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With the aim to study neurophysiologic correlates and to search for some possible predictors of therapeutic response correlation analysis has been carried out of links between temporal parameters of components of auditory event-related potentials (AERPs) and dynamics of quantitative clinical assessments of mental state conditions in two groups of patients--with depressive-delusional conditions (group 1) and with manic-delusional conditions (group 2) in the frames of attack-like schizophrenia. Statistically significant correlations have been revealed between values of peak latencies of main AERPs components and severity of psychopathologic symptoms before beginning of treatment course, as well as between initial (before treatment course) AERPs temporal parameters and quantitative clinical assessments at the stage of remission establishment. Larger severity of residual positive, negative and common psychopathologic symptoms of schizophrenia (and also of depression and anxiety in group 1) after course of treatment was associated with smaller initial (before treatment course) values of peak latencies of "early" (P1 and N1) and with larger initial values of "late" (P2, N2 and P3) AERPs components in both groups of patients. The data obtained allow to justify basic views on brain mechanisms of affective-delusional disorders, and to reveal possible neurophysiologic predictors of treatment efficacy in such disorders.

A complex clinical-psychopathological and follow-up study of 751 patients (the clinical group included 393 subjects; the follow-up group consisted of 358 patients) with endogenous juvenile depressions of nonpsychotic level showed that specificities of depressive conditions in patients of this age (16-25 years) and special features of their clinical manifestations were conditioned by the considerable contribution of pubertal psychobiological factors to their formation. These factors bring cognitive, overvalued, behavioral, and somatovegetative disorders, characteristic of adolescence, into the foreground. The above disorders do not only mask their depressive foundation but also complicate the correct interpretation of separate symptoms of the disease. The basic key features of juvenile depressions include polymorphism of the clinical picture, atypism and bluntness of a depressive triad with insignificant intensity of its thymic component and predominance of apatho-adynamic and dysphoric components. Five special typological varieties of depressions, characteristic only of adolescence, were revealed and studied as well as 3 varieties peculiar both to youths and patients of mature age. Correlations among the types of adolescent endogenous depressions, specificities of their course, and nosological position of the studied states were detected.

Based on the study of 486 patients, aged from 16 to 25 years, key features of psychopathology of juvenile depressions were specified. They included bluntness and atypism of a depressive triad with insignificant expression and rudimentariness of the thymic component per se, a large proportion of cognitive disorders and psychopathy-like disturbances, a higher frequency of special overvalued syndromes of metaphysical and dysmorphophobic character. Types of juvenile depressions were singled out as follows: depressions with the clinical picture of juvenile asthenic failure, dysmorphophobic, metaphysical, heboid, psychasthenic-like, depersonalization, senestho-hypochondriac depressions as well as depressions with obsessive-phobic disorders and with "psychogenic contents". The efficacy of the combined use of serotoninergic antidepressive drugs (SSRI) and antipsychotics (flupentixol, trifluoperazine, quentiapine, amisulpride ziprasidone) was confirmed and the high selectivity with respect to cognitive and overvalued disorders as well as to the impairment of mental activity was demonstrated. Correlations between therapeutic effectiveness of separate SSRI drugs and types of juvenile depression were found. The importance of complex approach, including not only psychopharmacotherapy but also cognitive-behavioral psychotherapeutic methods, is emphasized. Current concepts of peculiarities of neuroplastic changes in the human brain underlying manifestations of "puberty mentality" and their pathogenetic and pathoplastic contribution to the formation of juvenile depressions are discussed.

Proliferative activity of peripheral blood lymphocytes has been studied in patients with schizoaffective (18) and affective (24) psychoses in 4 experimental variants: cultivation of blood lymphocytes isolated by centrifuging in the density gradient with fetal (1st variant) or autologic serum (2nd variant); cultivation of lymphocyte obtained in plasma sedimentation with fetal (3rd variant) and autologic serum (4th variant). A level of functional lymphocyte activity was significantly decreased in patients. The data obtained suggest that different mechanisms underlie this decrease. In schizoaffective psychosis, a disturbance of cell cooperative interaction in immune response was observed. In affective psychosis, the determining factors were a decrease of the ability of lymphocytes to respond to mytogenic stimulation and a presence of the factor inhibiting a functional activity of lymphoid cells in patient's blood. Besides, it was shown that in patients with schizoaffective psychosis, lymphocyte proliferative activity inversely correlates with the disease duration and in affective patients the direct correlation between these indices was detected.

There were forty patients (mean age 20.7 years) who met the ICD-10 criteria of diagnosis of affective disorder (items F31-F33)--juvenile depression, successfully treated with antidepressants in psychiatric hospital and later on maintenance therapy for correction of residual symptoms. The duration of follow-up study was 2 years. All the patients were randomised into two groups, the first one receiving psychopharmacotherapy combined with cognitive behavioural therapy and the second--only the former one. In both groups, the antidepressant dosing was continuously decreased up to complete withdrawal. In the first group, patients revealed significantly fewer residual symptoms after antidepressants treatment compared with the second group, which was assigned only to psychopharmacotherapy. Also, depression relapse frequency tended to be lower in the first group than in the second one (15% vs 35%) but the differences were insignificant. The authors emphasize that further studies of cognitive behavioural therapy in depression relapse prevention are needed.

