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183-720: Pyotr Borisovich Gannushkin was born in the Russian Empire in 1875 in the village of Novosyolki in the Pronsk district of the Ryazan Governorate (the present-day Ryazan Oblast ). His father Boris was a physician , a compassionate and precise man. His mother Olga (née Mozharova) came of an impoverished Russian landed family. Well-bred and educated, she was fluent in French and German , interested in philosophy , and fond of music , poetry and art . She was, moreover,

366-544: A Western model. Alexander I ( r.  1801–1825 ) helped defeat the militaristic ambitions of Napoleon and subsequently constituted the Holy Alliance , which aimed to restrain the rise of secularism and liberalism across Europe. Russia further expanded to the west, south, and east, strengthening its position as a European power. Its victories in the Russo-Turkish Wars were later checked by defeat in

549-710: A brilliant exposition of his own findings about paranoia. After his thesis was accepted and approved, Gannushkin became a privat dozent (i.e. freelance university lecturer) of the Department of Mental Disorders in the Moscow State University. It was then that he began to deliver his course of lectures on "The Theory of Pathological Characters" ( Russian : Учение о патологических характерах ). In 1905, Gannushkin attended courses in postgraduate psychiatry at Kraepelin 's clinic in Munich . Thereafter he became

732-514: A certain level of performance relative to controls on working memory tasks. These abnormalities may be linked to the consistent post-mortem finding of reduced neuropil , evidenced by increased pyramidal cell density and reduced dendritic spine density. These cellular and functional abnormalities may also be reflected in structural neuroimaging studies that find reduced grey matter volume in association with deficits in working memory tasks. Positive symptoms have been linked to cortical thinning in

915-640: A crucial issue in Russia, leading to repressive measures by the Tsar 's protégé Lev Kasso , the education minister . In 1911, together with other progressive scholars and scientists, Gannushkin left the university in protest. From 1906 until 1914, when he was drafted into the army, he worked as a resident physician at the Moscow Alexeyev Psychiatric Hospital ( Russian : Московская Алексеевская психиатрическая больница ), known today as

1098-518: A few were introduced , no major changes were attempted. The liberal Alexander I was replaced by his younger brother Nicholas I (1825–1855), who at the beginning of his reign was confronted with an uprising. The background of this revolt lay in the Napoleonic Wars , when a number of well-educated Russian officers travelled in Europe in the course of military campaigns, where their exposure to

1281-539: A first-episode psychosis, and following remission, a preventive maintenance use is continued to avoid relapse. However, it is recognized that some people do recover following a single episode and that long-term use of antipsychotics will not be needed but there is no way of identifying this group. The primary treatment of schizophrenia is the use of antipsychotic medications , often in combination with psychosocial interventions and social supports . Community support services including drop-in centers, visits by members of

1464-481: A fitness advantage in unaffected individuals. While some evidence has not supported this idea, others propose that a large number of alleles each contributing a small amount can persist. A meta-analysis found that oxidative DNA damage was significantly increased in schizophrenia. Environmental factors, each associated with a slight risk of developing schizophrenia in later life include oxygen deprivation , infection, prenatal maternal stress , and malnutrition in

1647-424: A gift, the freed peasants had to pay a special lifetime tax to the government, which in turn paid the landlords a generous price for the land that they had lost. In numerous cases the peasants ended up with relatively small amounts of the least productive land. All the property turned over to the peasants was owned collectively by the mir , the village community, which divided the land among the peasants and supervised

1830-711: A gregarious and kind-hearted woman. In his early years, Pyotr was educated by his mother. After a while, the family moved to Ryazan , the regional capital, where his father started teaching at a high school for boys. Soon after his 9th birthday, the young Gannushkin enrolled at the same school. An excellent student, Pyotr was always sociable, honest, and inclined to irony; he nursed a dislike for severe discipline. During his school years, he edited his own home journal. Gannushkin's sister Maria noted in her memoirs that Pyotr never told anyone which profession he intended to pursue. When he turned 13, however, Gannushkin's keen interest in " personology " and human mentality became apparent. It

2013-566: A landmark in the theory of psychopathies in Russia. Among Russian psychiatrists, it was Gannushkin who developed the most accurate definition of various psychopathies (personality disorders). Gannushkin had many followers, among who it is possible to distinguish three generations. The first generation of disciples was formed of colleagues who worked under his direction: D.A. Amenitsky, I.N. Vvedensky, T.A. Geyer, V.A. Grombakh, M.O. Gurevich , P.M. Zinovyev, E.K. Krasnushkin, L.A. Prozorov, L.M. Rezenstein, M.Y. Serieysky, T.I. Yudin. The second generation

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2196-560: A major domestic factor with its support for liberating Balkan Christians from Ottoman rule and making Bulgaria and Serbia independent. In early 1877, Russia intervened on behalf of Serbian and Russian volunteer forces, leading to the Russo-Turkish War (1877–78) . Within one year, Russian troops were nearing Constantinople and the Ottomans surrendered. Russia's nationalist diplomats and generals persuaded Alexander II to force

2379-592: A number of drug withdrawal syndromes . Non-bizarre delusions are also present in delusional disorder , and social withdrawal in social anxiety disorder , avoidant personality disorder and schizotypal personality disorder . Schizotypal personality disorder has symptoms that are similar but less severe than those of schizophrenia. Schizophrenia occurs along with obsessive–compulsive disorder (OCD) considerably more often than could be explained by chance, although it can be difficult to distinguish obsessions that occur in OCD from

2562-441: A number of signs and symptoms, a period known as the prodromal stage . Up to 75% of those with schizophrenia go through a prodromal stage. The negative and cognitive symptoms in the prodrome stage can precede FEP (first episode psychosis) by many months and up to five years. The period from FEP and treatment is known as the duration of untreated psychosis (DUP) which is seen to be a factor in functional outcome. The prodromal stage

2745-723: A poor prognosis, and poor quality of life. Sleep onset and maintenance insomnia is a common symptom, regardless of whether treatment has been received or not. Genetic variations have been found associated with these conditions involving the circadian rhythm , dopamine and histamine metabolism , and signal transduction. Schizophrenia is also associated with a number of somatic comorbidities including diabetes mellitus type 2 , autoimmune diseases , and cardiovascular diseases . The association of these with schizophrenia may be partially due to medications (e.g. dyslipidemia from antipsychotics), environmental factors (e.g. complications from an increased rate of cigarette smoking), or associated with

2928-726: A population of 125.6 million with considerable ethnic, linguistic, religious, and socioeconomic diversity. The rise of the Russian Empire coincided with the decline of its rivals: the Swedish Empire , the Polish–Lithuanian Commonwealth , Qajar Iran , the Ottoman Empire , and Qing China . From the 10th to 17th centuries, the Russians had been ruled by a noble class known as the boyars , above whom

3111-637: A prenatal viral infection . Other infections during pregnancy or around the time of birth that have been linked to an increased risk include infections by Toxoplasma gondii and Chlamydia . The increased risk is about five to eight percent. Viral infections of the brain during childhood are also linked to a risk of schizophrenia during adulthood. Cat exposure is also associated with an increased risk of broadly defined schizophrenia-related disorders, with an odds ratio of 2.4. Adverse childhood experiences (ACEs), severe forms of which are classed as childhood trauma , range from being bullied or abused, to

3294-558: A proponent of Kraepelin's theory. The following year, Gannushkin visited St. Anne's Psychiatric Hospital ( French : Hôpital Sainte-Anne ) in Paris , where he familiarized himself with the work of Valentin Magnan , an influential figure in French psychiatry. In 1908 and in 1911 Gannushkin again attended postgraduate psychiatry courses at Kraepelin's clinic. In 1911 university autonomy became

3477-442: A psychiatrist was primarily a community worker. That is why, perhaps, he made psychopathies his main research subject. "Our generation does not limit itself to psychiatric hospitals. Using the same approach, we visit schools, barracks, and prisons. We are not looking for those who need to be hospitalized, but for the half-normal, borderline types, those who represent intermediate steps. Borderline psychiatry, minor psychiatry... - here

3660-403: A psychotic episode in schizophrenia, including delusions , hallucinations , and disorganized thoughts, speech and behavior or inappropriate affect, typically regarded as manifestations of psychosis. Hallucinations occur at some point in the lifetimes of 80% of those with schizophrenia and most commonly involve the sense of hearing (most often hearing voices ), but can sometimes involve any of

3843-407: A result, there was a slow improvement in the living standards of Russian peasants in the empire's last two decades before 1914. Recent research into the physical stature of Army recruits shows they were bigger and stronger. There were regional variations, with more poverty in the heavily populated central black earth region ; and there were temporary downturns in 1891–93 and 1905–1908. By the end of

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4026-453: A reverse relationship is found where their use improves these symptoms. However, substance use disorders are associated with an increased risk of suicide, and a poor response to treatment. Cannabis use may be a contributory factor in the development of schizophrenia, potentially increasing the risk of the disease in those who are already at risk. The increased risk may require the presence of certain genes within an individual. Its use

