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A comparative age-associated study of the efficacy and side effects of amitriptyline and maprotyline was carried out in a group of 93 patients over 50. The health status of the patients was assessed with the aid of Hamilton's depression scale and the scale of side effects on days 0, 7 and 28 of the therapy. It has been discovered that on day 28 maprotyline caused a more complete reduction of depressive disorders as compared to amitriptyline. Maprotyline produced a more intensive action on the anxious component of depression. There were differences in the intensity and range of side effects evoked by amitriptyline and maprotyline. Unlike maprotyline, the antidepressive effect of amitriptyline developed in a group of patients over 70, at later stages of the therapy. Therefore, it is more advisable that tetracyclic antidepressants be used for the treatment of senile patients.

Analysis of psychopathological traits of the paranoiac syndrome in 60 patients with late schizophrenia permitted to distinguish certan signs which can be allocated to the differentiation of late schizophrenia from other delusional psychoses in the elderly. The following differential signs were underlined: initial symptoms, such as rudimentary cenesthopathia, stable insomnia, etc., preceding the formation of delusions; appearance of episodic exacerbations in the form of short-time acute paranoiac states; a combination of paranoiac delusion with stable phasic affective disorders; unusual possession of delusional patients expressed in bizarre delusional behaviour, etc. Using this example as a model, the necessity of further profound and differentiated psychopathological studies of syndromes distinguished as predilective for old age is indicated.

A total of 552 patients with attack-like schizophrenia, who attained old age were examined clinically. It was established that the development of negative changes in such patients occurs predominantly during the first half of life. Subsequently not all patients demonstrate a progressive development of the disease and even if it does occur it is seen in the form of more frequent or longer attacks and a complication of psychopathological disorders. At the same time there is a certain correlation between the clinical picture of the attacks and the severity of deficitary changes. A reverse development of some personality changes in long-term remissions in old age are described.

On the basis of the results provided by clinical follow-up, clinico-epidemiological and clinico-genealogical studies, the authors have reviewed the systematics of the major forms of schizophrenia developed at the Institute of Psychiatry of the USSR Academy of Medical Sciences and offer a statistical characteristics of these forms. The authors specifically discussed the questions associated with the characteristics of the syndrome formation and course of slowly progressive (torpid) schizophrenia and the place these forms occupy in the modern foreign classifications, including the DCM-III). The paroxysm-like form was established to run predominantly the course with a small rate of attacks or the "one-paroxysm" course. Slowly progressive and psychotic forms of continuous schizophrenia were shown to be relatively continuous, being characterized by not only the signs of tortuosity of the course but also by those of regression and subsidence of the process. Attention is drawn to the necessity of special elaboration of the notion "residual schizophrenia". All these postulates are illustrated by the appropriate statistical population characteristics.

The study involved a clinical examination of 568 patients with continious forms of schizophrenia and different degrees of progression (from mild sluggish to malignant forms). The following stages of the diseases are differentiated: an initial one, a stage of the highest process activity, a stage of stabilization, reduction of the psychosis and formation of the terminal state. A thorough analysis of the cases demonstrated that even in a continuous development of schizophrenia, the progression of the process is limited in time. It was found that the more polymorphic and severe are the signs of the process in active phase, the less is the time taken by this phase. In compliance with varying duration of the active stages of the disease the age periods during which there ensue a stabilization of the malignant, sluggish and paranoid forms of schizophrenia are very diverse.

On the basis of a comparative clinico-catamestic study of 193 patients with attack-like schizophrenia and a different degree of progressiveness the authors describe the most common traits in the development of the attack-like process. The report contains data related to different tendecines in the course of the disease, its age dynamics and some correlations between the degree of progressiveness and separate clinical parameters. It was established that the most expressed negative personality changes are formed in the initial periods of the disease and to a large extent determine the traits in the course of the disease.

The authors studied 62 patients with late schizophrenia with the predominance of elementary misperceptions. The main variants of such psychoses with auditory, olfactory and tactile perceptive disturbances have been identified. The authors also ascertained common typological signs distinguishing these psychoses from the classical paranoids of late age. A possible role of the age and environmental factors in the formation of the above psychoses is considered.

Thirty-eight patients with late mentally deteriorating processes were studied. Using a standardized neuropsychological method, the authors have outlined four major variants of neuropsychological syndromes characteristic of damage to definite zones of the brain. Comparison of these data with the results of clinical and computer-aided tomographic examination showed that the neuropsychological approach is an adequate method in the combined study of senile dementia.