The aim of the work was to study the structure and dynamics of psychopathological symptoms among HIV-positive and HIV-negative patients with opiate addiction. Material and methods The survey was attended by 820 patients. We studied the parameters of the main psychopathological symptoms using a questionnaire SCL-90-R in the dynamics. The structure of psychopathology in patients with opiate addiction is presented. The changes psychopathological indicators of the state of the examined patients before and after complex rehabilitation, after 1, 3, 6 and 12 months from the start of observation are given. Results The findings suggest the presence of more severe psychopathology HIV-positive patients than HIV-negative patients with opiate addiction. It was found that the quantity indicators SCL-90-R in the examined patients, despite the positive trend at discharge significantly higher than in healthy individuals. Conclusion The results of the study indicate a lack of short-stage therapy to normalize the mental state of opiate addiction and the need to develop an algorithm of a long, corrected with the needs of patients, comprehensive rehabilitation programs.

Purpose: To identify factors influencing adherence to therapy in HIV-positive injecting drug users and offer a basic conceptual model aimed at improving adherence. Materials and Methods: Using the method of anonymous questionnaire to assess adherence to therapy in HIV-positive injecting drug users. Results: the factors that affect adherence to treatment, the study of which is necessary for the development of a conceptual model, which is the basis for the planned activities aimed at improving adherence to treatment in HIV-positive drug users. Summary: The individual and personal, health, social and organizational factors are involved in the structure of the conceptual model.

The purpose of research – the study of quality of life (QOL) of HIV-positive (HPN) and HIV-negative patients (HNN) with opiate addiction before and after treatment, at the stage of formation and stabilization of remission. To investigate the quality of life SF-36 questionnaire was used. It has been shown that HPN have lower QOL compared with HN. It was found that the value of QOL in HPN and HNN, despite their positive dynamics at the follow-up stage, is lower than in healthy individuals, indicating a failure of the basic course of therapy for the normalization of QOL and the need to develop tactics of HPN, providing the use of long-term integrated treatment and rehabilitation programs that address the needs of patients.

Purpose: to determine the nature of the impact of injecting drug use on cellular immunity and assessment of the importance of drug use as a factor contributing to HIV infection and aff ect the course of disease in HIV- positive patients. Materials and methods: surveyed 144 people - 109 patients with drug addiction, HIV infection and HIV - positive injecting drug users and 35 healthy individuals. Results: found that injecting drug potentiates caused by HIV infection decrease the percentage of helper cells ( CD4 + lymphocytes ), natural killer T (CD3 +16 +56 + lymphocytes), natural killer cells (CD3- 16 +56 + cells ), increased cytotoxic T lymphocytes (CD8 + lymphocytes), the proportion and absolute number of T- lymphocyte activation characteristics (CD3 + HLA-DR + cells). Summary: injecting drug use increases the risk of infection among injecting drug users (IDUs) without HIV, and decreases the antiviral response in HIV- positive patients, a statistically signifi cant potentiating caused by HIV in the blood decrease in helper cells, and natural killer T- natural, regulatory cells, immune hyperactivation that contributes to the progression of the disease.

The aim of the study was to investigate QL (the quality of life) in HIV-positive (ОDHIV+) and HIV-negative (ODHIV-) patients with opiate dependence before and after treatment at the stage of remission establishment and stabilization.SF-36 questionnaire was used to assess the quality of life in studied samples.ODHIV+ patients showed significantly lower QL level compared to ODHIV-patients.Despite of the positive dynamics of QL parameters after the treatment in ODHIV+ subjects, their values were still significantly lower than in healthy individuals at the stage of remission establishment and stabilization which indicates a failure of a basic therapy course to normalize QL in such patients and the need for correction of the existing management tactics regarding them with the use of a long-term complex program of treatment and rehabilitation.

Purpose: The research is devoted to working out and approbation of the scale for defining the level of desadaptation of patients with opioid dependence. Material and methods: The material under the investigation (264 subjects) shows high indices of validity-coordination, retest validity, convergence validity and the specific character of the methods undertaken. Results: The scale is an effective instrument in the objective assessment of the complex influence of interconnected factors, their role and informative character in the formation of desadaptation of patients with opioid dependence which influence the course and prediction of the disease. Summary: The scale for defining the level of desadaptation of patients with opioid dependence which allows diagnosing the level of their clinical and social functioning, defining the impact of various factors on the character and prediction of the disease, which makes it possible to determine the volume and direction of preventive, medical and organization measures.