4209-428: A significant impact on social or occupational functioning for at least six months. One of the symptoms needs to be either delusions, hallucinations, or disorganized speech. A second symptom could be one of the negative symptoms, or severely disorganized or catatonic behaviour . A different diagnosis of schizophreniform disorder can be made before the six months needed for the diagnosis of schizophrenia. In Australia,

4392-414: A temporary stimulant psychosis , which presents very similarly to schizophrenia. Rarely, alcohol use can also result in a similar alcohol-related psychosis . Drugs may also be used as coping mechanisms by people who have schizophrenia, to deal with depression, anxiety , boredom, and loneliness . The use of cannabis and tobacco are not associated with the development of cognitive deficits, and sometimes

4575-480: A third of people do not respond to initial antipsychotics, in which case clozapine is offered. In a network comparative meta-analysis of 15 antipsychotic drugs, clozapine was significantly more effective than all other drugs, although clozapine's heavily multimodal action may cause more significant side effects. In situations where doctors judge that there is a risk of harm to self or others, they may impose short involuntary hospitalization . Long-term hospitalization

4758-408: A total of 24 million cases globally. Males are more often affected and on average have an earlier onset than females. The causes of schizophrenia may include genetic and environmental factors. Genetic factors include a variety of common and rare genetic variants . Possible environmental factors include being raised in a city , childhood adversity, cannabis use during adolescence, infections,

4941-503: A very large and complex bureaucracy, and a court that rivaled those of Versailles and London . But the government was living far beyond its means, and 18th-century Russia remained "a poor, backward, overwhelmingly agricultural, and illiterate country". In 1801, over four years after Paul became the emperor of Russia, he was killed in Saint Michael's Castle in a coup. Paul was succeeded by his 23-year-old son, Alexander . Russia

5124-825: A wasteland and useless, and saw the government wasting money, but later, much gold and petroleum were discovered. In the late 1870s, Russia and the Ottoman Empire again clashed in the Balkans. From 1875 to 1877, the Balkan crisis intensified, with rebellions against Ottoman rule by various Slavic nationalities, which the Ottoman Turks had dominated since the 15th century. This was seen as a political risk in Russia, which similarly suppressed its Muslims in Central Asia and Caucasia. Russian nationalist opinion became

5307-547: A wide range of different transitional steps and transient mental states. He acknowledged that psychopaths (i.e. those with personality disorders) have made substantial contributions to science, scholarship, art, and literature. Gannushkin delineated the three main signs of behavioral pathology that underlie psychopathies: Some elements of Gannushkin's typology were later incorporated into a theory developed by Andrey Yevgenyevich Lichko , another Russian psychiatrist interested in personality disorders together with their milder forms,

5490-779: Is a motto for our times, an area to which our actions must be directed in the immediate future." While Gannushkin was finishing his seminal work on the Manifestations of psychopathies: their statics, dynamics and systematic aspects ( Russian : Клиника психопатий, их статика, динамика, систематика ), his health quickly deteriorated. After long hesitation he agreed to undergo the proposed operation. The best Russian surgeons and physicians tried to save him, but he died on 23 February 1933. Before his death he managed to read his monograph after proofreading and approve it for publication. The book appeared that year following his death. Research papers written by Gannushkin and his followers represent

5673-462: Is a reflection of dysfunction in other processes related to reward. Overall, a failure of reward prediction is thought to lead to impairment in the generation of cognition and behavior required to obtain rewards, despite normal hedonic responses. Another theory links abnormal brain lateralization to the development of being left-handed which is significantly more common in those with schizophrenia. This abnormal development of hemispheric asymmetry

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5856-452: Is affected the risk is about 13% and if both are affected the risk is nearly 50%. However, the DSM-5 indicates that most people with schizophrenia have no family history of psychosis. Results of candidate gene studies of schizophrenia have generally failed to find consistent associations, and the genetic loci identified by genome-wide association studies explain only a small fraction of

6039-464: Is akin to the behavior pattern typical for borderline personality disorder . As a psychotic episode , such reactions could happen during epidemic encephalitis , cerebral atherosclerosis , and brain injury . Gannushkin also took part in the experimental study of hypnosis . He criticized Lombroso's theory of crime. Gannushkin was interested in psychoanalytical ideas, and made experimental use of psychoanalytic therapy. His stance on psychoanalysis

6222-629: Is also known for Russia's involvement in the Seven Years' War , where it was successful militarily, but gained little politically. Catherine the Great was a German princess who married Peter III , the German heir to the Russian crown. After the death of Empress Elizabeth, Catherine came to power after she effected a coup d'état against her very unpopular husband. She contributed to the resurgence of

6405-406: Is associated with doubling the rate. The causes of schizophrenia are unknown, and a number of models have been put forward to explain the link between altered brain function and schizophrenia. The prevailing model of schizophrenia is that of a neurodevelopmental disorder, and the underlying changes that occur before symptoms become evident are seen as arising from the interaction between genes and

6588-462: Is concerned with the mental operations needed to interpret, and understand the self and others in the social world. This is also an associated impairment, and facial emotion perception is often found to be difficult. Facial perception is critical for ordinary social interaction. Cognitive impairments do not usually respond to antipsychotics, and there are a number of interventions that are used to try to improve them; cognitive remediation therapy

6771-476: Is difficult to distinguish childhood schizophrenia from autism. Prevention of schizophrenia is difficult as there are no reliable markers for the later development of the disorder. Early intervention programs diagnose and treat patients in the prodromal phase of the illness. There is some evidence that these programs reduce symptoms. Patients tend to prefer early treatment programs to ordinary treatment and are less likely to disengage from them. As of 2020, it

6954-401: Is later seen to be balanced by a post-menopausal increase in the development in females. Estrogen produced pre-menopause has a dampening effect on dopamine receptors but its protection can be overridden by a genetic overload. There has been a dramatic increase in the numbers of older adults with schizophrenia. Onset may happen suddenly or may occur after the slow and gradual development of

7137-733: Is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. For a diagnosis of schizophrenia, the described symptoms need to have been present for at least six months (according to the DSM-5 ) or one month (according to the ICD-11 ). Many people with schizophrenia have other mental disorders, especially mood disorders , anxiety disorders , and obsessive–compulsive disorder . About 0.3% to 0.7% of people are diagnosed with schizophrenia during their lifetime. In 2017, there were an estimated 1.1 million new cases and in 2022

7320-575: Is noted in Other specified schizophrenia spectrum and other psychotic disorders as a DSM-5 category. Schizoaffective disorder is diagnosed if symptoms of mood disorder are substantially present alongside psychotic symptoms. Psychosis that results from a general medical condition or substance is termed secondary psychosis. Psychotic symptoms may be present in several other conditions, including bipolar disorder , borderline personality disorder , substance intoxication , substance-induced psychosis , and

7503-473: Is noted in schizophrenia. Studies have concluded that the link is a true and verifiable effect that may reflect a genetic link between lateralization and schizophrenia. Bayesian models of brain functioning have been used to link abnormalities in cellular functioning to symptoms. Both hallucinations and delusions have been suggested to reflect improper encoding of prior expectations , thereby causing expectation to excessively influence sensory perception and

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7686-424: Is of particular help. Neurological soft signs of clumsiness and loss of fine motor movement are often found in schizophrenia, which may resolve with effective treatment of FEP. Onset typically occurs between the late teens and early 30s, with the peak incidence occurring in males in the early to mid-twenties, and in females in the late twenties. Onset before the age of 17 is known as early-onset, and before

7869-449: Is often made between those negative symptoms that are inherent to schizophrenia, termed primary; and those that result from positive symptoms, from the side effects of antipsychotics, substance use disorder, and social deprivation – termed secondary negative symptoms. Negative symptoms are less responsive to medication and the most difficult to treat. However, if properly assessed, secondary negative symptoms are amenable to treatment. There

8052-435: Is outlined in his "On Psychotherapy and Psychoanalysis" ( Russian : О психотерапии и психоанализе ). Not a committed proponent of Freud 's theory, Gannushkin did believe that under certain conditions psychoanalytical methods could be used as part of the process of treatment. Gannushkin regarded war and revolution as a "traumatic epidemic" affecting the entire population. There is a reciprocal influence, he used to say, between

8235-448: Is regarded as Gannushkin's main contribution to the discipline. In Manifestations of psychopathies: statics, dynamics, systematic aspects (1933), Gannushkin distinguished two types of pathological development: constitutional and situational. The situational development of psychopathy is evidently caused by trauma or distress: its onset is always marked by some serious mental change, after which everything becomes more or less static. While

8418-408: Is seen to have a role in the neurobiology of schizophrenia. The most common model put forward was the dopamine hypothesis of schizophrenia , which attributes psychosis to the mind's faulty interpretation of the misfiring of dopaminergic neurons . This has been directly related to the symptoms of delusions and hallucinations. Abnormal dopamine signaling has been implicated in schizophrenia based on

