Vol L, No 4 (2018)
- Year: 2018
- Articles: 26
- URL: https://journal-vniispk.ru/1027-4898/issue/view/845
Articles
EVIDENCE-BASED MEDICINE AND PSYCHIATRIC PRACTICE: TRIAL OF CLINICAL METHODOLOGICAL AUDIT
Abstract
The review paper provides the analysis of critical assessments regarding the principles and procedures of evidence-based medicine in the psychiatric practice. Incorrect nature of some critical comments with respect to evidence-based approaches is indicated. The practical importance of clinical research for the selection of optimal therapeutic solutions is underlined. The clinical aspects of psychiatric care that do not be allowed to formalize the therapeutic process completely are considered. Within the framework of the discussed problem, variants of consistent and complementary evidence and clinical approaches interactions are presented. The conclusion is drawn that the principles of evidence-based medicine remain the scientific basis for the development of clinical practice.
Neurology Bulletin. 2018;L(4):5-14
5-14
FAKE-DIAGNOSES IN PSYCHIATRIC CLASSIFICATIONS
Abstract
In the article the problem of creation of psychiatric classifications is analyzed. Scientific groundlessness of including in ICD and DSM of various behavioural deviations is discussed. Special emphasis is placed on assessment by it of such diagnoses as “harmful use», gambling, Internet dependence, hording. The conclusion about existence in psychiatric classifications a fake diagnoses is drawn. It becomes perceptible that in psychiatry unlike other medical specialties there is no consensus of scientists concerning a concept of the deviating and diagnostic criteria of psychopathologic symptoms. It is summarized that before agreeing about psychiatric classification, it is necessary to agree about symptoms and their differences from psychological phenomena.
Neurology Bulletin. 2018;L(4):15-18
15-18
METHODOLOGICAL SELF-DECEPTION. DO QUASIMEASUREMENTS OF HUMAN SENTIMENTS AND FEELINGS MAKE SENSE?
Abstract
The paper deals with the problem of quasi-measurements of sentiments and feelings, in particular, in terms of evidence-based medicine. The examination is centered on the assumption of the inherent incorrectness of quasi-measurements of sentiments and feelings, and on the generalization of such data in meta-analyzes (MA). Structural linguistics concepts are applied to build a mechanism for mediating the severity of psychic phenomena through the meanings of psychic experiences of a semiotic nature.
Neurology Bulletin. 2018;L(4):19-22
19-22
EVIDENCE PSYCHIATRY: FACT OR FAKE?
Abstract
The article discusses the theoretical significance and practical adequacy of the evidence-based approach in modern psychiatry, which statistically depersonalizes the patient. The necessity and expediency of maximally personalizing a psychiatric service, which fully reflects the unique individuality of psychopathological experiences and contributes to the optimization of therapeutic and diagnostic tactics, is justified as an urgent task.
Neurology Bulletin. 2018;L(4):23-25
23-25
INTEGRATION OF APPROACHES TO DIAGNOSIS AND CLASSIFICATION OF MENTAL DISORDERS BASED ON THE ANALYTIC HIERARCHY PROCESS
Abstract
The paper deals with the dimensional aspects of the classification of psychopathological states. Dimensional (rank) scales are widely used in psychiatry and neurology for comparative assessment of the severity of neurological, neurocognitive and emotional disorders in dynamics. A simple example for general medicine shows the inadmissibility of interpreting rank information as a numeric. A cardinal approach to the processing of rank (dimensional) information on the basis of the Analytic Hierarchy Process is proposed, which provides the formation of the results of processing of rank information in the scale of relations (numerical scale). A fundamental approach to the processing of rank information allows to obtain integrated estimates on different scales, which is of interest from the point of view of the formation of correct diagnostic and classification procedures in psychiatry.
