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Clinical and statistical surveys of 330 patients with alcoholism who made illegal acts when they were alcohol-intoxicated have revealed that there is a relationship of the frequency and degree of illegal acts with clinical progressive features of a diseases and sociodemographic characteristics of patients and defined organizational measures for their prevention. The most severe illegal acts are made by patients with Stage II alcoholism with a progressive course and a short disease duration. The changed pattern of intoxication with its involvement into the clinical picture of epileptoidicity phenomena increases risks for them to make illegal acts. There is a relationship between the making criminogenic acts by alcoholics and their age, education level, social activity, and marital status. A risk group as to illegal acts has been identified among alcoholic patients.

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Based on clinico-psychopathological and catamnestic examinations of 118 patients, the authors studied and compared the characteristics of the clinical picture, dynamics and outcome of schizophrenia and acute alcoholic hallucinosis associated with delirious, hallucinatory and pseudohallucinatory disorders of homosexual nature. Base the prognostic importance of psychopathological phenomena of homosexual nature in patients with schizophrenia and acute alcoholic hallucinosis. The rise in the clinical picture of schizophrenia and acute alcoholic hallucinosis of the portion of psychopathological phenomena of homosexual nature, not entering the number of permanent and necessary manifestations of the indicated clinico-nosological forms of psychoses, occurring, however, in the rudimentary form may be viewed as a manifestation of pathomorphism. It has been demonstrated that if schizophrenia and acute alcoholic hallucinosis are associated with psychopathological phenomena of homosexual nature, this may enhance the risk of the committing by the patients of grave aggressive and suicidal actions.

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The clinico-audiometric studies have shown that under the influence of acute alcoholic intoxication the normal examinees manifest dysfunction of the acoustic analyzer, whose intensity depends on the time elapsed since the moment of alcohol intake. In patients with alcoholism, chronic alcoholic intoxication results in the formation of steady dysfunction in the form of treble hypoacusis which correlates both with the stage and other clinico-dynamic parameters of the disease. In patients in the initial stage of acute alcoholic hallucinosis, acoustic analyzer function is characterized by marked disorders of audition in its central parts, which as acute alcoholic hallucinosis develops, tend towards aggravation.

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The authors have examined case histories of 402 patients with delirium tremens treated in 1897-1931, in 1955-1970 and in 1971-1985. An analysis has demonstrated a reduction in the frequency of visual hallucinations of zoological contents and an increase of erotic hallucinations. The duration of the psychotic state in different time periods has been determined. Changes in manifestations of emotional disturbances are described.

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Combined clinical and laboratory investigation of 94 patients provided a basis for classifying the alcoholic delirium into complete and incomplete forms according to its development stereotype and into "wet" and "dry" forms in terms of its somatic, autonomic and neurological disorders. The major role of acid-base balance disorders was revealed and the importance of goal-directed differentiated correction therapy for the rise in efficiency in treating patients with severe alcoholic delirium is stressed.

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The authors have investigated the clinical course, dynamics, and prognosis of acute alcoholic hallucinosis in different years (1955-1970, 1971-1985 versus 1900-1931). An analysis of clinical manifestations of acute alcoholic hallucinosis over the considered 30 years has pointed to a transformation in the main psychopathological phenomena of psychosis as compared to their description in 1900-1931, characterized by changes in the ratio of the subject of verbal hallucinations and delirious ideas and an increase in the proportion of psychopathological phenomena which were not included in the number of constant manifestations of psychosis and occurred now and then. The duration of acute alcoholic hallucinosis (2-3 weeks in 1900-1931) decreased to 5 days in 1955-1970 and 4 days in 1971-1985.

