Objective: depression among adolescents is a serious public problem. The majority of genetic and clinical studies showed that early — onset depressions etiologically may be distinct from adult — onset depressions. Itis possible to assume some differences in aged-dependent risk profile between depressions at adolescence and adulthood.

Aim: to study adolescent depressions for identification a number of novel risk factors for increase in frequency and early manifestation of the disorder.

Patients and methods: outpatient adolescents registered in one of the Moscow psychoneurological dispensary at 1999–2019 years (total 1704 boys and girls). From the entire cohort we selected all participants appealed for medical aid in connection with depression (F3 of ICD-10) during last decade.

Results: the significant increase in the incidence and early manifestation of adolescent depressions during last decade were revealed especially in girls with shift of male/female ratio from 3,1/1 in 2009 year to 1,8/1 in 2019 year. Some specific features of nowadays adolescent depressions are noted: beginning at an earlier age, increasing part of severe depressive episodes, growth of the autoaggressive behavior and suicidal potential. Novel links between adolescent depressions and risk factors are described. Some endocrinological changes resulting from premature pubertal timing and disordered circadian rhythms, social deprivation owing to socio-economic reforms with a lack of social support, low social expectations, absence of positive perspectives leading to low self-esteem and unwarranted self-criticism are turned out to be the most important factors heightening vulnerability to adolescent depressions.

Conclusion: identification of pathogenetic mechanisms of adolescent depressions creates an opportunity for early target psychosocial intervention and might help to reduce risk for depression among youth.

Background: non-suicidal self-injury (NSSI) in adolescence is a significant risk factor for suicide, and therefore, the search for neurobiological markers and predictors of risk for suicidal intentions and actions seems to be an urgent task. In particular, quantitative EEG parameters can be such predictors.

Objective: to identify the features of EEG in female adolescents with endogenous depressive conditions, manifested only by NSSI without suicidal intentions, in comparison with the EEG of patients who had suicidal auto-aggressive behavior (SAB) in the structure of depression.

Patients and methods: the study was conducted as a comparative clinical and neurophysiological. The study included 45 female patients aged 16–25 years with endogenous depressive conditions, divided into 2 subgroups: those who showed only NSSI (NSSI subgroup, 21 patients), or who had a history of SAB (SAB subgroup, 24 patients). Clinical-psychopathological, psychometric, neurophysiological and statistical methods were used.

Results and its discussion: intergroup differences were revealed in relation to the ratio and hemispheric asymmetry of the EEG spectral power of narrow frequency sub-bands of the parietal-occipital alpha rhythm. In the SAB subgroup alpha-2 (9–11 Hz) rhythm spectral power is higher than in the NSSI subgroup, the focus of alpha-2 spectral power is located in the right hemisphere, and alpha-3 sub-band (11–13 Hz) spectral power is higher than of alpha-1 (8–9 Hz). In the NSSI subgroup, alpha-1 (8–9 Hz) sub-band spectral power are higher than of alpha-3 (11–13 Hz), and focuses of alpha-2 (9–11 Hz) and alpha-3 (11–13 Hz) rhythms are localized in the left hemisphere. The results are discussed in terms of functional specialization of the brain hemispheres in relation to the regulation of emotions and control of behavior.

Conclusions: the spatial distribution of the EEG frequency components in the SAB subgroup reflects the greater activation of the brain left hemisphere that is more typical for the EEG of individuals with an increased risk of suicide. In the NSSI subgroup, the right hemisphere is relatively more activated that is more typical for EEG in depressive disorders.

The results obtained allow the use of quantitative EEG data to clarify the degree of suicidal risk in depressed female adolescents with non-suicidal self-injury.

The objective: the involvement of glutamatergic neurotransmitter systems in the pathogenesis of schizophrenic spectrum disorders and BD has been repeatedly proven. But today, there are no methods available to evaluate the glutamate metabolism in patients with mental disorders. The paper presents differences in the level of glutamate in the blood serum of patients with a schizophrenic spectrum disorder, bipolar disorder, and healthy individuals.

Patients and methods: the study included 224 people. 179 patients were presented with paranoid schizophrenia, simple schizophrenia, schizotypal disorder, acute polymorphic disorder, schizoaffective disorder and BD.

