The article provides information on particular issues of treatment of mental disorders. An analysis was made of the issues of therapeutic resistance and compliance among mental patients, which play an important role in possible discrepancies between the results of randomized placebo-controlled trials and the use of psychotropic drugs in routine clinical practice. The main aspects of clinical pharmacology are presented in an accessible form, which determine the complexity and at the same time professionalism in the practice of a psychiatrist. Grouped and deciphered are the factors that have a direct impact on the therapeutic response of the drug, including the primary pharmacological properties of the drug, nosological, general biological, social, subjective-psychological factors.

The article presents a unique clinical case of Daniil A. with multiple personality disorder (dissociative identity disorder according to ICD-11) the first detailed description of a rare syndrome in the Russian-language scientific literature. The patient also had dissociative movement disorders in the form of pseudoepileptic seizures. The clinical picture of the disease was dominated by the symptoms of alternative of personality, second essence, Alter ego and voices. The article provides a clinical analysis of the legitimacy of designating the identified phenomena as hallucinations and delusions. The theoretical analysis included an assessment of the possibility of diagnosing psychotic symptoms within non-psychotic disorders.

BACKGROUND. The problem of changing a psychiatric diagnosis is a reality. AIM. To study the frequency and probability of changing the exposed patient at the age of psychiatric illness when moving under the supervision of a psychiatrist served by a large population. MATERIAL AND METHODS. We analyzed 246 cases of patients who first applied to a psychiatrist in childhood (adolescence), then taken for consultative or dispensary registration. The study was follow-up in nature, was carried out with the help of the analysis of electronic databases of the RCPB. acad. V.M. Bekhterev of the Ministry of Health of the Republic of Tatarstan (Kazan), as well as by studying primary medical documentation (outpatient cards and case histories). The results of the study were processed on the basis of Statistica 6.0 and MS Excel 2020. RESULTS. The main variants of the outcomes of mental disorders diagnosed in childhood of patients are described. It is shown that in more than half of clinical cases the confirmation of a psychiatric diagnosis at an early age is not final, and the issue of further diagnostic search remains unresolved and requires revision. Using the methods of multifactorial statistics, the main transnosological (dimensional) models of algorithms for the development of mental disorders are modeled.