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E. V. Snedkov, A. E. Veraksa, P. Y. Muchnik
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-2-8-20

Abstract:
The article argues for the discrepancy between the artificial construction of «schizoaffective disorder» (SAD) and the principles of nosological diagnostics. The term of «acute schizoaffective psychoses», was introduced by Y. Kazanin in 1933, is still remain a controversial nosological unit. This diagnosis often made at the cut of a psychotic episode on a «dichotomous scale» by «weighing» schizophrenic and affective symptoms. In the history of the creation of the concept of SAD, there is a tendency towards reductionism and the search for universal manifestations. Each individual clinical case must be considered holistically. It is unacceptable to extract the individual signs (which does not fit syndromal structures) from general picture of the disease. However, this requirement is in contradiction with the current trends towards simplification, discreteness and loss of clinical thinking in currents classifications of diseases. The inadequacy of the available diagnostic approaches and criteria for distinguishing between SAD, bipolar disorder and schizophrenia leads to the fact that the patient’s diagnosis is based on the subjective preferences of a clinician, and during patient’s life can many times be changed. The results of the the phenotype and genotype of the corresponding disorders searching partially shed light on the features of the diagnosis; but at the same time, some researchers are artificially combine the discrete properties and coming to incorrect conclusions; often such an identity simply does not make sense. The authors join opinion of experts who suggesting the existence of a «third psychosis» or even several discrete forms of diseases, which, along with unrecognized attacks of bipolar psychosis and schizophrenia are still mistakenly dissolved in the dichotomous / dimensional hybrid SAD. Diagnostics, taking into account the follow-up, regularities of the course, pathophysiological changes and psychopathological structure, has not only clinical value, but is also responsible for the selection of effective treatment, correct preventive measures, affects the social status and, ultimately, the quality of life of the patient.
N. A. Gomzyakova, A. V. Lukyanova, N. G. Neznanov, N. M. Zalutskaya
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-2-78-89

Abstract:
In order to study the point of view of doctors supervising patients with dementia regarding the methods and tactics of treating diseases that occur with severe cognitive impairment, their experience in the use of drugs and criteria for choosing a drug for long-term treatment of dementia, an online survey of 197 specialists was conducted.The majority of Russian physicians surveyed prefer basic therapy for dementia, while the main criteria for choosing a drug for long-term therapy are effectiveness and safety of the drug. Despite the absence of drugs capable of complete curing of dementia, Russian doctors have certain expectations and goals when prescribing therapy, in particular, the hope for the longest possible preservation of the quality of life and capacity of patients, as well as slowing down the progression of the disease. 90% of respondents consider it necessary to continue (and even start) therapy even at a severe stage, despite the depletion of the effect. Memantine has become the main drug of choice in different regions of Russia as a drug with a wide range of registered indications, the fewest side effects and a low percentage of patient refusals.
T. A. Gubeidulina, Y. K. Rodygina
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-2-42-46

Abstract:
With the biopsychosocial approach, in rehabilitation among other medical fields, the researchers’ interest in various social and psychological issues and their influence rose. The role of these factors in skeletal trauma and orthopedic care and rehabilitation is studied intensively and is important both for scientific and practical healthcare purposes. It is shown that some personality traits are connected to the results of skeletal trauma and orthopedic treatment. This original study was conducted to evaluate personality traits of skeletal trauma and orthopedic patients during their outpatient rehabilitation. The purpose of this study was to investigate the gender differences in personality traits of skeletal trauma and orthopedic patients to determine the medical communication strategies. 120 skeletal trauma and orthopedic patients during their outpatient rehabilitation (experiment sample) and 39 healthy individuals (control sample) were evaluated with the 16PF Questionnaire. After statistical analysis significant differences were found between the groups in B (reasoning) and Q4 (tension) factors; no other factors had significant differences in the groups. The factor B differences pointed out that concrete-thinking was more typical for the experiment group than for the control group. The factor Q4 differences meant tension was lower in skeletal trauma and orthopedic patients than in healthy individuals. The gender differences were as follows: extraversion, submissiveness, trusting, abstractedness, openness, and sensitivity were more characteristic for men, when women tended to be more introverted, dominant, suspicious, practical, diplomatic, and less sensitive.
N. B. Khalezova, , M. A. Khobeysh
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-2-67-77

Abstract:
Hostility and aggressiveness can be a marker of individual psychological vulnerability to stressors leading to reduced social adjustment and the risk of mental disorder manifestation. The aggressive tendencies prevalence is believed to be high among people living with HIV. With an increase in the incidence of HIV infection, the number of HIV-positive patients with concomitant mental disorders is increasing.Aim: to evaluate the intensity and the structure of aggressive tendencies in HIV-infected persons with concomitant mental disorders. Material and Methods. 78 HIV-positive persons and 24 HIV-negative psychiatric patients. The Bass-Darkie Aggressive Level Questionnaire (BDHI) and Short Psychiatric Assessment Scale (BPRS) were used. Nonparametric statistics, dispersion analysis was performed with p≤0.05, Cohen’s d calculated (effect size).Results. We examined 102 people, 51 (50.0%) men, 51 (50.0%) women, the average age — 35.5 ± 9.7 years. 58 (74.4%) HIV-infected respondents had mental disorders. HIV-positive persons with schizophrenia had higher values of most aggressive tendencies (p<0.05) in the group of HIV-infected subjects. In comparison with HIV-negative patients, HIV-positive persons with schizophrenia had higher mean values of «Physical aggression» (p<0.001, Cohen’s d=1.0), «Verbal aggression» (p <0.001, Cohen’s d = 1, 0), and «Aggressiveness» (p=0.004, Cohen’s d=0.86). 4B clinical stage of HIV infection was associated with higher scores of «Physical aggression», «Indirect aggression», «Verbal aggression», «Negativism», «Aggressiveness» (p<0,05).Conclusion. The study findings contribute to the understanding of the features of aggressive tendencies in HIV-positive persons and call for further research to improving the quality and personalization of medical care for patients with concomitant mental disorders.
E. V. Fadeeva, A. M. Lanovaya, A. Yu. Nenastieva, G. A. Korchagina
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-2-56-66

Abstract:
The article is presenting results of the third stage of the examination of primary school students for the identification and assessment of the severity of structural and functional abnormalities of the central nervous system (CNS) that arose in connection with perinatal exposure to ethanol — 77 children with previously identified delayed physical development of various degrees and characteristic dysmorphological disorders were examined. The identification of structural abnormalities to the CNS was carried out on the basis of assessing the correspondence of the occipital frontal circumference of the child’s head with the normative values for a specific sex and age, determination of functional abnormalities was carried out on the basis of an assessment of intellectual development based on the results of the Wechsler Intelligence Scale for Children and behavioral characteristics according to the Vineland Adaptive Behavior Scales.The presence of structural abnormalities to the CNS, manifested by a decrease in the occipital frontal circumference 2 or more standard deviations below the mean for the age norm, was revealed in 59 patients (77%). A serious functional disorder of the CNS, manifested by mild and moderate mental retardation, was found in 23 children (30%). Mild or moderate functional impairment of the CNS in the form of delayed cognitive development was found in 21 children (27%).Assessment of behavior and adaptive skills revealed a significant number of children (72%), whose adaptive behaviors were unfavorably different from the norm. The most common ones were: low concentration of attention — in 77%, increased anxiety and fear — in 65%, hyperactivity — in 60%, impulsivity — in 44%, outbursts of anger — in 43%, deceit and theft — in 40%, excessive dependence or codependency — in 38%, deliberate destruction of one’s own or someone else’s property — in 14% of children.Statistically significant inverse correlations of a high level of significance (p≤0.01) between indicators of nonverbal intelligence and maladaptive behavior were obtained. Inverse correlations between structural abnormalities of the CNS and nonverbal intelligence are presented at the tendency level.
T. A. Karavaeva, M. V. Fomicheva
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-2-21-34

Abstract:
In the article, we analyze the diagnosis of psychogenic overeating (ICD-10), consider the problem of its diagnostic criteria, similarities and differences with the diagnosis of binge-eating disorder (DSM-V), which complicate the work of researchers. We are looking at the need to differentiate the different types of binge eating disorder. The role of psychogenic overeating is noted as a pathogenetic factor that triggers the process of gaining excess weight. We describe in detail the biological (gender and hereditary predisposition), psychological (individual psychological personality traits, adaptive and compensatory resources) and sociocultural (style of family education, social ideas about the reference body image, features of communicative behavior, etc.) groups of factors involved in the formation of psychogenic overeating. The article emphasizes the role of psychological triggers of the disease associated with the emotional-volitional sphere, the specificity of reactions to stressful influences, psychological defenses and perception of the image of one’s body. The article also raises the problem of the lack of adapted and standardized psychodiagnostic tools aimed at studying psychogenic overeating, which complicates the formulation of an accurate diagnosis and the choice of methods of its treatment. The article also discusses such therapeutic approaches to the treatment of the described nosology, such as psychoanalysis, positive psychotherapy, gestalt therapy, transactional analysis, body-oriented therapy. Particular attention is paid to the cognitive-behavioral approach, which has shown high efficiency when working with patients with eating disorders. It is noted, that it is promising to develop algorithms for diagnostics and therapy of the described nosology, the feasibility of identifying individual targets of psychotherapeutic interventions to create personalized complex programs that increase the effectiveness of therapy in relation to immediate and long-term results.
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-2-47-55

