Objectives . To seek associations of the genetic polymorphisms rs6280 of the DRD3 gene, rs4680 of the COMT gene, and rs7322347 of the HTR2A gene with schizophrenia. Materials and methods . The cohort included 300 inpatients with paranoid schizophrenia. The healthy control group consisted of 290 subjects. Associations between polymorphisms and study groups were assessed by logistic regression. Results . The severity of positive symptoms on the PANSS in the patient cohort was 14.0 [11.0; 18.0] points, the severity of negative symptoms was 21.0 [17.0; 27.0] points, and severity of other symptoms was 33.0 [27.8; 38.0] points. A between-group difference ( p = 0.012) was found on comparison of the genotype for the rs7322347 polymorphism. The CC genotype of the rs6280 polymorphism was found to be associated with schizophrenia (OR 3.37 (1.50; 8.03)). The TT genotype of the rs7322347 polymorphism was associated with the control group (OR 1.83 (1.25; 2.68)). Conclusions . The analysis results confirmed the hypothesis that the genetic polymorphisms rs7322347 of the HTR2A gene ( p = 0.006) and rs6280 of the DRD3 gene ( p = 0.004) are associated with the disease. The hypothesis that there is a link between the rs4680 polymorphism of the COMT gene could not be confirmed.

The aim of the study was to develop a new valid psychometric diagnostic tool for a multi-factor social network assessment of schizophrenic patients, called «The structural assessment of the social network of schizophrenic patients». The new development is based on the social network analysis model elaborated by S. L. Phillips (1981) and translated into Russian by Gurovich I. Ya. et al. (2007). The authors of this article additionally developed an algorithm for assessing the activity of patients on social networks of the Internet. Reducing non-informative variables and conducting a confirmatory factor analysis in a sample of 265 observations of schizophrenic patients (F20.0) aged from 18 to 55, recruited in four medical organizations (145 patients admitted to the hospital and 55 outpatients), resulted in determining a four-factor structure of the patients’ social network: «Objective parameters», «Internet activity», «Emotional aspect of social support» and«Reciprocal support». The method has demonstrated high internal and external validity, as well as applicability in the clinical practice in schizophrenia due to the low resource consumption and compact applicability. Measurable factor indicators of the patients’ social networks obtained by using the structural assessment of the social network of schizophrenic patients allow to determine the targets for psychocorrectional interventions and to increase the effectiveness of psychosocial rehabilitation. In addition an automated method for calculating final indicators has been developed, as well as manual, practical recommendations and corresponding printed forms.

OBJECTIVE:To explore the relationship between the indicators of quality of life (QOL) and social functioning (SF) of patients with schizophrenia with clinical and socio-demographic characteristics, indicators of cognitive functions and the severity of disease symptoms, using mathematical modeling methods.MATERIAL AND METHODS:The sample consisted of 300 patients with paranoid schizophrenia (aged 18-50 years, disease duration at least 5 years; total PANSS score <120). Clinical-psychopathological, psychometric and mathematical methods were used. A mathematical model based on the construct developed by the authors called the «Disease Burden Factor» (Factor «B») was utilized.RESULTS AND CONCLUSION:Statistically significant correlations of factor "B" with age, the time of disease onset, seeking psychiatric help and diagnosis, the length of hospital admissions in the past 12 months and PANSS and BACS scores were established. Factor «B» clusters of «prosperous» and «dysfunctional» patients, significantly differing in the frequency of exacerbations of the disease, its total duration, and indicators of QOL-SM, PSP, PANSS, BACS, were distinguished. The conclusion about the reliability and sensitivity of a new toolbox - Factor «B» for exploring the mutual influence of heterogeneous factors affecting the trajectory of patients with schizophrenia was made.

The review is devoted to comparative analysis of antipsychotics of three generations. When writing the review, a systematic search in the databases PubMed, Medline, Elsevier was carried out, a simple filter for keywords was used. Pharmacological and clinical issues of antipsychotic therapy were considered, the mechanisms of action of antipsychotics of different generations were revealed. Current trends in the development of approaches to the therapy of schizophrenia and the concept of atypicality of antipsychotics were discussed. A comparative analysis of indications for use, tolerance (safety of use) and efficacy of various antipsychotic drugs with an emphasis on the effect on negative (primary, persistent) symptoms has been conducted. The hypothesis underlying new approaches to the therapy of schizophrenia, based on the effect on dopamine autoreceptors, consisting of a high density of D2 and low density of D3 receptors, has been presented. It has been shown that antipsychotics of the third generation open up new possibilities in the therapy of psychosis within the framework of a personalized approach in psychiatry with the achievement of functional recovery of patients. The characteristics of the drugs representatives of the third generation of antipsychotics aripiprazole and cariprazine were given. The uniqueness of cariprazine as the only drug that inhibits D3 receptors in vitro, as well as in vivo in patients with schizophrenia was emphasized. The data of evidence-based studies of the effectiveness of cariprazine in the treatment of negative, including predominant negative symptoms were presented.

