Abstracts of scientific works of Independent Psychiatric Journal (IPJ), 2010, 2

Suggestions for working out ICD-11Yu.S.Savenko

Key words: ICD-10, ICD-11, syndromological approach.

While working out ICD-11 it should be necessary to take into account the following negative results of the application of its previous version: 1) Psychiatrists generally apply only this classification, "that is designed, first of all, for statistical purposes"; 2) The nature of the classification is considered as “closed” (politetic) and does not contribute to further development of clinical psychiatry; 3) Due to the usage of this classification, clinical thinking seems regressing to simple checking with the list of symptoms; 4) ICD-10 has lost the most fundamental narrative characteristic of "psychotic level” of mental disorders, which for the register of affective disorders suggests not the degree of clinical presentations of classical symptoms, and not the completeness of the set of these symptoms, but a less differentiated organization of all psychical activities that is regressing to a more primitive level; 5) In ICD-10 are combined and mixed two opposing principles: atheoreticity that is necessary for the natural classification and commitment to nosology. Implementation of these principles require a two-stage qualification. In the first stage it should be narrative detailed syndromological qualifications with identification of psychotic level of disorders. As for the second stage, the qualification should be nosological, based on complete clinical analysis. ICD-10, specifically brought to nosological certainty, may remain the natural foundation for nosological qualification. Implementation of the syndromic qualification at the first stage will allow to consider nosological features of each syndrome at the second stage and to expand the list of criteria in different clusters. Such a suggestion opens the prospect for subsequent revisions of the ICD and allows to direct our efforts and those of practitioners to the unified channel, where the statistical goals would not be implemented at the expense of the research ones.

Some aspects of pathomorphosis of neurotic obsessive-phobic disordersN.D.Lakosina, A.V.Pavlichenko

Key words: pathomorphosis, neurosis, obsessive-phobic disorders, reasons for pathomorphosis, treatment of phobias.

An objective of the study was to investigate a modern pathomorphosis of neurotic obsessive-phobic disorders. The features of obsessive-phobic disorders observed in the 60-80-years of the last century, included the following: acute stressful events were the main triggers of phobic disorders; panic attacks consisted of autonomic symptoms and fear of dying from heart disease; intrusive structure of phobias; phobias could be replaced by obsessions (aggressive impulses, pathological doubts); active coping strategies with obsessive-phobic disorders; subthreshold depression was secondary to the phobias; treatment included phenothiazine neuroleptics and sedative benzodiazepines. The following features of the modern neurotic obsessive-phobic disorders are pointed out: exacerbation of phobias precede the combination of pathological changes in social psychological and biological background; panic attacks involve autonomic symptoms, conversion symptoms, social phobias and various hypochondriacal fears; predominate phobias of several means of transport; overvalued structure of phobias; passive strategies of coping with fears; dynamics is due to the expansion of avoidance behavior; depression appear as comorbid disorder; treatment includes serotoninergic antidepressants and anxiolytics. А pathomorphosis of neurotic obsessive-phobic disorders are associated with reasons such as illness, treatment, patient and social environment.

On alcohol situation in Russia and the ways of improvement of narcological careA.G.Hofman, T.A.Kozhinova, I.V.Yashkin

Key words: alcoholism, drugs addiction, legislation, coercive.

The article focuses up on the problem of incidence of alcoholism and drug abuse in Russia, registered by Russian narcological establishments. Measures on reduction of alcoholic beverages’ sales, with account of USSR experience in this sphere and their effect on demographic determinants have been suggested. The drawbacks of current legislation concerning alcohol and drug addicted persons have been represented. Initiation of Law on Narcological Aid and organization of mandatory (coercive) treatment of certain part of alcohol and drugs addicted persons have been proposed.

Process of psychopathologisation of narcological symptoms as the dominating paradigm of Russian narcologyV.D.Mendelevich (Kazan)

Key words: addictive symptoms, psychopathology.

Article is devoted the psychological and psychopathological analysis of actually addictive symptoms (craving, to concept of degradation of the person, etc.). The conclusion that without due scientific proofs they are ranked as a psychopathological spectrum has been made. It leads to inadequate tactics of therapy with use of antipsychotics and other psychotropic means.

A new way of suppression of experts’ competition in courtYyu.S.Savenko

In notorious court trial against organizers of exhibition in Andrey Sakharov Museum both public prosecutor and judge used the demand which we have never heard. They refused to criticize the expert conclusion which there was in the case’s materials and even to call the name of its author.

Critical thinking in the theory and practice of psychotherapyOleg Savenkov (Sydney, Canada)

Key words: psychotherapy, psychology, psychiatry, evidence-based medicine, critical thinking, scientific methodology.

There has been a growing need in scientific testing of psychotherapy techniques and theories due to their significant number, particularly when some of them are of questionable scientific value. Scientific methodology is the best method to test the validity of theories which the psychotherapeutic techniques are based on. Empirical testing of such the theories may lead to a drop in psychotherapy numbers, their refinement and improvement in treatment outcomes.

Evaluation of hospital patients’ rights from their own and professionals perspectivesI.A. Byilim, E.B. Lyubov

Key words: hospital psychiatric patients, the right

Study indicates a deep divergence in aspect of evaluation of psychiatric inpatients rights from professionals and patients perspectives.

Psychotherapeutic preventive measures for posttraumatic disorders at military servicemenE.Yu.Sokolov

Key words: posttraumatic frustration, emergency situations, adaptation, exhaustion, self-control methods.

The information about observed psychosomatic complications at the military men who have visited situations of fighting stress is given. Variants of posttraumatic psychopathological frustration are considered. Active use of psychotherapeutic methods is recommended for treatment and in the first turn for prevention of these disorders. For this purpose the psychotherapeutic service should train people in epaulets to use competently and independently, both in peace and wartime, psychotherapeutic methods in order to reveal own reserve possibilities, which are а true barrier for posttraumatic frustration at military men.