Neurology Bulletin. 2018;L(4):26-30
26-30
ALEXITHYMIA IN CHRONIC AND ACUTE NON-SPECIFIC CERVICAL AND BACK PAIN
Abstract
Alexithymia (difficulty of verbalization of sensations) is currently considered as a factor aggravating the course of somatic diseases, including musculoskeletal pain. Objective: to determine the frequency of occurrence of alexithymia in patients with nonspecific pain in the neck and back and its association with the clinical features of pain. Contingent and examination methods: 156 patients aged 18-50 years (mean age 38.2 ± 10.1 years), 89 women and 67 men who applied to medical institutions for axial pain (paravertebral localization of pain) in the neck, thoracic region spine and lumbar region. Research methods: Toronto alexithymia scale, visual analogue scale (VAS) of pain, VAS influence of pain on disability, VAS life satisfaction, hospital scale of depression and anxiety, index of widespread pain. Results: patients with alexithymia and acute pain had statistically significantly higher rates for VAS (pain intensity), disability index and hospital anxiety and depression scale, and significantly lower life satisfaction index than non-alexithymic patients. The same pattern was found in the subgroup of patients with chronic pain. Conclusions: comorbidity of alexithymia, acute and chronic pain, anxiety and depression makes it advisable to register this phenomenon in the clinic to predict the disease and to develop further ways to overcome the problem.
Neurology Bulletin. 2018;L(4):31-34
31-34
CHRONIC PSYCHIATRIC WARD READMISSION PREDICTING
Abstract
The main clinical, social and organizational parameters in patients with rare and frequent readmissions in psychiatric hospital were observed. The link of these parameters with number of readmissions was analyzed, and factor profiles were created for indicated above patients’groups. Despite the general similarity in most parameters, patients with rare readmissions have a clinical profile and frequent readmission patients - social factor profile.
Neurology Bulletin. 2018;L(4):35-39
35-39
DIAGNOSIS OF ALEXITHYMIA IN ADOLESCENTS WITH TENSION-TYPE HEADACHE
Abstract
The aim of the work is to determine alexithymia in adolescents with tension headache and its association with other clinical symptoms in adolescents with tension headache. Contingent and methods. 52 patients suffering from tension headache (HDN), aged 13-17 years. Criteria for inclusion in the study: the presence of headaches for more than 6 months and the lack of prophylactic treatment; meeting the criteria for tension headache International classification of headaches 3rd edition (beta version of 2013). The Russian-language version of the Alexithymia Questionnaire for Children was used to diagnose alexithymia in children. Results. A high level of alexithymia was detected in 36.6% of adolescents with HDN, and 23% of adolescents were in the border group. No significant differences were found in the frequency of alexithymia occurrence among mothers of adolescents with HDN and mothers of children who do not suffer from headaches. Conclusion. In the practice of the neurologist, it is necessary to use tools for alexithymic patients, especially with complaints of pain, since the percentage of alexithymic adolescents is significant.
Neurology Bulletin. 2018;L(4):40-43
40-43
CEREBRAL HYPERPERFUSION SYNDROME IN PATIENTS WITH STENOTIC AND OCCLUSIVE LESION INTERNAL CAROTID ARTERIES AFTER SURGERY. LITERATURE REVIEW
Abstract
The literature on the cerebral hyperperfusion syndrome in patients with stenotic and occlusive lesion internal carotid arteries after surgery has been analyzed.Data of pathogenesis, clinical features, diagnostics, prevention and treatment of cerebral hyperperfusion syndrome are presented. Despite a large number of publications, there are no unified recommendations on treatment and prevention of cerebral hyperperfusion, there are no unified diagnostic criteria. Key words: cerebral hyperperfusion syndrome, EC-IC bypass, carotid endarterectomy, carotid artery stenting.
Neurology Bulletin. 2018;L(4):44-51
44-51
IS PHENOMENON «FOOLS-FOR-CHRIST» THE EXTRAORDINARY PSYCHOLOGICAL PHENOMENON OR A MENTAL DISORDER?
