Mental Health Research Center

Moscow, Russia

Mental Health Research Center

Moscow, Russia
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Pyatnitskiy N.Y.,Mental Health Research Center
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova | Year: 2017

K. Birnbaum's concept of psychopathic personalities is analyzed. K. Birnbaum was one of the first psychiatrists who had suggested the differentiation of psychopathic personalities according to the degree of social damage they caused. As personality abnormality classification according to one prominent trait that led to hiding signs of the general psychopathic constitution in clinical description, as the reliance on erroneous genetic theories with idealization of social behavior norms led to the antihuman medical recommendations. The analysis of K. Birnbaum's psychopathological concept confirms the widespread prevalence of 'the degeneration theory' in the views of many German psychiatrists before and after the Nazi ascension to power.В статье анализируется концепция психопатических личностей K. Бирнбаума, одного из первых психиатров, предложивших разделение психопатических личностей по степени выраженности свойственных им социальных нарушений. Классификация аномалий личности по одной выделяющейся черте привела к затушевыванию клинических признаков общей психопатической конституции, а опора на ошибочные генетические теории с 'идеализацией' норм общественных процессов - к антигуманным врачебным рекомендациям. Анализ психопатологической концепции K. Бирнбаума подтверждает широкую распространенность теории 'дегенерации' в воззрениях многих германских психиатров как до, так и после прихода нацистов к власти.

Burminskiy D.S.,Mental Health Research Center | Morozova M.A.,Mental Health Research Center
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2017

Objective. To evaluate the effect of changing therapy from typical antipsychotics to the atypical antipsychotic risperidone in the treatment of difficult-to-treat residual psychotic symptoms. Material and methods. The study included 15 patients, 8 men and 7 women, mean age 49.1±10.25 years, diagnosed with paranoid schizophrenia, partial remission (ICD-10 F20.04). At the beginning all participants received regular maintenance antipsychotic therapy with typical antipsychotics. The patient assessment with the PANSS, CGI scale and GAF scale was performed at the beginning (before the change of antipsychotics to risperidone) and in the end of the study. The primary efficacy endpoint was a reduction in scores on the PANSS items P1 «delusions» and P3 «hallucinatory behavior» to 1 (no such symptom) or 2 (minimal residual symptom). Secondary criteria were positive changes in the severity of other psychopathological symptoms and an increase in the social functioning level. The average dose of risperidone was 4.62±1.35 mg. The duration of treatment was 2 month. Results. After switching from typical antipsychotics to risperidone and two months monotherapy, there were significant positive changes in the total PANSS score as well as in positive subscale score and CGI-S score. The small, but statistically significant, changes were detected in the overall functioning of the patients (the increase in the GAF score). The dynamics of residual psychotic symptoms was unequal: the severity of hallucinatory symptoms decreased significantly while the delusional symptoms remained unchanged. Conclusions. The authors suggest that excessive dopaminergic blockade might play a significant role in the pathogenesis of residual symptoms. This fact may explain the positive effect of treatment in the cases with the less degree of dopaminergic blockade. If it is true, the treatment strategy in the maintenance phase should not be a direct continuation of acute phase therapy and switching to other drugs and changing of the dose are needed. © 2017, Media Sphera, All rights reserved.

Kananovich P.S.,Mental Health Research Center | Barkhatova A.N.,Mental Health Research Center
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova | Year: 2017

Anhedonia is the inability to experience pleasure. This disorder is heterogeneous across psychiatric disorders and is difficult for measuring and submitting to scientific analysis. Over the last several decades there has been increasing interest in the role that anhedonia plays in various psychopathologies. This article reviews the recent literature on anhedonia and its psychopathological features, which are important for prognosis in affective disorders and schizophrenia. Attempts to dissect various subtypes of anhedonia observed in negative syndrome and depression are reviewed as well.Ангедония - утрата способности испытывать удовольствие. Это расстройство является нозонеспецифическим элементом дефицита психической функции, который может возникнуть при разных психических заболеваниях. Неспецифичность и гетерогенность проявлений ангедонии создают существенные трудности для ее исследования и диагностической оценки. В настоящем обзоре приведен анализ имеющихся в литературе описаний психопатологических особенностей ангедонии, ее прогностическое значение при эндогенной патологии - в аффективных расстройствах и шизофрении. Освещены попытки дифференцирования ангедонии в структуре негативного синдрома и симптоматики депрессивного спектра.