Results: in this work shows that the level of glutamate in patients in all studied groups is statistically significantly higher than in healthy individuals, except for acute polymorphic psychotic disorder. Serum glutamate concentration in patients with schizotypal disorder is 1.6 times higher than in healthy individuals. The significant differences in glutamate levels were detected in patients with schizotypal disorder and OCD (p = 0.045), and patients with paranoid schizophrenia (p = 0.012). The concentration of glutamate is also increased in patients with simple schizophrenia compared to patients with paranoid schizophrenia (p = 0.039). In addition, it was observed a glutamate increase in healthy individuals compared in patients with a continuous course of schizophrenia (p = 0.001), in patients with an episodic course with progressive deficit (p = 0.0211) and in patients with a schizophrenia duration of more than 12 years.

Conclusions: thus, the concentrations of glutamate in the blood serum of patients are depending on the severity of the course of schizophrenia and maybe an additional paraclinical criterion for the diagnosis of schizotypal disorder.

Background: despite the significant increase in demand for gender change interventions observed over the past few years, the mechanisms for increasing the number of transgender people are rarely studied.

The Aim: to analyze the frequency and structure of patients’ requests for a certificate of gender change. Material: 179 medical records of patients who applied for a certificate of gender change in the Medical and Rehabilitation Research center “PHOENIX” during the period from 1991 to 2020.

Materials and Methods: clinical, mathematical, statistical.

Results: over the past decade, there has been an increase in cases of patients seeking to change their gender compared to the period from 2000 to 2009. Basically, this increase is due to a marked increase of the number of patients with schizophrenic spectrum disorders with sexual identification disorders compared to the previous two decades. The connection between the increased frequency of sexual identification disorders in endogenous diseases and the modern information environment is revealed.

Conclusions: it seems that the revealed change in the frequency and clinical structure of requests for sex change is due to the social pathomorphosis of schizophrenic spectrum disorders. A point of view based on established regularities is expressed by the necessary measures to improve assistance to persons suffering from sexual identification disorders. These measures, taking into account the medical and social dualism of the problem, should be based equally on natural-scientific reality, clinical evidence, ideas of humanism and legal norms of a democratic secular society.

In this study, we sought to assess the level of cognitive functioning in patients with comorbid alcohol dependence and affective disorder, as well as to compare the detected changes with the indicators of cognitive tests in patients suffering only from alcoholism or affective disorder. It is suggested that patients with comorbidity may have a more severe cognitive deficit than patients with a single diagnosis.

Materials and methods. We examined 100 patients aged 30–50 years before treatment: 30 patients with affective disorders, 40 patients with alcohol dependence and 30 patients with comorbid alcohol dependence and affective disorder. As a control group, 30 mentally and somatically healthy individuals were examined. The level of cognitive functioning was assessed using computer tests Go/No-go, Corsi and Stroop.

Results. Statistically significantly lower indicators of cognitive functioning were found in patients with comorbid alcohol dependence and affective disorder in comparison with all the studied groups.

Conclusion. The data obtained in the study indicate that the presence of comorbidity of alcohol dependence and affective disorder in patients leads to a significant deterioration in cognitive functions: Executive control, working memory, attention and cognitive flexibility compared to healthy individuals, as well as patients suffering only from alcohol dependence or affective disorder.

Background: The relevance of publication is due to the significant frequency of mental disorders during the times of infectious diseases. The coronavirus epidemic in Russia in 2020 was associated with various factors contributing to panic experience, the occurrence of reactive and / or induced mental disorders and exacerbation of existing ones. However, a targeted analysis of such disorders is not yet presented in the domestic scientific literature.

The aim: to describe the symptoms and the phenomenology of some mental disorders during the coronavirus epidemic and to discuss its possible pathway.

Materials and methods: 13 persons aged 14–66 years admitted to out-patient clinics were examined by psychiatrist. Clinical interview was used as well as experimental psychological examination (MMPI scale) and WHO quality of life questionnaire. Some patients and their relatives or other informants were interviewed on-line. Schizophrenia patients and patients with schizophrenic spectrum disorders were not included in the research.

Discussion of results: mental disorders during the coronavirus epidemic present heterogenous group due to phenomenological and etiological differences. Age, gender and social status are not critical. It is likely that the preceding personality characteristics such as the presence of borderline psychopathology, suggestibility, emotional dependence, stress tolerance, loneliness, attitude to death, somatic diseases could play the main role in the occurrence of these disorders.

Conclusions: according to preliminary data, mental disorders during the period of the coronavirus epidemic do not fundamentally differ from disorders during other epidemics or emergency situation. However, long-term social isolation of people due to contact limitation and repeated explanations of its necessity in media could cause long-term anxiety and depletion of psychological defense mechanisms, acquired great pathogenic significance in this epidemic. Taking into account the mentioned factors and impact of economic crisis anxiety, COVID-19 and its psychological and psychiatric consequence may be considered as needed research.

