V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY

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ISSN / EISSN : 2313-7053 / 2713-055X
Total articles ≅ 245
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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.
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.
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.
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.
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.
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.
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.
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.
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.
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