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Objective: To create a new taxonomy of schizophrenia spectrum disorders (SSD) based on the comparability of the design of SSD and borderline states., Material and Methods: The total sample consists of 205 patients with an established diagnosis of SSD (F21; F25; F22 according to ICD-10) collected from studies of the department of borderline mental pathology and psychosomatic disorders of the Federal State Budgetary Institution Mental Health Research Center and the Department of Psychiatry and Psychosomatics of Moscow State Medical University in the period 2014 to 2024. Clinical, psychometric, statistical methods were used., Results: A new two-level model of schizotypal personality disorder (STPD) has been developed: the first level is psychopathic-like disorders of the «Ferschroben» type; the second level are psychopathological disorders (positive, negative, etc.), appearing under their «mask», constituting a «tracing paper» of manifestations of schizophrenia «in miniature». The two-level psychopathological model of STPD is a complex clinical phenotype, including independent but overlapping phenotypic formations: psychopathic-like - the «Ferschroben» type; and basic - schizophreniform disorders., Conclusion: The clinical classification of schizophrenia spectrum disorders has been developed; pseudoneuroses and stress-induced disorders of the endogenous circle are considered in the aspect of the dynamics of STPD.

Objective: To evaluate the effect of discontinuation or prolongation of DMT on the activity of the disease during pregnancy and in the postpartum period in patients with aggressive MS from the Moscow region., Material and Methods: The study included female patients with an aggressive course of MS receiving DMT at the time of pregnancy. The patients were followed-up for the period 2016 to February 2024., Results: There were 17 cases of pregnancy during natalizumab (NZ) therapy; discontinuation of therapy in the first trimester of pregnancy provoked a resumption of disease activity in half of the patients. There were no exacerbations in patients whose therapy was prolonged until the 34th week of pregnancy. In 5 patients receiving fingolimod (FGL), therapy was discontinued upon the establishment of pregnancy, which caused the resumption of disease activity in three out of 5 cases. In 3 patients receiving anti-B-cell therapy, pregnancy occurred within a few months after the next infusion, there were no exacerbations during pregnancy., Conclusion: The cancellation of NS therapy in the early stages of pregnancy in most cases leads to the resumption of disease activity during pregnancy. Exacerbations in the postpartum period also correlated with early discontinuation of therapy and with a long period before the restart of infusions. Prolongation of infusions to 30-34 weeks of pregnancy contributed to stabilization of the condition throughout the perinatal period. Discontinuation of FGL therapy at the onset of pregnancy increased the risk of repeated relapses of the disease, up to the development of inflammatory immune restoration syndrome during pregnancy and contributed to the increase in disability in the postpartum period.

Objective: To identify the association between cerebrovascular diseases (CVD) and multiple sclerosis (MS) among patients over 50 years old in two independent populations of Moscow and Tyumen., Material and Methods: The study included 94 patients with MS in combination with CVD (main group) and 90 age-and sex-matched patients with MS without a vascular history (comparison group). An analysis of parameters such as disease duration, EDSS at different time points, disease progression index, duration of first remission in each population separately and in both populations together was carried out., Results: The presence of CVD in patients with MS was associated with the presence of other diseases that are associated with an increased risk of developing cerebrovascular pathology. In the main group, there was a statistically significant decrease in the duration of the first remission and an increase in the disease progression index. In addition, other diseases and syndromes were identified in the main group that, in combination with CVD in patients with MS, could lead to a worsening of the course of MS. These included arterial hypertension, diabetes mellitus, obesity, dyslipidemia, chronic venous insufficiency, and regular use of proton pump inhibitors., Conclusion: Comorbid vascular pathology can affect the severity of MS from the very beginning of the disease. It can lead to a shorter duration of the first remission and a higher disease progression index, increasing the degree of disability. The combination of autoimmune-inflammatory, demyelinating, and vascular processes can worsen the prognosis for MS.

