebrovascular disease, similar to the group of patients by sex and age composition (p>0,05). It was found, that patients with cerebrovascular diseases at an initial stage formation mechanisms of mental maladjustment presented anxiety symptoms in experiences of patients with ipohondrizatsii elements, as well as behavioral sensitivity trends in interpersonal interactions. Identified psychosocial predictors of patients with chronic cerebral ischemia should be considered when organizing the provision of psychotherapeutic care.

In this article the classification remitting conditions of autochthonous (endogenic) mental disorders is provided from the standpoint of the holistic approach outlined. This approach involves a multidimensional diagnosis, which is fundamental to the substantial work of various specialists (psychiatrists, psychotherapists, psychologists and social workers) within a multidisciplinary team.

The article discusses the phenomenological essence, the diagnostic and prognostic value of different options obsessive disorders. Discusses discriminatory signs phobias, obsessions and compulsion. Analyzes existing approaches to the systematics of obsessions.

The psychopathologic structure of „pathologic foresight“ syndrome and its place in the onset of paranoid schizophrenia are considered in the article. It is noted that contemporary mass media largely influence its forming. It is supposed that the syndrome is a kind of paranoiac syndrome following from picturesque delusion. The necessity of the timely detection of „pathologic foresight“ syndrome for the early diagnostics and prognostic assessment of paranoid schizophrenia stochastic course is stressed. It is important for the effective organization of medical and rehabilitation measures with the disease beginning.

The results of analysis of experimental and clinical studies have shown that Cerebrolysin application is safe and effective therapy for many neurological disorders ranging from stroke and ending Alzheimer’s disease. The primary effect of the medicine is associated with the influence of Cerebrolysin on certain areas of the hippocampus and their function. The medicine has a unique organ-multimodal action on the brain, it is capable of metabolic regulation, neuroprotection, functional neuromodulation and neurotrophic activity, detected in numerous experimental studies. The clinical efficacy of the medicine is confirmed by clinical trials performed based on GCP requirements. Side effects of the medicine are negligible.

On the basis of SPb GUZ «Nikolayevskaya hospital» assessed the efficacy and tolerability of the drug Gliatilin in the early postoperative period in patients undergoing General anesthesia for 2-2,5 hours. The study included 56 patients who received operative treatment in abdominal organs, mainly cholecystectomy, with transfusion therapy within 2-2,5 hours. All patients received anesthesia with Diprivan in a concentration of 1.5-2 mg/kg/h. Compared groups were statistically homogeneous for sex, age and baseline neuropsychiatric status (p<0.001). Monitoring of patients was performed before surgery, 3 hours, 24 hours, 48 hours and 5 days after surgery and anesthesia. We compared baseline neurological status (stroke Scale the National institutes of health NIHSS), the level of psychoemotional status (scale of depression of Montgomery-Asberg), higher cerebral functions (Mini mental test), including memory, understanding, logical thinking. While patients in the ICU they received standard intensive care, including complex of measures providing maintenance of life support systems. Pharmacotherapy the main and control groups differed only by the presence or absence of gliatilin. In group I (core) patients on the background of basic therapy were receiving gliatilin in the early postoperative period at a dosage of 1000 mg 2 times a day intravenously for 5 days, and in the II group (control) - only basic therapy. The obtained results indicate high efficiency of gliatilin in patients with ischemic-hypoxic brain damage after prolonged surgical interventions. Showed a significant influence of gliatilin on the processes of awakening, an earlier activation of the patients ‘ behaviours compared with the control group. It has been shown that gliatilin contributes to the normalization of the processes of memorization and reproduction of information improves the spatial and temporal orientation of patients has a positive effect on cognitive and behavioral reactions of patients, especially in the emotional-volitional sphere, reduces emotional lability, retraitement, improves mood. Thus, the use of gliatilin in the postoperative period allows you to quickly awaken the patient after prolonged anesthesia, faster and more efficiently to alleviate the effects of intraoperative ischemia / hypoxia of the brain, thereby reducing the risk of post anesthesia encephalopathy.

The article describes the features of formation of mental health services during the prerevolutionary period in Russia. Evidence-based models of the organization of psychiatric services had been developed and implemented after the Zemstvo reform (1864) and the reform of municipal government (1870). Different concepts of the organization of mental health services had been developed and implemented in various regions of the country. Features of «Moscow», «St. Petersburg», «Zemsky» and «Ministerial» models primarily were determined by socio-economic characteristics of regions and scientific understanding of the organizers. The diversity and success of different models suggest the possibility of using the experience of the organization of mental health services in the development of concepts of modern mental health services.