Abstract:
Резюме. Интерлейкин-6 (ИЛ-6) — один из важнейших провоспалительных маркеров, обладающих иммуномодулирующей активностью, ассоциированных с шизофренией. Возможное участие интерлейкина-6 в этиопатогенезе шизофрении и развитии отдельных кластеров симптомов остается дискутабельным, до сих пор не изучена связь повышения интрелейкина-6 с рядом возможных вмешивающихся факторов, в том числе, курением. Целью данной работы была пилотная оценка уровня ИЛ-6 сыворотки у пациентов с шизофренией в сравнении со здоровым контролем, а также изучение его ассоциации с клиническими симптомами, социо-демографическими факторами и курением. Материалы и методы: Обследованы 43 пациента с шизофренией и 24 здоровых добровольца. Определение ИЛ-6 проводили методом иммуноферментного анализа. Все пациенты обследованы с помощью Шкалы для оценки позитивных и негативных синдромов шизофрении (PANSS), Шкалы для оценки побочных эффектов терапии UKU (“The UKUSERS-Clin”, шкалы Симпсон–Ангуса (SAS), шкалы для оценки аномальных непроизвольных движений (AIMS), шкалы акатизии Барнса (BARS), шкалы Личного и социального функционирования (PSP). Результаты: У пациентов с шизофренией в российской выборке уровень ИЛ-6 сыворотки значимо ассоциирован со статусом курения (p=0.0017). Уровень ИЛ-6 у пациентов также коррелирует с выраженностью негативных симптомов и симптомов шкалы общей психопатологии PANSS (р=0,014 и р=0,038 соответственно), нарушений личностного и социального функционирования (PSP, р=0,011), а также побочных эффектов, измеренных с помощью шкалы UKU (общих, р=0,0041 и экстрапирамидных, р=0,018), а также лекарственного паркинсонизма (р=0,043), дискинезии (р=0,0084) и акатизии (р=0,043). При этом нельзя исключить влияние фактора курения на выявленные ассоциации, так как все эти показатели хуже у пациентов с никотиновой зависимостью. Возникновение ЭПС в ответ на стандартные дозы АП может служить клиническим маркером возможных иммуно-воспалительных нарушений у пациентов с шизофренией, а статус курения выступать фактором-провокатором усиления латентного воспаления. Для подтверждения полученных данных требуется репликация исследования.
V. A. Bogacheva, D. V. Zakharov, I. V. Buriak
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-2-35-41

Abstract:
The aim of the study was to study the personality characteristics and psychological state of patients with tremulous hyperkinesis in Parkinson’s disease. We studied men and women aged 49 to 75 years with an established diagnosis of «Parkinson’s disease» of a tremulous (main group) and akinetic-rigid form (control group), stages 1-2 according to Hyun and Yar. To study the psychological state of patients, the Giessen personality questionnaire was used, which made it possible to take into account personal, intrapsychic and socio-psychological variables, as well as to investigate their corresponding characteristics; to establish relationships between intra- and interpersonal variables; to correlate personality traits with interpersonal interaction, social behavior, social attitudes and reactions of the individual. To study the level of social adaptation of patients, a questionnaire of social maladaptation associated with tremor was selected, which made it possible to assess the social consequences of existing disorders, as well as the real severity of tremor. Psychological factors play a significant role in the formation and course of Parkinson’s disease (PD). The study of social adaptation in patients with tremor in PD was first conducted. The study of the personality characteristics of patients with PD showed that, regardless of the form of the disease, all patients with PD are characterized by a decrease in the perception of their social reputation, attractiveness, popularity, respect for others, and the ability to achieve their goals; lack of long-term attachments, lack of sociability, poor ability to surrender, poor fantasy. Only patients with an akinetic-rigid form are characterized by humility, obedience, complaisance, patience, distrust, distancing from other people. Patients with combined tremor are more prone to anxiety than patients with isolated tremor. Shivering hyperkinesis causes social disadaptation and self-stigmatization of patients.
N. A. Shnayder, A. K. Abdyrakhmanova, R. F. Nasyrova
Personalized Psychiatry and Neurology, Volume 2; https://doi.org/10.52667/2712-9179-2022-2-1-4-21

Abstract:
Antipsychotics (APs) are a class of psychotrophic medication primarily used to managepsychosis (including delusions, hallucinations, paranoia or disordered thought), principally inschizophrenia but also in a range of other psychotic disorders. Biotransformation is a major mechanism for APs elimination. Most APs undergo biotransformation, or metabolism, after they enter the body. There are three phases of APs metabolism. Cytochrome P450 (CYP) monooxygenase (mixed function oxidase) plays a central role in the most APs biotransformation. CYP’s functional activity depends on gene-drug and drug-drug interaction and influences on occurrence of adverse drug reactions (ADRs). So, it is extremely important for a practicing psychiatrist to know the oxidation pathway of APs, since most of them are metabolized in the liver and this is important both to prevent ADRs and to avoid unwanted drug-drug interactions, which will undoubtedly increase theeffectiveness and safety of AP therapy.
Z. A. Nurgaliev, V. V. Trefilova, M. Al-Zamil, N. A. Shnayder
Personalized Psychiatry and Neurology, Volume 2; https://doi.org/10.52667/2712-9179-2022-2-1-46-56

Abstract:
The intervertebral discs degeneration (IDD) is one of the leading structural substrates, causing chronic low back pain (LBP). LBP is a common neurological disorder but the LPB genetic predictors have not been sufficiently studied. Fibril collagens are important components of the nucleus pulposus, the anulus fibrosus and the vertebral endplate. Collagen type I is most studied as a structural component of the nucleus pulposus and the anulus fibrosus of the intervertebral disc. Single nucleotide variants (SNVs) of genes encoding alpha-1 and alpha-2 chains of collagen type I are associated with IDD, but the results of genetical studies are not translated into action. (1) The purpose of the study is the analysis of associative genetic and genome-wide studies of the COL1 gene family role in the development of IDD and LBP. The study of the COL1A1 gene’s SNVs association of with the IDD is important for the perspective of personalized neurology. A personalized approach can help to identify patients at high risk of the IDD developing and its complications, including intervertebral disc herniation and spinal stenoses in young and working age patients. On the other hand, the role of nutritional support for patients, carriers of the SNV risk alleles in the COL1A1 gene, including collagen hydrolysates and oxyproline preparations has not been sufficiently studied.
I. S. Efremov, A. R. Asadullin, E. A. Akhmetova, L. R. Migranova, V. L. Yuldashev, N. A. Marfina, E. R. Kunafina, M. N. Gilmiyarova, D. H. Kalimullina, S. U. Tuktarova, et al.
Personalized Psychiatry and Neurology, Volume 2; https://doi.org/10.52667/2712-9179-2022-2-1-73-80

Abstract:
Background: Suicidal behaviour is the leading cause of mortality from external causes at all ages worldwide. More than a million people commit completed suicide each year. According to the World Health Organisation, 25-50% of suicide victims suffered from alcohol and other substance use disorders, 22% of all suicide deaths were attributable to alcohol use (WHO, 2014). Several papers have suggested potential associations of insomnia and increased suicide risk in patients with alcoholism. We hypothesise that mutations in melatonin receptor genes may be associated with suicide risk in patients with alcoholism.Methods. The Insomnia Severity Index (ISI) was used as a tool to assess the presence and severity of insomnia. The Columbia Suicide Severity Rating Scale (C-SSRS) was used as a method to examine suicidal behavior. Genotyping of MTNR1A (rs34532313), MTNR1B (rs10830963) genes was performed using real-time polymerase chain reaction (RT-PCR). A comparative genetic study of two groups of patients was carried out: the first group, patients with alcohol dependence syndrome (F10.2); the second group, patients with alcohol dependence syndrome (F10.2) and insomnia, which persisted 7-14 days after starting alcohol withdrawal therapy.Results. Suicidal thoughts and a history of auto-aggressive behaviour were more common in subjects with insomnia in the post-withdrawal period. Carriers of the TT genotype of the MTNR1A gene (rs34532313) were more likely to have suicidal thoughts and a history of suicide attempts in a genetic study of patients with insomnia.Conclusions. Our study found that the TT genotype of the MTNR1A gene (rs34532313) is a genetic marker of suicidal behaviour risk in patients with insomnia in the post-withdrawal period. However, the same pattern was not observed in patients without insomnia.
A. K. Abdyrakhmanova, R. F. Nasyrova
Personalized Psychiatry and Neurology, Volume 2; https://doi.org/10.52667/2712-9179-2022-2-1-81-88

