PROBLEM-S0LVING ARTICLES
The main ideas of the book «the Call and all the rest» [1] and of the separately published «the Unexplored and Unexamined» chapters [2] on non-standard and not always well grounded approaches to the understanding of neuro-mental activity. «Staged» questions are considered and their solution cannot be completed without careful research study. It is proposed to use the following hypothetically formulated postulates:
1. Life processes that provide neuropsychic activity cannot be explained only by traditionally understood reflex mechanisms.
2. Any living structure has the biological ability not only to passively absorb information, but also to actively seek it out.
3. The conductor system uses muscle energy in every reflex action. Higher mental activity is formed by other energetic, both exogenous and endogenous flows.
4. Conscious (and perhaps not conscious) life events and behavioral experiences do not disappear from the functional «memory library».
5. Evolutionary unification, despite situational confrontations, is a vital necessity of the interaction process. Its neblinensis parts fall out of the further development cycle. This pattern determines the general theory of unification and development for biology and sociology.
In connection with the increase in the proportion of the elderly population, the multifaceted adverse significance of Alzheimer’s disease has recently been widely discussed, including its role as a cause of death. However, not always obvious influence of this disease on vital functions dictates the need for a differentiated methodological approach in this matter.
The authors consider the differences in the effects of generally accepted variants of the course of Alzheimer’s disease on the prognosis of patients, as well as the fact that clinically and morphologically mixed forms of this pathology with cerebrovascular disease are increasingly detected, which in turn leads the complications of the latter to be a cause of death in respective cases.
The general principles of the approach to solving the issue of the cause of death in elderly and senile people under the combined effect of the described cerebro-atrophic changes are formulated. At the same time, a sequence of arguments is proposed to consider Alzheimer’s disease as the cause of death.
SCIENTIFIC REVIEW
The review of data from the available literature cites the results of studies of psychological disorders comorbid to multiple sclerosis and highlights scientific papers detailing domestic and foreign research. The high prevalence of affective and adaptive impairment is linked both to the neurophysiological particularities of this chronic, progressive, neurodegenerative illness and to psychological factors — individual personality traits and the attitude of those afflicted to their illness, to the change in their social functioning and to their prognosis. It is demonstrated that patients with multiple sclerosis have a significantly higher frequency of depressive and anxiety disorders than the general population, which suggests the need for an integrated, personalized approach to people with this illness.
The literature review describes history of views on catatonia from Kahlbaum to present time. Descripted as a discrete disease by Karl Kahlbaum, since Kraepelin’s and Bleuler’s works catatonia was associated with schizophrenia for many years. At the present time catatonia is classified as a nonspecific syndrome, which can be observed in many mental diseases. Despite of common view on catatonia as a rare disease, a lot of studies show that this state is very frequent. Catatonia remains an underdiagnosed syndrome. Prompt recognition of catatonia is important since this state is life-threatening and catatonic patients need correct treatment. This article describes some diagnostic scales, used to recognize catatonia in psychiatric patients.
The review highlights the problem of early diagnostics of schizophrenia, trying to identify specific markers at the prodromal stage, before the appearance of full clinical symptoms. One of these markers may be negative symptoms, the core symptoms of schizophrenia. On the one hand, they can be considered as predictors of psychosis, and on the other hand, may indicate poor outcomes with a significant decrease of functioning. The report reflects the current concepts of the pathogenesis of negative symptoms, methods of diagnostics and promising directions of therapy.
RESEARCH PAPERS
The assessment of fluid distribution in water sectors by the method of integral rheography was carried out in 82 patients who were in the intensive care unit of the psychiatric hospital №3 named after I. I. Skvortsov-Stepanov, about the development of their alcohol delirious syndrome (ALD). As a result of the assessment, rough changes in the water-electrolyte balance and an increase in the content of extracellular fluid were revealed. Since the second day of the patient’s stay in the ICU, there has been a positive dynamics of mental status against the background of complex therapy, including aimed at normalizing the distribution of fluid in both the extracellular and cellular water sectors. Conducted infusion therapy in moderate, negativehydrobalance, was not accompanied by hemodynamicchanges, but led to the resolution of ALD.
The article is devoted to the development and testing of methods for screening and diagnosis of risk factors for the development of neurotic disorders and their initial clinical manifestations. Modern approaches to medicine are aimed at the prevention and early diagnosis of borderline mental disorders in order to provide more effective and personalized care. 87 people were examined, which, on the basis of a preliminary examination, were divided into individuals with low and high levels of neuropsychics resistance. The results of the study show significant differences in the indicators of ECG, EEG, speech signal on the psycho-activating effect between these groups. The data obtained can be used to develop a neuro-interface that has in its structure the ability to record and process ECG, EEG and speech signals, which will allow for holter monitoring of the state of mental health, thereby increasing the percentage of verified diagnosis of diseases of the neurotic spectrum.
