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Gorobets L.N.,Moscow Research Institute of Psychiatry
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2015

Objective. To study the characteristics of prolactin secretion in patients with a first psychotic episode (FPE) with regard to disease severity, gender and patient’s neuromediator system state. Material and methods. Author studied 76 patients with schizophrenic spectrum disorders and 34 normals (control group). Results and conclusion. There was a significant negative sex-related correlation between the severity of psychopathologic symptoms and plasma prolactin levels. Based on the results, author attempted to explain the hormonal disbalance in the patients with FPE taking into account the state of monoaminergic mediator systems in patients. © 2015, Media Sphera. All rights reserved. Source

Perugi G.,University of Pisa | Angst J.,Psychiatrische Universitsklinik | Azorin J.-M.,Hital Sainte Marguerite | Bowden C.L.,University of Texas at San Antonio | And 4 more authors.
Journal of Clinical Psychiatry | Year: 2015

Objective: To estimate the frequency of mixed states in patients diagnosed with major depressive episode (MDE) according to conceptually different definitions and to compare their clinical validity. Method: This multicenter, multinational cross-sectional Bipolar Disorders: Improving Diagnosis, Guidance and Education (BRIDGE)-II-MIX study enrolled 2,811 adult patients experiencing an MDE. Data were collected per protocol on sociodemographic variables, current and past psychiatric symptoms, and clinical variables that are risk factors for bipolar disorder. The frequency of mixed features was determined by applying both DSM-5 criteria and a priori described Research-Based Diagnostic Criteria (RBDC). Clinical variables associated with mixed features were assessed using logistic regression. Results: Overall, 212 patients (7.5%) fulfilled DSM-5 criteria for MDE with mixed features (DSM-5-MXS), and 818 patients (29.1%) fulfilled diagnostic criteria for a predefined RBDC depressive mixed state (RBDC-MXS). The most frequent manic/hypomanic symptoms were irritable mood (32.6%), emotional/mood lability (29.8%), distractibility (24.4%), psychomotor agitation (16.1%), impulsivity (14.5%), aggression (14.2%), racing thoughts (11.8%), and pressure to keep talking (11.4%). Euphoria (4.6%), grandiosity (3.7%), and hypersexuality (2.6%) were less represented. In multivariate logistic regression analysis, RBDC-MXS was associated with the largest number of variables including diagnosis of bipolar disorder, family history of mania, lifetime suicide attempts, duration of the current episode gt; 1 month, atypical features, early onset, history of antidepressant-induced mania/ hypomania, and lifetime comorbidity with anxiety, alcohol and substance use disorders, attention-deficit/hyperactivity disorder, and borderline personality disorder. Conclusions: Depressive mixed state, defined as the presence of 3 or more manic/hypomanic features, was present in around one-third of patients experiencing an MDE. The valid symptom, illness course and family history RBDC criteria we assessed identified 4 times more MDE patients as having mixed features and yielded statistically more robust associations with several illness characteristics of bipolar disorder than did DSM-5 criteria. © Copyright 2015 Physicians Postgraduate Press, Inc. Source

Popovic D.,University of Barcelona | Vieta E.,University of Barcelona | Azorin J.-M.,Hopital Sainte Marguerite | Angst J.,University of Zurich | And 4 more authors.
Bipolar Disorders | Year: 2015

Objectives: The Bipolar Disorders: Improving Diagnosis, Guidance, and Education (BRIDGE-II-Mix) study aimed to estimate the frequency of mixed states in patients with a major depressive episode (MDE) according to different definitions and to compare their clinical validity, looking into specific features such as suicidality. Methods: A total of 2,811 subjects were enrolled in this multicenter cross-sectional study. Psychiatric symptoms, and sociodemographic and clinical variables were collected. The analysis compared the characteristics of patients with MDE with (MDE-SA group) and without (MDE-NSA) a history of suicide attempts. Results: The history of suicide attempts was registered in 628 patients (22.34%). In the MDE-SA group, women (72.5%, p = 0.028), (hypo)mania in first-degree relatives (20.5%, p < 0.0001), psychotic features (15.1%, p < 0.0001), and atypical features (9.2%, p = 0.009) were more prevalent. MDE-SA patients' previous responses to treatment with antidepressants included more (hypo)manic switches [odds ratio (OR) = 1.97, 95% confidence interval (CI): 1.58-2.44, p < 0.0001], treatment resistance (OR = 2.07, 95% CI: 1.72-2.49, p < 0.0001), mood lability (OR = 1.98, 95% CI: 1.65-2.39, p < 0.0001), and irritability (OR = 1.80, 95% CI: 1.48-2.17, p < 0.0001). Multivariate analysis evidenced that risky behavior, psychomotor agitation and impulsivity, and borderline personality and substance use disorders were the variables most frequently associated with previous suicide attempts. In the MDE-SA group, 75 patients (11.9%) fulfilled Diagnostic and Statistical Manual (DSM)-5 criteria for MDE with mixed features, and 250 patients (39.8%) fulfilled research-based diagnostic criteria for a mixed depressive episode. Conclusions: Important differences between MDE-SA and MDE-NSA patients have emerged. Early identification of symptoms such as risky behavior, psychomotor agitation, and impulsivity in patients with MDE, and treatment of mixed depressive states could represent a major step in suicide prevention. © 2015 John Wiley & Sons A/S. Source

Sukhotina N.K.,Moscow Research Institute of Psychiatry
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2013

According to Russian and world publications, there is a growing prevalence of mental disorders among children and adolescences with the domination of mental retardation and nonpsychotic mental disorders. In this review, several main causes of growing prevalence of mental and behavioral disorders in these populations are specified. Source

Krasnov V.N.,Moscow Research Institute of Psychiatry | Gurovich I.,Moscow Research Institute of Psychiatry
International Review of Psychiatry | Year: 2012

Russian psychiatry has a dramatic history, and until now has been at a transitional stage of development. It is facing problems not only common in world psychiatry, but also specific to eastern Europe, in particular Russia. Starting from the beginning of the 1990s, considerable changes have occurred in psychiatry, especially after 1992 when the law on psychiatric care and guarantees of citizens' rights in its provision was adopted. It became the ideological and legislative basis for reforms. However, there are definite obstacles to structural reforms in psychiatry. They are unfavourable technical conditions in many psychiatric clinics, hypercentralization of psychiatric services, shortage of clinical psychologists and social workers in psychiatry, some difficulties in cooperation between psychiatric and general medical institutions. Economic difficulties in the transition period of Russia's social development prevent the overcoming of these problems. They are being actively discussed and some of them are being gradually solved, e.g. the organization of team work in mental health services, the increasing number of specialists on social work, and the involvement of non-government organizations in psychosocial rehabilitation. © 2012 Institute of Psychiatry. Source

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