Abstract:
Schizophrenia is a common and socially significant mental disorder that requires long-term use of antipsychotics (APs). Long-term use of APs increases the risk of developing adverse drug reactions (ADRs) and/or therapeutic resistance in some patients. This may be due to a genetically determined impairment of APs metabolism by cytochrome P450 enzymes. Pharmacogenetic testing (PGx) is a method to identify a group of patients with a high risk of developing AP-induced ADRs. Our experience of using PGx to search for low-functional and non-functional single nucleotide variants (SNVs) / polymorphisms of the CYP1A2, CYP2C9, CYP3A4, CYP3A5 and CYP2D6) genes encoding cytochrome P450 enzymes involved in APs metabolism demonstrates the importance of this new personalized approach to the choice of APs and its dosing in patients with pharmacogenetic profile poor metabolizer. The main purpose of the case report is to present the experience of using PGx in a 28-year-old patient with treatment-resistant schizophrenia and a medical history of AP-induced ADRs.
S M. Osipova, N. S. Shnayder
Personalized Psychiatry and Neurology, Volume 2; https://doi.org/10.52667/2712-9179-2022-2-1-98-106

Abstract:
Schizophrenia is a common and socially significant mental disorder requiring long-term use of antipsychotics (APs). Long-term use of APs increases the risk of developing adverse drug reactions (ADRs) and / or treatment resistance in some patients. This may be due to a genetically determined impairment of APs transport across the blood-brain barrier (BBB) and the membrane of APs target neurons in the brain. Pharmacogenetic testing (PGx) is a method to identify a group of patients with a high risk of developing AP-induced ADRs. Foreign panels for PGx do not include non-functional variants of genes encoding APs transporter proteins. However, our experience ofusing PGx to search for low-functional and non-functional single-nucleotide variants (SNVs)/polymorphisms of three genes (ABCB1, ABCG2, ABCC1) encoding APs transporter proteins demonstrates the importance of this new personalized approach to the choice of APs and its dosing in patients with a slow transporter PGx profile. The main purpose of the work is to present the experience of using pharmaco-genetic testing (PGx) in a 32-year-old patient with treatment-resistant schizophrenia and a medical history of AP-induced ADRs.
P. S. Goncharova, T. K. Davidova, N. A. Shnayder, M. A. Novitsky, R. F. Nasyrova
Personalized Psychiatry and Neurology, Volume 2; https://doi.org/10.52667/2712-9179-2022-2-1-57-66

Abstract:
We searched for full-text publications in Russian and English in the E-Library, PubMed, Springer, Clinical keys, Google Scholar databases, using keywords and combined word searches (amyotrophic lateral sclerosis - ALS, motor neuron disease, epidemiology, incidence, prevalence), for 2015 – 2020. In addition, the review included earlier publications of historical interest. Despite our comprehensive searches of these commonly used databases and search terms, it cannot be excluded that some publications may have been missed. A total of 74 publications were analyzed, reflecting epidemiological studies of ALS in 168 countries. The incidence of ALS worldwide varies from 0.4 per 100,000 per year (Ecuador) to 9.45 per 100,000 per year (Japan, Oshima region). Prevalence - from 0.1 per 100,000 population (Somalia) to 42.1 per 100,000 population (Canada). This data depends on many factors, including the quality of the diagnosis and the health care system.
N. M. Zhuravlev, N. A. Shnayder, E. E. Vaiman, A. K. Abdyrakhmanova, M. M. Petrova, E. N. Bochanova, I. V. Romanova, O. A. Gavrilyuk, N. V. Lareva, R. F. Nasyrova
Personalized Psychiatry and Neurology, Volume 2, pp 22-45; https://doi.org/10.52667/2712-9179-2022-2-1-23-45

Abstract:
In connection with the widespread use of anticonvulsants (antiepileptic drugs – AEDs) in psychiatric and neurological practice and the need for their long-term use to treat a wide range of mental disorders and neurological diseases, the question of their safety profile, including the assessment of the risk of developing life-threatening conditions and adverse reactions (ADRs), becomes relevant. In this regard, from the position of personalized medicine, it is critical to develop an interdisciplinary approach with the participation of doctors of various specialties and a new strategy of a personalized approach to predicting AED-induced prolongation of the QT interval as one of the most prognostically unfavorable cardiological ADRs (including sudden death syndrome – SDS). We searched for full-text publications for the period from 2011 to 2021 databases using the following keywords and its combination. We have found and systematized monogenic and multifactorial forms of long QT syndrome (LQTS) and candidate genes that slow down AEDs metabolism in the liver. Identification of risk alleles of single nucleotide variants (SNVs) of the candidate genes predisposing to the development of AED-induced LQTS and SDS will make it possible to adjust the choice and dosage of these drugs and prevent the development of ADRs, which will improve the quality of life of patients and prevent SDS in the patients with psychiatric and neurological disorders.
L. P. Linova, A. A. Torgovtsev, O. V. Limankin, R. F. Nasyrova
Personalized Psychiatry and Neurology, Volume 2; https://doi.org/10.52667/2712-9179-2022-2-1-89-97

Abstract:
Schizophrenia is a common and socially significant mental disorder that requires longterm use of antipsychotics (APs). Long-term use of APs increases the risk of developing adverse drug reactions (ADRs) and/or therapeutic resistance in some patients. This may be due to a genetically determined impairment of APs metabolism by cytochrome P450 enzymes and of Aps transport across the blood-brain barrier (BBB) and the cell membrane of APs target neurons in the brain. Pharmacogenetic testing (PGx) is a method to identify a group of patients with a high risk of developing AP-induced ADRs. The aim of the case report is to present the experience of using PGx in a 36-year-old patient with treatment-resistant schizophrenia and a medical history of AP-induced ADRs.
K. O. Mironov, I. I. Gaponova, V. I. Korchagin, A. S. Esman, E. A. Dunaeva, V. A. Zhivotova, V. S. Dobrodeeva, N. A. Shnayder, N. G. Neznanov, R. F. Nasyrova
Personalized Psychiatry and Neurology, Volume 2; https://doi.org/10.52667/2712-9179-2022-2-1-67-72

Abstract:
The antipsychotic-induced metabolic disorders (AIMD) are common side effects during the treatment of schizophrenia. Single nucleotide polymorphisms in the genes associated with AIMD, in particular in the leptin and neuropeptide Y genes were explored. The aim of this study was to develop a real-time PCR technique for SNP allele discrimination and allele frequency estimation in the Russian population. A total of 9 real-time PCR tests for rs7799039, rs1137101, rs8179183, rs16147, rs6837793, rs11100494, rs1414334, rs3813929 and rs518147 SNPs were developed and examined using 106 DNA samples. The revealed allele frequencies did not show any statistically significant differences with ones for the Caucasian population from Ensembl data base. Thus, our results are in accordance with the allele frequencies for the studied populations and allow using published data on the risk alleles for the development of new diagnostics PCR kits for the complex diagnostics of AIMD.
Р. Ф. Гасанов, И. В. Макаров, Д. А. Емелина
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-34-42

Abstract:
At the basis of numerous mental disorders lies a synaptic transmission impairment that causes metabolic and ionic changes and affects the current functional state of the brain, the reflection of which we find in electroencephalographic examination.Objective of the study: identification of electroencephalographic features in children under conditions of biochemical heterogeneity of hyperkinetic disorder (HD).Material and methods. 404 children aged 6-8 years with HD were divided into three subgroups according to the state of monoamine activity: the 1-st subgroup with a combination of hypofunction of the dopaminergic and hyperfunction of the noradrenergic systems — 120 children, the 2-nd subgroup with a combination of hyperfunction of the noradrenergic system with relative balance dopamine — 136 children, and the 3-d with a combination of hyperfunction of the dopamine and hypofunction of the noradrenergic systems — 148 children. In the selected groups, the serotonin system plays an inhibitory and modulating role in relation to the catecholamine metabolism systems. The control group consisted of 90 children (54 boys and 36 girls). An electroencephalographic study was carried out, where the following ranges and subranges were differentiated: theta rhythm (4–8 Hz) and beta1 rhythm (14–20 Hz). The power ratios of theta — and — beta1 rhythms (theta/beta1) were calculated.Results. It was the serotonin system that turned out to be the determining factor in the neurophysiological characteristics of HD. Moreover, the division into subgroups, based on the biochemical characteristics of children with HD, did not allow us to obtain significant differences. The only feature that globally distinguishes the subgroups from each other was the increase in the theta/beta1 activity index, corresponding to an increase in the tension and activity of the serotonin system from subgroup 1 to 3. The data obtained allow us to assert that the electroencephalographic index theta / beta1 can serve as a marker of inattention in children with hyperkinetic disorder and reflects the established state of imbalance of all monoamine systems, but better characterizes the behavior of the tryptophan system.Conclusion. The data on the relationship between the power of theta/beta1 rhythms in the EEG may indicate the nature of the activity of the serotonin system in prospective studies, providing a personalized approach to the selection of drug therapy in children with HD.
, , A V Vladzymyrskyy, O Z Khairetdinov
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-43-53

Abstract:
Telepsychiatric assistance in the “doctor-patient” format is at the stage of formation and requires the solution of legal, organizational and methodological issues. The aim of the study was to substantiate the methodology of telemedicine consultations of patients (legal representatives) in child psychiatry. Material and methods. The analysis of the results of 1129 telemedicine consultations (TMK) in the «patient-doctor» format for 559 patients aged 2 to 18 years was carried out. Results. Remote consultations have been tested for the entire spectrum of mental disorders in childhood and adolescence. During the primary patient-doctor TMK, a number of serious regulatory and technical limitations were identified. Repeated TMK «patient — doctor» in child psychiatric practice are defined as the most optimal and safe. There was a significant increase in the number of repeated TMKs and the expansion of the specialties of consultants during the period of restrictive measures in connection with the COVID-19 pandemic. The assessment of the effectiveness of TMK was carried out by means of a sociological survey (questionnaire) of doctors and patients (legal representatives). Conclusion. A methodology has been developed for organizing and conducting telemedicine consultations for patients under the age of 18 (legal representatives) in the field of psychiatry. A survey of beneficiaries recorded their high readiness and satisfaction with remote counseling. A survey of medical workers revealed a positive trend in attitudes towards carrying out TMK. The negative dynamics of the opinions of specialists in connection with the increase in the level of workload indicates the need for further organizational, methodological and educational work on the use of telemedicine technologies.
В. А. Винокур, Т. А. Караваева
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-8-15