Background: The introduction of modern classifications of mental disorders has caused a number of significant changes in the diagnostic process. Recently, both domestic and foreign authors began to pay more attention to the analysis of the “weaknesses” of the operational approach in the diagnosis of mental disorders. One of the “lacunae” that arose due to its distribution, which is hardly discussed in modern classifications, is the problems of the role of intersubjective experience in the doctor–patient relationship and the diagnostic process. The diagnostic technique based on the Praecox-Gefühl phenomenon is one of the most striking examples of the utility of such an experience.

The aim was to present and discuss modern and classic Praecox-Gefühl studies in the context of analyzing the role of intersubjective experience in psychiatric diagnosis.

Material and method: Modern and classic scientific publications were selected by using the keywords “Praecox-Gefühl” or “Praecox-feeling” in the databases of Web of Science, PubMed and in the other sources.

Conclusion: the professional use of intersubjective experience arising in a doctor–patient relationship can be one of the diagnostic tools for identifying schizophrenia, including the early stages of the disease. Modern psychological studies indirectly confirm this statement by revealing an impairment of functions that provide interpersonal communication among patients with schizophrenia.

The aim: to provide an overview of domestic and international studies examining various aspects of issue of depressive delusional ideas in endogenous delusional depression disease pattern

Materials and method: in order to compile a literature review for the keywords depressive delusions and delusional depressions, data from scientific articles posted in MedLine and PubMed databases as well as other bibliographic sources have been searched and analyzed during the formation of scientific psychiatry to the present.

Discussion: based on the analysis of scientific publications, this paper presents data on the psychopathological description of depressive delusions and its relatedness to the depressive affect. The researchers’ viewpoints on primary and secondary characteristics of depressive delusions are being analyzed. We have identified pathogenetic characteristics of the latter that affect the prognostic assessment, such as features of the depressive triad in endogenous depression, severity and type of depressive affect, risk of suicidal behavior, characteristics of premorbid personality traits, genetic background, as well as therapeutic efficacy of treatment methods for depressive delusions in patients with delusional depression. This research reveals the controversial nature of some provisions of scientific publications that gradually divert from clinical diagnostic approaches, which tend to be replaced by psychological and psychoanalytic ones when carrying out prognostic assessment in cases of depressive delirium, which is characteristic of current psychiatric science.

Conclusions: scientific publications data analysis testifies to the priority of the clinical and psychopathological method in studying the issues of depressive delusions structure in delusional depression disease pattern as well as in clinical differentiation of depressive delusions, justifies its clinical and prognostic value and enables to choose the treatment effectively.

Introduction: the important role of monocytes /macrophages, as well as cytokines produced by them was determined in the pathogenesis of mental disorders, as a macrophage-T-lymphocyte theory of bipolar disorder, schizophrenia and depression. According to this theory, there is an increase in the number of active circulating monocytes, macrophages and T-cells in patients with mental disorders. These cells migrate to the CNS as a result of the blood-brain barrier breach, destabilize the brain and lead to worsening of mental disorders.

The aim of work: to review research data on the role of proinflammator monocytes in the development of immune inflammation in the pathogenesis of a number of systemic diseases and to examine the molecular mechanisms mediating the interaction of proinflammatory monocytes with other cells involved in immune inflammation.

Material and methods: keywords “proinflammatory monocyte CD16+”, “cytokines”, “molecules of cell adhesion”, “monocyte-platelet aggregates”, “microglia”, “psychiatriс disorders”, are used to search for data published over the past 20 years in domestic and foreign studies in PubMed and e-Library.

Conclusion: in the first part of the review, the research data concerning the studies of the functional characteristics of a monocytes subpopulation that express on their surface an increased level of CD16 receptors when activated were analyzed. Most of researchers associate the proinflammatory functions of monocytes with this subpopulation. Molecular mechanisms of monocytes activation, which include increased secretion of CD16 receptors, cytokines, chemokines and receptors for them involved in their interaction with vascular endothelial cells, with neurons in the CNS and also with platelets in the development of systemic inflammation, are considered. Analysis of these mechanisms allows us to better understand the immune aspects of inflammation in the brain mediated by the interaction of CD16+ monocytes with neuronal cells, which results in cognitive disorders in patients with mental disorders, as well as to identify related new approaches to the treatment of cognitive decline in these patients. Studies of the monocyte unit of immunity in patients with mental disorders will be covered in the second part of the review.

