The Role of Treatment Motivation Subsystems in the Overall Structure of Compliance in Patients Undergoing Psychopharmacotherapy

Objective. To identify interactions in the structure of treatment motivation and compliance in patients in a psychiatric clinic. Materials and methods. A questionnaire and compliance scales were used to assess treatment motivation in 104 patients in the Department of Integrative Pharmaco- and Psychotherapy. These included 67 patients with schizophrenia and schizoaffective spectrum disorders, 15 with affective disorders, 13 with personality disorders and neurotic disorders, and nine with organic lesions. Results and conclusions. The key role in forming the overall level of treatment compliance is played by the motivation mechanism based on subjective experience of suffering from the disorder. Occurrence of amotivation syndrome has disastrous effects on the formation of compliance. Passive agreement by the patient to accept treatment leads to a degradation in the treatment alliance, which is worsened by cognitive deficit in patients and reduced insight into the condition. Predominance of external motivation to receive treatment, determined by the pressure of the patient's immediate environment, also had adverse impact on the compliance subsystem linked with the surroundings. Pressure from relatives was often not transformed into adequate social support. Extremely low levels of internal motivation based on an understanding of the nature of the disorder, led to decreases in compliance associated with attitudes to treatment with medication.

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Changes in the Ethogram in Rats Due to Contagion Behavior

Experiments were performed using a model of contagion behavior based on drinking behavior in rats. Observer rats without the drinking motivation, in the presence of a familiar conspecific with drinking motivation who demonstrated drinking behavior (demonstrator rats), displayed behavioral signs of the drinking motivation, i.e., signs of contagion behavior. Analysis of transition probability matrixes to investigate changes in the ethogram in observer rats demonstrated contagion behavior. Decreases in the frequency of aggressive and defensive behavioral patterns were seen in these animals, along with simultaneous increases in the frequency of exploratory activity, drinking, and exploratory approaches to bottles as compared with the ethograms of observer rats not displaying signs of contagion behavior on testing in the presence of a familiar conspecific demonstrator without the drinking motivation.

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“Unpredictable Stress”: Ambiguity of Stress Reactivity in Studies of Long-Term Plasticity

Data on the influences of stress on the function of long-term synaptic plasticity are analyzed. Using longterm potentiation (LTP) as an example, stress has been shown to have both stimulatory and inhibitory influences on the effectiveness of the induction of long-term modifications, the effect depending on the nature, duration, and intensity of the stress, the observation time point, the brain structure being studied, and, thus, the involvement in the stress response of the different mechanisms underlying LTP. Stress-induced increases in glucocorticoid levels did not obligately correlate with changes in long-term plasticity, while application of corticosterone in vivo and in vitro could lead to both activation and inhibition of LTP. Existing data provide evidence that changes in LTP are determined by the ratio of mineralocorticoid and glucocorticoid receptors, activation of the latter not so much impairing the mechanisms of generation as increasing the threshold of induction of LTP, regulating the metaplasticity of synapses. The unpredictability of the effects of stress is related in particular to the involvement of other transmitter systems regulating metaplasticity whose actions depend on the animal's individual experience in the stress reaction. The range of individual differences stimulates the ongoing search for significant factors determining the stress reactivity of longterm plasticity underlying stress resistance or susceptibility to its pathological consequences. Differences in the processing of signals arriving at neurons and their molecular mediation may constitute such a factor.

http://ift.tt/2zSUZzw

The Content of c-Fos-Positive Neurons in the Cerebral Cortex and Striatum and Behavioral Characteristics in Rats on Cutaneous Application of Antiseptic Dorogov’s Stimulator Paste

Experiments were performed on three groups of male Sprague–Dawley rats, each of six animals. Group 1 consisted of intact animals; group 2 of animals given zinc paste, and group 3 of animals given fraction 3 of antiseptic Dorogov's stimulator (ASD-3) by application to the skin on the back. Detection of c-Fos-positive neurons in different parts of the brain and studies of behavioral responses demonstrated activation of neurons in the cingulate, motor, and piriform areas of the cerebral cortex and the striatum, with increases in motor and ultrasound activity; there was a correlation between behavioral reactions and activation of neurons in these brain areas. These results provide evidence of the concomitant regulation of behavior by multiple brain structures and that ASD-3 has neurotropic properties.

http://ift.tt/2hp6PuK

Increasing the Efficacy of the Psychopharmacotherapy of Late Depression: Optimization of Treatment Duration

Objective. This study was performed to analyze the potential for using different methods to increase the efficacy of the psychopharmacotherapy of late depression, particularly by increasing the duration of treatment. Materials and methods. The study included 378 patients aged 50–82 (mean 60.6 ± 8.4) years. Treatment duration effects were studied by dividing patients into groups with short (4–8 weeks), intermediate (12 weeks), and long (20–24 weeks) durations of psychopharmacotherapy. Results and conclusions. Treatment results for durations of less than 8 weeks were significantly worse than those obtained with treatment duration greater than 12 weeks (these groups were not comparable because the initial cohorts were not comparable). By week 24, treatment responses were obtained in 63.9% of patients who had not responded to treatment by week 12, and 43.4% achieved remission. Partial responses and stable positive improvements by 12 weeks (about half the patients achieved remission) were predictors of responses with treatment durations of up to 24 weeks. These data were used to develop algorithms for selection of therapeutic tactics in patients with late depression depending on the results obtained at the first 12 weeks of psychopharmacotherapy.

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Cognitive Impairments in Stroke: Potential for Medication-Based Correction

Objective. To assess the efficacy and safety of Cellex for the correction of cognitive disorders in the acute period of ischemic stroke (IS). Materials and methods. The study included 246 patients in the acute period of IS. Patients were divided by random selection into two groups given Cellex or placebo for 10 days on the background of standard basal treatment. Patients were assessed dynamically in terms of neuropsychological status. Results and conclusions. This study showed that in patients with IS, mild and moderate cognitive impairments underwent faster and more marked regression when Cellex was prescribed (p < 0.05).

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Event-Related Potentials to Faces Presented in an Emotional Context

The ability to recognize faces is a key skill forming our social behavior. Much attention has been focused on studies of the perception of emotional faces and expressions, though the question of the effects of context on the face recognition process has received little study. Subjects in the studies reported here watched a video clip, after which EEG recordings were made as they performed a task with photographs of the neutral faces of the characters in the film and photographs of the neutral faces of fillers (characters not appearing in the film). Studies were performed using event-related potentials (ERP). Differences were found in the amplitude of the P200 component in responses to presentation of the faces of culprits and victims, which may be associated with the different subjective significance of these stimuli for the person watching the video clip. Correlations were also found between the subjects' personality characteristics (anxiety, aggressivity, hostility) and increases in the amplitude of the P200 component in response to the faces of victims as compared with fillers. Further studies of the effects of emotional context on the perception of faces are required.

http://ift.tt/2zS2cAa