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The review of the Russian and foreign literature on the relationships of psychosomatic medicine and Balint supervision of physicians was conducted. We selected and analyzed articles from MEDLINE / PubMed Elibrary.ru, Scopus databases during from 1990 till 2020, international medical journals and collections of scientific papers as well as relevant references in the bibliography of the analyzed articles. The search was carried out with the usage of search queries of various combinations of the specified key words.The “philosophy” of psychosomatic medicine and the theory of Balint supervision have the evident common historical grounds. Psychosomatic medicine and Balint supervision are united by the conception that the patient’s perceptions about his/her illness, related to it experiences and behavior as well as their relationships to his/her unconscious are very important in the therapy process. That means that the experiences and behavior of a physician related to the complicated communication with the patient are important as well. The patient has to be no more a passive object of the care so the process of therapy obtains the character of interpersonal communication and the mutual influence between the patient and the physician. This point is what Balint supervision is focused at. The technology of Balint group work helps physicians to shift an emphasis in the clinical practice from the disease-centered to the patient-centered approach. The analysis of Balint groups effectiveness provided during more than fifty years brought an evidence that Michael Balint presented very efficient method which helped physicians in different medical fields and psychologists reduce their emotional arousal in the treatment of “difficult” patients who are patients with psychosomatic disorders very frequently. The integrative relationships between basic approaches of psychosomatic medicine and Balint supervision in physicians and psychologists are described. The history of the relations and common principles related to the attention to the complexed issues of physician-patient communication and the therapy in psychosomatic disorders which becomes more successful due to the impact of analytical Balint supervision, are analyzed. The significance of Balint groups work in the training of the health care professionals, who are treating patients with psychosomatic disorders, difficulties and perspectives of implementation of Balint group method into the system of education and training of general practitioners, psychiatrists and psychotherapists are presented.
O Yu Shchelkova, M V Iakovleva, , E A Sushentsov,
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-79-94

Abstract:
Patients who face a stressful situation related to cancer and loss of a limb have not been thoroughly studied form a psychological perspective, what limits the possibilities of targeted psychological assistance and social rehabilitation. In this regard, the aim of the research was to study the clinical and psychological status, strategies and personal resources for coping with the stress of the disease, as well as the main parameters of the quality of life (QoL) of patients who underwent lower limb amputation due to cancer (group 1, n = 24, men — 62.5%, average age 47.25 ± 3.17), in comparison with patients amputated due to other somatic diseases not accompanied by an actual vital threat (group 2, n = 15, men — 93.3%, average age 59.67 ± 2.27), as well as with normative psychodiagnostic data. Methods of clinical and psychological diagnostics were used, including “Ways of Coping Questionnaire”, “Big V Questionnaire”, “Purpose in Life Test”, EORTC “Quality of Life of Cancer Patients Questionnaire” (QLQ-C30). It was found that functional capability (p<0.01), objective (p<0.001) and subjective (p<0.001) severity of pain syndrome, as well as employment (p=0.05) have the lowest indicators in group 1 compared with group 2; at the same time, the levels of QoL in both groups of patients do not differ and do not correspond the expert assessment, exceeding it; patients rate their cognitive and emotional activity most highly; the lowest, physical and role activity, and financial impact. In the structure of coping of group 1, the strategy “Seeking for social support” predominates; the values of the scales “Distancing” (p=0.05), “Escape–avoidance” (0.1<p<0.05), “Positive reappraisal” (p<0.05) are higher than in group 2, but lower than average normative values. In the personality of patients in group 1, “Conscientiousness” (p=0.01) and “Openness” (0.1<p<0.05) prevail in comparison with patients in group 2, as well as “Extraversion” (0.1<p<0.05), “Conscientiousness” (p<0.001) and “Emotional stability / Neuroticism” (p<0.05) — compared with the mean values of the test. The indicators of the scales “Meaning of life” (p<0.01), “Fullness of life” (p<0.01), “Life satisfaction” (p<0.01) in group 1 are higher than in group 2; patients’ internality is higher than in the control sample of men (0.1<p<0.05) and women (p<0.01). The results obtained can be used in the process of rehabilitation of orthopedic cancer patients.
М. В. Злоказова, N V Semakina
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-105-110

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Mental health and mental well-being of the population are the most important prerequisites for a good quality of life. A special position in the healthcare of the Russian Federation is occupied by the protection of the health of the younger generation, therefore, in the implementation of national projects, much attention is paid to the development of infrastructure for providing multiprofessional medical care to children and the prevention of mental and somatic diseases.Purpose. Description of the model of saving the mental health of the adolescent population, implemented in the city of Kirov (model). The presented materials reflect the advantages and novelty of the model organized with the involvement of the resources of related departments for the implementation of psychological education and continuous prevention with a risk group in schools, routing of persons with prenosological have shown the effectiveness of diagnostics using psycho-diagnostic screening to identify RISK GROUPS and PHENOMENOLOGICAL MENTAL STATES for further preventive work and medical and psychological assistance aimed at preventing the development of clinically pronounced MENTAL DISORDERS with impaired social adaptation.A detailed description of the stages of the model is presented, in which emphasis is placed on preventive work with the risk group in general education schools and medical, psychological and social care for persons with prenosological conditions in pediatric medical institutions, which reduces stigmatizing aspects and increases accessibility.Step-by-step implementation of measures involving administrative and human resources of departments providing preventive care and medical and psychosocial assistance to adolescents allows you to model and adapt the structure without attracting additional economic costs, which shows the versatility and functionality of the model.
Г. Н. Носачев, И. Г. Носачев
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-25-33

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The discourse is based on a review (article) by I.M.Zislin on an article by N.G. Neznanov et al. (Review of Psychiatry and Medical Psychology. 2019;1: 8-15). Based on the methodology and philosophy of science, the key words of the review are discussed. The subject of psychiatry as a medical (clinical) science is analyzed — the same for all its sections, taking into account the principle of demarcation. The humanitarian approach is reduced to the humanitarian (axiological, pragmatic) paradigm of psychiatry, in particular, the crisis of psychology. The importance of including spirituality in the biopsychosocial model (BPS model), mainly through psychotherapy, is pointed out.
, S A Perepelitsa, Ю. Е. Скалин, И. В. Реверчук, O A Tikhonova, A A Grishina Aa
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-54-62

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The aim of the study — to establish the severity of cognitive, psychoemotional, motivational and behavioral disorders in patients after acute period of ischemic stroke.Materials and methods. The study included 60 patients with a diagnosis of ischemic stroke. Depending on severity of neurological deficit according to the national stroke scale (NIHSS), patients were divided into two groups: group 1 — 30 patients with an NIHSS score of 0 to 8, associated with mild neurological deficit, group 2 — 30 patients with an NIHSS score of 9 to 15, associated with moderate neurological deficits. The study was conducted on the 7th day of treatment and included: assessment of the cognitive status according to the Montreal Cognitive Assessment scale; assessment of the level of distress, depression, anxiety and somatization using the Four Dimensional Symptom Questionnaire; assessment of mental and physical asthenia according to the MFI-20 scale, level of self-control using the Rotter’s Locus of Control Scale and assessment of the personality and the familial unconscious in Szondi’s test. Results. The study established the prevalence of depression and cognitive impairment in patients with moderate neurological deficits. Patients with mild neurological deficits are characterized by a moderate level of somatization, mental and physical asthenia, a low level of self-control in relation to health, low adherence to treatment and poor motivation to recover.Conclusion. The results of the study indicate the need inclusion of assessment of psychoemotional factors and personal resources of the patient in relation to illness and recovery in early diagnosis of patients with stroke. Along with neurological deficits, it is necessary to assess the cognitive, emotional and motivational levels of the “internal picture of the disease”. This can help determine the patient’s basic compensatory and adaptive capabilities and develop individual rehabilitation strategies.
, A N Gvozdetsky, К. Ф. Васильченко, С. Е. Голыгина, М. П. Марачев, Yu Yu Osadashiy, С. С. Потанин, И. А. Федотов, I O Shishkina,
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-63-78

