Introduction: cell-free plasma DNA (cfDNA) is used as a marker refl ecting the level of apoptosis in the human body under stress. Acute psychosis caused by endogenous (schizophrenia) and exogenous (alcohol intoxication) factors in the patient’s body is associated with oxidative stress. Presumably, cfDNA concentration in the blood plasma of patients with acute psychoses of endogenous and exogenous etiology is increased. The purpose of the study: comparative analysis of the cfDNA concentration in the blood plasma of treated and untreated patients with paranoid schizophrenia during the disease exacerbation, patients with alcoholic psychosis and healthy volunteers. Patients and methods: the concentration of cfDNA was determined in the blood plasma samples of 476 people: control group (n = 95); patients with schizophrenia in the acute stage of the disease (n = 334); patients with alcoholic psychosis (n = 47). Results: the concentrations of cfDNA in the plasma of patients with schizophrenia (median 931 ng/ml) is 2.2 times higher than in the control group (median 428 ng/ml) and 1.8 times higher than in the patients with alcoholic psychosis (504 ng/ml). For the patients with schizophrenia with high PANSS, we found the highest values of the cfDNA concentration in the blood plasma during psychosis, which indicates a more pronounced systemic process, which is accompanied by the cell death level increase. Conclusions: the concentration of cfDNA in the blood plasma could be used as a biochemical marker that refl ects the severity of the schizophrenia patient’ state upon admission to the hospital.

Failure to diagnose bipolar disorder (BD) in time leads to an increase in suicide risk, worse prognosis of the disease, and an increase in the socioeconomic burden. Aim: to assess the incidence of comorbidity of bipolar disorder (BD) and other mental and behavioral disorders, as well as the sequence of formation of this multimorbidity. Patients and methods: in the Affective States Department of the Mental Health Research Institute TNRMC, 121 patients with a diagnosis of bipolar disorder were selected for the study group according to the ICD-10 diagnostic criteria. The predominance of women in the study group was revealed (n = 83; 68.6%; p < 0.01). Median age of male patients was 36 [30; 54] years, for females — 47 [34; 55] years. Results: data were obtained on a high level of comorbidity in the study group: in 46.3% of patients, BD was combined with another mental disorder. It was found that personality disorders as a comorbid disorder in type I bipolar disorder are less common than in type II bipolar disorder. Gender differences were found in the incidence of anxiety-phobic spectrum and substance use disorders in bipolar disorder. The features of the chronology of the development of bipolar disorder and associated mental disorders have been revealed. Conclusion: in the case of bipolar disorder, there is a high likelihood of comorbidity with other mental disorders. Certain patterns in the chronology of the formation of comorbid relationships between BD and concomitant mental and behavioral disorders were revealed.

The aim of the study was to determine the immune markers of infl ammation in the blood plasma of the elderly patients with bipolar affective disorders (BD) in relation to the clinical specifi cities of the disease. Patients and methods: 134 blood samples from the elderly patients aged from 52 to 88 years old (mean age 66.7 ± 7.7 years) with diagnose of bipolar disorder were examined. Infl ammatory markers in the blood plasma were determined as follows: the enzymatic activity of leukocyte elastase (LE) and the functional activity of the D1-proteinase inhibitor (D1-PI), as well as the level of autoantibodies (aAB) to S100b and myelin basic protein (MBP), and the protease inhibitor index (PII), which was the ratio of LE and D1-PI activity and characterized the activity of the proteolytic system as the most important component of infl ammation. Cluster analysis was used to reveal immunotypes. Results and discussion: а signifi cant increase in D1-PI and the level of aAB to S100b was revealed in elderly patients diagnosed with bipolar disorders, as well as low proteolytic activity of infl ammation (according to PII). Immune markers of infl ammation in different types of affective episodes (depressions, manias, mixed affective states) and in therapeutic remission did not differ from each other. Immunological parameters in elderly patients with bipolar disorders depended on the severity degree of the affective disorder. A relationship was found between the severity of depression and the level of aAB to S100b; the difference between mania and hypomania in terms of LE and PII activity was shown; in mixed affective states immunological parameters differed from the control only in moderate disorders. Remission with residual symptoms differed from asymptomatic therapeutic remission in terms of LE and PII activity. The two identifi ed clusters (immunotypes) differed in the activity of LE and PII. Conclusion: the results indicated the participation of infl ammation in the pathogenesis of bipolar disorder, and the isolated immunotypes confi rmed the clinical diversity of the disease. The study of the pathogenetic signifi cance of infl ammation and the identifi cation of various immunotypes was aimed at search for new therapy targets, taking into account the contribution of infl ammation.

