Background: the Russian Federation is currently undergoing an intensive process of reform of residential social care, with the aim of improving the quality of life and for people with disabilities to realise their civil rights. No studies on analysing the quality of rehabilitation activities in residential social institutions were found in the available literature, which became the basis for the present study. The aim of the research is to study the process of rehabilitation activities in children’s boarding homes of the Moscow region for children with mental illnesses (hereinafter referred to as ChBH), to identify factors that influence the effectiveness of recommended and implemented rehabilitation measures for children with disabilities, and to analyse the existing quality criteria of rehabilitation services for disabled people in ChBH. Material and Methods: the content analysis of the main legal and regulatory documents that ensure the implementation of medical and social care, the process of providing rehabilitation service and ways of assessing their effectiveness was conducted. Results: residential children’s homes care for 4.2 per cent of the total number of disabled children in the region. The high need for rehabilitation services is determined by the prevalence of significantly pronounced impairments of mental and other vital functions among the inmates of boarding homes. The main tasks of residential children’s homes are to provide therapeutic, psychological and social assistance, as well as assistance in education and leisure activities. Serious gaps in staffing have been identified: the actual number of residents per one specialist significantly exceeds the norms, which negatively affects the quality of services. Rehabilitation activities are reflected in the personal files of residents, but no record of their results is kept. The Ministry of Social Development is responsible for implementing the measures recommended in individual rehabilitation and habilitation programmes (hereinafter referred to as IPRAH) for children with disabilities. According to the results of the evaluation of IPRAHs, the lack of results in the socially significant categories of life activity reaches 86 per cent. The procedure for independent assessment of the quality of services is regulated by law, but it is difficult for residents of children’s homes. The procedure for monitoring the quality of social services is not enshrined in normative acts. Conclusion: the identified shortcomings in the provision of rehabilitation services: lack of qualified specialists, territorial location, absence of clear criteria for assessing the results of rehabilitation measures and monitoring their provision to children with mental illness in residential institutions, require the development of an improved model for the provision of services to this contingent of citizens.

Background: suicide mortality during the pandemic, contrary to many fears, did not increase, but the situation in the postpandemic period, when new challenges emerged, has not been studied yet. The aim was to evaluate suicide mortality trends in St.-Petersburg (SPb) and Leningrad Region (LR) during last years, including postpandemic period. Material and Methods: data on completed suicides presented by the medical forensic bureaus and official statistics (Petrostat) were analyzed. The average annual mortality rates per 100000 of population were calculated with confidence intervals (as per Wilson). The division of society into generations — up to 19 years old (generation Z), 20–39 years (millennials, Y), 40–59 years (generation X), and > 60 years old (“baby boomers” and “traditionalists”) was used for detailed analysis. Results: over the last seven years, surveillance in the Northwestern Federal District has shown a significant (30–50%) drop in mortality in 2023 for certain subjects, including SPb and LR. LR has substantially higher suicide indices than SPb, most likely as a result of a larger percentage of the population living in rural areas. Men over 60 and those between the ages of 40 and 59 seemed to experience the most notable and statistically significant decline in suicide mortality in 2023. While the suicide mortality rate among women in the older groups is generally decreasing, in women under 39 it appeared to be either stable or increasing. From the perspective of the role of social integration, according to Durkheim theory, the sharp decline in male suicides can be attributed to increased social cohesion, signs of social optimism, as well as military and economic mobilization during the special military operation. Conclusion: preventive measures should be taken into consideration when significant contingents return from the conliict zone, taking into account possible increase of prevalence of post-traumatic stress disorder and potential employment competition between males of different ages.