8601-492: Is some evidence that the negative symptoms of schizophrenia are amenable to psychostimulant medication, although such drugs have varying degrees of risk for causing positive psychotic symptoms. Scales for specifically assessing the presence of negative symptoms, and for measuring their severity, and their changes have been introduced since the earlier scales such as the PANNS that deals with all types of symptoms. These scales are

8784-435: Is the high-risk stage for the development of psychosis. Since the progression to first episode psychosis is not inevitable, an alternative term is often preferred of at risk mental state . Cognitive dysfunction at an early age impacts a young person's usual cognitive development. Recognition and early intervention at the prodromal stage would minimize the associated disruption to educational and social development and has been

8967-444: Is treated as both verbal and non-verbal. Apathy accounts for around 50% of the most often found negative symptoms and affects functional outcome and subsequent quality of life. Apathy is related to disrupted cognitive processing affecting memory and planning including goal-directed behaviour. The two subdomains have suggested a need for separate treatment approaches. A lack of distress is another noted negative symptom. A distinction

9150-564: Is unclear whether the benefits of early treatment persist once the treatment is terminated. Cognitive behavioral therapy may reduce the risk of psychosis in those at high risk after a year and is recommended in this group, by the National Institute for Health and Care Excellence (NICE). Another preventive measure is to avoid drugs that have been associated with development of the disorder, including cannabis , cocaine, and amphetamines . Antipsychotics are prescribed following

9333-434: Is used on a small number of people with severe schizophrenia. In some countries where supportive services are limited or unavailable, long-term hospital stays are more common. Schizophrenia is a mental disorder characterized by significant alterations in perception , thoughts, mood, and behavior. Symptoms are described in terms of positive , negative, and cognitive symptoms . The positive symptoms of schizophrenia are

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9516-416: Is usually seen as the beginning of the "imperial" period of Russia. Following the reforms, the governance of Russia by an absolute monarch was enshrined. The Military Regulations made a note of the autocratic nature of the regime. During the reign of Peter I, the last vestiges of the independence of the boyars were lost. He transformed them into the new nobility , who were obedient nobles that served

9699-511: The 1828–1829 Russo-Turkish War , Russia invaded northeastern Anatolia and occupied the strategic Ottoman towns of Karin and Gümüşhane (Argiroupoli) and, posing as protector of the Greek Orthodox population , received extensive support from the region's Pontic Greeks . Following a brief occupation, the Russian imperial army withdrew back into Georgia. Russian emperors quelled two uprisings in their newly acquired Polish territories:

9882-544: The Boxer Rebellion . Japan strongly opposed Russian expansion, and defeated Russia in the Russo-Japanese War of 1904–1905. Japan took over Korea, and Manchuria remained a contested area. Meanwhile, France , looking for allies against Germany after 1871, formed a military alliance in 1894, with large-scale loans to Russia, sales of arms, and warships, as well as diplomatic support. Once Afghanistan

10065-591: The British domination. Peter I ( r.  1682–1725 ), also known as Peter the Great, played a major role in introducing the European state system into Russia. While the empire's vast lands had a population of 14 million, grain yields trailed behind those in the West. Nearly the entire population was devoted to agriculture, with only a small percentage living in towns. The class of kholops , whose status

10248-577: The Clinical Assessment Interview for Negative Symptoms (CAINS), and the Brief Negative Symptom Scale (BNSS) also known as second-generation scales. In 2020, ten years after its introduction, a cross-cultural study of the use of BNSS found valid and reliable psychometric evidence for its five-domain structure cross-culturally. The BNSS can assess both the presence and severity of negative symptoms of

10431-539: The Clinical Assessment Interview for Negative Symptoms (CAINS), and the Brief Negative Symptoms Scale (BNSS) have been introduced. The DSM-5 , published in 2013, gives a Scale to Assess the Severity of Symptom Dimensions outlining eight dimensions of symptoms. DSM-5 states that to be diagnosed with schizophrenia, two diagnostic criteria have to be met over the period of one month, with

10614-696: The Coalition and joined the Continental System . By 1812, Russia had occupied many territories in Eastern Europe, holding some of Eastern Galicia from Austria and Bessarabia from the Ottoman Empire ; from Northern Europe, it had gained Finland from the war against a weakened Sweden ; it also gained some territory in the Caucasus. Following a dispute with Emperor Alexander I, in 1812, Napoleon launched an invasion of Russia . It

10797-559: The Crimean War (1853–1856), leading to a period of reform and intensified expansion into Central Asia . Alexander II ( r.  1855–1881 ) initiated numerous reforms , most notably the 1861 emancipation of all 23 million serfs. From 1721 until 1762, the Russian Empire was ruled by the House of Romanov ; its matrilineal branch of patrilineal German descent, the House of Holstein-Gottorp-Romanov , ruled from 1762 until 1917. By

10980-563: The Crimean War , which Russia lost. The war was fought primarily in the Crimean peninsula , and to a lesser extent in the Baltic during the related Åland War . Since playing a major role in the defeat of Napoleon, Russia had been regarded as militarily invincible, but against a coalition of the great powers of Europe, the reverses it suffered on land and sea exposed the weakness of Emperor Nicholas I's regime. When Emperor Alexander II ascended

11163-506: The Enlightenment , the specter of revolution and disorder continued to haunt her and her successors. Indeed, her son Paul introduced a number of increasingly erratic decrees in his short reign aimed directly against the spread of French culture in response to their revolution . In order to ensure the continued support of the nobility, which was essential to her reign, Catherine was obliged to strengthen their authority and power at

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11346-623: The Franco-Russian Alliance , to contain the growing power of Germany; completed the conquest of Central Asia ; and demanded important territorial and commercial concessions from China. The emperor's most influential adviser was Konstantin Pobedonostsev , tutor to Alexander III and his son Nicholas, and procurator of the Holy Synod from 1880 to 1895. Pobedonostsev taught his imperial pupils to fear freedom of speech and

11529-621: The Great Northern War , which ended in 1721 when an exhausted Sweden asked for peace with Russia. As a result, Peter acquired four provinces situated south and east of the Gulf of Finland , securing access to the sea. There he built Russia's new capital, Saint Petersburg , on the Neva river, to replace Moscow, which had long been Russia's cultural center. This relocation expressed his intent to adopt European elements for his empire. Many of

11712-478: The Industrial Revolution , Russia began to lag ever farther behind, creating new weaknesses for the empire seeking to play a role as a great power. Russia's status as a great power concealed the inefficiency of its government, the isolation of its people, and its economic and social backwardness. Following the defeat of Napoleon, Alexander I had been ready to discuss constitutional reforms, but though

11895-622: The Italian and Swiss expedition ,—he inflicted a series of defeats on the French; in particular, the Battle of the Trebbia in 1799. Nicholas II Nicholas II, also known as Nikolai Alexandrovich Romanov, was the final Emperor of Russia, King of Congress Poland, and Grand duke of Finland. His reign started on 1 November 1894 and ended with his abdication on 15 March 1917. Born on 18 May 1868 at Alexander Palace , Tsarskoye Selo, Russian Empire, he

12078-590: The Lewy body dementias may also be associated with schizophrenia-like psychotic symptoms. It may be necessary to rule out a delirium , which can be distinguished by visual hallucinations, acute onset and fluctuating level of consciousness , and indicates an underlying medical illness. Investigations are not generally repeated for relapse unless there is a specific medical indication or possible adverse effects from antipsychotic medication . In children hallucinations must be separated from typical childhood fantasies. It

12261-606: The November Uprising in 1830 and the January Uprising in 1863. In 1863, the Russian autocracy had given the Polish artisans and gentry reason to rebel, by assailing national core values of language, religion, and culture. France , Britain , and Austria tried to intervene in the crisis but were unable to do so. The Russian press and state propaganda used the Polish uprising to justify the need for unity in

12444-493: The Ottoman Empire . The foundations of a Russian national state were laid in the late 15th century during the reign of Ivan III . By the early 16th century, all of the semi-independent and petty princedoms in Russia had been unified with Moscow. During the reign of Ivan IV , the khanates of Kazan and Astrakhan were conquered by Russia in the mid-16th century, leading to the development of an increasingly multinational state. Much of Russia's expansion occurred in

12627-601: The Ottoman Empire . His attention then turned to the north. Russia lacked a secure northern seaport, except at Arkhangelsk on the White Sea , where the harbor was frozen for nine months a year. Access to the Baltic Sea was blocked by Sweden, whose territory enclosed it on three sides. Peter's ambitions for a "window to the sea" led him, in 1699, to make a secret alliance with Saxony , the Polish–Lithuanian Commonwealth , and Denmark-Norway against Sweden ; they conducted