Abstract
This article deals with the phenomenon of the «Fools-for-Christ». It was performed a brief historical excursion of the phenomenon; described its essence and purpose; given a generalized description of the behavior of «Fools-for-Christ» and analyzed their main motives; the criteria for distinguishing the phenomenon of the «Fools-for-Christ» from outwardly similar phenomena: mentally ill, “homeless”, “possessed with devil”, “false idiots” are systematized. The article has an interdisciplinary character and is written at the intersection of psychiatry, medical psychology, orthodox psychology and Christian anthropology. As a result of the analysis, for the first time in psychiatry and medical psychology, it is proved that the phenomenon of the «Fools-for-Chist» is not a mental disorder, but an ascetic feat, which can only be understood guided by Christian anthropology.
Neurology Bulletin. 2018;L(4):52-56
52-56
DID OEDIPUS SUFFER FROM ON OEDIPUS COMPLEX? (FROM GREEK MYTH TO PSEUDO-STIGMATIZATION)
Abstract
The article covers the problems of the origin and development of the concepts of the Oedipus complex, and sexual addiction during the post Freudian era. We considered these syndromes as cultural phenomena built upon widely-spread historical mythic plots. The role of the concepts of «sex” and “gender” in the development and application of these diagnoses in modern psychiatry is shown. Clinical examples emphasize the importance of distinguishing between real mental problems and such phenomena as pseudo -victimization and pseudo-stigmatization. We have investigated the role of postmodern discourse, which allows to understand the origin of the outbreak of complaints of the cases of incest and sexual addictions.
Neurology Bulletin. 2018;L(4):57-66
57-66
RELIGIOUSNESS AND MENTAL DISORDERS - DIFFERENTIATION OF NORM AND PATHOLOGY
Abstract
In the article the topical issues concerning differentiation of norm and pathology from a position of relationship of religiousness and psychiatry are considered. Differentiation of religious experience and a mental disorder is given. And also the description of symptomatology of conditions of «False mysticism» is given.
Neurology Bulletin. 2018;L(4):67-69
67-69
70-71
THE ASSISTANCE PROGRAM FOR FAMILIES OF PATIENTS WITH SCHIZOPHRENIA IN FIRST EPISODE CLINICS
Abstract
This article reviews specific features of psychoeducational groups with relatives of first episode schizophrenia patients with the example of short-term in-patient treatment program. The indicated features which include short-term hospital stay, open group form, specific emotional response, do not allow implementing long-term full multi-family groups and make searching for new effective program in given conditions more important. Based on the available sources and clinical observation are described principles and rules of working with relatives of first episode patients, plan and basic framework of the sessions, main issues that are usually discussed and recommendations for the most effective way of working the group. This program is the initial stage of the long rehabilitation process, but at the same time allows short-term assistance and support for the relatives.
Neurology Bulletin. 2018;L(4):72-77
72-77
TRANSIENT NEUROLOGICAL DEFICIT IN NEURAL AMYOTROPHY OF CHARCOT-MARIE-TOOTH: CLINICAL OBSERVATION AND LITERATURE REVIEW
Abstract
Some acute transient insult-like episodes can occur in patients with Charcot-Marie-Tooth X-type disease, mainly in childhood and adolescence. Their development is probably associated with leukoencephalopathy due to the mutation of the GJB1 gene, which is observed in both peripheral and central nervous system. Acute neurologic symptoms with MRI-verified leukoencephalopathy can be wrongly supposed to the incorrect diagnosis, acute disseminated encephalomyelitis for example. Such patients can get unnecessary examinations and potentially dangerous treatment. We present a clinical case of the 19-year-old patient with CMTX, who entered neurology department of Republican Clinical Hospital in Kazan city after the development of two transient insult-like episodes with the following manifestations: hemiparesis, dysarthria, dysphagia with MRT-revealed white matter lesions of the brain.