Dementia is one of the main challenges to modern society. According to estimated data, as of 2019, there were 1.949.811 people living In Russia with dementia of various etiology. At the same time, there have been no large epidemiological studies of dementia in the Russian Federation. The article provides an overview of the available data on the epidemiology of cognitive impairment (CI) In Russia given from various sources. Not only estimated, but also available clinical data were analyzed. In general, the obtained prevalence values for CI are comparable to global values. Thus, in an epidemiological study of people over 60 years of age in a separate district of Moscow, the prevalence of dementia was 10.4%, Alzheimer's disease 4.5%. A study of outpatients aged 60 years and older showed a high prevalence of both dementia and non-dementia CI at general medical appointments (incidence of dementia 7.8%, MCI 49.6%). It has been shown that the problem of non-dementia CI is already relevant in people of pre-retirement age (the prevalence of non-dementia CI in patients 55-64 years old is 36.8-44.8%). Unique data obtained in a population of institutionalized centenarians (prevalence of dementia 69%), as well as data on the relationship of CI with both somatic and demographic factors are presented.

Objective: To analyze the work of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents, operating on the basis of the Morozov Children's City Clinical Hospital of the Moscow Health Department for the period 2018-2021 and to assess the peculiarities of organizing the provision of specialized care to children and adolescents with acute cerebrovascular accident (ACA)., Material and Methods: Annual reports of the Center for the period 2018-2021; included children and adolescents aged 1 month to 17 years 11 months 29 days, with new onset ischemic stroke (IS) and hemorrhagic stroke (HS), cerebral venous thrombosis (sinus thrombosis), confirmed clinically and radiologically., Results: Statistical data on stroke and organization of care for children with this pathology in Moscow are presented. The incidence of IS in Moscow for the period 2018-2021 ranged from 1.6 to 2.5 per 100.000 children, HI - from 2.35 to 3.3 per 100.000, sinus thrombosis from 0.5 to 1.38 per 100.000. When assessing the main etiological factors of stroke in The Center for International Pediatric Stroke Research categories, we noted a prevalence of chronic head and neck diseases (20-37%) and chronic systemic conditions (conditions or diseases with known changes in coagulation or vascular structure, including connective tissue dysplasia, genetic, hematological, inflammatory or diseases of the immune system) (15-20%). In addition, data on reperfusion therapy carried out at the Center are presented. From 2018 (first thrombolysis was performed) to 2021, 7.3-14.7% of all patients with IS underwent thrombolysis., Conclusion: The experience of functioning of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents has shown that the creation of such centers in the regions of the Russian Federation is relevant, but requires taking into account the characteristics of the pediatric population when organizing their work.

Objective: To study the features of the formation of gender reassignment`s ideas in schizophrenia spectrum disorders and to differentiate diagnosis of these psychopathological formations with transsexualism., Material and Methods: The study was carried out in the Department of Sexology and Therapy of Sexual Dysfunctions of the Moscow Research Institute of Psychiatry - a branch of the Serbsky National Medical Research Center for Psychiatry and Narcology in the period from October 2018 to May 2020. The study included 100 outpatients referred for gender reassignment. The subjects were divided into two groups. The first group consisted of 58 patients with schizophrenia spectrum disorders (Paranoid schizophrenia, F20.0; Schizotypal disorder, F21; Chronic delusional disorders, F22) with ideas of sex change. The second group included 42 patients with a diagnosis of «Transsexualism» (F64.0). Clinical-psychopathological, pathopsychological and statistical methods were used., Results: Patients with transsexualism are statistically significantly more often adapted in terms of work and family, have experience of life in the desired gender, use hormone therapy and gender-affirmative interventions before undergoing a medical commission on gender reassignment and less often hospitalized in psychiatric hospitals, compared to patients with schizophrenia spectrum disorders ( p <0.05). Patients with schizophrenia are more likely to experience delays and disharmony in psychosexual development. Sex reassignment ideas are more common in schizotypal disorder than in other types of schizophrenia., Conclusion: Ideas of gender reassignment in schizophrenia spectrum disorders, as a rule, are formed on the basis of existing deviations in the early stages of the formation of gender identity. The central place in the psychopathology of schizophrenia spectrum disorders with ideas of gender reassignment is occupied by depersonalization-dysmorphophobic experiences with the following formation of overvalued, delusional or paranoid ideas of sex reassignment.

