[Psychiatric aspect of Gilles de la Tourette disease].
A case of Gilles de la Tourette's disease of adult onset is described. An analysis of time-related course of mental derangements is presented.
Biomedical subjects
Publications and source records attributed to I I Kut'ko.
A case of Gilles de la Tourette's disease of adult onset is described. An analysis of time-related course of mental derangements is presented.
An experimental study has been conducted of validity of Lusher's "Clinical Colour Test" concerning the types of accentuations of characters according to classification of A. E. Lichko. The new informational indices were suggested, namely: "the sum of the main colours" (sigma n) and "the coefficient of the correlation of the sums of the main colours" (K(m)). These indices were absent in a classical variation of the test. The results of investigation showed the validity of Lusher's test for evaluation of the majority of accentuations types as well as of deliquency and organic basis of pathocharacterological deviations. It was also emphasized that the diagnosis of accentuations types by means of Lucher's test was possible only with consideration of correlation of preferences of "main colours". The conclusion was made about perspectivity of application of Lusher's test for both group and individual diagnosis.
The influence of endovascular laser therapy and of antioxidants on clinical immunological indices and energy metabolism was analysed in 148 schizophrenic patients including 86 patients with shift-like progredient (first group) and 62 patients with continuous-progredient (second group) forms of the disease. Positive trends in psychosis course were observed in 57% of cases in the first group and in 41.9% of patients of the second group. Pronounced improvement of the immunological indices was observed in patients with positive clinical dynamics: decreased peripheral blood immunocytes sensitization to the brain, hepatic, thymus tissue antigens as well as ATP elevation which was evidence of the improvement of energy metabolism.
320 persons Chernobyl liquidators were examined. The selection was made on the basis of presence of mental disturbances of nonpsychotic level. Five syndromes were revealed: astheno-neurotic (116 cases), astheno-depressive (92 cases), obsessive-phobic (57), astheno-hypochondriac (32), hysteric-hypochondriac (23 persons). The structure of above-mentioned syndromes was determined by combination of different symptoms (there were 40 symptoms). It was found that affective disorders of depressive spectrum are prevalent in all mental manifestations, while vasovegetative disturbances were common in psychosomatic manifestations.
127 patients were observed: 65 schizophrenic patients and 62 patients with vascular mental disorders. The treatment by hyperbaric oxygenation (HBO) was applied in such patients to overcome resistance to psychopharmacotherapy. A positive clinical effect was marked in 72.5% of cases (in 67.4% of schizophrenic patients and in 77.4% of patients with vascular diseases). The conclusion was made that HBO enabled to shorten the time of hospital treatment as well as to improve both clinical and social prognosis.
It was established in the course of 185 schizophrenic patients' examination that intensification of lipid peroxidation (LP) took place in relapses of the disease. It was manifested either in increase of blood serum levels of both malonic dialdehyde and diene conjugates, or in decrease of erythrocytes' resistance to LP mediated hemolysis. Alterations in indices of either spontaneous or induced chemoluminescence were revealed too. LP indices were lower by the end of the treatment in hospital, but remained significantly higher than normal values. Application of antioxidants in combined treatment of schizophrenic patients promoted decrease of LP activity as well as improvement in mental state of patients. LP activity was high in the remission too. Determination of LP indices may have prognostic importance.
126 patients with chronic alcoholism combined with hepatic pathology (of alcoholic genesis) were examined. Laboratory immunological observations with the using of monoclonal antibodies demonstrated the expressed alterations of immune homeostasis exactly the decrease of total T-lymphocytes population (CD11+) as well as the number of T-helpers/inductors (CD40, immunoregulatory index and the increase of the level of circulating immune complexes. The correlation between the immune alterations and the microhemodynamic disturbances was also observed. In connection with the results mentioned above the question arose about application worth of both immunological correctors and angioprotectors in therapy of alcoholism espessially combined with hepatic pathology.
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Overall 62 schizophrenic patients resistant to all forms of treatment were examined for the clinical efficacy of the treatment method on the basis of intravascular laser blood irradiation. A detailed description of the method, equipment, optimal doses, and the degree of effect in different psychopathological syndromes are provided. The best results were obtained in cases where the depressive paranoid symptomatology was predominant. The authors give recommendations for practical use of laser therapy under the conditions of the psychiatric hospital, discuss its action mechanism.
A study was made of the structure and intensity of vascular pathology in persons with completed suicides. The relation of that pathology to other risk factors was established as was the correlation between vascular pathology in different organs together with its role as a risk factor of suicides. Based on the data obtained, the system of medicosocial security of elderly patients is proposed in order to prevent suicides.
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An analysis of the clinical aspects in 156 patients with schizophrenia and 48 patients with maniac-depressive syndrome revealing symptoms in the form of neurasthenic, hysteric, obsessive and other effective manifestations allowed to establish an essential difference of neurosis-like disorders according to forms of schizophrenia at older age, in larved depressions within the limits of maniac-depressive psychosis. For precision of the nosological diagnosis of schizophrenia the authors based their conclusions on characteristic of this disease positive and negative psychopathological disorders with emphasis of thinking disorders ("atactic thinking") and peculiar changes of personality (apathetic-abulic defect).
A clinical, follow-up and psychophysiological (including investigations of the auditory, visual and motor analyzers) study involved 123 patients with psychic sequelae of brain injuries (51 patients with posttraumatic psychopathy-like syndrome and 72 patients with traumatic epilepsy). Criteria of clinical and sociooccupational compensation of patients have been developed. The results have been processed by analysis of correlations and multifactorial analysis of variances. The authors have developed a score scale for the evaluation of analyzer functions to objectively assess the severity of long-term sequelae of head traumas and of the effectiveness of therapeutic rehabilitative and readaptational impacts. The authors have demonstrated the possibility of using some psychophysiological parameters as additional characteristics of rehabilitative potentials of patients suffering from brain trauma aftereffects.
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