Dedication to Valentin Semke – Brief Note
Basic direction of research under leadership of academician of Russian Academy of Medical Sciences Valentin Semke included study of prevalence, early diagnosis and pathogenetic therapy of endogenous, borderline, affective, addictive disorders in different cohorts of the population of eastern region of Russia. This has led to development of regional aspects of narcological and psychiatric service. The result of priority investigations of world level carried out in the field of cultural psychiatry, ethnopsychiatry and ethnopsychology is continuing issuing of Atlases of mental health of the population of different regions of Siberia and Far East. V.Ya. Semke attached importance to influence of national, cultural, religious traditions on formation and dynamics of mental pathology including pre-nosological, neurotic and pathocharacterological; to evaluation of mental health state of various ethnoses; to linkage of ethnocultural factors with prevalence, clinical structure, dynamics and prognosis of mental disorders; development of appropriate re-adaptive and preventive measures. These themes have not lost their relevance and will continue to be actively elaborated by disciples of academician of RAMSci Valentin Semke.
- Ethno-territorial heterogeneity of formation of mental health problems in Russia –
Editorial N. Bokhan 55 – 56
- Basic principles and approach to therapy of mental disorders in aboriginal scanty peoples of East Russia –
Editorial V. Semke 57 – 58
- Social and transcultural characteristics of mental health in population in Siberia –
Special Article V. Semke 59 – 67
In Russia, major part of chronic pathological states appears under influence of mental tensions, properties of the environment, and genetic maladjustment to sub-acute and protracted stressful effects (sociogenic factors). Depopulation is one manifestation of crisis that can lead to reduction of populations of ethnoses of eastern region, decrease of their ability to work, weakening of spiritual potential of nation and many other negative consequences of social-economic development of today’s society. Under conditions of quick socioeconomic and political development, evaluation of transcultural situation is complicated by its forthcoming negative consequences. For Siberian researchers, many years working in the field of psychological, psychiatric, addictological and psychotherapeutic assistance, have brought new spirit into development of ideas, ways, approaches and methods of examination of various groups of population, management of therapy and prevention of mental disorders under very specific conditions of Siberia. Material about development of successful trials has been accumulated. Close interaction of science and practice has provided for academic science of eastern region of Russia leading position and priority which is given to preventive technologies and integral programs of early diagnosis and prevention of chronic non- infectious diseases, being the most relevant subdivision of regional healthcare and medical science. Under modern social-economic conditions of Siberia, idea of deep analysis of epidemiological situation is underlined (leading to conclusion of necessity of reforms of psychiatric, addictological and psychological services) with account for “local” conditions described in Atlases of mental health of the population of some districts and republics, including detailed evaluation of clinical-dynamic and rehabilitative characteristics of separate ethnoses. Disclosing the nearest and more remote horizons of coming-to-be of a psychiatrist in Russia, it should be said that this should be study of not only trans-cultural psychology and psychiatry (already many generations of clinicians), but also of the novel data from the field of basic neurosciences (immunological, genetic, neurophysiologic, biochemical, experimental- psychological investigations).
- Mental health of children with special education needs –
Case Report I. Kupriyanova, B. Dashieva, I. Karaush 68 – 73
We have examined 298 children with disabilities (cerebral palsy, neuro-sensory hearing disorders, and mental retardation). With method of multidimensional statistic (method of main components) we have identified “weighting contribution” of clinical-psychological, biological and social characteristics, influencing on development of psychopathological disturbances in children with disabilities. We have distinguished ‘pathogenetic’ and ‘sanogenetic’ factors of formation of psychopathological disturbances in such children.
- Ethno-cultural context of clinical-psychological interrelationships in alcohol dependence –
Original Paper A. Mandel, A. Peshkovskaya, T. Bokhan, I. Badyrgy 74 – 78
We have studied interrelationship between clinical manifestations of alcohol dependence and peculiarities of cognitive activity in persons of Tuvinian and Russian nationalities. Decrease of productivity of remembering and available level of generalizations having greater depth in Tuvinian alcoholic patients has been revealed. Interrelationship of severity of disease and graphic phenomena-indicators of organic disturbances has been identified.