Abstract:
The aim of the present study was to examine the characteristics of early career psychiatrists’ (ECP) work in Russia and to assess the prevalence and severity of burnout in them. Material and methods. The Early Career Psychiatrists Council of the Russian Society of Psychiatrists conducted an anonymous online survey of ECP in Russia in July-August 2019, consisted of a structured survey and screening for professional burnout using the Maslach Burnout Inventory (MBI). The final sample consisted of 165 people. Results. A high level of burnout according to at least one of the MBI scales was revealed in 79 (78.2%) women and 39 (60.9%) men (p=0.017). Mean values of the MBI Emotional Exhaustion scale corresponded to 23.33±8.97 and 17.97±8.49 (p=0.003), the MBI Depersonalization scale — 10.46±4.81 and 9.16±4.22 (p=0.083), and the MBI Personal Accomplishment scale — 33.02±5.98 and 35.32±5.75 (p=0.026) for women and men, respectively. The following risk factors for professional burnout were identified: female sex, overlapping of several working positions, difficulties in work due to changes in documentation requirements introduced since the start of professional career. Protective factors of burnout development were: work in private clinic, satisfaction with work atmosphere, subjective estimation of quality of life as above average or as good as possible. Conclusion. Burnout was established in 71.5% of ECP in Russia, which corresponds to one of the highest burnout rates in psychiatrists according to international and national studies. Further research is needed to assess the prevalence and severity and ways to prevent burnout in psychiatrists in Russia.
, A V Kudryashov, O V Matvievskaya, A A Mukhin, В. А. Лаврова, , N V Yaltseva, С. В. Кузьмина, Н. В. Костина, Е. В. Акимова, et al.
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-16-24

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The article provides a review of the scientific literature devoted to postcoid conditions. The concept of postcovid syndrome, its structure, and epidemiology are disclosed. The article contains the results of 2 meetings of experts (psychiatrists, psychotherapists, neurologists) from different regions of Russia who had experience in providing care to persons with postkovid syndrome. Particular attention is paid to postcovid depression, its clinical characteristics, and the experience of therapy. It was noted that the severity of the post-coV syndrome did not depend on the severity of the infectious disease suffered. The leading variants of depressive syndromes observed in SARS-CoV-2 patients were: astheno-depressive, apato-depressive and anxious-depressive syndromes. Anhedonia, anxiety, cognitive disorders, insomnia, and hypochondria occupied a significant place in the structure of postcovid mental disorders. It is emphasized that persons with postcovid syndrome, as a rule, initially found themselves in the field of vision of internists, therefore, their training in the diagnosis of postcovid mental disorders is relevant. Clinical experience has demonstrated the feasibility of antidepressant therapy for postcovid depression and the high efficacy and safety, including the risk of drug interactions, of using vortioxetine, including prescribing the drug to the elderly and the somatically impaired. The article is illustrated with clinical examples.
A A Yakovlev, A G Diachkov, , J Kelly, Л. А. Крамынин
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 56; https://doi.org/10.31363/2313-7053-2022-56-1-95-104

Abstract:
Purpose: To describe clinical and laboratory features and define a role of alcohol as a barrier to adherence in patients with acute retroviral syndrome, to study readiness of infectious diseases specialists to discuss alcohol consumption issues with their patients. Research materials: Retrospective analysis of medical records of 112 patients with established diagnosis of acute HIV-infection was performed, 22 of them fulfilled an anonymous questionnaire regarding they readiness for starting antiretroviral treatment and alcohol consumption. 82 infectious diseases doctors answered anonymous questionnaire about their attitude towards patients with alcohol related problems. Results: Among 112 hospitalized patients with acute HIV-infection 2 had stage 2А, 96 — stage 2Б and 14 — stage 2В. All patients at stage 2B had oropharyngeal candidiasis. Mean inpatient stay were 10 days, 2 patients required ICU admission. Only in 10 patients (8,9%) antiretroviral therapy was initiated while in-hospital. Half of a patients who fulfilled anonymous questionnaire had a dangerous level of alcohol consumption. Only one third of patients fulfilled survey were ready to start antiretroviral therapy. Medical workers had a low score on motivation scale and satisfaction scale while asked about their attitude towards patients with hazardous level of alcohol comsumption. Conclusion: Patients with acute HIVinfection presented with variety of clinical syndromes and possessed a high potential for spreading disease across society. Underestimation of alcohol consumption along with lack of motivation to work with alcohol abusers are typical for doctors and might facilitate further spreading of epidemy.
E. V. Fadeeva, V. I. Garder, O. I. Indinok, Y. V. Patlasova
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-86-96

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The article presents results of a regional project to prevent and reduce the prevalence of alcohol consumption among women in the Republic of Khakassia (Eastern Siberia, Russian Federation). In addition to the main preventive goal of reducing alcohol consumption among groups of women covered by the project, there was an objective to conduct screening using the AUDIT test and provide motivational counseling in case of identifying alcohol-related problems. 691 women took part in screening, among them 202 at enterprises of the Republic of Khakassia, and 489 when seeking social/psychological support to the Khakass Republican Branch of the Russian Red Cross, as well as to local branches of the Red Cross in other cities of the Republic of Khakassia. Levels of risk related to alcohol use were identified, based on the results of the screening the studied groups of women. Depending on the risk level, three types of socio-psychological interventions were carried out: informing about harmful consequences of alcohol use and the need to maintain a healthy lifestyle; motivational counseling; motivating women for treatment of dependency.Majority of women who were screened at workplaces were more likely to use alcohol with low risk (78.2%), much smaller proportion of women had risky alcohol consumption (14.4%), alcohol consumption with harmful consequences (2.5%) or signs of alcohol dependency (2.0%). Among women who applied for social and psychological support to branches of the Russian Red Cross, prevalence of low-risk use was lower (43.4%), and risky alcohol use (31.3%), alcohol use with harmful consequences (10.6%) or signs of alcohol dependency (14.5%) were significantly higher.
A. V. Trusova, A. A. Berezina, A. N. Gvozdetckii, S. G. Klimanova
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-76-85

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The alcohol consumption motivation inventory (ACM) was developed by V.Yu. Zavyalov. Now it is a widespread psychometric tool in research and clinical practice for the evaluation of alcohol consumption motivation in Russian-speaking patients with alcohol use disorders. The aim of the study is to analyze the psychometric properties of the ACM inventory. Results show that the factor structure of the ACM inventory significantly differs from the one stated in the original. The results of the statistical analysis allowed three significant clusters. Cluster A was composed of the scales of the conditioned triad—traditional, submissive, and pseudo-cultural motives. This cluster also partially included hedonistic motives and self-harm motives. Cluster B was composed of scales of personal and pathological triads—withdrawal, ataractic and hyperactivational motives. Hedonistic motives and addictive motives were also partially included. Cluster B included self-harm motives and hangover (addictive) motives. According to the data obtained, the ACM inventory cannot measure an alcohol consumption motivation in the way of the original method. Future work on the modification of the ACM inventory should be based on the results obtained recently in neurophysiological and clinicalpsychopharmacological studies in the field of motivation for alcohol consumption, and includes the revision of the items of the questionnaire, a statistically substantiated gradation of levels for assessing the effectiveness of the motives for alcohol use, and the validation of the version of the ACM questionnaire in women sample.
A. A. Pichikov, , Y. A. Yakovleva, T. A. Salomatina
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-106-112

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The pandemic of the new coronavirus infection (COVID-19) has contributed to an increase in problems related to eating behavior and body image in the population. Various risk factors that have become relevant due to changes in the usual lifestyle have significantly affected the frequency of eating disorders in the adolescent population. This necessitated the adapting of new strategies for providing medical care in conditions of limited personal contact.The aim of the work is the methodological substantiation and systematization of modern approaches to the prevention and treatment of eating disorders, body image disorders and risk factors associated with them in adolescents in the conditions of the COVID-19 pandemic.Materials and methods. The methodological basis of the work is a comprehensive analysis of modern medical and social approaches and recommendations on the organization of assistance to adolescents with eating disorders and body image disorders, with a description of personal experience of using various interventions on an outpatient basis during the pandemic.Results: Prevention and treatment of eating disorders and body image disorders in adolescents during the pandemic should be aimed at specific risk factors those have proved to be the most relevant in connection with restrictive measures: involvement in body image-related social media content and active use of the media; reduction of physical activity with simultaneous increase in access to food; social isolation and reduction of social support; restriction of access to qualified care. The most reasonable approaches during the pandemic are the approaches focused on the family of a teenager using, if possible, remote forms of assistance.Conclusions: Currently, there are no norms and standards in the organization of assistance to adolescents with eating disorders and body image disorders in the pandemic context. However, the analysis of the implemented approaches aimed at various risk factors of these disorders will allow the use of the most effective preventive and therapeutic practices in the future.
, Z. V. Lukovtseva
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-57-66