Objective: To study the prevalence of somatic diseases in patients with mental disorders based on the results of medical examination in Moscow mental health clinics in 2018., Material and Methods: A retrospective analysis of the results of the clinical examinations of 6492 outpatients, which accounted for 79.5% of patients who underwent medical examination in this time period., Results: Comorbid somatic diseases were found in 4883 (75%) patients. Hypertension and non-insulin-dependent diabetes mellitus were most frequent with the prevalence higher than in the general population of the Russian Federation. Patients with diagnosed schizophrenia, along with hypertension and diabetes mellitus, have found to be at increased risk of diseases of the endocrine system and metabolic disorders. The incidence of the mentioned diseases is not higher than that reported in literature., Conclusion: The higher prevalence of socially relevant diseases (hypertension, diabetes mellitus) among patients with mental disorders demands the development of strategies for prevention, early detection and treatment of these diseases in psychiatric patients.

Objective: The article presents an analysis of pre-hospital diagnosis of stroke in children., Material and Methods: Pediatric Stroke Center of Morozov Children's City Clinical Hospital (Center) for the period from October 2018 to December 2019, 502 cases of hospitalization of children by the First aid Station to the Center with directing diagnoses of ischemic stroke (IS), haemorrhagic stroke (HS), transient ischemic attack (TIA), vertebrobasilar syndrome (VBS) were analysed., Results and Conclusion: TIA was the most prevalent diagnosis made by the First aid station, with the lowest rate of confirmation after further examination in the hospital (7.8%). The higher rates of confirmation were observed for VBS (31.5%), IS (11.2%) and HI (9.1%). The so-called «masks of stroke» were diagnosed in 84.3% cases of hospitalizations that was in line with earlier studies, which reported 50 to 93%. Based on the data on the frequency of symptoms, their combinations and specificity, a screening scale for pre-hospital diagnosis of stroke in children was suggested.

Aim: To analyze the clinical and social outcomes of organic mental disorders (OMD), diagnosed in children and teens; establish the factors that are relevant for the formation of the clinical picture of OMD in different sexes; the circumstances that determine the dynamics of remote OMD and the level of social adaptation of patients in adulthood., Material and Methods: Four hundred and ninety-eight children with organic mental disorders were followed-up in one of neuropsychiatric outpatient clinics of Moscow, until they reached 23-25 years of age. The total duration of observation was from 7.5 to 22 years (M±σ: 17.3±3.5 years). Clinical-psychopathological and follow-up methods were used. To assess social functioning of patients, a form for recording social skills of adolescents and a questionnaire for assessment of social functioning and quality of life were used., Results and Conclusion: In 82% of patients, OMD reduced by the time of adulthood. Disorders with severe intellectual impairment, paroxysmal disorders, psychopathic syndrome, mixed forms of the disease were the causes of a lifelong disability in 3.6% of cases.

Aim: To analyze the characteristics of suicidal behavior, which was the reason of urgent admission to the psychiatric hospital, in adolescents., Material and Methods: Clinical and psychopathological analysis was performed for 143 adolescents, 55 boys and 88 girls, aged 15-17 years, admitted to a Moscow psychiatric hospital due to suicidal behavior., Results and Conclusion: Among all hospitalized on medical emergencies suicidal behavior was identified in 42%, repeated suicidal attempts were in 27% of boys and in 47% of girls. Mental disorders on admission and in the past history were found in 75%; 25% of the patients received psychiatric examination and treatment. Personality disorders and adaptation disorders were most prevalent; schizophrenia spectrum disorders made up 13%. Common features of suicidal behavior in adolescents were: the use of low fatal methods, mild expression of antivital feelings, short duration of pre-suicidal stage, suddenness of commitment of suicidal actions, an additional stressful event (conflict situation) for the development of suicidal behavior. Significant differences in the methods of realization of suicidal intentions, preferable character of suicidal behavior (blackmailing/demonstrative in girls, brutal and compulsive in boys) and typology of psychopathological symptoms were established.

Aim: To optimize a system of medical care, introduction of treatment and diagnostic guidelines, including secondary stroke prevention and rehabilitation measures, by implementation of pediatric stroke registry., Material and Methods: Fifty-seven patients, aged from 1 year to 17 years 11 months, included into the Moscow city registry of pediatric stroke were examined. Forty-two patients suffered ischemic stroke and 15 hemorrhagic stroke., Results and Conclusion: The diagnostic search for the causes of pediatric stroke is difficult due to the wide variety of etiologic factors and high frequency of their combinations. This confirms the necessity of multidisciplinary approach to the management of children and adolescents in the acute phase of stroke in a multiprofile hospital with the following specialized ambulatory care.

