Shmukler Alexander B, Movina Larisa G, Papsuev Oleg O, Salnikova Lyudmila I, Shashkova Nina G, Kiryanova Elena M
Consort Psychiatr. 2021 Nov 5;2(3):45-52. doi: 10.17816/CP95. eCollection 2021.
The article is devoted to the work of the Moscow Research Institute of Psychiatry to improve psychiatric care for patients with psychotic disorders. An important feature of this work was an integrated approach, in which the clinical picture of the disease was assessed in close connection with the patient's personal and psychological characteristics, social conditions of his life, therapeutic opportunities, rehabilitation potential and organizational structure of care. The article reflects the results of many years of work of the department of outpatient psychiatry and the organization of psychiatric care under the guidance of Professor I.Ya. Gurovich. The results of scientific research carried out by the staff of the institute in a traditional humanistic manner are presented. The translational nature of the research is emphasized by its inextricable link with clinical and social approaches. As a result of many years of work, a concept was developed to provide assistance to various groups of patients, starting with the first manifestations of the disease and ending with cases of long-term chronic disorders with a pronounced level of social maladaptation. As a result, a whole spectrum of new organizational forms of psychiatric care was proposed, such as departments (clinics) of the first psychotic episode, medical rehabilitation departments, assertive community treatment departments, designed for the most difficult patients. These organizational forms were fixed in the regulatory documents of the Ministry of Health and Social Development of the Russian Federation. To date, the above departments have been established in psychiatric institutions in many regions of the Russian Federation. Further development of this area is associated with neurobiological research to identify complex biomarkers of psychotic spectrum disorders. Thus, the research carried out at the present time preserves the tradition of an integrated clinical and social approach to the study of mental disorders. It is shown that an important advantage of this approach is their translational nature.
本文致力于莫斯科精神医学研究所为改善精神病性障碍患者的精神科护理所开展的工作。这项工作的一个重要特点是采用综合方法，即结合患者的个人和心理特征、生活的社会条件、治疗机会、康复潜力以及护理的组织结构来评估疾病的临床表现。本文反映了门诊精神科部门多年的工作成果以及在伊·亚·古罗维奇教授指导下的精神科护理组织情况。介绍了该研究所工作人员以传统人文方式开展的科研成果。研究与临床和社会方法的紧密联系凸显了其转化性质。经过多年工作，形成了一个为各类患者提供帮助的概念，从疾病的最初表现到社会适应不良程度明显的长期慢性疾病病例。结果，提出了一系列新的精神科护理组织形式，如首次精神病发作科室（诊所）、医疗康复科室、针对最难治疗患者的积极社区治疗科室。这些组织形式在俄罗斯联邦卫生和社会发展部的规范性文件中得以确定。截至目前，俄罗斯联邦许多地区的精神病机构已设立了上述科室。该领域的进一步发展与神经生物学研究相关，以确定精神病性谱系障碍的复杂生物标志物。因此，目前开展的研究保留了对精神障碍进行综合临床和社会研究的传统。结果表明，这种方法的一个重要优势在于其转化性质。