12810-473: The Partitions of Poland , Russia became the most populous state in Europe, ahead of France . The foundations of the Russian Empire were laid during Peter I 's reforms , which significantly altered Russia's political and social structure, and as a result of the Great Northern War which strengthened Russia's standing on the world stage. Internal transformations and military victories contributed to

12993-834: The Russian Provisional Government , and the proclamation of the first Russian Republic . Political dysfunction, continued involvement in the widely unpopular war, and widespread food shortages resulted in mass demonstrations against the government in July . The republic was overthrown in the October Revolution by the Bolsheviks , who proclaimed the Russian Socialist Federative Soviet Republic and whose Treaty of Brest-Litovsk ended Russia's involvement in

13176-606: The Russian nobility that began after the death of Peter the Great, abolishing State service and granting them control of most state functions in the provinces. She also removed the Beard tax instituted by Peter the Great. Catherine extended Russian political control over the lands of the Polish–Lithuanian Commonwealth , supporting the Targowica Confederation . However, the cost of these campaigns further burdened

13359-661: The Russo-Persian War (1804–1813) , they clashed with Persia over control and consolidation of Georgia, and also became involved in the Caucasian War against the Caucasian Imamate . At the conclusion of the war, Persia irrevocably ceded what is now Dagestan , eastern Georgia, and most of Azerbaijan to Russia, under the Treaty of Gulistan . Russia attempted to expand to the southwest, at the expense of

13542-647: The State Duma , although he still retained absolute political power. When Russia entered the First World War on the side of the Allies , it suffered a series of defeats that further galvanized the population against the emperor. In 1917, mass unrest among the population and mutinies in the army culminated in the February Revolution , which led to the abdication of Nicholas II, the formation of

13725-613: The World Health Organization (WHO). These criteria use the self-reported experiences of the person and reported abnormalities in behavior, followed by a psychiatric assessment . The mental status examination is an important part of the assessment. An established tool for assessing the severity of positive and negative symptoms is the Positive and Negative Syndrome Scale (PANSS). This has been seen to have shortcomings relating to negative symptoms, and other scales –

13908-542: The age of a person's mother or father , and poor nutrition during pregnancy . About half of those diagnosed with schizophrenia will have a significant improvement over the long term with no further relapses, and a small proportion of these will recover completely. The other half will have a lifelong impairment. In severe cases, people may be admitted to hospitals. Social problems such as long-term unemployment , poverty, homelessness , exploitation, and victimization are commonly correlated with schizophrenia. Compared to

14091-551: The collectivism of the medieval Russian obshchina or mir over the individualism of the West. More extreme social doctrines were elaborated by such Russian radicals on the left, such as Alexander Herzen , Mikhail Bakunin , and Peter Kropotkin . After Russian armies liberated the Eastern Georgian Kingdom (allied since the 1783 Treaty of Georgievsk ) from the Qajar dynasty 's occupation of 1802, during

14274-488: The liberalism of Western Europe encouraged them to seek change on their return to autocratic Russia . The result was the Decembrist revolt (December 1825), which was the work of a small circle of liberal nobles and army officers who wanted to install Nicholas' brother Constantine as a constitutional monarch. The revolt was easily crushed, but it caused Nicholas to turn away from the modernization program begun by Peter

14457-440: The prodromal stage , and may be present in childhood or early adolescence. They are a core feature but not considered to be core symptoms, as are positive and negative symptoms. However, their presence and degree of dysfunction is taken as a better indicator of functionality than the presentation of core symptoms. Cognitive deficits become worse at first episode psychosis but then return to baseline, and remain fairly stable over

14640-406: The superior temporal gyrus . The severity of negative symptoms has been linked to reduced thickness in the left medial orbitofrontal cortex . Anhedonia, traditionally defined as a reduced capacity to experience pleasure, is frequently reported in schizophrenia. However, a large body of evidence suggests that hedonic responses are intact in schizophrenia, and that what is reported to be anhedonia

14823-459: The " accentuations of character " ( Russian : акцентуации характера ). Taken as a whole, Gannushkin's bibliography includes three monographs, 19 articles, nine introductory notes for monographs and anthologies, and approximately 100 reviews. Russian Empire The Russian Empire was a vast empire that spanned most of northern Eurasia from its proclamation in November 1721 until

15006-583: The 17th century, culminating in the first Russian colonization of the Pacific , the Russo-Polish War (1654–1667) which led to the incorporation of left-bank Ukraine , and the Russian conquest of Siberia . Poland was partitioned by its rivals in 1772–1815;most of its land and population being taken under Russian rule. Most of the empire's growth in the 19th century came from gaining territory in central and eastern Asia south of Siberia. By 1795, after

15189-501: The 19th century, the Russian Empire dominated its territorial extent, covering a surface area of 22,800,000 km , making it become the world's third-largest empire. Schizophrenia Schizophrenia is a mental disorder characterized variously by hallucinations (typically, hearing voices ), delusions , disorganized thinking and behavior, and flat or inappropriate affect . Symptoms develop gradually and typically begin during young adulthood and are never resolved. There

15372-646: The DSM criteria are used predominantly in the United States and Canada, and are prevailing in research studies. In practice, agreement between the two systems is high. The current proposal for the ICD-11 criteria for schizophrenia recommends adding self-disorder as a symptom. A major unresolved difference between the two diagnostic systems is that of the requirement in DSM of an impaired functional outcome. WHO for ICD argues that not all people with schizophrenia have functional deficits and so these are not specific for

15555-613: The French journal Medico Psychological Annals ( French : Annales médico-psychologiques ) he published a monograph called "Voluptuousness, cruelty and religion" ( French : La volupté, la cruauté et la religion ), which was subsequently banned in Russia. In it Gannushkin emphasized the close relation between religiosity, sexuality, and cruelty, using the example of Ivan the Terrible as an illustration. In many cases religious fanatics demonstrated cruelty, wrote Gannushkin, and vice versa, i.e. many cruel people were religious. In 1902, at

15738-1076: The Great Northern War, served as the state's capital. This concept of the triune Russian people, composed of the Great Russians , the Little Russians , and the White Russians , was introduced during the reign of Peter I, and it was associated with the name of Archimandrite Zacharias Kopystensky (1621), the Archimandrite of the Kiev Pechersk Lavra and expanded upon in the writings of an associate of Peter I, Archbishop Professor Theophan Prokopovich . Several of Peter I's associates are well-known, including François Le Fort , Boris Sheremetev , Alexander Menshikov , Jacob Bruce , Mikhail Golitsyn , Anikita Repnin , and Alexey Kelin. During Peter's reign,

15921-445: The Great and champion the doctrine of Orthodoxy, Autocracy, and Nationality . In order to repress further revolts, censorship was intensified, including the constant surveillance of schools and universities. Textbooks were strictly regulated by the government. Police spies were planted everywhere. Under Nicholas I, would-be revolutionaries were sent off to Siberia, with hundreds of thousands sent to katorga camps. The retaliation for

16104-635: The HPA axis possibly disrupting the negative feedback mechanism, homeostasis , and the regulation of emotion leading to altered behaviors. The question of how schizophrenia could be primarily genetically influenced, given that people with schizophrenia have lower fertility rates, is a paradox. It is expected that genetic variants that increase the risk of schizophrenia would be selected against, due to their negative effects on reproductive fitness . A number of potential explanations have been proposed, including that alleles associated with schizophrenia risk confers

16287-512: The Kashchenko Mental Hospital ( Russian : больница имени П. П. Кащенко ). During this period Gannushkin and others set up a first-class research journal, The Korsakoff Journal of Neuropathology and Psychiatry ( Russian : Журнал невропатологии и психиатрии имени Корсакова ). In 1917, after being discharged from the army for health reasons,Gannushkin returned in the Moscow Alexeyev Psychiatric Hospital. From 1918 onwards he

16470-627: The Ottoman Empire . This resulted in a significant weakening of the Crimean Khanate , an Ottoman vassal and long-term Russian adversary. The discontent over the dominant positions of Baltic Germans in Russian politics resulted in Peter I's daughter Elizabeth being put on the Russian throne. Elizabeth supported the arts, architecture, and the sciences (for example, the founding of Moscow University ). But she did not carry out significant structural reforms. Her reign, which lasted nearly 20 years,

16653-406: The Ottoman Empire, respectively. As a result, Pan-Slavists were left with a legacy of bitterness against Austria-Hungary and Germany for failing to back Russia. Disappointment at the results of the war stimulated revolutionary tensions, and helped Serbia, Romania , and Montenegro gain independence from, and strengthen themselves against, the Ottomans. Another significant result of the war

16836-453: The Ottoman Empire, using recently acquired Georgia at its base for its Caucasus and Anatolian front. The late 1820s were successful years militarily. Despite losing almost all recently consolidated territories in the first year of the Russo-Persian War of 1826–1828 , Russia managed to favorably bring an end to the war with the Treaty of Turkmenchay , including the formal acquisition of what are now Armenia , Azerbaijan, and Iğdır Province . In

