RESUMEN
OBJECTIVE: Identification of psychopathological characteristics of depressive-delusional states with religious content, development of a typology, determination of formation features, nosological assessment. MATERIAL AND METHODS: A total of 79 patients (47 female, 32 male, mean age 27±6.5 years) with depressive-delusional states with religious content within the affective and schizophrenia spectrum disorders were studied. Clinical-psychopathological, psychometric (PANSS, HDRS, S. Huber CRS) and statistical methods were used. RESULTS: Based on the psychopathological structure, specific mechanisms of development of delusions and themes of the religious experiences, three types of depressive-delusional states were identified: type 1 - with a predominance of depressive delusions congruent with affect and delusional ideas of guilt, sinfulness, abandonment of God (14 patients, 17.7%; 6 women, 8 men; mean age 28±4.5 years; HDRS score 33±5.6, the total PANSS score 71±5.3, the PANSS positive subscale score 15.8±3.7); type 2 - with the addition of incongruent delusional constructs, persecutory disorders and acute sensory delusions to the existing depressive religious delusion, with the phenomenon of confessional ambivalence (27 patients, 34.2%; 16 women, 11 men; mean age at attack manifestation 25±9 years; HDRS score 29.6±4.4, the total PANSS score 87±6.2, the PANSS positive subscale score 23.5±4.2); type 3 - depressive-paranoid states with a predominance of Kandinsky-Clerambault syndrome of religious content (38 cases, 48.1%; 20 women, 18 men; mean age at attack manifestation 23.4±2.5 years; HDRS score 32.7±3.7, the total PANSS score 102±7.3, the PANSS positive subscale score 32.5±4.5). CONCLUSION: The study of depressive-delusional states with religious content has shown their clinical-psychopathological heterogeneity. The religious experiences served as a pathoplastic factor, which essentially modified the clinical-psychopathological picture of the disease due to presence of the specific religious phenomena. The identified types of depressive-delusional disorders with religious content had different diagnostic value.
Asunto(s)
Deluciones , Esquizofrenia , Humanos , Masculino , Femenino , Adulto Joven , Adulto , Adolescente , Deluciones/diagnóstico , Esquizofrenia/diagnóstico , Psicopatología , Religión , Trastornos NeurocognitivosRESUMEN
The paper presents the study in of the combined psychopharmaco-psychocorrective method designed specially for juvenile patients with endogenic depressive disorders. Psychocorrective measures included the method of "rehabilitation training of social habits" used on the stage of hospital therapy and psychocorrective training according to "social support" method used in group psychotherapy outpatiently. A 5 year follow-up study performed in 110 showed that psychotherapy has increased efficiency of the therapy in terms of both reduction of clinic disorders in the acute period and prophylaxis of the relapses as well as social readaptation.
Asunto(s)
Terapia Cognitivo-Conductual/métodos , Trastorno Depresivo/terapia , Adolescente , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Femenino , Humanos , Masculino , Psicoterapia de GrupoRESUMEN
The aim of this paper is to study the recognition of facial expression of emotions in depressed patients with major depressive disorder (MD) and schizotypal personality disorder (STP). The pictures of sad, emotionally neutral, and happy faces followed by a masking stimulus were displayed for 80 msec on a computer screen randomly in the left or right hemifield of vision (LHF and RHF). The subjects had to respond by pressing a three position key. Multiple analysis of variance revealed that all depressed patients, relative to control subjects, made more errors in a task of recognition of facial affect. The characteristics of impairment of performance were found to be related to the nosology of depression. MD patients revealed significantly impaired recognition of negative (in LHF and in RHF) and positive (in LHF) facial emotions, as well as poorer recognition in the right hemisphere, and reduced hemispheric asymmetry. In remission, they showed statistically significant recovery of recognition function. STP patients were less impaired and showed slightly poorer recognition of sad (in RHF) and happy (in LHF) expressions. This group demonstrated significantly poor recognition of happy expressions, and more marked dysfunction of the left hemisphere. In remission, STP patients failed to improve in recognition of emotion. This suggests, that the features of emotion recognition in MD and STP groups reflect some differences in the neurophysiological mechanisms underlying the affect-related dysfunction in these groups of depressed patients.
Asunto(s)
Atención , Trastorno Depresivo/diagnóstico , Expresión Facial , Trastorno de la Personalidad Esquizotípica/diagnóstico , Percepción Social , Adulto , Afecto/fisiología , Atención/fisiología , Corteza Cerebral/fisiopatología , Trastorno Depresivo/fisiopatología , Trastorno Depresivo/psicología , Dominancia Cerebral/fisiología , Femenino , Humanos , Masculino , Reconocimiento Visual de Modelos/fisiología , Recurrencia , Trastorno de la Personalidad Esquizotípica/fisiopatología , Trastorno de la Personalidad Esquizotípica/psicologíaRESUMEN
The functional activity of natural killer (NK) and of T-helper (TH) lymphocytes was examined both in 19 patients with schizophrenia and in 6 patients with schizoaffective psychosis as well as in 93 control individuals. The patients were examined both before the treatment and two months after it. The cytotoxic level of NK lymphocytes was considerably decreased in all the patients before the treatment. The TH activity was decreased in 8 of 17 schizophrenic patients and in 1 of 4 schizoaffective patients observed during the acute period. The increase of cytotoxic NK activity was seen in patients with schizoaffective psychosis after the treatment while such alterations in schizophrenic patients were absent. The TH activity changed neither in schizophrenic nor in schizoaffective patients after the treatment.
