BackgroundPULSE was a large, observational, multicenter study designed to evaluate the efficacy and safety of agomelatine in the treatment of major depression in patients with cardiovascular disease (CVD).MethodsPatients with mild-to-moderate major depressive episodes, without psychotic symptoms, were treated as outpatients or in cardiac facilities in 46 regions of Russia. The patients received antidepressant monotherapy with agomelatine 25 or 50 mg, once daily, for 12 weeks.ResultsThe mean age of the patients (N=896) was 51.4±9.9 years, and 68.5% were women. A progressive improvement in the total score on both the anxiety and depression subscales of the Hospital Anxiety and Depression Scale (HADS), from 13.1±3.8 and 13.9±3.1 at baseline to 3.7±2.8 and 3.9±3.0, respectively, was observed by 12 weeks. All individual HADS scores improved rapidly; the change between visits was also significant (P<0.0001). The majority (84.6%) were remitters (HADS total score <7) by 12 weeks. The Clinical Global Impression – Severity and Improvement scores also improved quickly. The mean hypochondria index (Whiteley Index) decreased significantly from 48.0±11.8 at baseline to 25.2±9.2 at 12 weeks (P<0.0001). The main hemodynamic indices improved or remained stable, and biochemical parameters reflecting liver function (aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, total bilirubin) did not exceed three times the upper limits of established norms.ConclusionAgomelatine resulted in statistically significant improvements in depressive symptoms, anxiety, and hypochondria in depressed patients with CVD, and had good tolerability. Our data suggest that agomelatine is safe to treat depression in patients with CVD.

Феномен дисморфофобии (ДМФ) остается одним из самых противоречивых и недостаточно изученных в психиа-трии. В литературе приводятся разные определения ДМФ. Так, Е. Morselli [1], предложивший термин «дисморфофо-бия», описал больного, страдавшего от «неприятных ощуще-ний» в области рубца на носу и высказывавшего «навязчи-вые мысли» о том, что его нос «имеет шаровидную форму» и поэтому привлекает внимание окружающих. E. Kraepelin [2] также относил ДМФ к «навязчивым неврозам». В.П. Осипов [3] считал ДМФ «мучительной мыслью, стыдом своего тела». В других публикациях конца XIX -начала XX в. ДМФ опре-деляется уже как «страх», вызванный минимальными изме-

In the view of growing number of patients consulting plastic surgeons and cosmetologists, evaluation of psychopathological disorders and personality traits of these patients is of great importance.The purpose of this screening study was to evaluate and to compare pathocharacterological and pathopsychological traits of plastic surgeons and cosmetologists’ patients.Method:The study used psychometric method. The validated scales used were Leonhard Personality Inventory, NEO-PI-R, SAS, SDS, HCL-32- R1, Holmes and Rahe stress scale, SAF. We included all patients who have applied to the Institute of Plastic Surgery and Cosmetology from February 2012 to June 2012 and who gave Inform Consent.Results:Study sample consists of 123 patients (103 women), 18-70 years. In the group of cosmetologists’ patients (n=92; 76 women; mean age 44,6+-2,5 years) histrionic and anxiety-phobic personality traits predominated. Constitutionally determined or gained extroversion, expressivity, impulsivity and emotional instability were detected. Anxiety symptoms were detected in 32,4% of patients; depressive symptoms were detected in 35,8% of patients. In the group of plastic surgeons’ patients (n=31; 27 women; mean age 36,7+-1,8 years) pedantic, sticking and disthymic personality traits predominated. Introversion, high level of self-control and detachment were detected. Anxiety symptoms were detected in 22,9% of patients; depressive symptoms were detected in 21,7% of patients.Conclusion:Our data give evidence of statistically significant differences in pathocharacterological and pathopsychological traits of plastic surgeons and cosmetologists’ patients. about one-third of these patients report about symptoms of depression, anxiety and hypomania. Complex diagnostic examination needed in order to determine nosological diagnosis and treatment strategies.

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Introduction:Taking into account epidemiological data about growing frequency of acute and chronic disorders of maxillofacial area evaluation of psychopathological disorders in this group of patients is of great importance.The purpose was to diagnose symptoms of psychopathological disorders in maxillofacial surgeons’ patients.Method:The study used psychometric method. The validated scales used were SAS, SDS, Holmes and Rahe stress scale, HCL-32-R1. We included all patients who have applied to the clinic of Moscow State Medico-Stomatologic University from January 2010 to March 2013 and who gave Inform Consent.Results:Study sample consists of 408 patients (206 men, 202 women), 18-71 years old. According to somatic status all patients were divided into three groups. First group (n=160) – patients with chronic somatic disease resulted in fixed deformity of maxillofacial area. 41,3% of patients had depressive symptoms, 31,3% had anxiety symptoms and 16,3% had hypomania symptoms. Second group (n=127) - patients with acute posttraumatic face tissue injury. 10,7% of patients had symptoms of depression, 20% of patients had symptoms of anxiety and 32,3% of patients had symptoms of hypomania.Third group (n=121) – patients without evident somatic pathology wishing to perform surgical correction of appearance.51,2% of patients had depressive symptoms, 40,5% of patients had anxiety symptoms and 35,7% of patients had hypomania symptoms.Conclusion:Our data suggest that 10-55% of maxillofacial surgeons’ patients have different symptoms of mental disorders (affective, anxiety). Further investigation needed to determine syndromal characteristics and nosological diagnosis and to elaborate psychopharmacotherapy and psychotherapy approaches.

ObjectiveMaxillofacial surgeons and dentists often (up to 10%) deal with the phenomenon of atypical facial pain (AFP) – painful condition of maxillofacial area without clear organic pathology. Psychiatric studies of this disorder are almost lacking.AimThe aim of this study was to define psychopathological disorders in patients with AFP and to set up psychopharmacological treatment strategies.MethodsThe study used clinical psychopathological and psychometric (Pain measurement scales: Brief Pain Inventory, VAS, Pain Catastrophizing Scale) methods. We included patients with AFP examined in the clinic in December 2014 - September 2015.ResultsStudy sample consists of 54 patients with AFP: 45 women (83.3%), 9 men (16.7%), 18-70 years old (39.5 ± 14.7 years). In 67.8% of patients (33 women, 4 men), AFP was associated with affective disorders; among them, recurrent major depressive disorder was verified in 9.2% (4 women, 1 men), single depressive episode – in 33.6% (15 women, 3 man), bipolar II depression – in 3.6% (2 women), cyclothymic disorder – in 7.1% (4 women), dysthymia – in 14.3% (8 women). In 10.8% of patients (6 women), AFP was considered as a symptom of somatoform pain disorder. In 21.4% (6 women, 5 men), AFP was related with schizotypal personality disorder. Psychopharmacological agents used were SSRIs (fluvoxamine, escitalopram), SNRIs (venlafaxine, duloxetine), agomelatine and antipsychotics (quetiapine, amisulpride, alimemazine). The pain subsides in 87,04% of patients and the severity of pain decreased in 12.96% of patients.ConclusionPatients with AFP should be examined by psychiatrist in order to determine psychopathological disorders and to elaborate psychopharmacological treatment strategies.Disclosure of interestThe authors have not supplied their declaration of competing interest.