The changes in the concept of psychopathies and psychopathic reactions of the prominent German psychiatrist O. Bumke who in the first edition of his textbook (1919) was oriented on E. Kraepelin’s systematics of psychopathic personalities but included hysteric personality in psychopathies and tried to delineate the special type of “affectepileptoids” are analyzed. In the second edition of the Textbook (1924) O. Bumke subjected E. Kretschmer’s typology of schizoids and “prototypical” constitutional approach to psychopathies systematics to convincing criticism. In the third edition of the Textbook (1929) O. Bumke accepted partly “constitutional” approach and suggested his own typology of schizoid types among which he marked out fanatics, dissatisfied, emotionally cold and “enemies of the society”, and some originally described “tymopathic” types: “gentle egoists”, “gentle autists” and anxious. Other psychopathic types: paranoid, explosive, hysteric, dypso- and poriomans from O. Bumke’s point of view appeared on heterogenous constitutional ground. From the third edition of the Textbook O. Bumke separately described hysterical “attitude” underlining the meaning of environmental factors in the formation of hysterical personality, and two types of paranoic personality development: litigious and sensitive in O. Bumke’s comprehension were corresponding to paranoic “attitude”. The peculiarity of O. Bumke’s concept of psychopathies and psychopathic reactions was its accent on the prevalence of mixed and transitive forms in the clinical reality and corresponding impossibility for differentiation.

Purpose: to present an overview of domestic and foreign current research covering the treatment of late-life depression.

Materials and method: the keywords “depressive disorder”, “late age”, “psychopharmacotherapy” were used to search for scientific articles in the databases MedLine, PubMed for the period 2000–2020.

Discussion and conclusions: the variability of multiple aging factors in depressive patients of late age leads to significant heterogeneity of geriatric depressions and difficulties in selection of therapy. In the current literature on the treatment of late-life depression, there are quite heterogeneous recommendations on the choice of different drugs, recommended dosages, duration of therapy and time to replace drugs if they are ineffective. The global trend of transition to personalized therapy of mental diseases requires identification of predictors of therapeutic response in patients. Significant data has already been accumulated on potential predictors of therapeutic response to antidepressants in young and middle-aged patients using clinical, neurobiological, neurocognitive and genetic parameters. The search for predictors of therapeutic response is especially important in late life, since the selection of adequate antidepressant therapy is associated not only with the effectiveness, but also with the safety of treatment of elderly patients. To date our knowledge of the problem of predicting the therapeutic response in this group of patients remains very limited and requires further study

Background: the clinical experience testifies to the fact, that the increase of dementia severity in late age occurs quickly in some cases and in others it proceeds slowly, which is reflected in the total duration of the disease and survival. One of the aspects of dementias research is the study of significant differences in dementia progression rates.

The objective of the review was to generalize the obtained data on progression rates of late age dementias of various genesis, first of all due to Alzheimer’s disease and its associated disorders.

Material and methods: papers in MedLine/PubMed bases from1990 to 2020 were selected and analyzed according to the key words: “old age”, “dementia”, “Alzheimer’s disease”, “vascular dementia”, “progression”, “progression rate”, “disease trajectories”, as well as relevant papers in the references of the analyzed works.

Conclusion: the history of research of old age dementias natural course was presented in the review of scientific publications. According to the results of development of progression rates detection methods, singling out of dementias with rapid and slow increase in the severity of cognitive decline was substantiated. Works devoted to the study of frequency and nosological belonging of dementias with different progression rates were considered. In the most recent studies prognostic models with detection of various trajectories of the course of the disease were developed. The concept of various dementias progression rates admittedly has practical meaning for provision of diagnostic and treatment assistance and planning of medical and social support measures for patients with dementia and their families. Differentiation of dementia progression clinical patterns during formation of comparable groups of patients seems appropriate for investigation of new therapy methods, as well as in clinical-biological studies of pathogenesis.

Purpose: summing up the results of the Russian scientific-practical conference with international participation “Prevention of Behavioral Disorders: The Family Aspect of Biopsychosocial-Spiritual Approach”, held in Moscow on March 12, 2020 and organized by the Scientific Center for Mental Health FSBSI together with partner organizations.

Results and discussion: at the conference the results of domestic and foreign studies on family prevention of behavioral disorders were reported, experience in conducting rehabilitation programs in psychiatry and narcology was presented, issues of the interaction of a multidisciplinary team of specialists in the implementation of a biopsychosocial and spiritual approach in the prevention of behavior disorders were discussed.

Conclusion: the introduction of programs and methods of high-quality family-oriented care for patients with mental and behavioral disorders, including those based on traditional spiritual values, into the activities of psychiatric and narcological institutions and institutions, as well as NGOs, will improve the quality and effectiveness of psychiatric and narcological assistance.