The article discusses the features of the adaptive-compensatory mechanisms of the psyche in patients with paranoid schizophrenia through the prism of the interconnections of self-regulation of behavior with the level of subjective control and life-sense orientations. The data of modern studies of these psychological features in procedural patients are presented. Patients with paranoid schizophrenia (N=30) were examined and the results were compared with a control group of people who did not suffer from a mental disorder (N=30). Based on the results obtained, the targets of psychocorrectional impact on patients with schizophrenia were highlighted.
Anorexia nervosa is a disorder, that mostly starts at teenage years. In addition, one of the most important feature of that period is transformation of size and shape of a teenager’s body, that leads to changes in his perception of his own body. Anorexia nervosa is also characterized by tranformation of interoceptive processing, and it is a phenomena which predisposes and maintains eating disorder. We studied the features of interception (accuracy, sensibility, awareness) of girls who suffer anorexia nervosa under therapy and during the catamnesis. Also had been provided study of interoceptive accuracy in stress situation, connected with eating (800 kcal). Significant differences in interoceptive indicators in dynamic between the control group and research group was found.
In order to study the effect of anxiety and depression on the severity of chronic pain syndrome, 216 patients with the diagnosis of juvenile idiopathic arthritis (JIA) were examined. All children included in the study underwent a traditional rheumatological examination, with an assessment of the disease activity, and a psychometric assessment of the severity of pain, anxiety and depression. Comparison of various clinical groups showed significantly higher levels of severity of anxiety and depression in the case of chronic pain syndrome regardless of the presence of active or inactive phase of JIA, which confirms the necessity of using evidence-based psychological interventions such as relaxation techniques and cognitive behavioral therapy in all patients with JIA suffering from pain.
The purpose of this work is to analyze the similarities and differences in the clinical and psychosocial indicators of men and women with paranoid schizophrenia. In the course of the study, socio-demographic, psychosocial and clinical indicators were studied. In terms of outcome, women showed worse social and cognitive functioning than men. In men, significant correlations were established between social functioning and passport age, duration of illness, number of hospitalizations, length of hospitalizations, negative symptoms and quality of life; in women — with passport age, negative symptoms, quality of life, and cognitive indicator. Logit-regression analysis showed that gender is more associated with social functioning, but not with cognitive indicator and quality of life.
To date, there is an urgent need to develop psychometric scales that would not depend on the distribution of assessments and on the construct itself. Creation of such scales is possible only on the basis of technologies that are not conceptually related to distribution parameters. These technologies include the Rush model. The purpose of the study: to evaluate the diagnostic parameters of the scales of overcontrol and low control of the questionnaire of neurotic disorders. Surveyed 296 people. The main statistical method of work is the Rush metric system. Results: on the basis of the metric system Rasha developed new scales: a scale of overcontrol and a scale of low control of the questionnaire of neurotic disorders; statements of both scales have adequate constructive validity; measures of difficulty points — within the regulatory range from -2 to +2 logites; both scales are one-dimensional, have a balanced metric structure; reliability index supercontrol scale is 0.78, and the low control scale — 0.76; scales are able to differentiate 3 levels of severity of properties.
GUIDELINES FOR THE PRACTITIONER
Currently, an increasing aspect in the provision of psychiatric care is shifting towards the outpatient link. After the stage of stopping therapy, it is rational to carry out the stage of stabilizing therapy in the conditions of a day hospital or outpatient department. The article presents a clinical observation when, as a result of errors in receiving supportive therapy, the patient ended up in a hospital with developed attacks of schizophrenia and after long-term treatment was discharged with residual psychotic symptoms, indicating resistance and an increase in the defect. However, the use of paliperidone palmitate * in submaximal doses in the outpatient department allowed him to stabilize his condition, restore his social and labor status, and re-transfer to maintenance therapy in medium therapeutic doses.
The article considers the main targets for jealousy based individual maladaptation and couple stress psychotherapy. The main relationship system development features and early attachment types responsible for later intensive jealousy experiences are defined. The cognitive processing and biases assessment targets are recommended alternative cognitive strategies are proposed. The article presents main techniques and exercises of the metacognitive CBT model.
The analysis was presentedabout the dynamics of the functional and psychological state and quality of life of patients with trunk deformities in Parkinson’s diseaseusing Dysport. The optimal regimens was reflected about the administration of botulinum toxin for patients with camptocormia and Pisa syndrome.
ISSN 2713-055X (Online)