Eighteen patients with schizophrenia and 18 patients with affective disorders (depression) underwent regisTration of auditory event-related potentials (ERPs) recording in oddball paradigm. All the patients were in remission. In both groups of the patients, the N100 ERPs amplitudes to non-target stimuli were significantly smaller and N200 and P300 latencies were longer than in 18 normals. In the patient's group with affective disorders, prolongation of P200 and N100 ERPs latencies to target stimuli has been found. The group of patients with schizophrenia was characterized by P300 amplitude reduction. The results show stimuli processing decrease in patients with affective disorders, while in patients with schizophrenia a cognitive function disturbance was recorded.

Recently association between VNTR-17 (12 copies, allel 12) and schizophrenia has been reported. Relations between allele polymorphism of serotonin transporter gene and schizophrenia in 71 Russian families with schizophrenia (n = 253) were studied. Genotyping was made by VNTR-17 and HTTLPR loci. Allele 10 was transmitted 25 times and allele 12 was transmitted 28 times. In the case of HTTLPR polymorphism allele I was transmitted 26 times and allele s was transmitted 19 times. These differences in transmission also were statistically insignificant (p = 0.69). Therefore, our findings do not support association between 5-HTT polymorphism and susceptibility to schizophrenia.

Interleukin level and mononuclear phagocytes (MPh) activity have been studied in 19 patients with mono- and bipolar depression. All the patients were examined at admission to a hospital before treatment. The depression was characterized by low MPh activity, a significant (p0.05) fall in IL-1 beta production by stimulated monocytes, a trend to reduction of IL-2 production by stimulated lymphocytes, significant (p0.05) IL-2 serum concentration increase and significant (p = 0.05) decrease of soluble IL-2 receptor (siL-2R) concentration in the serum. Significant positive correlation (r = 0.76; p0.05) between MPh activity and IL-1 beta production has been found. Interleukin alterations were most manifest at the early disease stage (symptoms onset is less than one year). It is suggested that IL-2 accumulation in the blood serum in these patients is strongly influenced by a significant decrease of siL-2R serum concentration. MPh (the main IL-2 producers) activity reduction results in the monocyte IL-1 beta production decrease followed by changes in interleukin (in particular, IL-2) production by lymphocytes and other changes in interleukin system.

By means of MMPI test 287 healthy relatives of 159 patients with schizophrenia and schizoaffective disorders were examined. Anomalies of personality were found in 44% of 287 relatives examined, that did not differ significantly from the same index (36% of 179) in the control group of healthy individuals without any family history of mental diseases. A cluster analysis has revealed that anomalies of personality in the patients relatives can be divided into the next types: schizoid (15%), sociopathic (7%), masculine, superrational (5%) and neurotic (16%). In most of schizoid relatives anomalies of personality were reflected by the 2-7-8 profile of personality that differed them from schizoid personalities in control group. On the basis of both the results obtained and literature data it was suggested that together with the schizoid relatives, the relatives with sociopathic features should be included in the schizophrenic risk group, while anomalies of personality of both neurotic and superrational types were the reactions to the stress in families of the patients with schizophrenia.

Genetic polymorphism of the serotonin receptor (5-HTR2A) gene has been reported to be associated with the expression of clinical signs characteristic of major psychoses, including schizophrenia and affective disorders. In this study, personality traits of patients with these diseases and the associations of these traits with 5-HTR2A allelic polymorphisms were studied. It was demonstrated that schizophrenic and affective patients with the 2/2 genotype of serotonin receptor had lower scores on the anxiety scale and on the anxiety-related hypochondriasis and neuroticism scales than subjects with the 1/1 and 1/2 genotypes.

The paper presents the study in of the combined psychopharmaco-psychocorrective method designed specially for juvenile patients with endogenic depressive disorders. Psychocorrective measures included the method of "rehabilitation training of social habits" used on the stage of hospital therapy and psychocorrective training according to "social support" method used in group psychotherapy outpatiently. A 5 year follow-up study performed in 110 showed that psychotherapy has increased efficiency of the therapy in terms of both reduction of clinic disorders in the acute period and prophylaxis of the relapses as well as social readaptation.