Objective: To identify people at high risk of endogenous psychosis in patients of juvenile age with nonpsychotic mental disorders., Material and Methods: Authors examine 49 patients of juvenile age with symptoms of nonpsychotic mental disorders (ICD-10 diagnoses of mood disorder, personality disorder or schizotypal disorder)., Results: In all cases, symptoms related to signs of the premorbid stage of endogenous psychosis (schizophrenia and schizoaffective psychosis) were identified. After psychopharmacological treatment, an incomplete (<30%) reduction of psychopathological disorders recorded at admission was found in 24.5% of patients. Based on the response of patients to treatment, family history (having a first-degree relative with psychosis) and the diagnosis of mental disorder, it was singled out "high-risk" (20.4% patients) and "ultra-high risk" (18.4%) states for psychosis., Conclusion: In light of these findings, the necessity of a longitude prospective study of these patients and pharmacological interventions in outpatient conditions is discussed.

Objective: Until now the problem of the typical age of schizophrenia onset has been actively discussing in the world literature. Though there are more and more publications, which mention the growth in the number of cases with late-onset and very-late-onset of the disease, a conviction that schizophrenia is the illness of teenagers or young people is still exists. Author aimed to determine a preferable age of the onset of schizophrenia., Material and Methods: Data obtained in multi-year epidemiological research in Mental Health Research Center (Moscow) were analized. The total number of patients with schizophrenia and spectrum disorders was 5486. A subgroup of the patients with the diagnosis that met the current diagnostic criteria of schizophrenia included 1108 people. The study was based on clinical-epidemiological and statistical methods., Results: Most of patients had early onset schizophrenia (16-20 years old maximum). However, it mostly depended on demographic factors, because more than half of patients were young or middle aged at the moment of the examination. The examination of the group aged over 60 years and those who conditionally belonged to this generation (if 100% would have lived to that age) showed that the maximum number of patients had onset between 30-40 years old., Conclusion: This research demonstrates the essential predominance of cases with onset of the disease in adolescent and young age that may be rather related with demographic characteristics than pathogenetic mechanisms of schizophrenia. The latter determine predominantly middle age of disease onset (30-40 years). Cases both with early and late onset of the disease are not rare and are random deviations from the mean valuation.

The diagnosis of multiple sclerosis in children and adolescence should be differentiated from a group of rare white matter diseases, with fuzzy diagnostic criteria. Some of these conditions require modern diagnostic techniques and wide knowledge of the doctor. The Moscow Division for treatment of children and adolescents with multiple sclerosis is a specialized advisory structure, which has specialists with experience in the differential diagnosis of multiple sclerosis with pediatric onset. The emphasis on the clinical aspects in differential diagnosis of early onset multiple sclerosis can reduce the time for the diagnosis and help to avoid diagnostic mistakes.

The epidemiological study of multiple sclerosis (MS) has been done in the population (927 400 people) of the North-Western Administrative District (SZAO) of Moscow for the period of 2008-2012. In average for the 5 years the prevalence of MS was amounted to 53.38 cases per 100 000 population, incidence was 2.16 cases per 100 000 population and the mortality rate was 0.23 cases per 100 000 population. Thus, the population of SZAO belongs to high-incidence area. An increase in the prevalence of MS as well as a reduction of incidence and mortality were observed during a comparative analysis with the epidemiological indicators of MS in Moscow in the period of 1991-1996. Such dynamics of epidemiological indicators is due to the accumulation of patients in population that, in the first place, is related with the quality improvement of diagnostic and therapeutic-rehabilitative measures which increased the frequency of early diagnosis and patient's life expectancy together with the implementation of disease-modifying therapy (DMT) and modern methods of symptomatic treatment.

Neurological diseases, mental disorders and inherited developmental abnormalities held a prominent place in the structure of primary children disability. Children cerebral palsy is the main cause of children disability, its prevalence reaching 2-3.5 cases per 1000 children. This disease has the noticeable negative consequences (both clinical and economic). Adherence to treatment means patient's compliance with doctor's orders including taking medicines as prescribed, sticking to diet and changing life style habits. While the adult patient plays an active role in doctor-patient alliance, the child patient interacts with the doctor together with his/her family. The authors consider the effect of different factors on the adherence basing on the analysis of 270 questionnaires completed by persons involved in the treatment of minor patients.

