A master course in psychiatry with the participation of Italian scientists took place June 6-7, 2011 in the Conference Hall of the St. Petersburg V.M. Bekhterev Psychoneurological Research Institute.

A master course in psychiatry with the participation of Italian scientists took place June 6-7, 2011 
in the Conference Hall of the St. Petersburg V.M. Bekhterev Psychoneurological Research Institute.

PROGRAM

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June 6, 2011

  • 09.00 – Opening address of Prof. N.G. Neznanov – 

        Director of the St.Petersburg V.M.Bekhterev Psychoneurological Research Institute, 
        President of the Russian Society of Psychiatry, 
        President of the World Association for Dynamic Psychiatry 
     
  • 09.15 – LECTURE: Cognitive impairment in schizophrenia: Dynamics in the process of antipsychotic treatment (M. Ivanov, D. Kosterin, M. Shipilin, M. Yanushko). 

        Cognitive impairment is recognized as one of the core features of schizophrenia. 
        It is highly important to estimate the extent of cognitive deficit in schizophrenia patients 
        as it impacts their social functioning a lot. Second generation antipsychotics seem to be 
        more efficient in correction of some parameters cognitive deficit, although the future research is still needed. 

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  • 10.15 – Coffee break 
     
  • 10.30 – LECTURE: Neuroendocrine and metabolic disturbances in the use of antipsychotic treatment of exacerbations of schizophrenia (M. Ivanov, G. Mazo, A. Chomsky, L. Libin). 

        Unlike typical antipsychotics, second-generation antipsychotics cause pronounced neuroendocrine and metabolic side effects. 
        Often, these violations constitute a serious threat to the whole process of treating patients with schizophrenia. 
        This lecture will present the latest data on the frequency and nature of side effects of atypical antipsychotics. 
        Also, it will highlight the issues preventing the correction of side effects of this group of drugs. 

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  • 11.30 – Discussion (questions, exchange of experience). 
     
  • 12.30 – Lunch break 
     
  • 13.30 – Visit to the Institute’s clinics; exchange of experience between Italian, Polish and Russian scientists. 
     
  • 15.30 – LECTURE: Psychotherapy of Psychoses (V. Wied). 

        The lecture deals with the rationale of the psychoses psychotherapy, limitations of the psychopharmacotherapy effectiveness, 
        the role of psychosocial factors in psychotic relapse mechanisms, the role of psychological defense in coping behavior deficits, 
        the difference between psychotherapy of neuroses and psychoses and models of the psychoses psychotherapy. 

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  • 16.30 – Discussion (questions, exchange of experience). 
     
  • 17.30 – Conclusions. 
     

June 7, 2011

  • 09.00 – LECTURE: Naltrexone for opiate dependence in Russia: oral, implantable, and injectable (Evgeny Krupitsky). 

        Opioid dependence is one of the most severe drug dependencies. Naltrexone is a medication that completely blocks all subjective effects of opioids. 
        Being administered to detoxified opioid addicts it prevents a relapse to opioids and helps to maintain abstinence. 
        The major problem with naltrexone is a poor compliance which is particularly the case in the countries where there is a treatment alternative 
        to naltrexone based on the substitution of illicit opioids (first of all, heroin) with orally administered opioid agonists (methadone) 
        or partial agonists-antagonist (buprenorphine) prescribed by physician. In Russia substitution therapy is forbidden by the law and naltrexone 
        is the only available pharmacotherapy for heroin dependence. As it was demonstrated in our double blind placebo controlled randomized clinical 
        trials with naltrexone we have been doing for more than a decade, due to lack of alternative to naltrexone and also stronger family control 
        of compliance naltrexone in Russia is more effective for relapse prevention and abstinence stabilization than in the Western countries. 
        Combination of naltrexone with antidepressants or alfa-adrenergic ligands does not improve treatment outcome significantly. 
        Our studies also demonstrated that long acting sustained release formulations of naltrexone (injecatble and implantable) are particularly effective 
        compared to the oral ones as they make control of compliance easier. 

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  • 10.00 – LECTURE: Functioning: Russian experience in using paliperidone in psychiatric practice (M. Ivanov). 

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  • 11.00 – Coffee break. 
     
  • 11.30 – LECTURE: Psychoaffective disorder: a controversial diagnosis? (M. Mauri). 
     
  • 12.30 – Virtual clinical cases discussion. 
     
  • 13.30 – Discussion. 
     
  • 14.00 – Lunch break. 
     
  • 14.30 – LECTURE: Principles of early diagnosis of schizophrenia at the Clinic of Borderline Neuropsychic Disorders (A. Vasilyeva). 

        The clinic of borderline neuropsychic disorders encompasses probably the most widest spectrum of mental disorders. 
        The socio-economic changes brought about the new norms in the behavior in the society as well as the new values and standards, 
        increase of comorbidity, treatment with atypical neuroleptica, all these, mentioned above brought about the growing difficulties 
        in the diagnostic and decrease of the reliability of the old classic differentiation criteria. On the other hand in order to escape 
        iatrogenic complications and to start the appropriate treatment for the patient it is very important from the very beginning 
        to define which category psychotic, personality disorder or neurotic the patient belongs. The presentation suggests the diagnostic algorithm 
        as well as some special features and criteria to make the right diagnosis and to plan adequate treatment for schizophrenic patients. 

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  • 15.30 – LECTURE: Traditional and new methods of treatment of schizophrenia” (M. Popov). 

        The number of atypical antipsychotic drugs available on the pharmaceutical market is increasing. But despite undeniable benefits 
        of novel compounds they cannot be always considered an equal therapeutic alternative to conventional antipsychotics which are in general 
        superior in terms of sedation/inhibition and in time of onset of clinical effects. And in certain clinical situations these features of 
        conventional drugs might be beneficial, for instance in the treatment of acute psychotic episodes with predominantly positive symptoms. 
        Thus, optimization of therapeutic process involving conventional antipsychotic drugs still remains an important goal. One of the main strategies 
        of treatment optimization is administration of adjunctive medications. Current approaches to adjunctive use of different classes of medications 
        in the treatment of schizophrenia will be reviewed. Theoretical background for the adjunctive therapeutic strategies will be provided. 
        Further perspectives of the adjunctive strategies of optimization of antipsychotic therapy aiming at increasing of clinical efficacy and reducing 
        of side effects, will be discussed. 

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  • 16.30 – WORKSHOP: Problems of compliance and comorbidity (N. Lutova). 

    The goal of this workshop is to review barriers for treatment compliance among mentally ill patients. 
    During the workshop we will cover the following topics: 
    • epidemiology of adherence problems;
    • consequences of adherence problems;
    • factors that affect medication compliance;
    • methods of assessing medication adherence;
    • strategies to improve treatment compliance.

     
  • 17.30 – Discussion (questions, exchange of experience). 
     
  • 18.00 – Closing remarks.
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