Background: the lack of data on the relationship between the level of social adaptation as a complex of macro- and microsocial factors with suicide risk in patients with schizophrenia determines the relevance of this study. Aim: to investigate the relationship between social adaptation self-evaluation and suicide risk in patients with schizophrenia. Patients and methods: we examined 68 patients with schizophrenia. Suicide risk was evaluated using the Beck Hopelessness Scale, the level of social adaptation was assessed using the Social Adaptation Self-evaluation Scale. An assessment of clinical and psychopathological symptoms was performed using the PANSS. Results: the level of hopelessness was higher in the group with a low level of social adaptation self-evaluation than in the group with a high level of social adaptation self-evaluation. However, the groups were comparable for a number of objective indicators of social adaptation (such as education level, marital status, social status). Conclusions: it can be assumed that hopelessness and suicide risk more depend not on the level of social adaptation, but on the subjective experience of the level of adaptation as low or high.

Background: the reduction in the premature mortality as a result of non-contagious diseases by way of the improvement measures to be adopted with the purpose of prevention and treatment of the substance abuse and general health care activities were outlined by the United Nations Organization as the primary objectives as far back as 2015 in order to work towards sustainable development (the objective № 3 “Promotion of healthy lifestyle and furtherance of wellbeing of individuals of all ages” in 2030 perspective). There is a high risks for the Russian Federation of transnational drugs expansion developing [1]. Concurrently, in order to build a national dependence prevention system, Decree № 581н as of 06.10.2014 “On the Preventive Medical Screening to be made at educational establishments” was issued by the Ministry of Health of the Russian Federation. Purpose: the research was supposed to focus on Preventive Medical Screening as a measure of prevention of illegal usage of substances and mental disorders among minor students and on the optimization of such preventive medical screening. Materials and methods: the fi ndings are based on the posthoc analysis of the data of the Federal statistical survey form and of the research and information reports (n = 491 280 students). The results: the fi ndings of the preventive medical screening made across the Russian Federation and in Moscow over the years 2016–2018 show the increase of minor students involved into such preventive medical screening, as well as the decrease of those who might use psychoactive drugs. The same fi ndings show that the majority of the illegal drug users were students of secondary vocational schools. The fi ndings can be called a trend across the Russian Federation and in Moscow. Conclusions: non-medical usage of substances among minor students can be a serious threat to the mental health of the youth. There are suggestions for improvement prevention of mental disorders among students at the results of the research. These include methodology of Brief Motivational Consulting at a time of preventive medical screening and the ways of increase effectivity toxicology screening in different educational organizations offering to add in preventive medical screening cotinine (it’s metabolite of nicotine) screening for students of primary school; it’s have to systematically update and expand types of screening tools for substances in preventive medical screening in all educations organizations.

Background. The comorbid course of Mood Disorders (MD) and Alcohol Use Disorder (AUD) is a problem actively discussed by national and foreign researchers. Scientists pay close attention to clinical and pathodynamic polymorphism of symptoms in their works. Objective of the study: to compare the Clinical-Dynamical characteristics of AUD and MD, taking into account the formation chronology of their comorbidity, in a clinical sample of the specialized psychiatric hospital. Patients and methods: the study enrolled 56 patients under treatment in Department of Affective Disorders or Addictive Disorders of Mental Health Research Institute Clinics with a comorbid diagnosis of AUD (F10.2 according to ICD-10) and MD (F31–F34.1 according to ICD10). The Clinical-Dynamic, Psychometric and Statistical Methods were used in work. Results: according to statistical analysis in the case of the primary onset of AUD a relatively later formation of the comorbidity was shown (p = 0.001, Mann–Whitney test) and a higher frequency of Dysthymia as a Secondary MD (p = 0.043, chi-square test). Inspite of relatively shorter Duration of the Disease (p = 0.001, Mann–Whitney test), Secondary AUD characterized by rapid evolution of clinical and dynamic traits: the Alcohol Tolerance and Duration of Withdrawal Symptoms are comparable to the Primary AUD (p = 0.739, Mann–Whitney test; p = 0.359, Mann–Whitney test), and slightly shorter Duration of Light Gaps (p = 0.087, Mann–Whitney test) and Heavy Drinking Days (p = 0.034, Mann–Whitney test). A Psychometric study of the severity of symptoms of Depression, Anxiety and Craving for alcohol in the dynamics of psychopharmacotherapy demonstrate their comparability both at the beginning of treatment and by the 28th day of therapy (p > 0.05, Mann–Whitney test). Thereby, AUD developed in the background of a formed MD characterized by a prognostically unfavorable course of Disease.