17019-537: The Ottomans to sign the Treaty of San Stefano in March 1878, creating an enlarged, independent Bulgaria that stretched into the southwestern Balkans. When Britain threatened to declare war over the terms of the treaty, an exhausted Russia backed down. At the Congress of Berlin in July 1878, Russia agreed to the creation of a smaller Bulgaria and Eastern Rumelia , as a vassal state and an autonomous principality inside

17202-539: The Polish–Lithuanian Commonwealth during the Partitions of Poland , alongside Austria and Prussia . As part of the Treaty of Georgievsk , signed with the Georgian Kingdom of Kartli-Kakheti , and her own political aspirations, Catherine waged a new war against Persia in 1796 after they had invaded eastern Georgia . Upon achieving victory, she established Russian rule over it and expelled

17385-434: The Russian capital from Moscow to the new model city of Saint Petersburg , which marked the birth of the imperial era, and led a cultural revolution that introduced a modern, scientific, rationalist, and Western-oriented system. Catherine the Great ( r.  1762–1796 ) presided over further expansion of the Russian state by conquest, colonization , and diplomacy, while continuing Peter's policy of modernization towards

17568-523: The Russian state grew by an average of 35,000 km (14,000 sq mi) per year. Major events during this period include the transition from the Rurik to the Romanov dynasties, the conquest of Siberia , and the reign of Peter the Great ( r.  1682–1725 ). Peter transformed the tsardom into an empire, and fought numerous wars that turned a vast realm into a major European power. He moved

17751-526: The Senate that its mission was to collect taxes, and tax revenues tripled over the course of his reign. Meanwhile, all vestiges of local self-government were removed. Peter continued and intensified his predecessors' requirement of state service from all nobles, in the Table of Ranks . As part of Peter's reorganization, he also enacted a church reform . The Russian Orthodox Church was partially incorporated into

17934-409: The ability to represent goal related information in working memory, and to use this to direct cognition and behavior. These impairments have been linked to a number of neuroimaging and neuropathological abnormalities. For example, functional neuroimaging studies report evidence of reduced neural processing efficiency, whereby the dorsolateral prefrontal cortex is activated to a greater degree to achieve

18117-502: The age of 13, as can sometimes occur, is known as childhood schizophrenia or very early-onset. Onset can occur between the ages of 40 and 60, known as late-onset schizophrenia. Onset over the age of 60, which may be difficult to differentiate as schizophrenia, is known as very-late-onset schizophrenia-like psychosis. Late onset has shown that a higher rate of females are affected; they have less severe symptoms and need lower doses of antipsychotics. The tendency for earlier onset in males

18300-438: The already oppressive social system, under which serfs were required to spend almost all of their time laboring on their owners' land. A major peasant uprising took place in 1773, after Catherine legalized the selling of serfs separate from land. Inspired by a Cossack named Yemelyan Pugachev and proclaiming "Hang all the landlords!", the rebels threatened to take Moscow before they were ruthlessly suppressed. Instead of imposing

18483-556: The building of the Trans-Siberian Railway , 1890 to 1904. This opened up East Asia ; and Russian interests focused on Mongolia, Manchuria , and Korea . China was too weak to resist, and was pulled increasingly into the Russian sphere. Russia obtained treaty ports such as Dalian / Port Arthur . In 1900, the Russian Empire invaded Manchuria as part of the Eight-Nation Alliance 's intervention against

18666-482: The country's administrative structure, in effect making it a tool of the state. Peter abolished the patriarchate and replaced it with a collective body, the Most Holy Synod , which was led by a government official . Peter died in 1725, leaving an unsettled succession. After a short reign by his widow, Catherine I , the crown passed to Empress Anna . She slowed the reforms and led a successful war against

18849-406: The course of the illness, perhaps linked to the age-related decline in dopamine activity. Negative symptoms are deficits of normal emotional responses, or of other thought processes. The five recognized domains of negative symptoms are: blunted affect – showing flat expressions (monotone) or little emotion; alogia – a poverty of speech; anhedonia – an inability to feel pleasure; asociality –

19032-596: The course of the illness. The deficits in cognition are seen to drive the negative psychosocial outcome in schizophrenia, and are claimed to equate to a possible reduction in IQ from the norm of 100 to 70–85. Cognitive deficits may be of neurocognition (nonsocial) or of social cognition . Neurocognition is the ability to receive and remember information, and includes verbal fluency, memory , reasoning , problem solving , speed of processing , and auditory and visual perception. Verbal memory and attention are seen to be

19215-449: The death of Peter were returned in the 1732 Treaty of Resht and 1735 Treaty of Ganja as a deal to oppose the Ottomans. Peter reorganized his government based on the latest political models of the time, molding Russia into an absolutist state. He replaced the old Boyar Duma (council of nobles) with a nine-member Senate , in effect a supreme council of state. The countryside was divided into new provinces and districts . Peter told

19398-420: The death of a parent. Many adverse childhood experiences can cause toxic stress and increase the risk of psychosis. Chronic trauma, including ACEs, can promote lasting inflammatory dysregulation throughout the nervous system. It is suggested that early stress may contribute to the development of schizophrenia through these alterations in the immune system. Schizophrenia was the last diagnosis to benefit from

19581-616: The delusions of schizophrenia. There can be considerable overlap with the symptoms of post-traumatic stress disorder . A more general medical and neurological examination may be needed to rule out medical illnesses which may rarely produce psychotic schizophrenia-like symptoms, such as metabolic disturbance , systemic infection , syphilis , HIV-associated neurocognitive disorder , epilepsy , limbic encephalitis , and brain lesions. Stroke, multiple sclerosis , hyperthyroidism , hypothyroidism , and dementias such as Alzheimer's disease , Huntington's disease , frontotemporal dementia , and

19764-546: The development of psychiatry in Russia. In 1933, the Health Care Commissariat's Research Institute of Neuropsychiatric Treatment established an annual Gannushkin award. In 1936, Moscow's Psychiatric Hospital No.4 was named after Gannushkin ( Russian : Психиатрическая клиническая больница № 4 им. П.Б. Ганнушкина ). Later a Gannushkin memorial museum was created inside the hospital. A river embankment in Moscow

19947-433: The development of schizophrenia. The genetic component means that prenatal brain development is disturbed, and environmental influence affects the postnatal development of the brain. Evidence suggests that genetically susceptible children are more likely to be vulnerable to the effects of environmental risk factors. Estimates of the heritability of schizophrenia are between 70% and 80%, which implies that 70% to 80% of

20130-888: The diagnosis. Functional magnetic resonance imaging (fMRI) has become a tool in understanding brain activity and connectivity differences in individuals with schizophrenia. Through resting-state fMRI, researchers have observed altered connectivity patterns within several key brain networks, such as the default mode network (DMN), salience network (SN), and central executive network (CEN). Alterations may underlie cognitive and emotional symptoms in schizophrenia, such as disorganized thinking, impaired attention, and emotional dysregulation. Many people with schizophrenia may have one or more other mental disorders , such as anxiety disorders , obsessive–compulsive disorder , or substance use disorder. These are separate disorders that require treatment. When comorbid with schizophrenia, substance use disorder and antisocial personality disorder both increase

20313-457: The disorder itself (e.g. diabetes mellitus type 2 and some cardiovascular diseases are thought to be genetically linked). These somatic comorbidities contribute to reduced life expectancy among persons with the disorder. To make a diagnosis of schizophrenia other possible causes of psychosis need to be excluded . Psychotic symptoms lasting less than a month may be diagnosed as brief psychotic disorder , or as schizophreniform disorder. Psychosis

20496-523: The elevated risk of schizophrenia. Other risk factors include social isolation , immigration related to social adversity and racial discrimination, family dysfunction, unemployment, and poor housing conditions. Having a father older than 40 years , or parents younger than 20 years are also associated with schizophrenia. About half of those with schizophrenia use recreational drugs including alcohol , tobacco, and cannabis excessively. Use of stimulants such as amphetamine and cocaine can lead to

20679-416: The empire entered the 20th century in a perilous state. A devastating famine in 1891–1892 killed hundreds of thousands and led to popular discontent. As the last remaining absolute monarchy in Europe, the empire saw rapid political radicalization and the growing popularity of revolutionary ideas such as communism . After the 1905 revolution , Nicholas II authorized the creation of a national parliament,

20862-577: The empire. The semi-autonomous polity of Congress Poland subsequently lost its distinctive political and judicial rights, with Russification being imposed on its schools and courts. However, Russification policies in Poland, Finland and among the Germans in the Baltics largely failed and only strengthened political opposition. In 1854–1855, Russia fought Britain , France and the Ottoman Empire in

21045-497: The end his dynasty was overthrown by the Russian Revolution . The Industrial Revolution began to show significant influence in Russia, but the country remained rural and poor. Economic conditions steadily improved after 1890, thanks to new crops such as sugar beets, and new access to railway transportation. Total grain production increased, as well as exports, even with rising domestic demand from population growth. As