Background: the relevance of this research is determined by the challenges encountered in the differential diagnosis of Borderline Personality Disorder (BPD), the necessity to investigate the depressive syndrome in BPD to enhance comprehension of the disorder, and the pursuit of the most significant diagnostic criteria. The aim of the study was to investigate the depressive syndrome in patients with BPD as part of decompensation to improve differential diagnosis accuracy. Materials and Methods: 58 medical histories (74% women) analyzed. The average age of patients was 31.03 ± 1,87 years. ICD-10 diagnosis were F60.31 «Emotionally unstable personality disorder, borderline type» (n = 26), F33 «Recurrent depressive disorder» (n = 14), and F31 «Bipolar disorder» (n = 18) were examined. An archival method, including medical history, clinical interview, experimental psychological examination, was applied in the research. Results: depressive syndrome in BPD patients is characterized by ideas of self-deprecation, reduced self-esteem and self-confidence, and high levels of anxiety. According to the results of self-assessment, BPD patients noted the severity of depressive experiences: clinically pronounced depression was noted in more than half of cases, contrary to the results of objective assessment, where the mental state of patients’ majority corresponded to criteria of mild depression. A logistic regression model was developed that predicts with 96% efficiency the diagnosis of BPD in depressed patients based on ten predictors: controlling, unpredictable caregiver behavior, homo/bisexuality, chronic feelings of emptiness, unstable mood, ideas of guilt and self-deprecation, difficulty understanding feelings as measured by EPE, and average suicidal risk on the Suicide Risk Assessment Scale increase the likelihood of a BPD diagnosis. Symptoms such as substance use and anger outbursts are the most likely to increase the likelihood of diagnostic error, as they can lead to false positive diagnoses. Conclusion: clinical features of depression in BPD are significant for diagnosis and differential diagnostics.

Background: neuroinfiammation which occurs as a long-term latent activation of systemic infiammation in the central nervous system is currently considered as one of the main pathogenetic mechanisms of the neurodegeneration progression in the brain of patients with Alzheimer’s disease. The aim of study is to research the prognostic significance of clinical and immunological parameters determined in the blood serum of patients with amnestic Mild Cognitive Impairment (aMCI) and to form an immunological profile that determines the further dynamics of the syndrome. Patients and Methods: 261 outpatient with aMCI were followed up at the FSBSI “Mental Health Research Centre” in the period from 2014 to 2023. The study participants underwent a general clinical examination and assessment of cognitive functions using a battery of psychometric tests and scales (MMSE, MoCA, CDT, tests of 10 words and 5 geometric shapes memorization, the Hachinski ischemic scale). In addition, patients underwent an initial level of cytokines study (TNFa, IL-1, IL-1b, IL-1RA, IL-2, IL-4, IL-6, IL-8, IL-10) in blood serum by enzyme immunoassay (ELISA); the levels of leukocyte elastase enzymatic activity (LE) and α1-proteinase inhibitor functional activity were determined in blood plazma by the spectrophotometric method. The protease inhibitory index was calculated. Conclusion: the cytokines set and immune response indicators have been identified. The distinguishing levels of TNFa, IL-6, IL-1b, LE predict various variants of three year course of aMCI including the conversion to dementia.

Background: therapeutic drug monitoring represents one of the most promising tools in clinical practice to optimise antidepressant treatment. Nevertheless, little is still known regarding the relationship between clinical efficacy and serum/ plasma concentration of venlafaxine. The aim of study was to develop personalized approaches to prescribing venlafaxine for depression through therapeutic drug monitoring of minimum and maximum levels of the drug. Patients, Materials and Methods: 52 hospitalized patients with depression (F32 and F33 according to ICD-10) receiving venlafaxine were selected. Plasma concentrations of the drug and its active metabolite O-desmethylvenlafaxine were determined using a validated HPLC-MS method. The effects of potentially infiuencing factors was assessed using a multivariate linear regression model. Results: 73% and 67% of patients reached the venlafaxine active moiety concentrations within the recommended therapeutic range (previous and revised therapeutic ranges respectively). Plasma concentrations were dependent on age, weight, and CYP2D6 activity. Venlafaxine metabolism expressed as a metabolite-to-parent concentrations ratio was infiuenced by a combination of age, CYP2D6, and body mass index (BMI). We did not observe any significant difference in plasma concentrations between the patients with a single and two per day administration. Combining variables made an additive effect on plasma concentrations. Active moiety plasma concentrations were higher in older women. Conclusion: this study strongly suggests that monitoring could represent a more appropriate tool than the oral dosage to optimise the treatment with venlafaxine. Specifically, highest efficacy might be achieved in patients at active moiety levels around 400 ng/mL. Therapeutic drug monitoring of venlafaxine is recommended in clinical practice, especially in the elderly when beginning the pharmacotherapy.