Nowadays, the regional psychiatric service is a main structured part of the mental health care system in Russia. The development of psychiatric service at the present stage is intended to contribute meaningfully to achievement of the goals of National projects:»Health Care» and «Demography». At the same time, abilities of Russian psychiatric service in mental health protection field are limited. Today, psychiatric service is lacking resources for social assistance for the patients, is unable to do psychoprophylactic and psychohygienic work, including work for vulnerable groups. At the present time, the development of the Russian mental health protection system is widely discussed among experts.The draft of the Regional mental health care system development plan that is proposed by the authors of the article has been designed according to the characteristics of St. Petersburg, the region of the Russian Federation. The European mental health action plan (The Plan of the WHO) served as the basis for development of the thesis. The document contains a preamble, a main objectives section, a conclusion and an appendix. The justification for the development of the mental health care, based on the adapted provisions of the Plan of the WHO, domestic approaches and other informational materials, is provided in the preamble. The next section contains 4 objectives that are the most relevant for the region. Each objective has a plan of the key activities with a clarification regarding which otganisations are responsible for executing it. The activities are summarised in tables and are presented in the appendix. The material is published in reduced form.

The purpose of this work is to analyze the similarities and differences in the clinical and psychosocial indicators of men and women with paranoid schizophrenia. In the course of the study, socio-demographic, psychosocial and clinical indicators were studied. In terms of outcome, women showed worse social and cognitive functioning than men. In men, significant correlations were established between social functioning and passport age, duration of illness, number of hospitalizations, length of hospitalizations, negative symptoms and quality of life; in women — with passport age, negative symptoms, quality of life, and cognitive indicator. Logit-regression analysis showed that gender is more associated with social functioning, but not with cognitive indicator and quality of life.

Metacognitive functioning is the basis of the individual’s ideas about his ability to build relationships with other people and manage own’s social behavior. Deterioration of metacognitive functioning in schizophrenia patients, presumably due to neurocognitive deficiency and other manifestations of the disease, probably contributes to disruptions of social functioning and quality of life. The aim of this study was to assess the metacognitive functioning (MF) of patients with paranoid schizophrenia, operationalized as a cognitive ability to understand their own and other people’s emotions, and to explore the connection between social functioning (SF) and quality of life (QOL), as well as to establish logical relationships between MF with clinical indicators and socio-demographic characteristics of patients. In a sample of 300 patients with paranoid schizophrenia (age from 18 to 50 years, disease duration of at least 5 years, a total PANSS score of less than 120), MF was assessed using the Lyusin emotional intelligence test (EmIn) and the subjective assessment of interpersonal relationships (SOMO) test. Cognitive deficit was verified using a standardized battery of a Brief Assessment of Cognition in Schizophrenia (BACS). The indicators obtained using the quality of life questionnaire for schizophrenia patients (QOL-SM) and the social functioning scale (PSP) were used to create an integrated indicator that comprehensively assesses SF and QOL of schizophrenia patients (Factor B). Reliable associations of this factor with indicators obtained using the Emin method (p<0.05), SOMO (p<0.001), the PSP scale, the QOL-SM questionnaire, the BACS and PANSS scales, and also with a number of clinical-dynamic and socio-demographic characteristics were established. Significant relationships between the parameters of MF, SF and QOL were obtained, and logical relationships between MF, neurocognitive deficiency and other clinical manifestations of schizophrenia were established.