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The article is devoted to the question of the possible improvement of the psychological examination of persons previously examined in alcoholic intoxication (hereinafter—PEAI). The authors propose an original view on the definition of the target of «alcohol screening», the principles and methods of assessing psychological markers of the systematic substance abuse. Purpose of the study: to determine the differential diagnostic significance of identifying the profile of the lateral organization (hereinafter—PLO) when assessing of the systematic of alcohol abuse in those previously examined in a state of alcoholic intoxication. The researchers made an attempt to highlight the features of PLO of such a «risk group» as those previously examined in a state of alcoholic intoxication (based on data obtained during the study according to the typology of E.D. Khomskaya (with a combination of three types of asymmetries: manual, auditory-verbal and visual) of lateral preferences of 19 PEAI patients of the branch of the Moscow Research and Practical Center for Narcology). As a result, the tendency of those previously examined in the state of intoxication to the lack of a «leading ear» and «leading eye», significant differences in the distribution of the attribute «leading hand» among those previously examined in a state of alcoholic intoxication and in the population were revealed. Conclusion. According to the results of this study, it is difficult to assume the presence of a significant differential diagnostic significance of PLO detection during «alcohol screening» among those previously examined in a state of alcoholic intoxication. At the same time, it should be noted that taking into account lateral preferences can contribute to the improvement of preventive work programs in the narcological service, providing greater individualization of psychological support measures. Directly in the rehabilitation work with PEAI, it is advisable to actively apply social and psychological training (because of a significant part of the contingent among the main factors of relapse with a high degree of probability has social stressors). The creation of short-term (3-5 meetings) programs of group exercises of a preventive orientation, which have different targets depending on the «vulnerability factors» of the owners of certain lateral profiles, also seems justified.
Y. A. Yakovleva, M. Y. Kissin, , A. A. Pichikov, N. Y. Safonova, T. M. Goguadze
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-113-121

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Психозы при эпилепсии встречаются чаще, чем в общей популяции. Частота психотических психических расстройств варьирует от 0,5% до 10%. В статье представлена динамика развития концепции эпилептического психоза в зависимости от эволюционных подходов к изучению проблемы психических расстройств при эпилепсии. Материалы и методы: проведен анализ русско- и англоязычных статей в научных базах, по ключевым словам, с 1971 по 2011 гг. Результаты: первые систематические описания психических расстройств, встречающихся при эпилепсии, относятся к XIX веку. Описан вклад зарубежных и отечественных авторов в изучение проблемы. Выделены шесть основных периодов формирования концепции, включающие определения понятия эпилептического психоза, динамику клинических проявлений, роль влияния биологических, личностных и социальных факторов в генезе и развитии психотических расстройств при эпилепсии. В качестве факторов риска развития психозов рассматриваются: форма эпилепсии; возраст дебюта приступов, латерализация эпилептического очага, пол, медикаментозная терапия. Представлены варианты классификационных подходов к проблеме. Обсуждаются разногласия в систематизации «эндоформных» синдромов, а также проводимые параллели между шизофренией и психозами при эпилепсии. Отражена динамика научных взглядов на заинтересованность в процессе формирования эпилептических психозов различных отделов мозга: височной доли (миндалина, гиппокамп, паралимбические зоны и парагиппокампальный изгиб), а также ГАМК-ергических нейронов верхних бугорков четверохолмия, заднего гипоталамуса и серотонинергических нейронов дорзального шва и норадренергических нейронов голубого пятна. Отмечена связь психопатологических проявлений с нейрофизиологическими, биохимическими, генетическими и морфофункциональными коррелятами. Подчеркивается интерес авторов к психозам, связанным с применением противоэпилептических препаратов. Заключение: несмотря на все попытки систематизации данных состояний, факторы, провоцирующие развитие психозов у больных эпилепсией, их структура и прогноз остаются малопредсказуемыми и требуют дальнейшего углубленного изучения.
А. В. Васильева, T. A. Karavaeva,
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-122-130

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The establishment of psychotherapy and clinical psychology in a Russia is a very complicated and contradictive process. B. D. Karvassarsky has played an essential, key role in the psychotherapy formation as a science and distinct discipline. The article describes the crucial points of this discipline development, presents the main key studies of this mental health field. The Leningrad-Saint-Petersburg psychotherapy school maid a serious impact in the modern Russian neurosology cornerstone issues, that allowed to consider the multidimensional aspects of this pathology. This publication emphasizes the recent research results in this field, makes a deep analysis of the target phenomena understanding in different approaches, other methods integration in personality oriented reconstructive psychotherapy, elaboration of the nosocentric target oriented psychotherapy algorithms and strategies, and also different psychotherapy interventions research.
D. V. Zakharov, Y. V. Buriak
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-97-105

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COVID-19 infection is a significant and poorly understood problem of modern world medicine. As the virus spreads, data on the clinical picture of the disease and damage to the nervous system are accumulating. Symptoms such as fatigue, anxiety, depression, sleep disturbances and many other neurological and somatic symptoms are often recorded, persist for a long time even after the acute infectious stage of the disease has been stopped, and make it difficult for the patient to fully recover. These symptoms occur even with a mild disease and persist for many months. One of the most common and disabling symptoms of post-COVID syndrome is cognitive impairment, in the formation of which, in addition to the direct ability of the virus to penetrate the nervous system and pathology of the microvasculature, various pathological mechanisms are involved, including dysregulation of cholinergic transmission. A comprehensive approach is important in the treatment of cognitive impairment; it is advisable to use both medication and non-medication methods. The main approaches to the treatment of secondary cognitive disorders are based on the hypothesis of replenishing the defect in mediator systems, including those associated with the death of cholinergic neurons. With these abnormalities, it is advisable to replenish acetylcholine. Among the precursors of choline, choline alfoscerate occupies a special place due to its proven efficacy in the treatment of neurodegenerative diseases, as well as due to data on its multifactorial action. The article presents the actual literature data on the mechanisms of development and features of the clinical manifestations of post-COVID cognitive impairment, as well as materials of experimental and clinical studies of the drug choline alfoscerate (Gliatilin).
E. E. Vaiman, , N. G. Neznanov,
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-15-35

Abstract:
Antipsychotic-induced parkinsonism is an undesirable reaction from the extrapyramidal system that occurs against the background of taking antipsychotics (AP), more often in patients with schizophrenia. Antipsychotic-induced parkinsonism belongs to the group of secondary parkinsonism. Its prevalence in the world is about 36%. It is assumed that this undesirable AP reaction is genetically determined. In recent years, numerous associative genetic studies of predisposition to the development of antipsychotic-induced parkinsonism have been conducted. However, the research results are contradictory.Purpose. Review of the results of studies of genetic predictors of antipsychotic-induced parkinsonism in patients with schizophrenia.Materials and methods. We searched for full-text publications in Russian and English in the RSCI, PubMed, Web of Science, Springer databases using keywords and combined searches for words over the past decade.Results. The review considers candidate genes encoding proteins/enzymes involved in the pharmacodynamics and pharmacokinetics of AP. We analyzed 23 genome-wide studies examining 108 genetic variations, including SNV/polymorphisms of 26 candidate genes involved in the development of AIP in schizophrenic patients. Among such a set of obtained results, only 22 positive associations were revealed: rs1799732 (141CIns/Del), rs1800497 (C/T), rs6275 (C/T) DRD2; rs167771 (G/A) DRD3; VNTR*9R DAT1; rs4680 (G/A) СOMT; rs6311 (C/T) 5HTR2A; rs6318 (C/G), rs3813929 (С/Т), haplotype-997G, -759C, -697C и 68G HTR2C; rs2179652 (C/T), rs2746073 (T/A), rs4606 (C/G), rs1152746 (A/G), rs1819741 (С/Т), rs1933695 (G/A), haplotype rs1933695-G, rs2179652-C, rs4606-C, rs1819741-T и rs1152746-G, haplotype rs1933695-G, rs2179652-T, rs4606-G, rs1819741-C и rs1152746-A RGS2; haplotype TCCTC ADORA2A; rs4795390 (C/G) PPP1R1B; rs6265 (G/A) BDNF; rs12678719 (C/G) ZFPM2; rs938112 (C/A) LSMAP; rs2987902 (A/T) ABL1; HLA-B44; rs16947 (A/G), rs1135824 (A/G), rs3892097 (A/G), rs28371733 (A/G), rs5030867 (A/C), rs5030865 (A/C), rs1065852 (C/T), rs5030863 (C/G), rs5030862 (A/G), rs28371706 (C/T), rs28371725 (A/G), rs1080983 (A/G) CYP2D6. However, at the present time it should be recognized that there is no final or unique decision about the leading role of any particular SNV/polymorphism in the development of AIP.Conclusion. Disclosure of genetic predictors of AP-induced parkinsonism development may provide a key to the development of a strategy for personalized prevention and treatment of the neurological complication of AP-therapy of schizophrenia in real clinical practice.
M. T. Andreeva, T. A. Karavaeva, I. V. Kalinin
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-46-56

Abstract:
Attitude towards the disease and quality of life of patients with multiple sclerosis as a target of personalized psychotherapy for PTSDA chronic, progressive, potentially disabling disease with a poor prognosis can trigger the development of post-traumatic stress disorder (PTSD). The article presents the results of a survey of 127 patients with multiple sclerosis (MS), of which 61 patients had PTSD symptoms that developed in connection with the underlying disease were verified. The control group included 67 patients with MS who were resistant to stress. To fulfill the objectives of the study, all patients underwent a thorough collection of anamnestic information. To study the structure of the internal picture of the disease, we used a test technique aimed at diagnosing the type of attitude toward the disease (TOBOL). The study of QOL indicators was carried out using the SF-36 questionnaire.To assess the cognitive, emotional and behavioral aspects of anxiety about progression, the following questionnaires were used: “A short questionnaire for assessing the fear of disease progression” A. Mehnert, P. Herschbach, P. Berg (2006), adapted by N.А. Sirota, D.V. Moskovchenko (2014) and “Questionnaire of cognitive ideas about the disease” A. Evers, F. Kraaimaat (1998), adapted by N.A. Sirota, D.V. Moskovchenko (2014). As a result of the study, it was revealed that the patients of the main group have significantly lower scores of both physical and mental functioning when assessing the quality of life. At the same time, patients with PTSD are characterized by a higher intensity of anxiety about progression, negative thinking, and emotional reactions associated with the disease. An inadequate internal picture of the disease, characterized by the presence of mental maladjustment due to the disease, prevails in the group of patients with PTSD. All of these factors can be predictors of the development of PTSD. It is necessary to conduct further studies of the psychological characteristics of this group of patients in order to identify the targets of psychotherapeutic influence.
, L. V. Leonova, E. D. Kasyanov, N. G. Neznanov,
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-8-14