Background: research in the field of neurobiology of memory allows us to expand the knowledge of the cellular and molecular mechanisms of information storage. A small composite structure located in the medial temporal lobes, the hippocampal formation (HF), plays a fundamental role in memory processes. Currently, the role of specific departments of the HF in various types of memory disorders is poorly understood. The aim was to study the relationships between changes in the volume of HF subfields, regional lateralization of the atrophic process with various types of memory disorders in patients with the most common types of mild cognitive impairment (MCI): amnestic (aMCI) and subcortical vascular (svMCI). Patients, Control Group and Methods: the study included 60 patients with MCI syndromes who were examined on the basis of the Federal State Budgetary Institution “V.M. Bekhterev National Medical Research Center of Psychiatry and Neurology” Ministry of Health of the Russian Federation: 30 patients were with the aMCI (mean age 71.67 ± 6.93) and 30 patients were with the svMCI (mean age 75.67 ± 5.29). The control group consisted of 30 conditionally healthy volunteers (mean age 71.50 ± 5.43) without neurological and psychopathological symptoms, as well as without gross organic changes during magnetic resonance imaging (MRI) of the brain. The Wechsler Memory Scale (WMS) was used to evaluate the indicators of various types of memory. The scan was performed on Excelart Vantage Atlas XGV MR scanner (Toshiba, Japan) with 1.5 Tesla magnetic field induction. Postprocessing was performed using the FreeSurfer 6.0 software to obtain the volumes of the HF subfields. Results: indicators of visual memory impairment in patients with aMCI were associated with a decrease in the volumes of the CA1 and molecular layer of the right HF. Indicators of impaired verbal associative memory in patients with svMCI correlated with a decrease in the volumes of the subiculum and molecular layer of the left HF. Conclusions: the study showed that the features of atrophy of the subfields of the hippocampal formation play a unique role in impaired various types of memory in patients with predementia state. The obtained results show the prospects for further research in this area to determine the patterns of HF atrophy in various neurodegenerative diseases and chronic cerebral ischemia.

Background: post-COVID cognitive impairment is an important medical and social problem. Many studies focus on the analysis of the characteristics of cognitive impairment after infection, but neurorehabilitation issues are rarely considered. The aim was to study the effectiveness of combined use of neuropsychological correction and rhythmic magnetic stimulation (rTMS) in the rehabilitation of patients with post-COVID cognitive impairment. Patients and Methods: two groups of 20 people with postCOVID cognitive impairment were compared: group 1 underwent rehabilitation using a multimodal method, group 2 — according to the standard program. The areas of rTMS stimulation were selected based on high-quality neuropsychological diagnostics, which made it possible to identify and form the patient’s neuropsychological profile. The correction program was based on the identified neuropsychological profile and developed individually for each patient. The Montreal Cognitive Assessment, Frontal Area Dysfunction Battery, Clock Drawing Test, Semantic Verbal Fluency Test, 10-Word Learning, Symbolic-Digit Coding Test, Subjective Asthenia Inventory (MFI-20), and Hospital Anxiety and Depression Scale (HADS) were used to assess the state of higher mental functions. Results: after correction, significant differences were found in the MoCA, 10-Word Learning, Symbolic-Digit Coding, and MFI-20 scales, with higher scores in group 1. Comparative analysis showed significant differences in score dynamics between the groups, with group 1 demonstrating better results. Conclusions: multimodal neuropsychological rehabilitation in combination with rTMS demonstrates significantly higher results compared to standard rehabilitation protocols established in the order of the Ministry of Health of the Russian Federation dated July 31, 2020 No. 788n “On approval of the Procedure for organizing medical rehabilitation of adults” [1], as well as with clinical recommendations presented on the website of the Union of Rehabilitation Specialists of Russia [2–4].

Background: Migraine is a common neurological disorder characterized by recurrent headaches, while dementia is a progressive neurodegenerative condition leading to cognitive decline. Recent studies indicate that these conditions may share common underlying mechanisms, such as vascular dysfunction, Neuroinflammation, oxidative stress, and structural brain changes, all of which could contribute to cognitive impairment. The aim was to explore the potential connection between migraine, particularly migraine with aura, and an augmented risk of dementia. Material and Methods: the keywords Migraine, Dementia, Vascular Dysfunction, Neuroinflammation, Oxidative Stress, Cognitive Decline are used to search for articles in the PubMed and others databases for the period from 2000 to 2024. Conclusions: studies on the general population indicate that those who suffer from migraines, particularly those who have aura, may be more susceptible to dementia, including vascular and Alzheimer’s diseases. However, the results are inconclusive, and further research is needed to understand this potential link. Shared mechanisms like endothelial dysfunction, neuroinflammation, and oxidative stress provide evidence of a connection between migraine and dementia. This potential link has significant clinical implications. Patients with a history of migraine should have their mental health closely watched by medical professionals, especially if they experience frequent auras or chronic migraines. Addressing vascular risk factors, improving migraine management, and informing patients about potential risks can help reduce the likelihood of developing dementia. Future investigations should focus on longitudinal studies to track the progression of migraine and dementia, mechanistic studies to understand the underlying pathways, genetic studies to identify shared susceptibility, and clinical trials to evaluate interventions aimed at reducing dementia risk in individuals with migraines. Public health initiatives aimed at raising awareness and promoting early intervention are crucial in influencing the prevalence of dementia in individuals with migraines.