Neurology Bulletin. 2018;L(4):78-81
78-81
82-84
THE ANALYSIS OF PLACEBO EFFICIENCY IN THE THERAPY OF ASTHENIC DISORDERS IN SCHIZOPHRENIA
Abstract
Clinical and immunological assessment of placebo effectiveness in patients with schizophrenia in remission with different variants of asthenic symptom-complex was conducted. The results presented confirm the existence of placebo effect and prove placebo effectiveness - treatment for affective-asthenic symptoms in schizophrenia. At the same time this is a short-term effect and it does not occur in the predominance of negative symptomatology in the mental status of patients, which once again demonstrates the irreversible nature of these disorders. In placebo therapy, the relation between the LE and α1-PI inflammatory markers in serum and the change of the mental condition of the patients with affective-asthenic symptoms is established.
Neurology Bulletin. 2018;L(4):84-86
84-86
NEW SEARCH OF TERMINOLOGY IN PSYCHIATRY
Abstract
Questions concerning validity of need to give psychological sense to the concept «hallucinatory delusion» and of need of observance of accuracy for psychiatric terminology are raised by the author in debatable article. Particularly the concept «pseudo-dementia» received unreasonable expansion; the term «iatrogeny» began to include «iatropathy». It is noted that there are attempts to make in psychiatric terminology «corrections». Some of them are based on special theoretical views of the authors, the other part - on disregard for the accuracy of the content of the formulations, as well as on the banal ignorance of certain provisions of the subject under discussion.
Neurology Bulletin. 2018;L(4):87-88
87-88
INFLUENCE OF APATHY ON LATE-LIFE DEPRESSION
Abstract
Apathy is a common phenomenon in late age depressions, which has recently become the object of close study. The aim of this study was to compare patients with late-onset depression with and without the apathetic component. The data obtained showed that it is apathy that has a greater effect on the serious conditions in patients, their quality of life and cognitive impairment.
Neurology Bulletin. 2018;L(4):88-89
88-89
INCREASING THE MOTIVATION OF THE FAMILY TO IDENTIFY RISK GROUPS OF BORDERLINE NEURO-MENTAL DISORDERS IN CHILDREN
Abstract
The questionnaire for identification of risk group of children with borderline mental pathology at mass preventive examinations is modified. The technique is designed to identify subclinical manifestations of mental health abnormalities, transitional states from normal to pathological, stimulates the involvement of the child’s parents in the diagnostic process, does not require much time, allows doctor to structure a preventive visit and to detail the doctor’s conversation, in a short period of time to find out possible complaints completely.
Neurology Bulletin. 2018;L(4):90-91
90-91
THE MENTAL HEALTH OF COMBATANTS IN A MONTH AFTER EXECUTION OF OPERATIONAL TASKS IN SPECIAL CONDITIONS
Abstract
In order to analyze the dynamics of the mental state of combatants a month after the execution of operational and service tasks in special conditions, 954 combatants returned from business trips with the execution of operational and service and combat tasks in special conditions as part of the consolidated police units in the center for psychophysiological diagnosis (CPD) of the Medical and sanitary unit (MCH) of the Ministry of internal Affairs of Russia in the Kirov region were examined. It is shown that, a month after returning from a business trip, in mentally healthy combatants revealed prenosological disorders of mental health, leading to a decrease in social, including professional, functioning. In combatants receiving therapy for borderline mental disorders, a month later, against the background of a significant reduction in psychopathological symptoms, an emotional limitation - “insensitivity” - was formed, which indicated the need for further complex therapy. It is offered to consider a question of improvement of methodological approaches to carry out recovery rehabilitation actions to combatants in the Centers of mental health of the Ministry of internal Affairs of Russia.
Neurology Bulletin. 2018;L(4):92-94
92-94
CONJUGATION OF ILLEGAL ACTIONS OF MENTALLY ILL PATIENTS WITH NEGATIVE SOCIAL AND ENVIRONMENTAL FACTORS
Abstract
The role of negative social and environmental factors in mentally patients’ criminal behavior was investigated. From 379 persons who have made offence having various mental frustration, financial straits have been objectively confirmed in 16,2 % of cases, adverse living conditions - in 2,9 % of the cases, the compelled change of a residence - in 1,2 % of cases, disputed relations in 10,6 % of cases, an antisocial environment - in 30,1 % of cases. The share of having negative social and environmental influence among patients having made property crimes, was 62, 2 %, hooligan-like actions of 48,9 %, offences against the person - 62,6 %, sexual - 27,3 %, other offences - 64,1 %. The risk of socially dangerous actions and a group of patients with an increased risk of antisocial behavior should be considered for the system of medical preventive measures as the main clinical and epidemiological characteristics.
