Ruslan Tyumenev: ‘Modern treatment methods for mental disorders are at the peak of efficacy’

5-6 million Russians have psychiatric and neurological disorders

According to the Russian Health Care Ministry’s official statistics, about 2,1 million people are subject to regular psychiatric and neurological check-ups, but another 3-4 million people who turn to anonymous private clinics can be added here too. Psychiatrist and drug therapist of Insight clinic from Kazan Ruslan Tyumenev told Realnoe Vremya. Another expert Candidate for Medical Sciences, chief doctor of Ibis medical centre in Kazan Iskander Mindubayev talks about a smaller number of people with psychiatric and neurological diseases. He says that 1,4 million people do regular check-ups, while the real number of patients with mental disorders reaches 3,8 million people.

“Modern treatment methods for mental disorders are at the peak of efficacy. Psychotherapy proved its efficacy for addicts and people with mental disorders around the world in the 70s. And we have known for 50 years now that psychotherapy is the most part of the work with patients,” Ruslan Tyumenev shared.

He said that two main treatment methods were used to treat psychiatric and neurological disorders — medicines and psychotherapy. In the first case, a patient can be prescribed neuroleptics for psychoses — inappropriate behaviour, suicide attempts and hallucinations, tranquilisers for psychoses and simply for excessive psychomotor excitement — a desire to do something, an absence of sleep, panic and other symptoms, antidepressants are prescribed too, which are more familiar.

Tranquilisers eliminate painful perception disorders (hallucinations), thinking (delirium), fear, excitement, aggression. Tranquilisers have a calming effect, eliminate emotional tension, anxiety, excessive excirement, make muscles relax, have a sedative effect. Antidepressants boost a painfully bad mood, get rid of slow psychic activity and mobility, Iskander Mindubayev added.

“Psychiatric and drug therapy is one of the most effective methods to treat mental disorders, that’s to say, the use of medicines that influence the psyche, with the use of psychotropic medicines. The success of the treatment mainly depends on how smartly a drug therapy was chosen,” the expert shared.

“There is psychotherapy too. In modern-day clinics it is a job of a team of specialists, and not only with the patient. It is a psychiatrist, psychotherapist, clinical psychologist and even volunteers who are patients who finished their treatment and now help others. Group psychotherapy is the foundation where a patient establishes social habits and changes them. At the same time, an individual job with the family is done too,” the doctor said and indicated that both methods need to be combined in treatment.

Ruslan Tyumenev said that these methods, first of all, refer to in-patient treatment. After being released, a patient can continue going to self-help groups, which are many in our country, and turn to a doctor if drug support is needed.

As Iskander Mindubayev said, other non-drug-based treatment methods include:

• transcranial magnetic stimulation is brain cell stimulation using magnetic fields. It can often be used for depression, migraine, sounds in the ear, neuralgia, etc.;
• light therapy is exposure to light for seasonal depressive disorders, sleep disorders, feeling of tiredness;
• biofeedback is a modern method used to recover the neurological, psychic and somatic state with the help of special equipment, a screen, computer programmes and sensors that are placed on the patient. This method can be used for neurological diseases, neuroses, overexcitement;
• dry needling is a method of placing needles on acupuncture biologically active points. The method is used for neurotic states, panic attacks, sleep and other disorders;
• psychiatric and drug therapy is one of the most effective methods to treat mental and behaviour disorders.

“Depressions, bipolar disorders, schizophrenia, psychosis, dementia, mental deficiency and so on are one of the main mental disorders,” he added.

“We certainly have issues with diagnostics”

Ruslan Tyumenev indicated not only the high efficacy of modern treatment methods but also the fact that there is a problem of diagnostics of psychiatric and neurological disorders in Russian medicine. According to the doctor, it is fully based on an analysis of the patient’s behaviour and thoughts as well as learning medical history.

“We don’t have accurate medical markers indicating a specific disorder,” the specialist concluded.

At the same time, Ruslan Tyumenev specified that patients must be admitted to the clinic. He says this is needed not only because of attempts of shouting at the wall or committing a suicide but, for instance, a banal absence of hygiene.

“An inpatient clinic is always recommended for diagnostics and primary health care in general. After the clinic a therapy can be received in outpatient clinic visiting your psychiatrist or psychotherapist and even a psychologist,” the expert added.

Unwillingness to study or work can be a sign of a disorder

Obvious signs of psychiatric and neurological disorders are well-known: hallucinations, a suicidal behaviour, delirium and so on. But Ruslan Tyumenev says that the list can include an absence of hygiene, unwillingness to study or work, an unstable behaviour, disorder in everyday life, overeating or fasting, insomnia or dizziness. When having such markers the correct option is to see a doctor.

“Many people have to live together and neighbour alcoholics, drug addicts, gambling addicts, neurasthenics, aged parents, people with dementia, etc. Constant scandals, accusations, threats, physical abuse, suicide attempts are the first signs of something is wrong with the mental state of people involved in such conflicts. If a person’s behaviour repeats over and over and starts to impact other people’s lives, we are talking about a psychiatric disease and it needs to be examined by specialists — psychiatrists and drug therapists,” said Iskander Mindubayev.

At the same time, society changes its attitude to people with psychiatric and neurological disorders. Of course, the doctor indicates, if the patient doesn’t receive treatment and does nothing to stay healthy, he or she treated cautiously. However, an ordinary person can unlikely notice something when talking, let’s say, with a schizophrenic who sees a doctor.

“When talking with a schizophrenic who periodically receives drug therapy and visits his psychiatrist or psychotherapist, you can unlikely notice something. And if he confides that he is sick, how will your attitude change? It won’t,” Ruslan Tyumenev summarised.

Iskander Mindubayev’s opinion is a bit different. He says that there is still some taboo on the topic of psychiatric and neurological disorders in society that needs to be eliminated this raising the awareness of the population and reducing the level of cautiousness.