- The role of ethno-cultural features for mental health and adaptation process of Slavic and Armenian refugees from Chechnya –
Original Paper B. Tsygankov, A. Bilim, A. Yaltonskaya 79 – 87
Multiple studies have shown that refugees displaced from war zones are extremely vulnerable to developing mental disorders. These disorders can be caused by the traumatic experiences involving armed conflict, by long-term hardships and instability, by the multiple troubles of adaptation to a new cultural environment or through a combination of any of these factors. Despite the similarities in social and economic situations, and common psychological reactions to severe stress and displacement, refugees do not react and adjust in the same way. In this study, we analyzed ethno-cultural factors and their contribution to developing and maintaining mental distress and long-term psychopathology among war refugees from Chechnya in the Southern Federal District of The Russian Federation. 169 non-Chechen refugees (mean age 37.8 ± 2.7 years, 45% females) were examined by a psychiatrist with regard to the presence of stress-related mental disorders according to ICD-10 criteria. The assessment took place in stages both one month and one year after displacement from Chechnya during the First Chechen War in 1996. In order to study ethno-cultural factors we divided all of the subjects into two groups: a group of refugees of Slavic nationality (N = 117) and a second group of refugees of Armenian nationality (N = 52). No statistical differences were found in the presence of stress-related mental disorders between these two groups during the first stage of the study (one moth after displacement). However, during the second stage of the study (one year after displacement), it was found that the Armenian refugees were diagnosed with Adjustment Disorders, Mixed Anxiety and Depressive Disorder, Obsessive–Compulsive Disorders and Neurasthenia with less statistically significant frequency than those from the Slavic ethnic group. Furthermore, a higher rate of improvement in the mental health state and disorder discontinuation was found among more Armenian refugees than Slavic ones. The socio-cultural differences and the ways of communication within ethnic groups were also analyzed. The factors with a positive influence on the adjustment process were found and described.
- Pica as predictor of substance dependence in adolescence of West Siberia –
Original Paper T. Nevidimova, N. Bokhan, T. Vetlugina, D. Savochkina, E. Batukhtina 88 – 92
Pica and concomitant gustatory and olfactory deviations are factors playing predisposing role in development of substance dependence. Severity and age of onset of pica are significant for heightening the risk of dependent behavior formation. In spite of heightened frequency of family history signs of iron deficiency in addicts, to the moment of examination they more often display not iron deficiency but cytokine mediated anemia of inflammation, accompanied by increase of content of interleukin-6, ferritin, and decreased level of CD71+-lymphocytes.
- Clinical-biological peculiarities and efficacy of therapy in alcohol patients of different ethnic groups in Siberia –
Original Paper T. Shushpanova, V. Semke, N. Bokhan 93 – 99
Objective Disturbances in exciting and inhibiting functions in brain can induce high nerve excitation laid down in basis of high risk of alcoholism. Alcoholism is associated with abnormal levels of certain neuroactive steroids: progesterone (PG) and cortisol (CS), more severe in different ethnic groups. Drugs that normalize levels of neurosteroid hormones (NS) are perspective in treating of alcohol abstinent patients. Method Clinical evaluation of state of patients was conducted with clinical-psychopathological and clinical-dynamic method. RIA kits from blood serum in examined persons measured assay of cortisol and progesterone before and after treatment with original anticonvulsant Galodif (meta-chlor-benzhydryl urea). Results Using Galodif during 21 days in dose 300 mg daily in alcoholic patients induced reduction of symptoms specific for alcohol withdrawal syndrome (AWS). Dynamic reduction of total scores of Hamilton scales for anxiety and depression was quicker in investigated patients. Galodif decreased level of CS on 138% and increased level of PG on 160%, making it means like in samples from healthy control group. Alterations levels of NS in alcoholic patients suggest the abruption regulation of NS as one of the mechanisms of development of compulsive craving for alcohol. Comparative study of NS levels in blood serum of alcoholic patients showed significant decrease the level of PG, compared with healthy donors; investigations levels of CS showed significant increase of alcoholic patients, especially in patients from Tuvinian ethnic group. Conclusion New approaches in psychopharmacotherapy of alcohol craving and prevention of relapses in alcoholic persons from different ethnic groups are associated with genetic anthropometric peculiarities.
- Organization of specialized psychiatric help at outpatient stage in Siberia –
Original Paper V. Lebedeva 100 – 105
During assessment of mental state of patients in general medicine network, obtained data indicated high co-morbidity of mental disorders with somatic pathology, prevalence of these disorders has constituted 39 per 10,000 of the population served by territorial policlinic. Efficacy of rehabilitative programs conducted at outpatient stage is determined by clinical features of revealed mental disorders, age, cooperativeness and continuity of care. Basic links of therapeutic programs have been described.
- Clinical characteristics of addictive states in aborigines of the Russian North –
Original Paper N. Bokhan, D. Kurgak 106 – 112
Ethnocultural aspects of risk factors, formation of clinical dynamics of alcoholism in 409 patients (group 1) from aboriginal population of Kamchatsky Krai living under conditions of Far North (Koryaks, Evens, Aleuts, Chukchi, Itelmens, Yakuts, Nivkhi, etc.) compared with patients of Slavic nationality (group 2, n=168) were studied. Specific factors of alcoholism are presented: early onset, quick tempo of development and progression of course with psychopathologic transformation of intoxication up to withdrawal syndrome development, brutality of aggressive behaviour in intoxication during excessive nature of alcoholization and high level of consumption of surrogates of alcohol, severe degradation of the personality with high level of social maladaptation and asocial behaviour.