The article examines the biopsychosocial model of schizophrenia - particularly such concepts as vulnerability, barrier of vulnerability, psychic diathesis, barrier of diathesis, stressors, coupled with adaptation-compensatory model of the disease. These accents are made due to the fact that the current bias in favor of the biological treatment of schizophrenia is not always justified, while psychosocial factors that contribute to the development of this disease, as well as the formation of relapse, are often overlooked. Special attention is paid to the concept of maladaptive schemas and their role in the biopsychosocial model. These schemas are considered as additional risk factor that reduces patient’s adaptation potential and contribute to the exacerbation or recurrence of the disease.

At the current stage of development of psychotherapy problems of cross-cultural differences have not lost their meaning, but have acquired deeper features due to increase of migration, overall rise of interest in our culture, our origin. In the foreground are the culture peculiarities which play an important role in the alliance “therapist-patient”. Migrants coming to Russia are mostly of Islamic culture and from the point of this aspect the article focuses on such problems as gender differences, especially the features of family hierarchical system, the problem of dichotomy of individualism/collectivism, stigmatization and religion issues. The paper points out the necessity of psychotherapy sessions with a cultural intermediary who will participate in translating as well as in decodification of cultural problems.

In the article theoretical substantiation of the transtimpanal chemical destruction of vestibular receptors application possibility form dicinal purposes in patients with amnestic syndrome is presented. The results of treatment of 29 patients of male presented. Treatment consisted of acombined application of transtimpanal chemical destruction of vestibular receptors and transcranial direct current stimulation in the projections of the rear of the associative areas of the cerebral cortex. Good positive results were obtained in 25 patients. Before and after the treatment was carried out psychological examination. Tests for the study of different forms of memory and intellect were used. Also electroencephalography testing was carried out. The characteristic dynamics of three-stage restoration of mental functions was noted in all patients. The course of treatment lasted for 4 - 5 weeks. Recovery of cognitive abilities in patients experienced at the end of treatment. A clinical case of showing the results of the treatment is given in the article. The article is illustrated with the results of the electroencephalographic studies in the dynamics. The psycho-physiological positions changes in the spatial synchronization of the cerebral cortex discussed.

The clinical-epidemiological study was carried on patients of urban population with neuroses who were traced to the prospective follow-up for 15 years.497 patients with neurotic disorders (116 men and 381 women) have been surveyed. The clinical, epidemiological and statistical methods of study have been used. The results of the study are statistically reliable. Catamnesis research has revealed options for outcomes of neurotic disorders depending on flow type of disease. Intensive index of neurotic personality development for the urban population was 0.5 per 1 000 population older than 16 years. The significance of debut syndrome of neurotic disorders was analysed for the formation of neurotic personality development.

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 is established that for persons with a debut of a cerebrovascular disease the increase of the general indicator of tension of mechanisms of psychological protection due to «denial», «compensations», «projections», «regressions», «replacement», «jet education» is typical. Identified psychosocial predictors of patients with chronic cerebral ischemia should be considered when organizing the provision of psychotherapeutic care.

Principles of adequate pharmacotherapy in psychiatry imply that shifting from one antipsychotic to another requires recalculation of the effective dose using the «chlorpromazine equivalent». The latter is deemed a reference measure for finding equally effective doses among antipsychotics. Given the molecular masses of the active substances and recommended drug doses, the association between the potential antipsychotic efficacy and the «complexity» of the molecules is analyzed in the present study. It is shown that the treatment efficacy is connected with the number of the substance molecules consumed with the certain drug dose. The lack of difference between «selective» and «non-selective» antipsychotics regarding association of their molecular masses and respective clinical activity challenges the suitability of the «chlorpromazine equivalent» for calculating antipsychotic doses. We assume that the approach based on the proportional ratio utilizing the highest drug dose recommended by the manufacturer is more adequate method of the antipsychotic dose estimation.

Dysfunction of family system can be seen as a deterrent of social adaptation of mentally retarded children. In this research there were investigated some specific psychological and social characteristics and needs to be dealt with and deserve consideration of rehabilitation service.

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.