Hough D.,Johnson and Johnson Pharmaceutical Research and Development L.L.C. | Gopal S.,Johnson and Johnson Pharmaceutical Research and Development L.L.C. | Vijapurkar U.,Johnson and Johnson Pharmaceutical Research and Development L.L.C. | Lim P.,Johnson and Johnson Pharmaceutical Research and Development L.L.C. | And 2 more authors.
Schizophrenia Research | Year: 2010

Objective: We assessed efficacy and tolerability of the injectable atypical antipsychotic paliperidone palmitate in delaying time-to-relapse in adults with schizophrenia. Methods: Eligible patients (Positive and Negative Syndrome Scale [PANSS] total score < 120) were transitioned from previous antipsychotics to paliperidone palmitate during a 9-week, open-label phase. Patients received the first 2 intramuscular injections of paliperidone palmitate (50 mg eq) one-week apart, then subsequent injections (25, 50, or 100 mg eq, flexibly-dosed), once-monthly. Stable patients (PANSS total score ≤ 75) continued into the 24-week maintenance phase. At maintenance phase endpoint, stabilized patients were randomized (1:1 ratio) to either continue paliperidone palmitate (at stabilized dose) or begin placebo in the variable-duration, double-blind phase. Results: The preplanned interim analysis (conducted after 68 relapse events) included 312 patients: mean age = 40 years, 55% men, 66% white, and mean transition baseline PANSS total score (SD): placebo, 69.5 (16.89); paliperidone palmitate, 69.3 (17.39). Time-to-relapse (primary endpoint) favored paliperidone palmitate (p < 0.0001, log-rank test) at interim and final analysis (n = 408). The hazard ratio (placebo/paliperidone palmitate) at the final analysis was 3.60 (95% CI: 2.45, 5.28). Treatment-emergent adverse event rates (final analysis set) were: 67% for transition and maintenance phases, and 45% (placebo) and 44% (paliperidone palmitate) for the double-blind phase. Across phases, the incidence of glucose-related adverse events was low (≤ 4%), while mean weight increased by 1.9 kg for paliperidone palmitate and remained unchanged for placebo patients. Injection site tolerability was comparable between groups. Conclusion: Paliperidone palmitate significantly delayed time-to-relapse compared with placebo and presented no new safety signals. © 2009 Elsevier B.V. All rights reserved.

Gopal S.,Johnson and Johnson Pharmaceutical Research and Development L.L.C. | Vijapurkar U.,Johnson and Johnson Pharmaceutical Research and Development L.L.C. | Lim P.,Johnson and Johnson Pharmaceutical Research and Development L.L.C. | Morozova M.,Mental Health Research Center | And 2 more authors.
Journal of Psychopharmacology | Year: 2011

The safety and tolerability of paliperidone palmitate, an injectable atypical antipsychotic agent, were assessed in a 1-year open-label extension of a double-blind study in patients with schizophrenia. Patients from the double-blind study who experienced a recurrence, remained recurrence free until study end, or who were in the transition, maintenance or double-blind phases and had received at least one injection of paliperidone palmitate when enrollment was stopped, were eligible for the open-label extension. Patients received gluteal injections of paliperidone palmitate once every 4 weeks: starting dose 50 mg eq. followed by 25, 50, 75, or 100 mg eq. flexible dosing. Of the 388 patients enrolled, 288 completed the open-label extension. During the open-label extension, the median (range) duration of exposure to paliperidone palmitate was 338 days (10; 390), and 74% of patients received all 12 open-label injections of paliperidone palmitate. The most frequent (≥5% in total group) adverse events were insomnia (7%); worsening of schizophrenia; nasopharyngitis; headache; and weight increase (6% each). Potentially prolactin-related adverse events occurred in 13 (3%) patients, mostly women, and none resulted in study discontinuation. Extrapyramidal treatment-emergent adverse events were reported in 25 (6%) patients; tremor was the most frequently reported (n = 8, 2%). At open-label extension endpoint, investigator-rated redness at the injection site was observed in ≤4% of patients in each group. Injection-site pain was rated by investigators as absent in 82-87% of patients. Schizophrenia symptoms measured by Positive and Negative Syndrome Scale and personal and social performance changes improved during the open-label extension. © 2011 The Author(s).