Abstract:
Despite the emergence of new antidepressants with different mechanisms of action, a large number of problems in antidepressant therapy remain. Considering the known antimicrobial activity of antidepressants, the role of the microbiota in the thymoanaleptic activity of these drugs is of high interest. In recent years, important data have been obtained on the role of the gut microbiota in the regulation of behavior and the pathophysiology of a number of mental disorders, including depression. Of particular interest is the assessment of the normal intestinal microbiota role in the course of the therapeutic process. The emerging bi-directional interactions between drugs and microorganisms may be critical for personalized drug selection and future drug development. However, at the present time, this problem remains poorly understood. The proposed manuscript articulates the main directions that are of clinical importance and can become an object for further study in this area.The research results indicate that the effect of antidepressants on the microbiota is a promising area, the study of which could provide many important findings for clinical practice. This type of therapeutic manipulation can provide an opportunity for intervention in order to potentiate the activity of antidepressants or to minimize side effects. The problem with this method of intervention is enormous complexity, when manipulations can have both positive and negative effects simultaneously, depending on different strains of microorganisms influencing different therapeutic effects. More research is needed to understand what changes occur in the microbiome with acute and chronic administration of specific antidepressants. Perhaps this will contribute to the development of microbiomodulatory tactics for individualized interventions.
, , E. A. Umarov, P. Z. Aitmaganbet, Z. S. Tlegenova,
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-67-75

Abstract:
The article presents data on the study of the content of lithium in the hair of the adult population of the Aktobe region of the Republic of Kazakhstan and the relationship with mental illness. The aim of the study is to assess the content of lithium in the biosubstrates of the adult population and its relationship with the morbidity of the population of the Aktobe region.Materials and methods: A one-stage cross-sectional study was carried out on the territory of the Aktobe region of the Republic of Kazakhstan. The study included 340 residents aged 18-60 years permanently residing in the study area using the method of simple random sampling. The lithium content in hair was determined by inductively coupled plasma mass spectrometry on a NexION 300D spectrometer (PerkinElmer Inc., USA) equipped with an ESI SC-2 DX4 sampler (Elemental Scientific Inc., USA). The morbidity rates were studied according to the ICD-10 classes per 100 thousand population. To assess the relationship between the Li content in the hair and the morbidity rates, the Spearman rank correlation coefficient was calculated.Results: According to the results of the study, significant deviations from the reference values were observed for the lithium content in the Aktobe region. There is an excess of lithium for 80.59% (CI: 76.38; 84.79) of the subjects, the norm is 19.41% (CI: 15.21; 23.62). Excess lithium is more common in men than in women (χ2 =11.07 df=1; p=0.001). Considering the districts of the Aktobe region, the highest content of Li (Me (q25-q75)) was found in the Aitekebi district (0.084 (0.022 -0.134)) mcg/g, in the Kobda district 0.069 (0.060- 0.076) mcg/g, in the Mugalzhar district 0.046 (0.019-0.066) mcg/g, in the Oiyl district 0.044 (0.021-0.0762) mcg/g, in the Alga district 0.040 (0.024-0.090) mcg/g. Spearman’s correlation rank analysis showed a weak positive association of Li content with age (r=0.20, p =0.0001), no association with body mass index was found (r=0.10, p =0.06). The correlation analysis established a direct inverse average relationship between the content of Li and morbidity in the class of diseases “Mental disorders and behavioral disorders” (r=-0.62; p= 0.044).Conclusions: The high prevalence of excess lithium content in the hair of the population and its relationship with mental illness requires further research. The study of the bioelement status of the population can serve as an indicator of environmental pollution, and also aims at monitoring the ecological situation in the region.
G. N. Nosachev, I. G. Nosachev
V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, Volume 57; https://doi.org/10.31363/2313-7053-2021-57-4-36-45

Abstract:
The article is discussed («Review of psychiatry and medical psychology named after V.M. Bekhterev». 2020; 2: 3-15), which examines the biopsychosocial model as the theoretical basis (scientific, clinical, preventive, therapeutic) of modern psychiatry, in particular, the biological (genetic) domain.The purpose of the discourse: from the standpoint of philosophy and methodology of science, to determine the place of the biological domain (biomedical research) of the biopsychosocial (biopsychosocial—spiritual) (BPS) approach (theory) in Russian psychiatry, in particular, from the standpoint of the subject of psychiatry and its main section-clinical psychiatry.Based on methodology and philosophy, and based on anthropological and holistic approaches, the biological domain of the BPS model, which is based on clinical psychiatry as a practice and, accordingly, theory, is discussed through the subject of psychiatry as a science. The significance and role of the subject of psychiatry (pathology, disorders, abnormalities of mental activity) in the ICD-10 and the components of the biopsychosocial (model) approach are discussed. There are differences in the domains of the model and the difficulties of clinical diagnosis (multi-axis, functional, multidimensional) and, accordingly, the study of the etiopathogenesis of mental disorders, the "bias" of diagnosis and therapy. The article deals with the neurological component of the biological domain and the "expansion" of neurologists into psychiatry, which leads to hidden antipsychiatry. The author emphasizes the independence, contiguity and two-paradigm nature of psychiatry as a science (with its own unity of subject and its own method of research—clinical and psychopathological). In addition to the interdisciplinarity of clinical neuroscience, it is proposed to be multidisciplinary (for the sections of psychiatry), but the future belongs to the transdisciplinary research methodology.
O. S. Shilkina, S. N. Zobova, E. A. Domoratskaya, D. V. Dmitrenko
Personalized Psychiatry and Neurology, Volume 1; https://doi.org/10.52667/2712-9179-2021-1-2-95-105

Abstract:
Juvenile myoclonic epilepsy (JME) is reported as a clinically and genetically heterogeneous disease with a high risk of inheritance. The aim of the study was to establish phenotype features and genetic risk factors for juvenile myoclonic epilepsy to advance existing approaches of prevention, treatment, and observation of patients with JME. Methods: anamnestic; clinical; neurophysiological (EEG); neuroradiological (MRI), neuropsychological; laboratory (DNA-diagnostics). JME starts with absences more frequently in females as compared to males (32.0% vs. 15.4%), and with GTCS and myoclonic in males as compared to females (46.2% and 36.5% vs. 36.0% and 31.2%, respectively). The 1st phenotype of JME was more frequently encountered in male individuals in comparison with female ones (55.8% vs. 34.7%), and the 2nd phenotype was more frequently encountered in female individuals in comparison with male ones (16.9% vs. 5.8%). Homozygous carriage of the T allele of the GJD2 gene (rs3743123) was associated with the development of JME in the study population, OR = 2.66 (95% CI 1.24 to 5.74). 41.5% of patients with JME have a slow metabolizer pharmacogenetic status, which is a risk factor for pseudo-pharmacoresistance and the development of adverse drug reactions.
O. V. Balberova, E. V. Bykov, G. V. Medvedev
Personalized Psychiatry and Neurology, Volume 1; https://doi.org/10.52667/2712-9179-2021-1-2-83-94

Abstract:
It is generally recognized that an elite athlete's status is a multifactorial phenotype depending on many environmental and genetic factors. Variations in the sequence of nucleotides in deoxyribonucleic acid (DNA), in particular, single-nucleotide variants (SNVs) act as key internal factors associated with achieving high results in sports. The determination of specific individuals' genetic characteristics allows us to identify athletes who have the greatest genetically determined potential for certain sports that require speed, strength or endurance manifestation. Of course, peculiarities of the structure and function of skeletal muscles are among the most important characteristics in sports results context, in sports associated with the development of power / strength or endurance phenotypes. The composition and function of skeletal muscles are controlled by many different genes, and their SNVs can serve as strength or endurance athletes' status biomarkers. (1) Background: to conduct a thematic review of candidate genes studies and their single-nucleotide variants (SNVs) associated with the functioning of skeletal muscles in athletes. (2) Methods: A search for articles for the period from 2010 to 2020 was conducted in the databases SCOPUS, Web of Science, Google Calendar, Clinical keys, PubMed, e-LIBRARY using keywords and their combinations; (3) Conclusions: The identification of genetic biomarkers associated with muscular system regulation can help neurologists, sports doctors and coaches in developing personalized strategies for selecting children, adolescents and young adults for endurance, strength and speed sports (for example, running short, medium or long distances). Such a personalized approach will increase sports performance and reduce the risk of sports injuries of the musculoskeletal system.
N. Yu. Safonova, M. R. Sapronova, O A. Gavrilyuk, T. E. Popova, A. A. Tappakhov
Personalized Psychiatry and Neurology, Volume 1; https://doi.org/10.52667/2712-9179-2021-1-2-117-125