A multicenter, unblinded, randomized, controlled clinical trial was conducted to evaluate the efficacy and tolerability of L-aglycerylphosphorylcholine (L-a-GPC) 1 gm/day IM compared with that of cytidine diphosphocholine (CDP-choline) 1 gm/day IM in 112 patients with mild to moderate multi-infarct dementia. A 90-day treatment period with the test drug was followed by a 90-day follow-up period without treatment to observe how long the results obtained with treatment could be maintained. A total of 97 patients completed the treatment period; of these, 73 completed the follow-up period. Eighteen patients did not complete the study because of poor compliance, and 21 patients at one center were not followed up. Treatments were started after a 2-week washout period during which other drugs that could affect cognitive function were withdrawn. Clinical efficacy was evaluated by comparing the results at baseline, after 30 days, at the end of treatment, and at the end of the follow-up period on the following psychometric tests: the Sandoz Clinical Assessment Geriatric (SCAG) Rating Scale, the Blessed Dementia Scale, the Blessed Information, Memory, Concentration test, the Wechsler Memory Scale (WMS), the Rapid Disability Rating Scale 2 (RDRS 2), the Word Fluency test, the Token test, and the Simple Drawing Copy (SDC). The patients receiving L-a-GPC showed a significant improvement of cognitive functions, behaviour, and personality at the end of the treatment, compared with baseline values. This improvement was still apparent at the end of the follow-up period. A comparison of the results obtained with L-a-GPC and CDP-choline shows that the performance of the patients treated with L-a-GPC was significantly better than that of the CDP-choline group on the Blessed Dementia Scale, WMS, RDRS 2, and SDC at the end of treatment and on the Blessed Dementia Scale, WMS, SCAG, and Token test at the end of the follow-up period.

Alcohol use disorders often co-occur with affective disorders, anxiety disorders and schizophrenia. The presence of dual diagnosis worsens the prognosis in patients. However comorbid patients rarely receive specialized treatment that addresses both conditions. This paper reviews currently available treatment options for patients with dual diagnosis, as well as addresses the issues of common neurobiological mechanisms converging on monoaminergic neurons originating from the brain stem. Particular emphasis is made on the updated role for dynorphin / kappa-opioid (KOP) receptor system modulation of the mesocorticolimbic dopaminergic circuitry - a neuronal hub playing a major role in the pathology of the majority of mental disorders and chemical addictions. The interest to the kappa-opioid system is caused by the role of endogenous opioid neuropeptide dynorphin being one of the most powerful endogenous depressants of monoaminergic (dopamine, norepinephrine, and serotonin) and glutamatergic neurotransmission in the cerebral cortex and subcortical limbic structures. This designates the strategic role for the kappa-subtype opioid receptor in regulation of mood, emotions, motivation, cognitive performance, perception and impulse control. Most of the KOP-antagonists are still being under clinical development and are not yet routinely available to clinicians. These agents are being developed for the treatment-resistant depression, bipolar, dissociative disorders and addictions. However, recently nalmefene - a new treatment for alcohol addiction, has been approved in Europe and Russia. Nalmefene is an opioid receptor antagonist with the preferential affinity to the KOP receptor. As this psychopharmacological agent carries therapeutic potential beyond substance abuse and addiction, possible clinical benefits of nalmefene in the treatment of complex comorbid patients are discussed. In comorbid schizophrenia patients the validity and necessity of the simultaneous therapy with antipsychotics and drugs used for the treatment of alcoholism (including opiate receptor blockers) were proved.

The article discusses the problem of long-term therapy of dementia, provides information on factors playing a role in the formation of commitment to therapy in patients with Alzheimer’s disease, discusses factors that influence the organization of care to patients with dementia. The article presents data on the clinical and economical effectiveness of akatinol memantine and opportunities to improve adherence to treatment at application of a once-daily memantine

In December 2015, the scientific community commemorated the 140th birth anniversary of L.M. Puusepp, and in February 2016 we will mark the 159th birth anniversary of V.M.Bekhterev. Both scientists were among the pioneers of the new specialty - surgical neuropathology, which was focused mainly on brain tumor surgery. The article presents the previously unknown correspondence between the two scientists.