Fifty-eight patients, 13 girls and 45 boys, with early-onset schizophrenia (mean 5.4 years) were followed up for 9.5 years. The men age at end point was 19.7 years. Full remission or recovery was not identified in any of the patients. The partial remission was observed in 14 (24%) patients and 44 (76%) patients had chronic course without remissions. Two thirds of patients were disabled including 9 patients with severe, 25 patients with moderate and 1 patient with mild disability. Most of the patients (62%) became disabled in childhood. Fourteen patients need the constant care and control from caregivers; 24 patients were able to work in special conditions, 20 patients can live independently and support themselves; 57 patients lived with parents and 1 patient was married. It has been concluded that notwithstanding the intensive psychopharmacotherapy and rehabilitative programs, patients with early-onset schizophrenia show poor outcomes. Therefore, new social-therapeutic approaches for providing care to these patients are needed.

Data on the prevalence and features of cognitive impairment in patients with rheumatoid arthritis (RA) are presented. Cognitive impairment was noted in 66% of patients, it did not reach the threshold of dementia and met the diagnostic criteria for moderate cognitive impairment. Anxiety-depressive spectrum disorders were found in 94% patients. Cognitive impairment was associated with apathic affect and anxiety-depressive spectrum disorders (depressive episodes, dysthymia, and elevated anxiety). The impairment of thinking was correlated with the high to moderate inflammatory activity including non-joint RA symptoms, higher levels of proinflammatory cytokines and low doses of glucocorticoids. Cognitive impairment was not associated with the duration and character of standard treatment of RA and concomitant cardiovascular diseases.

According to the questionnaire results, high smoking rates among medical doctors working in Moscow drug-addiction out-patient clinics were identified: 78% of males and 42% of females smoke or used to smoke. The long duration and high intensity of smoking were noted. Interestingly, a large number of smoking doctors (36% of men and 43% of women) do not want to quit smoking. Smoking addiction medicine specialists pay far less attention to prevention and treatment of tobacco dependence in their patients.

We studied SNP41 (rs152312) and SNP87 (rs2910829) of the PDE4D gene in 577 stroke patients and 270 healthy controls. The significant differences in the distribution of genotype and allele frequencies of the SNP41 between patients and controls were revealed. Genotypes AA and AG were associated with the higher risk of stroke in the Moscow population (OR 1,6). No association between SNP87 and stroke was found.

Parents and teachers of 342 school children, aged from 7 to 11 years, were questioned with the <> (SDQ) using non-randomized method. The following comparative analysis of SDQ items measured in parents and teachers of children with ADHD and age-matched controls was carried out. It has been shown that the spectrum of disturbances characteristic of ADHD is not confined only to main symptoms of ADHD. The results of questionnaire of both parents and teachers indicated the marked intensity of emotional disturbances, behavioral problems and difficulties in interactions with peers as well as the underdevelopment of social trends in behavior in children with ADHD compared to the controls. The data obtained confirm the necessity of treatment extension beyond the core symptoms with considering more general parameters of the patients quality of life.

Three hundreds and forty children with borderline mental disorders (BMD) experiencing difficulties in learning have been studied. The typology of BMD has been elaborated and the types have been specified as follows: disontogenetic, with cerebral alteration and deprived. In accordance to these types, the differentiated modules of corrective and rehabilitative programs have been singled out. The elaborated technology of corrective and rehabilitative work of specialists in educational institutions of compensative character allows to optimize the transition of children with BMB to a common educational setting.