Abstract:
(1) Background: to reveal the prevalence of non-motor disorders in Parkinson’s disease (PD), we analyzed both Russian and international studies on the issue of PD-associated non-motor disorders in Caucasian patients; (2) Methods: We have carried out a search for full-text Englishand Russian-language articles published during the last ten years (from 2010 to 2020) in PubMed, Scopus, Web of Science, Springer, Clinical case, and E-library databases using multiple versions of keywords and their combinations. (3) Results: General prevalence of PD-associated non-motor disorders proved to be high. At the same time, we did not find significant differences between the prevalence of cognitive, affective, or behavioral disorders in PD patients. However, depression was found to be more common in PD patients in the Russian Federation; (4) Conclusions: According to the results of our review, cognitive and affective disorders in PD represent the issues of major concern.
M. A. Novitsky, A. De Sousa, A. R. Asadullin, O. A. Gavrilyuk, A. V. Petrov, R. F. Nasyrova
Personalized Psychiatry and Neurology, Volume 1; https://doi.org/10.52667/2712-9179-2021-1-2-21-45

Abstract:
The purpose of this review is to analyze approaches to the treatment of depressive and negative disorders in schizophrenia in terms of their level of efficacy and safety. Materials and Methods: A search was conducted for full-text articles published over the last 10 years in PubMed, Springer, Wiley Online Library, Taylor & Francis Online, APA PsycInfo, CORE, Science Direct, and eLIBRARY.RU databases. Several articles published previously to this period were also included into the review due to their high scientific value. Results: Our review suggests that antidepressants (ADs) are effective medications and they can be prescribed to correct depressive disorders and negative symptoms in patients with schizophrenia when used in combination with antipsychotics (АPs). However, when administering ADs and АPs combinations, it is important to consider the safety profile of these combinations as well as their tolerance. Negative symptoms of schizophrenia, including those induced by a number of АP, are less amenable to correction by АDs monotherapy, which requires a long period of АPs (on average - 8 weeks), which can be limited in the real life of the patient outside the hospital. Current approaches to the therapy of depressive disorders in patients suffering from schizophrenia vary from country to country. However, most of АDs used in clinical psychiatric practice are widely used in the comorbid state under consideration. Conclusion: The efficacy and safety of АDs of the different classes considered in this review depends on their mechanisms of action, duration of admission, type of АPs taken, and specific clinical situation (acute depressive disorder, major depressive episode, or chronic depressive episode). Most promising in clinical practice are serotonin–norepinephrine reuptake inhibitors (SNRIs) and dual ADs. The use of tricyclic antidepressants (TCAs) is limited due to a higher risk of adverse drug reactions (ADRs). The use of most selective serotonin reuptake inhibitors (SSRIs) is limited due to the risk of aggravation of hallucinations (this risk being higher for patients with visual hallucinations, and lower for those with auditory hallucinations) and\or iatrogenic psychosis. These ADRs may probably occur in patients suffering from schizophrenia due to their ideal "poor metabolizer" pharmacogenetic profile, since most of the drugs considered in this review have hepatic metabolism.
N. A. Shnayder, K. V. Petrov
Personalized Psychiatry and Neurology, Volume 1; https://doi.org/10.52667/2712-9179-2021-1-2-2-20

Abstract:
Due to the high prevalence of the disease, its genetic and clinical heterogeneity, the need for lifelong therapy and the emergence of new views on the pathogenesis and course of JME, it is necessary to provide primary care physicians (general practitioners, district therapists, neurologists) with up-to-date systematized information about the most common form of genetic generalized epilepsy (Herpin-Janz syndrome). JME is a genetically determined disease of the brain, accompanied by a triad of seizures (absences, myoclonia, generalized tonic-clonic seizures), and developing mainly in adolescence and young age. In recent years, monogenic and multifactorial forms of JME have been identified, but questions about the genetics of JME are far from being resolved. JME is characterized by the preservation of intelligence, life expectancy with adequate therapy does not differ from the average population, but the frequency of failures of pharmaco-induced remission is high when taking anticonvulsants is canceled. This explains the need for lifelong pharmacotherapy, individual selection of anticonvulsants. About 30% of patients with JME have non-psychotic mental disorders, disorders of the sleep and wake cycle, which in turn leads to an aggravation of epileptic seizures mainly in the first half of the day. This review presents an analysis of full-text publications in Russian and English over the past five years in the databases eLibrary, PubMed, Web of Science, OxfordPress, Springer, and Clinicalkeys. In addition, the review includes earlier publications of historical significance.
P. S. Goncharova, T. K. Davydova, N. G. Zhukova
Personalized Psychiatry and Neurology, Volume 1; https://doi.org/10.52667/2712-9179-2021-1-2-63-82

Abstract:
Ascorbic acid (vitamin C) is a vital nutrient that belongs to the group of antioxidants. Vitamin C plays an important role in the functioning of the central (CNS) and peripheral nervous system (PNS), including maturation and differentiation of neurons, formation of myelin, synthesis of catecholamines, modulation of neurotransmission and antioxidant protection. Neurological diseases and mental disorders are characterized by increased generation of free radicals. At the same time, the highest concentrations of vitamin C are found in the brain and neuroendocrine tissues. It is believed that vitamin C can affect the age of debut and the course of many neurological diseases and mental disorders. However, its potential therapeutic role continues to be studied. The efficacy and safety of vitamin C is likely influenced by the pharmacogenetic profile of the patient, including the carriage of single-nucleotide variants (SNVS), candidate genes associated with vitamin C metabolism in the human body in normal and neuropsychic disorders. The purpose of this thematic review is to update current knowledge about the role of vitamin C pharmacogenetics in the efficacy and safety of its use in neurological diseases (amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, Huntington's disease, Alzheimer's disease, etc.) and mental disorders (depression, anxiety, schizophrenia, etc.). Special attention is paid to the possibility of translating the results of pharmacogenetic studies into real clinical practice in neurology and psychiatry.
E. A. Dontseva, V. V. Trefilova, T. E. Popova, M. M. Petrova, M. Al-Zamil
Personalized Psychiatry and Neurology, Volume 1; https://doi.org/10.52667/2712-9179-2021-1-2-46-62

Abstract:
Anticonvulsant-induced osteoporosis (AIO) and associated pain syndromes and patient disabilities are an important interdisciplinary medical problem generated by various molecular, genetic and pathophysiological mechanisms. AIO are the most important pathological processes associated with chronic pain in adults with epilepsy. Standard approaches to their prevention and treatment do not always solve the problem of the progression of the pathological process and chronicity of AIO. This is the reason for the search for new personalized strategies for the prevention and treatment of AIO. Vitamin D metabolism, expression and specificity of vitamin D receptors (VDRs) may play a key role in the development of AIO and chronic back pain in patients with epilepsy. The aim of the study was to review publications on changes in the vitamin D system in patients with AIO. We searched for articles published in e-Library, PubMed, Oxford Press, Clinical Case, Springer, Elsevier, and Google Scholar. The search was carried out by key-words and their combinations. The role of vitamin D and VDR in the development of AIO and the chronicity of back pain has been demonstrated mainly in animal models and humans. Associative genetic studies have shown that single nucleotide variants (SNVs) of the VDR gene encoding VDR may be associated with the development of osteoporosis of the spine (including those associated with the intake of an anticonvulsants). The prospects for the use of vitamin D preparations for modulating the effect of anticonvulsants used to treat epilepsy are discussed. Genetic association studies of VDR gene SNVs are important for understanding the genetic predictors of AIO and chronic back pain in patients with epilepsy, as well as for developing new personalized pharmacotherapy strategies.
I. S. Efremov, D. R. Tukhvatullina, U. S. Efremova, V. R. Gashkarimov, N. R. Tulbaeva, E. A. Akhmetova, T. R. Gizatullin
Personalized Psychiatry and Neurology, Volume 1; https://doi.org/10.52667/2712-9179-2021-1-2-111-116

Abstract:
Alcohol withdrawal is the most threatening condition encountered in patients with alcohol use disorder. Our study aimed to investigate the association of alcohol withdrawal severity with polymorphic variants in melatonin receptor genes. Methods. The clinical study was carried out on the basis of the Republican Narcological Dispensary №1 in Ufa and the Republican Narcological Dispensary №2 in Sterlitamak. Genetic analysis was performed at the Department of Personalised Psychiatry and Neurology at the V.M. Bekhterev Research Centre, Saint Petersburg. The final sample consisted of 307 subjects. Results. Carriers of the TT genotype of the MTNR1A gene (rs34532313) were found to have less hypertension during alcohol withdrawal than carriers of the other genotypes. In comparison, carriers of the GG genotype of the MTNR1B gene (rs10830963) experienced more symptoms than other genotypes: paroxysmal sweating, visual hallucinations, anxiety, and overall CIWA-Ar score. Conclusions. Thus, it can be concluded that the TT genotype of MTNR1A gene (rs34532313) is associated with a lower risk of hypertension during alcohol withdrawal compared to carriers of other gene genotypes. The GG genotype of MTNR1B gene (rs10830963) is associated with severe withdrawal. In general, it can be concluded that melatonin receptors are involved in the pathogenesis of alcohol withdrawal and the severe of some of its symptoms.
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