Serotonin receptor 5HTR2A gene polymorphism was reported to be associated with psychiatric disorders, in particular schizophrenia, in numerous studies. This study aimed to analyze a possible association between 5HTR2A gene polymorphism and clinical and pathogenetic characteristics in schizophrenia and schizophrenia spectrum disorders. We studied 209 individuals with schizophrenia and related disorders (107 male and 102 female, mean age 34.7 +/- 17.2 years) and 116 healthy controls (44 males, 72 females, mean age = 33.6 +/- 14.4 years). Diagnoses were made according diagnostic criteria of ICD-10. Positive and Negative Symptoms Scale (PANSS) assessed clinical symptoms. Significant difference (p0.01) was found for 5HTR2A genotype distribution between affected and control groups. The frequencies of genotypes A1A1, A1A2 and A2A2 for schizophrenia were 13.3%, 44.0% and 42.7%, respectively, versus 33%, 47% and 27% in controls. These results support the evidence for association between 5HTR2A A2A2 genotype and schizophrenia. Schizophrenics with A2A2 genotype were characterized by significantly higher mean values of the PANSS negative symptoms subscale than those with A1A1 genotype (22.6 vs 17.8; p0.05) and, consequently, by majority of deficit patients and patients with more severe forms of schizophrenia. Patients with A1A1 genotype were younger compare to those with A2A2 genotypes and had the least familial factors (35.7% vs 46.1%). In agreement with the results obtained in the study the 5HTR2A gene polymorphism appears to be considered as additional diagnostic or prognostic trait in the medical genetic studies of schizophrenia.

In 46 male patients with endogenic depressions of different nosology (22 patients with affective disorder, 24 with juvenile slow-progredient schizophrenia) and 22 healthy individuals (a control group) visual evoked potentials (EPs) were registered during recognition of emotionally positive, negative or neutral facial expression. It was found that deficient recognition of emotions in depressions was determined by alteration of different stages of information analysis. In inferio-temporal and occipetal cortical areas the Eps revealed delayed primary analisis of visual information and reduction of components responsible for classification stage and decision making. In anteriocentral cortical areas only late stages of analysis were altered, and they were depending on nosology of depressive sindrom. Dynamics of topographic maps revealed disturbance of analysis in the right hemisphere in patients with affective disorders and in left hemisphere in schisophrenics. In both groups of patients deficit of interhemispheric transfere was found.

47 patients with endogenous depressions were treated with paxil (paroxetine) during 4 weeks in the daily dose of 30-40 mg. Improvement of psychical state was observed in 89.3% of the patients; improvement was significant in 78.7%. Severity of the depression reduced from 28.9 to 6.0 scores according to Hamilton Depression Rating Scale. Antidepressive activity of paxil was observed at the third day of the therapy. Symptoms of depression disappeared completely in 46.7% of the patients 2 weeks after the beginning of treatment and in 62.8% of the cases in 4 weeks. Thymoleptic and sedative-anxiolytic effects prevailed in the spectrum of antidepressive activity of paxil; while its stimulating effect was expressed smaller. Mentioned peculiarities of paxil action, its small toxicity and positive subjective attitude of the patients towards the drug make this preparation quite valuable, especially in the treatment of classic melancholic and anxious depressions.

A clinical and follow-up study of 155 young adults with a symptomcomplex of "juvenile asthenic deficiency"--"endogener juveniler asthenischer Versagensyndrome" (J.Glatzel, G.Huber, 1968) was carried out. It was found that protracted states in the youth with prevalence of educational disadaptation, weakening of initiative, psychophysical fatiguability should be attributed to atypical depressions, characterized by predominance of ideatoric disturbances with obliterated thymic and motor components. Depending on the specificities of ideatoric disturbances, 3 basic typological varieties of such depressions were recognized, i.e. depressions with prevalence of inhibition, disautomatization or distortion of cognitive processes, which statistically correlated reliably with definite nosological forms (affective disorders, schizophrenia). Depending on the nosologic belonging the studied states differed also in frequency of comorbid disturbances (obsessive-phobic, depersonalization, overvalued ideas), which occurred significantly rarer in the cases of affective disorders, than in schizophrenia. On the whole, follow-up study revealed relatively favourable prognosis of youth endogenous depressions with a clinical picture of "juvenile asthenic deficiency": in cases of affective disorders the course of disease was more frequently in the form of a single cyclothymic attack, while in cases of schizophrenia it took the form of protracted atypical pubertal attack.

Peculiarities of cognitive process were studied in 34 right-handed endogenously depressed patients with "juvenile asthenic deficiency" ("endogener juveniler Versagensyndrome" according to J. Glatzel and G Huber, 1968) by means of visual evoked potentials (EP) in the emotional recognition task. Two control groups consisted of 19 healthy individuals and 20 patients with other types of depressions. The main and control groups were matched for age, sex, handedness and education level. Compared to controls the patients with "juvenile asthenic deficiency" demonstrated highly significant alterations in indices of EP late negative wave in anterior areas of the left hemisphere which related to neither the nosology of "juvenile asthenic deficiency" (cyclothymia, schizophrenia) nor the types of dominant cognitive disorders. Dependence on both nosology and clinical subtype of asthenic deficiency was found only for separate characteristics of earlier EP waves. The results suggest the disturbance of the final stages of information processing and the decision making specific for "juvenile asthenic deficiency".