Publications by authors named "Iovchuk N"

Based on the analysis of literature and own clinical experience, we discuss diagnostic issues of early autistic disorders in children. Main differential-diagnostic signs that permit to differentiate mild forms of autism in childhood diagnosed as Asperger's syndrome from childhood schizophrenia, residual organic CNS damage, circular affective disorders are described. Cases of Asperger's syndrome followed up for many years and recommendations for social and psychological adaptation of children and adolescents with Asperger's syndrome in different age periods are presented.

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Existing system of psychiatric care for children and adolescents is in need of basic reorganization. The authors propose: 1) reestablishment of the speciality of children's and adolescent psychiatrist, a specialist in children's and adolescent narcology, a psychiatrist of early child's age and a pediatric medical psychologist; 2) carrying out the reform of child mental care equal in rights with general psychiatry; 3) preservation and widening of both specialized inpatient and outpatient clinics in general system of child's mental care; 4) legislative and public rehabilitation of children's psychiatry, which suffered considerably from antipsychiatric campaign; 5) professionally organized systematic elevation of psychohygienic, psychiatric and psychotherapeutic knowledges of allied medical and other specialists as well as of parents and of all population too; 6) integration and interaction of govermental services concerning mental health of children and adolescent; 7) organization of regional psychoprophylaxic interdisciplinary centers for children and adolescent.

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To reveal the symptoms of depressions in juvenile population the method of double questioning of both parents and juveniles was elaborated. By means of this method 524 adolescents, boys and girls aged 12-17 years, the pupils of 7-11th classes of schools with different forms of education were examined. The study showed that this method permitted to reveal depressive states in adolescents with high degree of accuracy.

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Based on a ++clinico-statistical analysis of patients (n-159) with cyclothymia and schizophrenia with predominant affective symptomatology who fell ill in childhood and were followed up for 5 to 18 years the main tendencies of the disease course and different patterns of the personality dynamics were discovered, correlating with a number of the premorbid characteristics and the structure of the first attack. The mathematic treatment using the Boolean model enabled one to obtain a prognostic model which may form the basis for the expert system to objectively evaluate, specify and accelerate the process of individual forecasting in the endogenous affective syndromes in childhood. The author provides evidence for relativity of the alternative importance of the clinical signs whose genuine prognostic weight only becomes known in diverse combinations with the other signs.

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Forty schizophrenics (5 girls and 35 boys) aged 4-12 years with long-standing (2-8 years) hypomaniac states were examined. The clinical material was analyzed in comparison with a control group of constitutionally hyperthymic children. The results of the analysis have shown that chronic hypomanias may develop in childhood both in the framework of the ongoing schizophrenic process and in the form of a thymopathic hypomaniac remission.

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The preventive lithium therapy of paroxysm-like endogenic psychoses is associated with a change in the personality responses, in particular to the patient's own mental disease which makes it possible to speak about certain personality changes that manifest themselves phenomenologically by the formation of the adequate criticism of the disease, the psychological dependence on the lithium therapy and by peculiar reduction of emotional responses. The pathogenetic treatment of the described phenomena is sophisticated and calls for the consideration of both therapy and features of the endogenous process.

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[Endogenous depression in children].

Zh Nevropatol Psikhiatr Im S S Korsakova

February 1984

The phenomenology of 96 depressive paroxysms in 56 preschool and early school age children suffering from paroxysmal schizophrenia and cyclothymia was studied. It was concluded that the major characteristics of child depressions included their "masked" character with the prevalence of ideational disturbances and the predominance of anxiety and fear, a tendency toward excessive fearfulness, rarity and naivity of self-condemnation ideas, a pronounced nature of the dysphoric mood tone, a tendency toward paroxysmal episodes of fear, dysphoria, restlessness, somatoalgetic crises, changeable nature of depressive symptomatology, its liability to environmental influence, a peculiar diurnal rhythm of affect, and a reactive nature of the development of depressive disturbances. Six clinical variants of endogenous depression in children were identified.

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The paper is related to an analysis of the diurnal rhythm of mood in 87 adolescents suffering from circular schizophrenia. The diurnal mood fluctuations, as in adults, were seen in most of the patients where the depression had a tendency towards an increase and decrease, as well as in cyclothymo-like phasic depressive disorders. The author describes a special diurnal rhythm of mood in profound depressive states with agitation and hysterical components.

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The author examined 64 adolescents with schizophrenia with a prevalence of phasic affective disorders in the clinical picture. In accordance with the degree of severity 4 groups of patients were distinguished. A comparison of these groups depicted some structural traits of the depressive and manic attacks and their dynamics which correlated with the progress of the process.

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