An analysis of 650 patients (350 female and 300 male, mean age 70.7 +/- 8.1 years) with ischemic stroke on the background of arterial hypertension and cerebral atherosclerosis revealed that secondary ischemic stroke occurred in 25% of all the cases with lethality 1.5 times higher than in the initial stroke and more severe disability. Follow-up study of 50 patients with secondary stroke on the background of arterial hypertension during 1 year and 8 months showed high rates of stroke (28%) and cardiac infarction (8%) and mortality in both diseases of 22%. In the subgroup of patients, receiving regularly antihypertensive and antithrombotic medications, morbidity and mortality of ischemic stroke and cardiac infarction were significantly lower then in the subgroup without the regular treatment. A regular intake of antihypertensive and antithrombotic medications was considered as a favorable prognostic factor of the disease course. Follow-up (mean 1 year and 1 month) of 90 primary ischemic stroke survivors with arterial hypertension demonstrated significantly lower incidence of secondary stroke (8.8%) and mortality (2.2%). Cases of cardiac infarctions were not observed. Most of the patients began a regular intake of antihypertensive and antithrombotic drugs after physician's secondary consultations and explanations of regular treatment necessity. In rehabilitative centers, patients stick to regular treatment more often.

Analysis of the incidence of alcoholic psychoses in Moscow in 1982-1993 revealed a considerable increase of their number during the period from March till July-August and a decrease by October-November. It was found that such increase resulted from low-concentration atmospheric oxygen in spring-summer period. Hypoxia as a factor provoking alcoholic psychosis is responsible for 10-12% of the cases. The highest sensitivity to hypoxia occurred in the last days of the abuse.

Simultaneous study of both external and hereditary risk factors of the development of multiple sclerosis (MS) was carried out in Moscow population. As a result of the genotyping of HLA-DR locus on the chromosome 6, there were found markers of the predisposition to MS: by HLA-DR: DR2(15) way, especially, in homozygous heredity and in the absence of such specificity--alleles of DR3 group. The data were confirmed concerning both the elevation of frequency of the alleles of tumor necrosis factor (TNF)a1 and alpha 2 and the decrease of frequency of TNF-alpha 7 allele in MS. There was also confirmed association of the disease with the external factors, such as "predominance of the meat nutrition at the age under 15 years" and "tonsillitis at the age under 15 years". There were two combinations of the external and hereditary factors, when the power of the association increased significantly: "predominance of meat nutrition at the age under 15 years" and DR2(15) and "tonsillitis at the age under 15 years" and DR3. When genetic factors were excluded, the relation of MS with the external factors was considerably reduced; when the external factors were excluded, the association of MS with genetic markers became statistically insignificant. A combination of these external factors, which were the sources for the additional antigenic immunostimulation, with certain genetic factors in DR region suggested the presence of the genetically determined peculiarities of the composition of antigen presentation HLA-DR in the individuals with DR2(15) and DR3. There was no statistically confirmed presence of a combination of the external factors with TNF-alpha alleles which increased additionally MS risk. The presence of immunostimulating antigen-containing external factors may be significant for the influence of TNF-alpha in less degree than for the realization of predisposition in form of the certain composition of HLA molecules.

Descriptive epidemiologic investigations revealed the necessity of the exogenous influence for the development of multiple sclerosis (MS). By means of "case-control" method the relations of MS with exogenous factors were studied. On the first stage there were analysed questionnaire data on 250 "patient-control" pairs matched by age, sex, nationality and birth in Moscow or out of it. The questionnaire was elaborated on the basis of the epidemiologic one recommended for the epidemiologic studies in the countries of South-East Europe. Significant correlations were found between MS and exogenous factors, namely: "tonsillitis at the age under 15 years" and "predominance of meat in the diet at the age under 15 years". These associations were confirmed by the data of both stratificative, discriminative analysis and logic regression. More detailed questionnaire was used on the second stage in 110 "patient-control" pairs. The second study confirmed such associations and found the most significant connection between MS and both tonsillitis at the age of 7-15 years and consumption of smoked meat. The influence of both exogenous factors were probably conditioned by permanent antigenic stimulation of the immune system in predisposed individuals.

A total clinical epidemiologic survey was performed in one of Moscow regions in 1985-1990. On the first stage 2660 medical records of the individuals unfitted for military service were picked out. 42.8% of them had mental diseases. From 2102 medical records of the soldiers and sailors there were 66 of the discharged from the army. 45.5% of them were dismissed because of mental disease. On the second stage, 30 men dismissed because of mental disease and 299 men called for military service but discharged because of mental disease were examined. The duration of the follow-up was from 2 to 8 years. The most frequent reason both for the discharge from the army and for unfittness because of medical indications were borderline mental diseases (56.6% in the group of the discharged from the army and 40.9% in the group of men called up for military service). Endogenic diseases (schizophrenia, manic-depressive psychosis) made up only 16.6 and 15.8%, respectively. It was found that personal peculiarities and structure of mental diseases as well as risk factors of microsocial and biological nature were the most important indices for fitness for military service and for rehabilitative-prophylactic work in soldiers during the first 6 months of the service.