The aim of the work was to study the clinical and psychosocial characteristics of patients with paranoid schizophrenia who are under the supervision of a psycho-neurological dispensary, and to determine the predictors of the prediction rate of hospitalizations. The study examined the socio-demographic, psychosocial and clinical indicators included in a specially developed formalized map. After the correlation analysis performed using the logistic regression method, the parameters, the values of which make it possible to predict the hospitalization rate, were determined. It has been established that it is possible to assume frequent hospitalizations in patients with a severe mental state, determined by the general clinical impression scale, a history of more than 20 previous hospitalizations, the absence of a specific place of residence, the lack of communication with other people, the absence of a family, more than 4-5 appointments made to a hospital in 5 years, and the absence of a job in the last 10 years.

The review presents and analyzes literature data on the influence of environmental pathoplastic factors on the course of the schizophrenic process. One of the most promising areas is the study of social factors. Their interaction with the biological and psychological characteristics of patients is reflected on the nature of psychopathological manifestations and their dynamics. Social functioning also depends on socio-economic changes. A number of authors come to the conclusion that a significant part of the dispensary contingent of mentally ill persons reveals shortcomings of social functioning practically in all spheres of life: labor, family, material and household, as well as social contacts. The review shows that the best personal and social functioning was observed in patients who had family support, permanent employment, the absence of other family members with mental disorders, and treatment in a day hospital. At the same time, many questions remain insufficiently clarified. In particular, this relates to the correlation of psychosocial indicators in various spheres of life activity, features of social functioning at patients with rare hospitalizations and gender peculiarities. These questions determine the trajectory of further research.

The analysis of the organization of mental health services to patients of a multi-profile hospital from 2009 for 2015 is provided. The cliniсo-epidemiological analysis of prevalence, structure of mental pathology among the patients hospitalized in somatopsychiatric department and the center of treatment of sharp poisonings of a multi-profile hospital is carried out. The annual average percent of people who need the mental health services constituted 3.39±0.16% of a total quantity of the patients and victims who are on treatment. The efficiency of use of bed fund of somatopsychiatric department for the long-term period is shown. The considerable prevalence of patients with the organic mental disturbances, frustration connected with acceptance of psychoactive agents, neurotic and somatoform disorders in general structure of mental pathology is established.

The aim of this study is to identify psychosocial characteristics of older people who attempted suicide by self-poisoning. A total of 44 older people with suicide attempts by self-poisoning was examined, 12 of whom were male and 32 were female, their average age was 71,9+10,8. The comparison group consisted of 53 young people - 19 males and 34 females, their average age was 26,6+4,4. In both groups dominated deliberate self-poisoning with antiepileptic, sedative, soporific, Antiparkinson and psychotropic drugs (40,9 % vs 47,2 %, p>0,05). Amongst older people number of those who engaged in deliberate self-poisoning with drugs affecting the autonomic nervous system (25 % vs 9,4 %, p<0,05) was significantly higher. Compared with younger adults, older adults are more likely to commit a suicide attempt with serious intentions to complete suicide (62,5 % vs 24,5 %, p<0,05). There is a positive statistically significant correlation between the factor of «suicide attempt with serious intentions» and factors «loneliness» (Y=0,68), «severe physical illness» (Y=0,58) and «constant pain» (Y=0, 60).

Aim. Multi-level evaluation by case-control method of social, sociocultural and behavioural risk factors of HIV-infection spread among male migrant workers arriving to Russia from near abroad countries. Materials and methods. Interviews of migrants, that had appealed for medical examination for work permit, were carried out for detection of risk factors. Results of interviewing of 191 migrants with HIV-infection (case group) and 190 migrants without HIV-infection (control group) were analyzed. Methods of descriptive statistics and logistical regression were used for the analysis. Results. Factors, related to dangerous sexual behavior, were leading in development of HIV-infection. Furthermore, HIV-infected migrants had inferior work and accommodation conditions, lower salary, lower subjective health evaluation, became object of xenophobia more frequently and had more previous travels into the receiving country. Factors, that reduce risk of infection and spread of HIV-infection, were detected: HIV-infection awareness, adherence to religion and legal requirements of the receiving country. Advantages and disadvantages of surveying during detection of HIV-infection risk factors are discussed. Conclusion. The same risk factors of HIV-infection spread are significant in the population of migrant workers as in the indigenous population. Factors specific for migrants, that facilitate infection spread, were also established. HIV prophylaxis system among migrants should be based on prevention and correction of risk factors detected in the study and enhancement of factors, that cause preventive effect.

This article observes the problem of the dependence between suicidal behavior and religiousness. Conclusion is based on analyzing of the different religions texts, researches of suicides made by the people of different confessions. Authors suppose that the religion as Judaism, Christianity, Islam, have the most important role in the reduction suicidal risk in opposition to the East Religion. Necessary condition is the active practice of this religions.