Asunto(s)
Trastornos Psicóticos/inmunología , Esquizofrenia/inmunología , Subgrupos de Linfocitos T/inmunología , Adolescente , Adulto , Enfermedad Crónica , Pruebas Inmunológicas de Citotoxicidad/métodos , Humanos , Células Asesinas Naturales/efectos de los fármacos , Células Asesinas Naturales/inmunología , Masculino , Trastornos Psicóticos/tratamiento farmacológico , Psicotrópicos/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Subgrupos de Linfocitos T/efectos de los fármacos , Linfocitos T Colaboradores-Inductores/efectos de los fármacos , Linfocitos T Colaboradores-Inductores/inmunologíaRESUMEN
The recognition of facial emotional expression in depressed patients with major depressive disorder (MDD) and slow progressive schizophrenia (SPS) in acute state and in remission was studied in comparison with healthy persons. All the subjects were right-handed. The drawings of sad, neutral and happy faces followed by masking stimulus were displayed in the center field and in the left or right hemifield of vision on the computer screen for 80 ms. All the depressed patients revealed marked impairment of facial emotion recognition, especially for negative on, and disturbances of hemisphere asymmetry. There were some differences between MDD and SPS patients. The MDD patients showed more significant impairment of emotion recognition and right hemisphere disfunction. The SPS patients were less impaired and revealed mild worsening in the left hemisphere only. In remission MDD patients showed a significant improvement of emotion recognition contrary to SPS patients who failed to recover this function. The revealed emotion recognition disturbances in MDD patients are supposed to be dynamic, whereas in depressed patients with SPS it is considered to be a trait feature.
Asunto(s)
Trastorno Depresivo/psicología , Emociones , Expresión Facial , Adulto , Antidepresivos Tricíclicos/administración & dosificación , Trastorno Bipolar/tratamiento farmacológico , Trastorno Bipolar/psicología , Trastorno Depresivo/tratamiento farmacológico , Dominancia Cerebral , Humanos , Masculino , Psicofisiología , Recurrencia , Inducción de Remisión , Psicología del Esquizofrénico , Trastorno de la Personalidad Esquizotípica/tratamiento farmacológico , Trastorno de la Personalidad Esquizotípica/psicologíaRESUMEN
The authors studied therapeutic properties of fluoxetine in the treatment of 100 patients with endogenous depressions. The drug was introduced during 6 weeks in a daily dose 20 mg. On the basis of the analysis of its clinical action and adverse reactions, fluoxetine belonging to the class of antidepressants has been ascertained. A prevalence of thymoleptic and stimulating components in its action, equal by their degree of expressivity and a smaller degree of anxiolytic effect have been demonstrated. Differentiated indications to fluoxetine prescription, its predilection in the therapy of apatho-adynamic and melancholic depressions and the feasibility of its use in inpatient conditions are discussed.
Asunto(s)
Fluoxetina/uso terapéutico , Adolescente , Adulto , Anciano , Trastorno Depresivo/tratamiento farmacológico , Trastorno Depresivo/psicología , Femenino , Fluoxetina/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Pruebas Psicológicas , Psicopatología , Inducción de Remisión , Comprimidos , Factores de TiempoRESUMEN
In schizophrenic patients, the course of lipid peroxidation (LP) was investigated as indicated by pentane contents in the expired air (gas chromatography) during a course of psychotropic drug therapy. In 80% of the patients LP was activated before the therapy and reduced in its course with the levels in remission comparable to those characteristic of healthy controls. The LP decreased in a "leap-like" manner with episodes far exceeding the control levels. These leaps' rate and the baseline LP increase before therapy positively correlated with severity of the signs of the disease, its duration, and pre-existing level of negative disorders.
Asunto(s)
Peroxidación de Lípido , Esquizofrenia/metabolismo , Adulto , Pruebas Respiratorias , Cromatografía de Gases , Humanos , Peroxidación de Lípido/efectos de los fármacos , Pentanos/análisis , Pentanos/metabolismo , Esquizofrenia/tratamiento farmacológicoRESUMEN
Clinical catamnestic and experimental psychologic techniques allowed the authors to single out a range of personality and psychosocial structures in patients with juvenile slow progredient neurosis-like schizophrenia with favorable outcome up to "virtual recovery". Influencing these structures with respect to the patients' age could promote their general and special activities, heighten their level and quality of adaptation to major spheres of social functioning. This provided a basis for establishing the major goals of social rehabilitative and psychic corrective aid to the juvenile patients.
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Rehabilitación Vocacional , Esquizofrenia/rehabilitación , Psicología del Esquizofrénico , Adolescente , Adulto , Estudios de Seguimiento , Humanos , Psicología Social , Psicopatología , Esquizofrenia/diagnóstico , Ajuste SocialRESUMEN
The drug antibodies were radioimmunologically detected in 58.3% of depressive patients treated with Imipramine. A group of patients with the antibodies permanently present either proved fully resistant or showed a minor effect. A group with antibodies arising just at the start of the treatment displayed either complete remission or substantial improvement. Antibodies were not found in patients exhibiting full recovery or considerable improvement.
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Anticuerpos/análisis , Trastorno Depresivo/inmunología , Imipramina/inmunología , Adulto , Trastorno Depresivo/tratamiento farmacológico , Resistencia a Medicamentos , Humanos , Radioinmunoensayo , Factores de TiempoRESUMEN
On the basis of the results of an 18-26-year-long follow up of 100 patients with juvenile slowly progressive neurosis-like schizophrenia with an onset of the disease in youth the authors have identified a group of patients (n = 25) who presented practical cure. Comparison of the peculiarities of neurosis-like disturbances and their dynamics during the active stage of the disease in this group and in patients in whom stable neurosis-like manifestations persisted up to the late stages of the disease (n = 75) has made it possible to determine those types of neurosis-like states which correlate with the outcome of the disease. Some clinical and pathogenetic signs have been identified which help specify some aspects of the clinical and social prognosis.