Introduction. The problem of late schizophrenia is one of the most controversial in clinicalpsychiatry. The organic factors that accompany the aging process make diagnosis difficult. Based on the consensus statement from an international group of experts in the field, this review discusses the features of schizophrenia in old age with a debut at a young age, late-onset schizophrenia (illness onset after 40 years of age) and very-late-onset schizophrenia-like psychosis (onset after 60 years). Method. The author conducted a study of MEDLINE sources on late schizophrenia.Results.This review provides data on the prevalence, neuroanatomy, pathogenesis, clinical presentation and treatment of schizophrenia in the elderly.Conclusion. Late schizophrenia is becoming a serious public health problem worldwide. Particularly relevant are the problems of the course of the disease, medical care and comorbidity in older psychiatric patients (general and illness-related), and treatment concerns related to the use of antipsychotics

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.

The review presents and analyzes literature data on the influence of environmental pathoplastic factors on the course of the schizophrenic process. One of the most promising areas is the study of social factors. Their interaction with the biological and psychological characteristics of patients is reflected on the nature of psychopathological manifestations and their dynamics. Social functioning also depends on socio-economic changes. A number of authors come to the conclusion that a significant part of the dispensary contingent of mentally ill persons reveals shortcomings of social functioning practically in all spheres of life: labor, family, material and household, as well as social contacts. The review shows that the best personal and social functioning was observed in patients who had family support, permanent employment, the absence of other family members with mental disorders, and treatment in a day hospital. At the same time, many questions remain insufficiently clarified. In particular, this relates to the correlation of psychosocial indicators in various spheres of life activity, features of social functioning at patients with rare hospitalizations and gender peculiarities. These questions determine the trajectory of further research.

В одномоментном обсервационном исследовании изучена динамика показателей общей и первичной заболеваемости умственной отсталостью у лиц 60 лет и старше в Северо-Западном федеральном округе (СЗФО). Установлено, что в диагностической структуре общей заболеваемости психическими расстройствами пожилых людей в СЗФО в 2018 г. доля умственной отсталости составляет 2,9 % . Среди всех пациентов с умственной отсталостью удельный вес лиц пожилого возраста в регионах СЗФО колеблется от 1,9 до 7,6 %. С 2016 по 2018 г. в СЗФО прирост общей заболеваемости умственной отсталостью пожилых за счет кумулятивного эффекта составил 9,6 %, а снижение показателя первичной заболеваемости произошло на 26,5 %. Случаи первичной диагностики умственной отсталости у пожилых людей могут быть обусловлены миграционным фактором и ошибками диагностики. Необходима более тщательная оценка клинической картины когнитивных нарушений у пациентов пожилого возраста и точное следование критериям диагностики. In a single-stage observational study, the dynamics of indicators of prevalence and incidence of mental retardation in persons aged 60 years and older in the North-Western Federal district was studied. It was found that in the diagnostic structure of the prevalence of mental disorders of older people in the northwestern Federal district in 2018, the share of mental retardation is 2,9%. Among all patients with mental retardation, the proportion of elderly people in the regions of the northwestern Federal district ranges from 1,9 to 7,6%. From 2016 to 2018 in the northwestern Federal district, the increase in the prevalence of mental retardation of the elderly due to the cumulative effect was 9,6%, and the decrease in the incidence rate was 26,5%. Cases of primary diagnosis of mental retardation in older people may be due to migration factors and diagnostic errors. A more thorough assessment of the clinical picture of cognitive disorders in elderly patients and accurate follow-up of diagnostic criteria is required.