Lebedeva I.S.,Mental Health Research Center
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2015

Objective. The search of the structural and functional brain characteristics is one of the most studied directions in the modern biological psychiatry. However, in spite of the numerous studies the results are still controversial. As the necessity of the shift of the current paradigm in schizophrenia research evolves it has been suggested to discriminate not only abnormal but stable functioning neuronal circuits as well. Consequently, the aim is formulated as the search of the minimal brain damage sufficient for disease development. Material and methods. Author analyzed the auditory oddball P300 latency (as a marker of information processing speed), N-acetylaspartate level in the dorsolateral prefrontal cortex (as a marker of neuronal integrity in this brain area) and fractional anisotropy of the fasciculus uncindtus which connects the frontal and temporal lobes (as a marker of white matter bundles microstructure) in 30 patients with schizophrenia and 27 healthy people. Results and conclusion. The findings showed that all the tested characteristics are not «obligatory» for schizophrenia. © 2015, Media Sphera. All rights reserved.

Vostrikov V.M.,Mental Health Research Center | Kolomeets N.S.,Mental Health Research Center | Uranova N.A.,Mental Health Research Center
European Journal of Psychiatry | Year: 2013

Background and Objectives: Alterations and deficits of oligodendrocytes reported in the grey and white matter in schizophrenia may contribute to neuronal disconnectivity. Prefrontal-parietal functional disconnections have been implicated in diverse clinical symptoms of schizophrenia, including poor insight. We studied the effects of schizophrenia diagnosis and insight on numerical density (Nv) of oligodendrocytes in the inferior parietal lobule (IPL). Methods: Nissl-stained sections from the Stanley "Parietal Collection" from male schizophrenia subjects (n = 24) having poor, fair, or good insight and healthy matched controls (n = 24) were examined. The Nv of oligodendrocytes was estimated in layer 3 of BA 39 and BA 40 of the IPL and in white matter underlying layer 6 by optical dissector method. Results: In BA 39 we found a significant 15% decrease in the Nv of oligodendrocytes in layer 3 in the schizophrenia group. Nv of oligodendrocytes in the poor+fair insight subgroup was 20% lower compared to controls (p< 0.05) and to good insight subgroup (p = 0.055). Nv of oligodendrocytes in the good insight subgroup did not differ from the control group. A significant lateralization of oligodendrocyte density was detected in layer 3 (L>R) only in the control group. There were no significant group differences in the Nv of oligodendrocytes in BA 40 or in the white matter underlying BA 39/40 areas. Conclusions: Lack of insight in schizophrenia may be associated with a deficit of oligodendroglia in the grey matter of IPL.

Golimbet V.E.,Mental Health Research Center
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2016

Advanced genome technologies, including genome-wide association studies, next generation sequencing analysis, whole exome sequencing, encourage the development of theoretical insights on the role of genetic factors in schizophrenia. In this context, the author considers a monogenic model of schizophrenia and its evolution. © 2016, Media Sphera. All rights reserved.

Kolomeets N.S.,Mental Health Research Center | Uranova N.,Mental Health Research Center
World Journal of Biological Psychiatry | Year: 2010

There is a lot of evidence of astrocytic dysfunction in schizophrenia. We performed an electron microscopic morphometric study of astrocytes in the CA3 hippocampal region in 19 cases of schizophrenia and 16 normal controls. No significant group differences were found in cell size, volume fraction (Vv) and area density (Na) of mitochondria and lipofuscin granules. Young control subjects (<50 years old) had significantly lower area of cell, nucleus and cytoplasm and higher Vv and Na of mitochondria than old controls (>50 years old), and young and old schizophrenic cases. No significant differences between young and old schizophrenic subgroups were found. Vv and Na of mitochondria correlated negatively (r=-0.66, r=-0.72, P<0.01) and Vv of lipofuscin granules correlated positively (r=0.72, P=0.001) with duration of illness. These parameters did not correlate with age in controls and in schizophrenic subjects. Both Vv and Na of mitochondria were significantly lower in the subgroup of cases with duration of disease of>21 years. than in the control group and in the subgroup of cases with duration of illness of<21 years (P<0.01). The data suggest progressive disturbances of astrocyte function due to the deficit of mitochondria in schizophrenia. © 2010 Informa UK Ltd.

Barkhatova A.N.,Mental Health Research Center
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2015

Objective. To study the structure of deficit disorders identified in the initial phase (first 5 years) of youth-onset endogenous psychosis. Materials and methods. Author examined 232 patients with the first episode of juvenile endogenous psychosis during the period from 2005 to 2015 using integrated phenomenological and clinical/psychopathological approaches. The follow-up was administered to 151 patients. Results and conclusion. The working hypothesis on the formation of deficit symptom variants based on the mutual competition of its components was formulated. Identified typological species allowed to hypothesize the existence of continual series of variations of deficit disorders manifested as phenomena with multilateral dependencies, characterized by dynamism and a wide range of modifications and verifiable in remission at the initial stages of attack-like endogenous psychosis. © 2015, Media Sphera. All rights reserved.

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