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A comprehensive clinical, therapeutical, laboratory, and follow-up examination of 239 patients with chronic alcoholism has made it possible not only to specify the structure and proportion of complications associated with teturam therapy but also to validate an important role of disorders of the acid-base and water-electrolyte balance (levels of potassium and sodium in the plasma and red blood cells and the volume of the circulating blood and its components) in the pathogenesis of chronic alcoholism and in complications of teturam therapy. The results of examination have evidenced that the initial parameters of the acid-base equilibrium, the volume of the circulating blood and electrolyte balance may serve as prognostic signs indicating the possibility of the development of teturam therapy complications. The authors validate an important role of correction of pathological changes in hemostatic parameters for the prevention of teturam therapy complications, and outline differential routes of prophylaxis depending on the severity of the above pathological shifts determined by biochemical, pathophysical, and clinical parameters of the disease.

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The therapeutic efficacy of Bulgarian antidepressants (adepren, linamiphen, and emovit) was assessed. The results showed that adepren, due to the predominance in the spectrum of its action of a stimulating effect over a sedative one, proved the least effective in anxiety depressions and most effective in inhibitory, asthenic and adynamic depressions. Linamiphen had a more marked antidepressive and stimulating action and was effective in inhibitory depressions of different genesis but the incidence of side effects (fast pulse, elevated blood pressure) was rather high. Emovit was characterized by the predominance of sedative versus stimulating action and, hence, it was most effective in anxiety, asthenic-anxiety, depressive-paranoid and hypochondriac depressions, showing no effect in inhibitory depressions. It did not lead to exacerbation of any other, in particular paranoid, symptomatology.

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Combined clinico-therapeutic and follow-up study of 86 habitual drinkers, 168 patients with the first and 13 with the second stage of chronic alcoholism treated anonymously at a narcological outpatient centre has shown that a new organizational form of narcological service (a room of anonymous treatment), in contrast to other forms of narcological treatment appeals to younger individuals with a high educational and professional status and with a high degree of familial and social adaptation. The follow-up of patients after anonymous treatment showed its high efficiency: remission over 3 years was observed in 19.7% of cases, from 2 to 3 years in 38%, from 1 to 2 years in 29.9%, and up to 1 year in 12.4%. A high therapeutic efficacy and a prophylactic nature of anonymous treatment seem to validate the necessity of setting up rooms of anonymous treatment in the framework of a narcological outpatient centre, which may prove to be another effective component in the staged system of narcological service.

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Examination of 57 paranoid schizophrenics with Kandinsky's syndrome who had attempted to commit suicide showed that the pathological mechanisms of the dangerous actions directed against oneself were determined by individual manifestations of the psychopathological phenomena characteristic of this syndrome. In a quantitative assessment of the causes of suicidal actions, the first place belongs to imperative verbal pseudohallucinations which are in a fabular connection with the preceding pseudohallucinations of a threatening and accusing nature; verbal menacing pseudohallucinations and cenesthopathic automatism symptoms of a similar nature come second; and the third group is represented by verbal pseudohallucinations combined with signs of kinesthetic automatism manifested in the feeling of being possessed. Suicidal actions committed under the influence of the psychopathologic phenomena of Kandinsky's syndrome are characterized by particular severity and frequently lead to a tragic end.

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The results of evaluating the therapeutic efficacy of the new psychotropic drugs adepren, didepil, anq tempalgin made by the "Farmakhim" plant (the People's Republic of Bulgaria) are presented. Clinical trials revealed new facts that allowed to expand the scope of the indications for use formulated in the "Farmakhim" recommendations. It was found that Adepren could be used with success (in addition to the indications suggested by "Farmakhim") in the treatment of patients with depressive-paranoid paroxysms of periodic schizophrenia taking its course in the presence of general depression, as well as patients with somatogenic lingering astheno-depressive states. The therapeutic efficacy of didepil (an antiepileptic) was found to be in a direct relationship with the disease duration, character of the attacks, presence or absence of epileptic chandes of personality. The effect was the best in cases of a short duration of the disease and absence of gross epileptic personality changes, when the paroxysmal disorders were confined mostly to grand mals. A new scheme for arresting the epileptic status with didepil solution is offered. For the first time the efficacy of tempalgin in the treatment of patients suffering from alcoholic abstinence syndrome was substantiated. Optimal doses of the drugs have been determined with regard to the disease nosology and the leading syndrome. Contraindications to the use of the drugs have also been formulated.

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