Neurology Bulletin. 2018;L(4):94-96
94-96
STRUCTURE OF ILLEGAL ACTIONS AND CLINICAL CHARACTERISTICS OF MENTALLY ILL PERSONS RECOGNIZED AS SANE
Abstract
Clinical characteristics of 190 tested patients having various mental disorders recognized by the expert assessment commission as responsible for their illegal deeds incriminated to them were investigated in forensic psychiatry clinic. Structure of the offences accomplished by them following: the illegal actions directed against the person - 38,3 %, property offences - 23,7 %, hooligan-like actions - 6,6 %, sexual character offences - 3,2 %, «other» offences - 26,3 %. The analysis of conformity of clinical characteristics of the specified contingent to character of the perfect offences has revealed a number of their authentic parities.
Neurology Bulletin. 2018;L(4):97-99
97-99
PROBLEM OF SUBSTANTIALITY OF THE VIOLENCE ENDURED IN THE CHILDHOOD: IDENTIFICATION OF SIGNS OF TRAUMATIZATION
Abstract
This research is devoted to the analysis of the directions of identification signs of traumatization of violence over the child. The main types of violence endured in the childhood, and also their diagnostic signs are given: medical, physiological, pedagogical, psychological and psychiatric ones. Diagnostic opportunities and the evidential importance of these approaches have been analyzed.
Neurology Bulletin. 2018;L(4):99-102
99-102
CLINICO-PSYCHOPATHOLOGICAL AND IMMUNOLOGICAL TYPES OF MANIC-PARAPHRENIC FORMS IN THE FRAMEWORK OF PAROXYSMAL COURSES OF ENDOGENOUS PSYCHOSES
Abstract
In the present study 73 patients with manic-paraphrenic form developed within the framework of the paroxysmal course of endogenous psychoses were examined. It is established that in manic-paraphrenic psychoses not only inflammatory but also autoimmune reactions are triggered, reflecting the severity of the current pathological process in the Central nervous system. After a thorough psychopathological analysis of the mechanisms of delirium and their relationships with manic affect, 3 types of the studied States were identified. At type 1, there was a moderate increase in the activity of inflammatory markers. In patients of type 2, a marked increase in the activity of inflammatory markers was revealed. Increased activity of both inflammatory and autoimmune markers was revealed in patients of type 3. Taking into account the obtained data, it was found that the level of activation of the immune system, including inflammatory (the activity of leukocyte elastase and а1-proteinase inhibitor) and autoimmune markers (the level of autoantibodies to the neuroantigen S100-B) increases with the aggravation of psychopathological symptoms and is an unfavorable factor in terms of the further course of the disease.
Neurology Bulletin. 2018;L(4):102-105
102-105
THE VERSION OF SOCIAL DISADAPTATION IN PEOPLE WITH MENTAL DISORDERS IN THE FEATURES OF USING INTERNET TECHNOLOGIES: RELATION BETWEEN THE PATTERN OF INTERNET USING AND INTENSITY OF PSYCHOPATHOLOGICAL SYMPTOMS
Abstract
The research was directed to study the relation of internet patterns using and level of actual psychopathological symptoms. There were survey 82 men, from 16 to 32 years old, who were hospitalized in MHCR clinic. The selection criterions were: presence endogenous psychical disorder, actual lack of psychotic symptoms, agreement to participations in the study. The methods, that were used, were: SCL-90-R, author’s semi-structured questionnaire, developed specially for this study. Results demonstrate how features of actual psychopathological symptoms are reflected on the patterns of using internet technologies.
Neurology Bulletin. 2018;L(4):105-107
105-107