In the present work we studied suicidologist, substance abuse and experimentally-psychological specifications spouses from families where the husband suffers from alcohol addiction, formed and functioning in the framework of models with initially closed family system. It is shown that spouses in such marriages, in respect to these characteristics, represent the most typical, "average" cut both in dependent and codependent groups. They form the vast majority, the most familiar to clinicians, autoaggressive specifications alcoholic families in General. The study assessed the representation of self-destructive patterns, demonstrated suicidological, substance abuse and psychological characteristics of the spouses. It is crucial to conduct differentiated preventional work, a probabilistic evaluation of the potential autoaggressive responses in the dependent-codependent dyad and implementation of effective and highly individualised therapeutic measures as dependent and codependent links.

Objective. To study indicators of treatment of schizophrenia in different stages of psychiatric care, to reveal prognostic factors of the dynamics of psychopathological symptoms in treatment of schizophrenia and to estimate the risk of schizophrenia relapse. Material and methods. Three hundreds of patients, aged 18-65 years, diagnosed with schizophrenia (ICD-10) were included in data analysis. Patients were stratified into 4 groups by the type of psychiatric care: inpatients (n=68), outpatients of day hospital (n=71), outpatients of psychoneurological dispensary rehabilitation department (n=75) and outpatients supervised by psychoneurological dispensary local doctor. Treatment characteristics (use of 1st and 2nd generation antipsychotics) of these groups were compared. Results and conclusion. The positive effect of modern antipsychotics on schizophrenia course, frequency of relapses and hospitalizations was identified. The results can help in improvement of psychiatric care due to wide implementation of 2nd generation antipsychotics.

Introduction Suicidal rating Russia is one of the highest in the world. Only few publications are devoted to psychopathological characteristics of suicide subjects in emergency hospital. Objectives Clinical characteristics of emergency hospital patients with suicide attempts were studied. Methods Interview together with specially elaborated formalized card were used. Patients were diagnosed up to ICD-10 criteria. 970 patients (320 male, 650 female; mean age - 40±16) hospitalized to I.I. Dzhanelidze Institute of Emergency Medical Care (St. Petersburg) in 2011 due to the suicide attempt were investigated. Results The majority of patients were diagnosed as anxiety disorders (35,5%) and substance use disorders (SUD) (30,8%). Affective disorders (F30-F39) were diagnosed in 90 (9,3%), and schizophrenia in 4,1% cases. Self-poisoning was found the absolutely preponderant (87,1%) suicide mode. Chemical substances were used in 3,7%, psychoactive drugs in 2,1%, other medical products in 81,3%. Blood alcohol level higher than 1 ‰ was found in 45,2% patients. Suicidal patients have demonstrated low psychosocial level. Fulltime employment and permanent income was only in 20,8%. The first hospital care was carried out by resuscitators, surgeons, toxicologists, etc. After their recommendations patients were consulted by psychiatrist or psychotherapist. Outcomes 70,2% were discharged, in 13,6% out-patient psychiatrist supervision was recommended, 10,4% were transferred to psychiatric hospital, 5,8% died. Conclusions The majority of suicidal patients in emergency hospital have anxiety disorders or SUD and used self-poisoning mode. Alcohol as a provoking factor was found in nearly half of subjects.

Analysis of different aspects of application of extracorporeal hemocorrection (EH) in psychiatric practice allows to make a conclusion about the necessity of a differential approach to the use of isolated and combined procedures. The latter were assessed by the results of combined treatment of 226 patients. Indications and contra-indications for EH use in psychiatric practice are outlined.

544 patients resistant to pharmacotherapy were treated by different methods of extracorporal hemocorrection (EH). Positive changes in mental state were achieved in more than half of the patients by means of EH without any psychopharmacologic drugs. These changes were caused by antipsychotic and antidepressive effects of EH as well as by its ability to normalize biochemical, immunological and rheological blood indices

544 patients resistant to pharmacotherapy were treated by different methods of extracorporal hemocorrection (EH). Positive changes in mental state were achieved in more than half of the patients by means of EH without any psychopharmacologic drugs. These changes were caused by antipsychotic and antidepressive effects of EH as well as by its ability to normalize biochemical, immunological and rheological blood indices.