Purpose: To identify factors influencing adherence to therapy in HIV-positive injecting drug users and offer a basic conceptual model aimed at improving adherence.Materials and Methods: Using the method of anonymous questionnaire to assess adherence to therapy in HIV-positive injecting drug users.Results: the factors that affect adherence to treatment, the study of which is necessary for the development of a conceptual model, which is the basis for the planned activities aimed at improving adherence to treatment in HIV-positive drug users.Summary: The individual and personal, health, social and organizational factors are involved in the structure of the conceptual model.

С целью определения особенностей клеточного иммунитета у ВИЧ-позитивных потребителей инъекционных наркотиков (ВПН) проведено обследование когорты из 37 ВПН, из них 19 (51,4 %) мужчин и 18 (48,6 %) женщин. Группа сравнения была представлена 49 ВИЧ-негативными наркозависимыми пациентами (ВНН), из них 23 (46,9 %) мужчины и 26 (53,1 %) женщин. Группу контроля (K) составили 19 здоровых лиц: 6 (31,5 %) мужчин и 13 (68,4 %) женщин без маркеров парентеральных вирусных гепатитов и ВИЧ-инфекции, в возрасте от 23 до 41 года, медиана (Me) - 24,0 года; нижняя квартиль (Q25) - 23,0 года; верхняя квартиль (Q75) - 34,0 года. Путь инфицирования установлен на основании детализации у ВПН эпидемиологического анамнеза. Для определения клинической стадии ВИЧ-инфекции использовалась классификация ВОЗ (2006). В результате исследования установлено, что изменения, выявленные у ВПН в клеточном составе периферической крови, характеризуются значительными нарушениями в клеточном звене иммунитета, в частности, снижением Т-хелперов (CD4+ клеток), естественных киллеров и Т-естественных киллеров (CD3-CD16+56+ и CD3+CD16+56+ клеток), В-лимфоцитов (CD19+ клеток) и регуляторных клеток СD4+25+ в сочетании с повышенным количеством Т-киллеров (CD8+ клеток) и активированных Т-лимфоцитов (CD3+HLA-DR+ клеток). Установление корреляционной зависимости между нарушениями в клеточном звене иммунитета и приемом наркотиков («стажем наркотизации» и возрастом пациентов) свидетельствует о наличии дополнительного, значительного по силе иммуносупрессорного эффекта наркотических веществ на состояние иммунореактивности ВИЧ-инфицированных потребителей наркотиков. Установление факта нарушений в клеточном звене иммунитета у ВНН патогенетически обосновывает необходимость мониторинга за иммунным статусом ПИН и проведения у них иммунокоррекции, так как потребители инъекционных наркотиков являются наиболее угрожаемой группой риска инфицирования ВИЧ.

A new method of estimation of immunoreactivity of the organism, based on determining the type of systemic reaction of the human organism is described. This method allows estimating general nonspecific and immune reactivity of the organism. Patients with chronic inflammatory diseases of the appendages of the uterus of Chlamydia etiology show derangement of immune reactivity of the organism, described by breaking neutrophil emigrations and expressed immune imbalance in the zone of inflammation.

The «life quality» index ofadolescents with psychoactive substances dependence has been evaluated. This index consists of nine factors characterizing personality and microsocial environment. It has been determined that in adolescents with psychoactive substances dependence the least satisfaction is in the social adaptation. The obtained data will help to develop differentiated rehabilitation programs for these patients.

The problems of affective disorders and dependence syndrome correlation are presented in the article. It is stated that the main treatment method of affective disorders in drug abusers is psychopharmacology. The methods depend on peculiarities ofthe disorders, patient's personality characteristics, his social and psychological status. The recommendations on treatment of affective disorders in the structure of dependence and withdrawal syndrome have been given.

In the International Classification of Diseases of the 10-th review the episodic paroxysmal anxiety is singled out as a separate form of nervous and mental disorders in the group Neurotic disorders, disorders connected with stress and somatoform disorders. Its main symptom are recurring attacks of severe anxiety (panic) also called panic attacks. The frequency of such disorders is rather high, unfortunately among children and adolescents as well. They have been described very little in literature and are almost absent in the infantile andjuvenile psychiatry and psychotherapy.