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Altogether 194 patients suffering from attack-like schizophrenia lasting not less than 15 years since the manifest attack were examined for the clinico-dynamic features of the remission conditions as dependent on a number of endogenous and process factors: the disease period, disease duration from the manifest attack, the number of the attacks suffered by the patient. The data obtained can be used in elaboration of the socio-rehabilitation and medicamentous measures in patients suffering from attack-like schizophrenia.

Using a clinico-psychological approach, personality changes have been studied in 40 patients with attack-like schizophrenia presenting asthenic (n = 22) or sthenic (n = 18) types of remissions. The common regularities have been identified, namely personality alterations of a superficial level with the preservation of "the nucleus of personality". In an asthenic type of remission the defect is total and all the main components of the personality are involved. This variant of schizophrenic defect is distinguished by impairment of the motivational-stimulating component of mental activity without reduction in its other components (exhaustion, fatigue, etc.) characteristic of asthenic syndromes of other etiology. In a sthenic type of remission personality changes are partial.

In 31 patients with paroxysm-like progressive and 19 with continuously progressive paranoid schizophrenia the authors examined the results of long-term (from 4 to 11 years) treatment with moditen depot. The mean dosage of the drug was 25-50 mg per 3-4 weeks. A good therapeutic response was observed in more than half the cases. In group I patients it was expressed in the absence of relapses, improvement of quality and increase in the duration of the remissions; in group II it was expressed in an increased tendency toward a regressing course with a reduced intensity of processional manifestations. A favourable effect was accompanied by improved social and occupational adaptation of patients.

Using immunofluorescence techniques, the authors measured the peripheral levels of B-lymphocytes and the number of immunoglobulin-synthetizing cells in 16 patients with malignant juvenile continuously progressive schizophrenia and in 19 healthy donors. The schizophrenic patients showed elevated amounts of circulating B-lymphocytes--24.4% versus 15.9% in the healthy donors. Moreover, this elevation came about at the expense of lymphocytes carrying immunoglobulins G and M on their surface. The study of the immunoglobulin-synthetizing property of B-lymphocytes showed that B-lymphocytes in schizophrenic patients were more active. The blood of schizophrenic patients contained two times as many cells with cytoplasmic immunoglobulins as in the control group. Differences in the number of cells with cytoplasmic immunoglobulins became even more significant following cultivation of lymphocytes with polyclonal B-cellular PWM activator.

The study of T lymphocyte suppressors in juvenile continuously progressive schizophrenia showed that the number of suppressor cells in patients was significantly decreased as compared to a group of mentally normal donors; 20.4% and 28.9% respectively. The parallel study of the number of suppressor cells in the peripheral blood and the proliferative activity of T lymphocytes upon their stimulation with mitogenic lectins of PHA and Con A demonstrated that in the mentally normal donors, these parameters were inversely correlated, whereas in the patients with juvenile continuously progressive schizophrenia, there was no such correlation between the above indices. The data obtained are indicative of the impaired regulatory activity of T lymphocyte suppressors in this group of schizophrenic patients.

The aim of this study was to investigate the interleukin-2 (IL-2) production in schizophrenic patients with different forms of disease and controls. 70 schizophrenic patients and 20 healthy subjects were studied. Results obtained have shown that the IL-2 production depend on the forms of disease and different forms of progression. The results showed normal IL-2 production in patients with most forms of progression and decreased IL-2 level in the group with least forms of progression of disease.

A clinical follow up study carried out 10 to 15 years after the schizophrenia onset in 130 patients who fell ill in adolescence and youth has shown that there are differences in the degree of the process advancement at late stages of the disease course. This makes it possible to speak about three different tendencies in the disease development, and namely: a) rapid formation of the so-called terminal states (31.5%), b) retention of the process activity with continuing complication of the productive disorders (40%), and c) noticeable reduction of the morbid manifestations with signs of compensation of the personality defect and possibilities of social and working adaptation (the so-called late remissions, 28.5%). Some clinico-pathogenetic differences correlating with the above variants have been discovered. This makes it possible to deduce prognostic criteria in those forms of the disease.

Delusions of selfjustification directed towards a denial of imaginary guiltiness are characterized by an activity of delusional speech and behaviour. In delusions of innocence the patients partially acknowledge imaginary guiltiness, their opinions and behaviour are passive. These forms of delusions are encountered in the structure of depressions with delusions, paranoid-depressive, hallucinatory-paranoid, acute delusional and paraphrenic syndromes. Delusions of appeal and justification are frequently seen in the structure of paraphrenic syndromes. These forms of delusions occupy a subordinate position in relation to other forms of psychopathological structures.

The authors investigated the effect of the immunostimulant levamisole on the immunological reactivity of schizophrenics and the resultant decrease in the therapeutic resistance of these patients toward psychotropic therapy. Thirteen patients with juvenile malignant continuously progressive schizophrenia were studied, using a double blind design of examination. The number of suppressor T-cells in patients treated with levamisole increased from 16.6% to 22.8% (p less than 0.001) which was not observed in patients on placebo. It has been demonstrated that the immunological parameters in patients with juvenile malignant continually progressive schizophrenia can be fully recovered. Yet, the changes observed in the clinical picture were heterogeneous and unremarkable. The experimental findings suggest that the use of levamisole may be more effective in patients with less progressive forms of the disease.

On the basis of a long-term follow-up of 48 patients with terminal juvenile process schizophrenia the authors studied the major structural characteristics of their marked personality changes and the regularities of their formation. It has been established that the key feature of the pattern of schizophrenic defect in these patients is the total loss of activity in all spheres of mental functioning combined with pronounced retardation of psychic maturation not infrequently with the signs of personality regress. It has been revealed that the first signs of personality defect in these patients can be detected already at the initial stage, the disease beginning with negative disturbances.

Basing on follow-up studies (for 10 and more years) of the final stages of juvenile malignant schizophrenia (79 patients), a new principle of differentiating the final stages is advanced, suggesting that they should be divided into "psychotic" and "deficient" ones. The authors describe the features of dementia in patients with juvenile malignant schizophrenia, with these features being determined upon relative weakening of massive catatonic delusional-hallucination disorders seen in the patients. Moreover, a special symptom-complex of ecmnestic character with a picture of the "life in the past" is reviewed.

The paper deals with the effect of psychotropic drugs on blood levels of suppressive T-lymphocytes in patients with continuously progressive schizophrenia. The patients were examined three times: the first sample of blood was taken after a long psychotropic therapy, the second 3 weeks after the discontinuation of the therapy and the third one 3 weeks after the resumption of treatment. The lowest levels of suppressory T-lymphocytes (averaging 16.3%) were observed during the first examination. Following the discontinuation of therapy the content of T-suppresspors increased to 21.3% (P less than 0.001) failing, however, to reach the mean level characteristic of normal donors (25.7%). The amount of suppressory T-lymphocytes decreased again after treatment resumption. It is concluded that one of the factors contributing to changes in the immunological status in patients with juvenile continuously progressive schizophrenia may be a long-term use of psychotropic drugs.

beta-endorphin concentration in cerebrospinal fluid (CSF) in 21 schizophrenic and 15 neurological patients was determined by radioimmune assay. On the basis of the obtained data a correlation between the change of beta-endorphin level in CSF of schizophrenics and that of the clinical state of these patients was assumed as a result of a short-term discontinuance of the treatment. It was established that the reduction of beta-endorphin level in CSF of schizophrenics correlates with the intensification of hallucinatory-delusional disorders.