21228-528: The environment . Extensive studies support this model. Maternal infections, malnutrition and complications during pregnancy and childbirth are known risk factors for the development of schizophrenia, which usually emerges between the ages of 18 and 25, a period that overlaps with certain stages of neurodevelopment. Gene-environment interactions lead to deficits in the neural circuitry that affect sensory and cognitive functions. The common dopamine and glutamate models proposed are not mutually exclusive; each

21411-504: The expense of the serfs and other lower classes. Nevertheless, Catherine realized that serfdom must eventually be ended, going so far in her Nakaz ("Instruction") to say that serfs were "just as good as we are" – a comment received with disgust by the nobility. Catherine advanced Russia's southern and western frontiers, successfully waging war against the Ottoman Empire for territory near the Black Sea , and incorporating territories of

21594-675: The first to show the process whereby, at least in some cases, obsessions were transformed into schizophrenia . In 1904, Gannushkin submitted his thesis on "Acute paranoia" ( Russian : Острая паранойя ). It took the form of a sketch of the historical development of the theory of acute paranoia. The thesis opened with a description of the research of Vincenzo Chiarugi and Jean-Étienne Dominique Esquirol . The focus then shifted to works by Wilhelm Griesinger , Bénédict Morel , and Karl Friedrich Otto Westphal . Next Gannushkin presented observations made by Sergei Korsakoff , Vladimir Serbsky , Emil Kraepelin , and Eugen Bleuler . Finally Gannushkin gave

21777-400: The five recognized domains and an additional item of reduced normal distress. It has been used to measure changes in negative symptoms in trials of psychosocial and pharmacological interventions. An estimated 70% of those with schizophrenia have cognitive deficits, and these are most pronounced in early-onset and late-onset illness. These are often evident long before the onset of illness in

21960-475: The focus of many studies. Schizophrenia is described as a neurodevelopmental disorder with no precise boundary, or single cause, and is thought to develop from gene–environment interactions with involved vulnerability factors. The interactions of these risk factors are complex, as numerous and diverse insults from conception to adulthood can be involved. A genetic predisposition on its own, without interacting environmental factors, will not give rise to

22143-624: The formation and maintenance of neural circuits and it is believed that disruption in this role can result in a number of neurodevelopmental disorders including schizophrenia. Evidence suggests that reduced numbers of astrocytes in deeper cortical layers are assocociated with a diminished expression of EAAT2 , a glutamate transporter in astrocytes; supporting the glutamate hypothesis. Deficits in executive functions , such as planning, inhibition, and working memory, are pervasive in schizophrenia. Although these functions are separable, their dysfunction in schizophrenia may reflect an underlying deficit in

22326-738: The formation of beliefs. In approved models of circuits that mediate predictive coding , reduced NMDA receptor activation, could in theory result in the positive symptoms of delusions and hallucinations. Schizophrenia is diagnosed based on criteria in either the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association or the International Statistical Classification of Diseases and Related Health Problems (ICD) published by

22509-450: The general population, people with schizophrenia have a higher suicide rate (about 5% overall) and more physical health problems , leading to an average decrease in life expectancy by 20 to 28 years. In 2015, an estimated 17,000 deaths were linked to schizophrenia. The mainstay of treatment is antipsychotic medication, including olanzapine and risperidone , along with counseling , job training, and social rehabilitation . Up to

22692-571: The government and other major buildings were designed under Italianate influence. In 1722, he turned his aspirations toward increasing Russian influence in the Caucasus and the Caspian Sea at the expense of the weakened Safavid Persians . He made Astrakhan the base of military efforts against Persia, and waged the first full-scale war against them in 1722–23 . Peter the Great temporarily annexed several areas of Iran to Russia, which after

22875-460: The guideline for diagnosis is for six months or more with symptoms severe enough to affect ordinary functioning. In the UK diagnosis is based on having the symptoms for most of the time for one month, with symptoms that significantly affect the ability to work, study, or carry on ordinary daily living, and with other similar conditions ruled out. The ICD criteria are typically used in European countries;

23058-553: The implicit threat to India ; and decades of diplomatic maneuvering resulted, called the Great Game . That rivalry between the two empires has been considered to have included far-flung territories such as Outer Mongolia and Tibet . The maneuvering largely ended with the Anglo-Russian Convention of 1907. Expansion into the vast stretches of Siberia was slow and expensive, but finally became possible with

23241-443: The individual differences in risk of schizophrenia are associated with genetics. These estimates vary because of the difficulty in separating genetic and environmental influences, and their accuracy has been queried. The greatest risk factor for developing schizophrenia is having a first-degree relative with the disease (risk is 6.5%); more than 40% of identical twins of those with schizophrenia are also affected. If one parent

23424-610: The lack of desire to form relationships, and avolition – a lack of motivation and apathy . Avolition and anhedonia are seen as motivational deficits resulting from impaired reward processing. Reward is the main driver of motivation and this is mostly mediated by dopamine. It has been suggested that negative symptoms are multidimensional and they have been categorised into two subdomains of apathy or lack of motivation, and diminished expression. Apathy includes avolition, anhedonia, and social withdrawal; diminished expression includes blunt affect and alogia. Sometimes diminished expression

23607-404: The link made between ACEs and adult mental health outcomes. Living in an urban environment during childhood or as an adult has consistently been found to increase the risk of schizophrenia by a factor of two, even after taking into account drug use , ethnic group , and size of social group . A possible link between the urban environment and pollution has been suggested to be the cause of

23790-554: The mentality of the population and its life in society. Under Gannushkin's direction a new form of medical care for people with mental disorders was created in Russia. He helped to organise a network of psychoneurological out-patient clinics in the USSR. He worked on issues linked to the teaching of psychiatry and the prevention of mental illness. Pyotr Borisovich Gannushkin married the pianist Sofia Vladimirovna Klumova (1880-1945). They had one son Alexey Petrovich Gannushkin (1920-1974) who

23973-598: The military, 20 percent to government economic activities, 12 percent to administration, and nine percent for the Imperial Court in St. Petersburg. The deficit required borrowing, primarily from bankers in Amsterdam ; five percent of the budget was allocated to debt payments. Paper money was issued to pay for expensive wars, thus causing inflation. As a result of its spending, Russia developed a large and well-equipped army,

24156-423: The most affected. Verbal memory impairment is associated with a decreased level of semantic processing (relating meaning to words). Another memory impairment is that of episodic memory . An impairment in visual perception that is consistently found in schizophrenia is that of visual backward masking . Visual processing impairments include an inability to perceive complex visual illusions . Social cognition

24339-439: The mother during prenatal development. A risk is associated with maternal obesity, in increasing oxidative stress , and dysregulating the dopamine and serotonin pathways. Both maternal stress and infection have been demonstrated to alter fetal neurodevelopment through an increase of pro-inflammatory cytokines . There is a slighter risk associated with being born in the winter or spring possibly due to vitamin D deficiency or

24522-736: The new parliament (the Duma). He signed the Anglo-Russian Convention of 1907 to counter Germany's influence in the Middle East, ending the Great Game between Russia and the British Empire . However, his reign was marked by criticism for the government's suppression of political dissent and perceived failures or inaction during events like the Khodynka Tragedy , anti-Jewish pogroms, Bloody Sunday (1905) , and

24705-481: The newly established Persian garrisons in the Caucasus. Catherine's expansionist policy caused Russia to develop into a major European power, as did the Enlightenment era and the Golden age in Russia. But after Catherine died in 1796, she was succeeded by her son, Paul . He brought Russia into a major coalition war against the new-revolutionary French Republic in 1798. Russian commander Field Marshal Suvorov led

24888-401: The obligation of the nobility to serve was reinforced, and serf labor played a significant role in the growth of the industry, reinforcing traditional socioeconomic structures. The volume of the country's international trade turnover increased as a result of Peter I's industrial reforms. However, imports of goods overtook exports, strengthening the role of foreigners in Russian trade, particularly

25071-586: The other senses such as taste , sight , smell , and touch . The frequency of hallucinations involving multiple senses is double the rate of those involving only one sense. They are also typically related to the content of the delusional theme. Delusions are bizarre or persecutory in nature. Distortions of self-experience such as feeling that others can hear one's thoughts or that thoughts are being inserted into one's mind , sometimes termed passivity phenomena, are also common. Positive symptoms generally respond well to medication and become reduced over

25254-446: The press, as well as dislike democracy, constitutions, and the parliamentary system. Under Pobedonostsev, revolutionaries were persecuted—by the imperial secret police , with thousands being exiled to Siberia —and a policy of Russification was carried out throughout the empire. Russia had little difficulty expanding to the south, including conquering Turkestan , until Britain became alarmed when Russia threatened Afghanistan , with