The authors analyze both the demographic situation in Russia during the past years and its perspective. A number of patients with paranoid schizophrenia and with schizophrenia on the whole (all forms of disease) was estimated for the period of the coming 15 years (till 2011 yr.). The level of the patients' detection in some Russian regions was estimated by means of comparison of the calculated number of the patients (according to tables of incidence) and actually known during the same period. The proportion of registered schizophrenic patients was up to 95.7% from calculated data in Moscow, while in other regions this index was not more than 50%. A low detection of the schizophrenic patients was explained by both specificity of the organization of psychiatric care in the regions, a shortage of psychiatrists as well as by other factors.

The range of prevalence rates for borderline mental disorders is very wide: from 17 to 210 cases per 1000 population. Considerable differences are explained both by a problem of detection of such patients and by certain diagnostic difficulties. Most clinical notions concerning borderline states are insufficiently definite and this has considerable influence on the results of epidemiologic researches. Analysis of the frequency of clinical diagnoses in two Moscow primary care out-patient clinics showed considerable differences which has disappeared under ICD-10 diagnosis.

233 patients (53 men and 180 women) at the age of 60 years and older were treated in day gerontopsychiatric out-patient clinic for 5 years. 60-69 year old patients prevailed (146 individuals). Nearly all mental diseases characteristic for the old age were found in such patients; majority of patients suffered from schizophrenia (31.3%) and affective pathology (25.8%). Vascular form of dementia prevailed among the patients with dementia while atrophic degenerative dementia was rarely observed (2 patients). Syndromological distribution revealed that the main groups were formed by patients with depressions (41.6%) as well as individuals with neurosis- and psychopathic-like conditions (37.3%). Mental disorders with paranoid syndromes were observed in 8.6% of the patients. It is shown that day gerontopsychiatric out-patient clinic had some preferences in comparison with usual mental hospitals and psychoneurological out-patient clinic.

Examination of patients in two Moscow general out-patient clinics (No 84 and 127) revealed that there were much more women (80.9%) with borderline mental disorders (BMD) in comparison with men. This finding corresponded well to literary data about higher incidence of BMD (especially of mild depressions) in women. However, profound investigation revealed that existing indices of BMD sex prevalence didn't reflect the real differences in BMD (affective especially) incidence in men and women, but they occurred most probably as the result of interaction of three factors, namely: the real sex difference in prevalence of these disorders, their masking by alcoholism in men, and differences in "medical behaviour" in women and men.

Epidemiology study of patients in primary care settings has shown prevalence of borderline mental disorders (41.58 per 1000 population) in comparison with patients of psychiatric outpatient clinic (11.4 per 1000). The question arises were those undetected by psychiatric out-patient clinics (those who didn't visit psychiatrist for individual reasons) or they represented another contingent. Comparative analysis of groups standardized on nosological, syndromal and educational levels revealed that there were various contingents of patients. The main difference was determined by different duration of disease before the first visit to psychiatrist, that reflected various severity of the disease (less severity of the disease was observed in patients of primary care institutions).

Patients' genotyping of Russian ethnic group with multiple sclerosis (MS) was performed for the first time in two loci of the main complex of histocompatibility: in DR HLA class II (gene DRB1) and in the locus of tumor necrosis factors (TNF). There was no difference in the incidence of alleles groups which correlated with some specificity of DR. Meanwhile TNF-a1 and TNF-a9 alleles were encountered significantly more frequently in patients and TNF-a7 in control group. When all the patients and controls examined were divided into groups in dependence on combination of DR and TNF it was found that relations observed between MS and TNF-a7 and TNF-a9 alleles were displayed much more in individuals which carried alleles of gene DRB1, corresponding to DR15 specificity. These are alleles which are known as the main risk factor of MS in Caucasians. The patients with "protective" TNF-a7 allele were characterized by more favorable course of the disease. Thus highly significant genetic markers were revealed for the first time in region of TNF genes which were associated with increased or decreased risk of MS development at least in Russian ethnic group. There was also possibility of their interaction with group of DR15 alleles of DRB1 gene. One of the markers revealed (TNF-a7) occurred to be bound both with decreased risk of MS and with favorable clinical course, which was observed for genetic markers of MS for the first time. Manifestation of one or another property of TNF-a7 marker depends on the presence of alleles of DRB1 gene which corresponds to DR15 specificity.

