Religious-archaic delusional complex (RADC) includes unhealthy ideas with a religious and archaic plot. The aim of the present work-specification of psychopathological structure RADC, definition of influence of a historical situation on its subjects annd revealing of specificity of delusional behavior. The authors used clinico-psychopathological method and Positive and Negative Syndrome Scale (PANSS). 300 patients (men-77, women-223) are surveyed. Results: Schizophrenia and delusional disorders are diagnosed at 231 (77%) by patiennts, affective disorders with psychotic symptoms-at 19 (6,3%), psychotic organic mental disorders-at 31 (10,4%), psychotic disorders connected with the use of alcohol-at 19 (6,3%). The mystical delusion came to light in 74 (24,7%) supervision, mesianic delusion-in 65 (21,7%), delusion of religious reforms-in 14 (4,7%), delusion of sin-in 34 (11,3%), delusion of witchcraft-in 64 (21,3%) and delusion of possession-in 49 (16,3%). It is established, that specificity of a RADC is determined by presence in structure of syndromes reflecting deep disorder of mental activity (hallucinatory-paranoid syndrome, paraphrenic syndrome, syndromes of aberration of consciousness), the delusional behavior, and representing social danger.

Introduction:Alcohol abuse is the cause of many somatic diseases, more severe illness manifestation, and the premature patient deaths.Aims:The aim of this study was to determine the prevalence and severity of alcohol abuse and dependence among patients with a c somatic diseases hospitalized in emergency multidisciplinary hospital.Methods:Within five days, 807 patients were examined with the help of clinical and psychometric tools: specially designed patient study card, Alcohol Use Disorders Identification Test (AUDIT) and Hospital Anxiety and Depression Scale (HADS). In addition, all patients were tested for AST, ALT, GGT, and blood ethanol. In 1.5 months treatment outcomes were analyzed.Results:The study revealed a high percentage of patients with substance abuse disorders (about a quarter). The vast majority of them (80%) had a problems with alcohol. About the same number of patients admitted to hospital in varying degrees of alcohol intoxication. Among patients admitted to somatic hospitals, “hidden” contingent of people who have problems with alcohol is much greater than the “left out” (who consulted in the specialized addiction outpatient clinic). The majority of this hidden contingent did not seek any specialized treatment. Alcohol was found as a significant risk factor for urgent hospitalization, more severe disease manifestation and outcome. Alcohol problem were often observed in toxicology patients, patients with head injury, burns, diseases of the central and peripheral nervous system and diabetes.Conclusions:A program for qualified treatment intervention in somatic patients with alcohol problems is needed.

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.

Schizophrenia is a chronic psychotic disease which occurs as a rule in young patients and often leads to their disability. A long time it was thought that a neurocognitive deficit in schizophrenia patients is unremediable but introduction of atypical antipsychotics in the therapy of schizophrenia shows us a principal possibility of its correction. It also shows that neurocognitive deficit is a plastic heteronomous phenomenon in the structure of psychopathology.The aim of our study was to show the influence of the atypical antipsychotics and drugs which have influence on sigma receptors on the neurocognitive deficit in schizophrenia patients.Material and methodsFor our investigation we observed 167 patients with paranoid schizophrenia according to the criteria of ICD 10. Patients were randomized into 3 groups. Patients of 1st group (n = 52) received sertindole monotherapy 16–20 mg per day, patients of 2nd group (n = 67) received paliperidone 9–12 mg per day and fluvoxamine in combination with zuclopenthixole depot 150–200 mg per day.ResultsSocial functioning in patients with schizophrenia significantly improved in all three groups especially in group №3. We suppose that it was connected with activating activity of fluvoxamine.ConclusionThus the results of the study indicate the significance of differences of dynamics of neurocognitive deficit in schizophrenia and the importance of choice of biological therapy for correction of neurocognitive deficit in patients with schizophrenia.The use of modern atypical antipsychotics and drugs which can influence on sigma-receptors can restore the social functioning in young patients with schizophrenia.

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.