25437-548: The proclamation of the Russian Republic in September 1917. At its height in the late 19th century, it covered about 22,800,000 km (8,800,000 sq mi), roughly one-sixth of the world's landmass, making it the third-largest empire in history , behind only the British and Mongol empires. It also colonized North America between 1799 and 1867. The empire's 1897 census, the only one it conducted, found

25620-513: The redrawing of the map of Europe at the Congress of Vienna (1815), which ultimately made Alexander the monarch of Congress Poland . The " Holy Alliance " was proclaimed, linking the monarchist great powers of Austria, Prussia, and Russia. Although the Russian Empire played a leading political role in the next century, thanks to its role in defeating Napoleonic France, its retention of serfdom precluded economic progress to any significant degree. As Western European economic growth accelerated during

25803-420: The research data he was working with. As L.A. Prozorov commented: "Gannushkin could stir the interest of young people in research, even if it was crude; he sought out and selected research scientists." Remembering her husband, Sophia Gannushkina said, "Once he decided to do something, he grew fearless." Throughout his life, Gannushkin believed that psychiatry and our life in society are closely connected. To him

25986-484: The responsibilities of a junior medical staff member. Gannushkin graduated from Moscow University in October 1898. He turned down a proposal to become a permanent resident physician, because it then included superintendent's responsibilities. During the next years, up to 1902, he was a non-resident of the psychiatric hospital. He worked in the outpatient clinic and wrote a variety of scholarly works. In 1901, for example

26169-488: The revolt made "December Fourteenth" a day long remembered by later revolutionary movements. The question of Russia's direction had been gaining attention ever since Peter the Great's program of modernization. Some favored imitating Western Europe while others were against this and called for a return to the traditions of the past. The latter path was advocated by Slavophiles , who held the "decadent" West in contempt. The Slavophiles were opponents of bureaucracy, who preferred

26352-440: The risk for violence. Comorbid substance use disorder also increases the risk of suicide. Sleep disorders often co-occur with schizophrenia, and may be an early sign of relapse. Sleep disorders are linked with positive symptoms such as disorganized thinking and can adversely affect cortical plasticity and cognition. The consolidation of memories is disrupted in sleep disorders. They are associated with severity of illness,

26535-462: The risk of developing schizophrenia by as much as 20-fold, and are frequently comorbid with autism and intellectual disabilities. The genes CRHR1 and CRHBP are associated with the severity of suicidal behavior. These genes code for stress response proteins needed in the control of the HPA axis , and their interaction can affect this axis. Response to stress can cause lasting changes in the function of

26718-463: The same for any psychosis and are sometimes referred to as psychotic symptoms. These may be present in any of the different psychoses and are often transient, making early diagnosis of schizophrenia problematic. Psychosis noted for the first time in a person who is later diagnosed with schizophrenia is referred to as a first-episode psychosis (FEP). Positive symptoms are those symptoms that are not normally experienced, but are present in people during

26901-461: The serfs, was the single most important event in 19th-century Russian history, and the beginning of the end of the landed aristocracy's monopoly on power. The 1860s saw further socioeconomic reforms to clarify the position of the Russian government with regard to property rights. Emancipation brought a supply of free labor to the cities, stimulating industry, while the middle class grew in number and influence. However, instead of receiving their lands as

27084-485: The start of the 19th century, Russian territory extended from the Arctic Ocean in the north to the Black Sea in the south, and from the Baltic Sea in the west to Alaska, Hawaii, and California in the east. By the end of the 19th century, Russia had expanded its control over the Caucasus , most of Central Asia and parts of Northeast Asia . Notwithstanding its extensive territorial gains and great power status,

27267-501: The state for the rest of their lives. He also introduced the Table of Ranks and equated the votchina with an estate . Russia's modern fleet was built by Peter the Great, along with an army that was reformed in the manner of European style and educational institutions (the Saint Petersburg Academy of Sciences ). Civil lettering was adopted during Peter I's reign, and the first Russian newspaper, Vedomosti ,

27450-405: The statics of psychopathies refer to the actual substance of the subject, noted Gannushkin, the dynamics of psychopathies indioate the types, laws, and developmental schemes of psychopathies. Gannushkin did not consider psychopathies to be progressive mental states and contrasted them with serious mental disorders that caused retardation. Borderline psychiatry, he was at pains to emphasise, includes

27633-407: The students, including Gannushkin, were fascinated by the way Korsakoff interacted with the mentally disabled. As Korsakoff explained, "mental patients should not be regarded as soulless creatures: they should be considered personalities familiar to everyone who is somehow related to them." In addition to attending lectures and recitals during his university years, Gannushkin served as an orderly with

27816-472: The suggestion of Sukhanov, Serbsky, and Rossolimo , Gannushkin was made a full member of the Moscow Society of Neuropathologists and Psychiatrists ( Russian : Московское общество невропатологов и психиатров ). At the same time, he was elected a supernumerary assistant at the psychiatric hospital headed by Serbsky, after Korsakoff's early death from heart failure. Korsakoff's assistant Sergei Sukhanov

27999-471: The synchronizing of neural ensembles needed during working memory tasks. These give the neural oscillations produced as gamma waves that have a frequency of between 30 and 80 hertz . Both working memory tasks and gamma waves are impaired in schizophrenia, which may reflect abnormal interneuron functionality. An important process that may be disrupted in neurodevelopment is astrogenesis – the formation of astrocytes . Astrocytes are crucial in contributing to

28182-508: The thalamus and the cortex . Studies have shown that a reduced expression of a glutamate receptor – NMDA receptor , and glutamate blocking drugs such as phencyclidine and ketamine can mimic the symptoms and cognitive problems associated with schizophrenia. Post-mortem studies consistently find that a subset of these neurons fail to express GAD67 ( GAD1 ), in addition to abnormalities in brain morphometry . The subsets of interneurons that are abnormal in schizophrenia are responsible for

28365-422: The throne in 1855, the desire for reform was widespread. A growing humanitarian movement attacked serfdom as inefficient. In 1859, there were more than 23 million serfs in usually poor living conditions. Alexander II decided to abolish serfdom from above, with ample provision for the landowners, rather than wait for it to be abolished from below by revolution. The Emancipation Reform of 1861 , which freed

28548-489: The traditional punishment of drawing and quartering, Catherine issued secret instructions that the executioners should execute death sentences quickly and with minimal suffering, as part of her effort to introduce compassion into the law. She furthered these efforts by ordering the public trial of Darya Nikolayevna Saltykova , a high-ranking noblewoman, on charges of torturing and murdering serfs. Whilst these gestures garnered Catherine much positive attention from Europe during

28731-552: The transformation of Russia into a great power, playing a major role in European politics. On 2 November [ O.S. 22 October] 1721, the day of the announcement of the Treaty of Nystad, the Governing Senate and Synod invested the tsar with the titles of Peter the Great, Pater Patriae (father of the fatherland), and Imperator of all Russia . The adoption of the title of imperator by Peter I

28914-410: The two developed friendly relations, publishing six research papers together. They preferred to study individual mental disorders rather than their mixed types, believing that this approach would contribute to the study of acknowledged diseases, the discovery of new mental disorders, and the development of psychiatric taxonomy. Sukhanov and Gannushkin distinguished a particular form of obsession and were

29097-446: The usefulness of medications that affect the dopamine receptor and the observation that dopamine levels are increased during acute psychosis. A decrease in D 1 receptors in the dorsolateral prefrontal cortex may also be responsible for deficits in working memory . The glutamate hypothesis of schizophrenia links alterations between glutamatergic neurotransmission and the neural oscillations that affect connections between

29280-745: The variation in the disease. Many genes are known to be involved in schizophrenia, each with small effects and unknown transmission and expression . The summation of these effect sizes into a polygenic risk score can explain at least 7% of the variability in liability for schizophrenia. Around 5% of cases of schizophrenia are understood to be at least partially attributable to rare copy number variations (CNVs); these structural variations are associated with known genomic disorders involving deletions at 22q11.2 ( DiGeorge syndrome ) and 17q12 ( 17q12 microdeletion syndrome ), duplications at 16p11.2 (most frequently found) and deletions at 15q11.2 ( Burnside–Butler syndrome ). Some of these CNVs increase

29463-449: The various holdings. Although serfdom was abolished, its abolition was achieved on terms unfavorable to peasants; thus, revolutionary tensions remained. Revolutionaries believed that the newly freed serfs were merely being sold into wage slavery in the onset of the industrial revolution, and that the urban bourgeoisie had effectively replaced the landowners. Seeking more territories, Russia obtained Priamurye ( Russian Manchuria ) from

29646-679: The violent suppression of the 1905 Russian Revolution. The Russo-Japanese War , which resulted in the destruction of the Russian Baltic Fleet at the Battle of Tsushima , further eroded his popularity. By March 1917, public support for Nicholas II had dwindled, leading to his forced abdication and the end of the 304-year rule of the Romanov (dynasty) in Russia (1613–1917). Nicholas II was deeply devoted to his wife, Alexandra, whom he married on 26 November 1894. They had five children: Grand Duchesses Olga, Tatiana, Maria, Anastasia, and Tsesarevich Alexei. The Russian Imperial Romanov family