Background: the transition from a categorical diagnostics to a dimensional model based on the characteristics of personality trait domains and assessment of clinical symptoms severity has created difficulties in differentiating borderline personality disorder. The aim of the study is to analyze published works on the categorial approach and features of the dimensional characteristics of trait domains associated with borderline personality disorder. Materials and Methods: the keywords «borderline personality disorder», «categorial and dimensional models», «diagnosis of personality disorders» used to search for articles in Russian and English in the PubMed and e-Library databases for the period from 2000 to 2024. Conclusion: the analysis of published works shows that the diagnosis of borderline personality disorder requires taking into account clinical heterogeneity, dynamic variability of symptoms, and comorbidity with other mental disorders. Using only a categorical approach in diagnostics does not fully cover the complexity and variability of clinical features of borderline personality disorder. The used five-factor model of assessing the domains of personality traits has limitations in the diagnosis of borderline personality disorder due to use of self-report questionnaires, non-specificity of dimensional factors, as well as the presence of additional dimensional characteristics that go beyond the five-factor model, but have high sensitivity to the manifestations of the borderline pattern. The need for research on the correspondence of categorial, prototypical characteristics of borderline personality disorder, dimensional not limited by the framework of the five-factor model is substantiated.

Background: the prevalence of self-harming behavior in modern society is high and is especially relevant for adolescents and young adults. Self-harm is considered as a risk factor for suicide. At the same time, the concept of self-harm remains insufficiently developed, and its relationship with suicidality remains unexplored. Domestic publications on the issue of self-harm are mainly devoted to the psychological aspects of the problem. The aim of review was to analyze existing ideas about self-harming behavior in scientific publications. Material and Method: the publications were searched in the electronic databases MEDLINE, Google Scholar, PubMed for the keywords “self-harm”, “non-suicidal self-harm”, “suicide”; “self-harm”, “non-suicidal self-injury”, “suicide”, “adolescence and youth”. The selection of publications was carried out manually. A descriptive approach was used to summarize the data. Conclusion: the review provides current data on the study of prevalence of self-harm among adolescents and youth, reveals the concept of self-harming behavior and its place in modern classifications of mental disorders, discusses contradictions in the use of the term. The researchs of self-harming and suicidal behavior risk factors are analyzed, including interrelations with mental disorders. A consensus of researchers has been established that non-suicidal self-harm is an important indicator in assessing the risk of depression and suicidality in young peoples. The research directions of assistance and prevention of selfharming and suicidal behavior in adolescence and youth are considered

Background: learning difficulties themselves are not a type of mental disorder, but one of the main symptoms of neurodevelopmental disorders. With the deepening of research on learning difficulties, some high-level and large-scale children’s hospitals in China have opened clinical departments for learning difficulties since the 2020s. The aim of review article is to consider clinical features of mental disorders in children with learning difficulties and to analyze options of treatment and correctional interventions in the conditions of such units. Discussion: this practice is an innovation in diagnosis and treatment, and it also constructively considers the related disorders of learning difficulties, which can better screen, diagnose and treat children with learning difficulties, but there are still many problems that need to be explored and clarified. This article analyzes the practical significance of the opening of clinical departments for learning difficulties and the diagnosis, comorbidity and distinction of related disorders of learning difficulties, and discusses its advantages and disadvantages at this stage. Conclusion: experience of organization specialized units for children with academic difficulties due to neurodevelopmental disorders or other mental reasons needs to comprehensive study, first of all, to research the effectiveness of this new form of psychological and psychiatric assistance to children.