Psychic state of the majority (84.5%) of 410 consulted by the psychiatrist in a district outpatient clinic patients was found as non-psychotic. Psychic disorders of exogenic-organic nature accounted for 34.4% and neurosis--26.5% of all the cases. Psychoneurological care, available in the district outpatient clinic, is an adequate form of aid for patients with borderline psychic disorders.

75 occasions of suicide attempts carried out by self-burning were analysed. It was revealed that the individuals in the age of 40-49 (unemployed and disabled) as well as physically working people predominated in most cases. Suicides were usually performed out of working sphere. In more than 70% of occasions either alcohol intoxication or some psychic diseases (which did not combine in one person) accompanied this kind of injury. No sex prevalence was observed in this group of patients.

The epidemiological survey covered 2000 city schoolchildren. They ranged in age from 7 to 15 years. Hypothalamic deficiency (HD) was detected in 5% of the examinees. Clinical and physiological findings on HD children are provided. They were found to have the history of hereditary or natal damage evidencing the acquired nature of the disease. Special emphasis is placed on HD manifestations in prepubertal and pubertal age. The authors show defective regulation of nonspecific brain systems in the form of predominant activation of the septohippocampal system and relative insufficiency of the brain stem mesencephalic reticular formation. Activation of cerebral ergotropic vegetative mechanisms combines with peripheral vegetative failure (sympathetic and parasympathetic), probably, of congenital origin.

The screening of the random sample from an open population of males aged 40-65 was performed to compare frequency and severity of hemodynamic changes in major head arteries (MHA) due to atherosclerosis in subjects with vascular diseases and clinically normal controls. 866 of the examinees were subjected to MHA ultrasonic dopplerography. Normal circulation appeared only in 13% of the examinees. The rest of them had insufficient circulation or at least one vessel affected with stenosis. The standard index of MHA stenosis amounted to 20.2%. The frequency of MHA stenosis was related to the age, vascular involvement and severity of the latter.

A clinical trial covered 69 schizophrenics subjects to frequent rehospitalizations because the patients' need in repeated inpatient treatment. The author points out, that frequent hospitalizations form psychological hospital dependence.

Clinical and statistical analyses of the patients with attack-like schizophrenia admitted to Moscow mental hospitals provided evidence for prognostic evaluation of the frequency of the patients' hospitalization in the initial 10 years. The number of hospitalizations was clearly correlated with social and occupational adaptation of the patients. Maintenance therapy produced no effect on the number of the patients' hospitalizations.

Sequelae of severe trichotillomania initiating in childhood and adolescence were studied in 26 patients aged 21-32. A mean prospective follow-up lasted for 13 years. Thirteen patients were qualified as healthy. In the rest trichotillomania remained the main symptom of the illness, in 9 patients the progressive disease became the basis for secondary psychopathies, pathocharacterological personality of deficiency type. The following factors reliably affecting the prognosis were revealed: residual-organic origin of trichotillomania, intensity, generalization and polymorphism of the habit, persistence of the syndrome development, severity of vegetative component, late therapy start.

The paper reviews the results of registration reorganization in one of the Moscow gerontological psychiatric consultations. Two groups of psychic pathology were recognized: advanced psychoses and dementia (1168 patients), nonpsychotic diseases of the nonpsychotic level were registered in the group of "consultative follow-up". Hospitalization in this group made up 38 cases. The analysis showed that patients of advanced age require a special approach in follow-up, examination and hospitalization planning.

Epidemiological survey of 2076 schoolchildren in the city of Moscow aged 7-15 revealed vegetative disorders in 63.8% of the examinees. Sex- and age-specific features of clinical presentation, complaints are described. An original questionnaires were used to enable physicians to distinguish normal children with vegetative lability from patients with vegetative dystonia.