29829-646: The war, but who nevertheless were opposed by various factions known collectively as the Whites . During the resulting Russian Civil War , the Bolsheviks conducted the Red Terror . After emerging victorious, they established the Soviet Union across most of the Russian territory; it would be one of four continental empires to collapse as a result of World War I , along with Germany , Austria–Hungary , and

30012-699: The weakened Manchu-ruled Qing China , which was occupied fighting against the Taiping Rebellion . In 1858, the Treaty of Aigun ceded much of the Manchu Homeland, and in 1860, the Treaty of Peking ceded the modern Primorsky Krai , also founded the outpost of future Vladivostok . Meanwhile, Russia decided to sell the indefensible Russian America to the United States for 11 million rubles (7.2 million dollars) in 1867. Initially, many Americans considered this newly gained territory to be

30195-552: Was a member of the presidential Council for the Development of Civil Society Institutions and Human Rights until her resignation in June 2012. Gannushkin was a modest and diffident man and he disliked public speaking . When attending psychiatric conferences, he preferred to stay in the background. Only among fellow scientists and when lecturing to his senior students was Gannushkin able to speak his mind. An experienced clinician, he

30378-647: Was a professor in the Department of Psychiatry at the Moscow State University (from 1930 he was professor at the I.M. Sechenov First Moscow State Medical University ) and director at the University Psychiatric Hospital: today this is known as the Korsakov Clinic of Psychiatry at the Sechenov Moscow Medical Academy ( Russian : Клиника имени С. С. Корсакова АМН России имени И. М. Сеченова ). Gannushkin

30561-449: Was a proponent of the natural science method who considered himself an enemy of pompous and meretricious declamation. Gannushkin's power of observation was enhanced by his erudition and ability to discern the most useful points in a variety of different monographs and articles. He recorded each new thought and accurately gathered all required materials. His lectures and clinical vignettes show how carefully he scrutinized and systematized all

30744-523: Was also renamed in his honor. Gannushkin was immortalised in fiction as Professor Titanushkin, a character in Ilf and Petrov 's satirical novel The Little Golden Calf (1931). Pyotr Borisovich Gannushkin divided psychiatry into two principal categories: major psychiatric conditions, such as schizophrenia, bipolar disorder, etc., and minor psychiatric conditions (the psychopathies or personality disorders). The theory of psychopathies or "pathological characters"

30927-466: Was an absolute monarch titled the tsar . The groundwork of the Russian Empire was laid by Ivan III ( r.  1462–1505 ), who greatly expanded his domain, established a centralized Russian national state , and secured independence against the Tatars . His grandson, Ivan IV ( r.  1533–1584 ), became in 1547 the first Russian monarch to be crowned " tsar of all Russia ". Between 1550 and 1700,

31110-611: Was an aircraft design engineer, USSR State Prize Laureate, and father of Svetlana Gannushkina (b. 1943). Svetlana Alexeyevna Gannushkina is a mathematician and human rights activist, working particularly to help immigrants and refugees through the Civic Assistance NGO. (She was reported to be a serious contender for the 2010 Nobel Peace Prize .) A professor of mathematics at the Historical Archives Institute between 1970 and 1999, Gannushkina

31293-486: Was assassinated by the Narodnaya Volya , a Nihilist terrorist organization . The throne passed to Alexander III (1881–1894), a reactionary who revived the maxim of "Orthodoxy, Autocracy, and Nationality" of Nicholas I. A committed Slavophile, Alexander III believed that Russia could be saved from turmoil only by shutting itself off from the subversive influences of Western Europe. During his reign, Russia formed

31476-427: Was catastrophic for France, whose army was decimated during the Russian winter . Although Napoleon's Grande Armée reached Moscow, the Russians' scorched earth strategy prevented the invaders from living off the country. In the harsh and bitter winter, thousands of French troops were ambushed and killed by peasant guerrilla fighters. Russian troops then pursued Napoleon's troops to the gates of Paris, presiding over

31659-402: Was close to that of slaves , remained a major institution in Russia until 1723, when Peter converted household kholops into house serfs , thus counting them for poll taxation. Russian agricultural kholops had been formally converted into serfs earlier in 1679. They were largely tied to the land, in a feudal sense, until the late 19th century. Peter's first military efforts were directed against

31842-620: Was executed by who were believed to be drunken Bolshevik revolutionaries under Yakov Yurovsky, as ordered by the Ural Regional Soviet in Yekaterinburg on the night of 16–17 July 1918. This marked the end of the Russian Empire and Imperial Russia. Russia was in a continuous state of financial crisis. While revenue rose from 9 million rubles in 1724 to 40 million in 1794, expenses grew more rapidly, reaching 49 million in 1794. The budget allocated 46 percent to

32025-703: Was in a state of war with the French Republic under the leadership of the Corsica -born First Consul Napoleon Bonaparte . After he became the emperor , Napoleon defeated Russia at Austerlitz in 1805, Eylau and Friedland in 1807. After Alexander was defeated in Friedland, he agreed to negotiate and sued for peace with France; the Treaties of Tilsit led to the Franco-Russian alliance against

32208-456: Was informally partitioned by the Anglo-Russian Convention in 1907, Britain, France, and Russia came increasingly close together in opposition to Germany and Austria-Hungary. The three would later comprise the Triple Entente alliance in the First World War . In 1894, Alexander III was succeeded by his son, Nicholas II , who was committed to retaining the autocracy that his father had left him. Nicholas II proved as an ineffective ruler, and in

32391-573: Was made up of Gannushkin's senior students: B.A. Belousov, A.G. Galachyan, F.F. Detengor, S.G. Zhislin, A.N. Zalmanov, M.Z. Kaplinsky, R.E. Lusternik, N.S. Molodenkov, A.N. Molokhov, N.I. Ozeretsky, D.S. Ozeretskovsky, T.P. Simpson, Y.A. Florenskaya, B.D. Fridman, Y.P. Frumkin, A.O. Edelstein. A third generation included his junior students (A.P. Alexandrova, A.M. Dubinin, O.V. Kerbikov, S.V. Krayts, A.Y. Levinson, D.E. Melekhov, V.M. Morozov, A.I. Ponomoryov, B.A. Famin, P.D. Fridman, Y.D. Shulman). Together, Gannushkin's followers made significant contributions to

32574-483: Was one of the first psychiatrists to talk about the schizoid reaction type, the somatogenic and psychogenic reactions of schizoids . In 1927, he identified the "epileptoid reaction type", which is usually characterized by repeated temporary reactions caused by the influence of psychogenic factors and unfavorable situations. This reaction type is expressed by symptoms of dysphoria, i.e. malicious actions combined with anger, anguish, and fear. In many ways, this reaction type

32757-444: Was published. Peter I promoted the advancement of science, particularly geography and geology , trade, and industry, including shipbuilding, as well as the growth of the Russian educational system. Every tenth Russian acquired an education during Peter I's reign, when there were 15 million people in the country. The city of Saint Petersburg , which was built in 1703 on territory along the Baltic coast that had been conquered during

32940-579: Was the acquisition from the Ottomans of the provinces of Batumi , Ardahan , and Kars in Transcaucasia , which were transformed into the militarily administered regions of Batum Oblast and Kars Oblast . To replace Muslim refugees who had fled across the new frontier into Ottoman territory, the Russian authorities settled large numbers of Christians from ethnically diverse communities in Kars Oblast, particularly Georgians , Caucasus Greeks , and Armenians , each of whom hoped to achieve protection and advance their own regional ambitions. In 1881, Alexander II

33123-433: Was the eldest son and successor of Aleksandr Aleksandrovich (later known as Alexander III of Russia ) and his wife Maria Fyodorovna (formerly Dagmar of Denmark ). During his rule, Nicholas II supported the economic and political reforms proposed by his prime ministers, Sergei Witte and Pyotr Stolypin . He favored modernization through foreign loans and strong ties with France, but was reluctant to give significant roles to

33306-492: Was then that he read Sechenov 's 1863 monograph "Brain Reflexes", a successful attempt to describe the physiological mechanisms of mental activity. In 1893 Gannushkin graduated from the high school with a gold medal, the highest award, and entered the department of medicine at Moscow State University . In his third year of studies, he finally decided to become a psychiatrist after being influenced by such university professors as Aleksei Kozhevnikov and Sergei Korsakoff . All

33489-466: Was willing to help young physicians, fostering them in word and in deed. Sukhanov was a proponent of the nosological approach. He demonstrated a remarkable power of observation. Borderline psychiatry, especially psychopathies and psychogenies, was among his main research interests. His inclination towards synthesis led Sukhanov to note both the scientific and social importance of this problem. Sukhanov managed to stir Gannushkin's interest in these issues and

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