Thomas Edison received the honorary title of the most useful man of America "(Thomas Edison" Haydn Middleton - Oxford University press 1997. P. 43).
The first psychotic episodes in schizophrenic patients
IJ Gurovich, AB Shmukler In recent decades, accumulated a significant amount of new data are important for understanding neurofunctional processes in the brain of patients with schizophrenia and schizophrenia spectrum disorders [1]. In particular, using neuroimaging (positron emission tomography - PET, single photon emission computed tomography - SPECT, magnetic resonance spectroscopy - MRS) in schizophrenic patients revealed the same changes (including reducing the level of metabolism, membrane synthesis and prefrontal regional blood flow cortex, as well as reduced delta sleep EEG) in certain brain areas, mainly in the prefrontal cortex, which made an assumption about the role of "gipofrontalnosti" in the development of symptoms of schizophrenia [3]. Even more important are the data of neuropsychological research. In particular, the tests by which the assessed cognitive function of patients and detect violations in the same areas of the brain that results obtained using the techniques of neuroimaging. All this led to a new paradigm shift in understanding the pathogenesis of schizophrenia, a significant role in which is attached to neurocognitive deficits. At present manifestations of neurocognitive deficits are regarded as the third (along with positive and negative disorders), a core group of symptoms in schizophrenia, responsible, inter alia, for violation of the social functioning of patients [5,7,9]. Shown that 94% of patients with schizophrenia (compared with 7% in healthy populations) in varying degrees, exhibit neurocognitive deficits [18]. Cognitive deficits in a significant number of cases diagnosed in relatives of patients with schizophrenia [14,16]. It is found in untreated patients with first episode of the disease [15] and, as expected, the largest of its deepening happening in the first 2-5 years after the onset of the disease, which requires more active intervention (such as medical and psychosocial) in this period. Shown [8,10,17] that atypical antipsychotics (in contrast to conventional antipsychotics) reduce the severity of neurocognitive deficits in schizophrenia patients. All this attracted the attention of a large number of researchers to the initial, the first episode of schizophrenia and, furthermore, finds increasingly reflected in the practice of psychiatric care. On the other hand, it is noted [6,11,13] that the average time from disease onset to treatment for mental health care is about 1 year and only 1 / 3 of patients come to the attention of psychiatrists in the first two months. Among the reasons for late requests for assistance and delayed the start of treatment patients referred to a lack of understanding the nature of existing disorders, the fear of the consequences of mental illness (stigma and samostigmatizatsiya), lack of screening by general practitioners, incorrect diagnosis when seeking psychiatric help.
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