Background: studies of the psychological mechanisms of perpetuation and quality of life in patients with somatoform disorders are important for identifying targets for psychological interventions and defi ning risk groups. Aim: to reveal specifi c hypochondriac beliefs and behavior in patients with somatoform disorders related to severity of somatic complaints and subjective well-being. Patients and methods: 100 patients with somatoform disorders were assessed by using Screening for Somatoform Symptoms, Toronto Alexithymia Scale, Cognitions About Body And Health Questionnaire, Scale for the Assessment of Illness Behaviour, and Quality of Life Enjoyment and Satisfaction Questionnaire-18. Results: level of somatoform symptoms is higher in patients with a tendency to catastrophize bodily sensations, autonomic disfunction, mental scanning for bodily symptoms, and disturbances in daily activities due to illness. Regardless of somatoform symptoms’ severity, subjective well-being is lower in patients with belief in bodily weakness and somatosensory amplifi cation, autonomic sensations, expression of symptoms, and changes in daily activities due to illness. Conclusions: the results are discussed in the context of possible psychological and behavioral factors in the perpetuation of somatoform disorders. Patients of older age are at risk of perpetuation of somatoform disorders due to a greater tendency to catastrophize bodily sensations and higher belief in bodily weakness.

Purpose: analysis of domestic and foreign literature on the possibilities, features, benefi ts and limitations of telepsychiatry/ telepsychology. Material and method: the keywords “telepsychiatry, telepsychology, remote psychiatric care, impact of pandemic on mental health, information technology in psychiatry” were used to select publications available in MEDLINE/PubMed, Scopus, Web of science, eLibrary, Google. Results: literature research has shown that telepsychiatry is a service-enhancing modality that promotes equitable access and high levels of patient satisfaction. The coronavirus pandemic has led to an inevitable increase in the use of this method in the provision of psychiatric as well as psychological services. Telepsychiatry has both clinical and non-clinical applications, e.g. in administration, training and research. A large body of evidence shows that telepsychiatric diagnostic assessments are reliable and that the clinical outcomes of telepsychiatric interventions are comparable to those of traditional treatment among various patient groups, irrespective of age, diagnosis and other variables. However, the evidence base for telepsychiatry/telepsychology is still relatively limited in many aspects of effectiveness, and is often complicated by methodological problems, including technological diffi culties, negative opinions and pessimistic perceptions among psychiatrists, and several legal, ethical and administrative barriers. These impede wide implementation of telepsychiatry and its integration into everyday medicine. Conclusion: further advances in remote technology and research will solve many of the problems of telepsychiatry, and its development is likely to consist in the application of telepsychiatry as an adjunct to conventional medicine, and in the development of hybrid models, incorporating both conventional and telepsychiatric forms of psychiatric and psychological care.

Background: сognitive impairment and late depression, along with dementia, are the most common mental disorders in elderly and senile patients. Currently, more and more attention is being paid to preventive therapeutic approaches in the treatment of these conditions and to the study of drugs with multimodal neuroprotective and neurotrophic properties that contribute to the strengthening of the so-called endogenous system of protection and recovery of the brain, which is a kind of barrier to the incipient neurodegeneration. Objective: to present a review of domestic and foreign modern studies devoted to the study of the multimodal effects of the drug cerebrolysin, which has neurotrophin-like properties, and the results of its use in the treatment of cognitive disorders that do not reach the degree of dementia, as well as late depression. Material and methods: using the keywords “late age, mild cognitive disorders, depression, MCI syndrome, therapy, cerebrolysin”, we searched for scientifi c articles in the MEDLINE and PubMed databases for the period 2000–2020. Conclusion: the data presented in the review showed that cerebrolysin, acting as a multi-target drug, affects multiple molecular mechanisms of the pathogenesis of pre-dementia cognitive disorders and late-age depression. The drug detects a neurotrophin-like effect, improves the processes of neuroplasticity and can help enhance the protection and restoration of the brain under various pathological infl uences. Neurobiological studies and the results of a pilot prospective study indicate the preventive potential of cerebrolysin in preventing the development or slowing the progression of the neurodegenerative process of Alzheimer’s type. In the studies presented in the review, the ability of cerebrolysin to increase the effectiveness of modern antidepressant therapy (with second-generation drugs) in the elderly has been shown, presumably by potentiating the therapeutic effect of antidepressants or by improving their tolerability, which makes it possible to safely use higher doses of antidepressants in the elderly and senile patients.

Background: although the search for biomarkers of mental disorders that is aimed at improving diagnosis, individualizing therapy based on knowledge of pathophysiological processes and preventing the development of mental illness is actively underway for endogenous mental disorders, the study of biological markers in non-endogenous mental disorders and posttraumatic stress disorder (PTSD) in particular has received much less attention. Aim: to analyze current state of research dedicated to genetic and biochemical biomarkers that can be used to identify high risk groups and clarify the diagnosis of PTSD. Material and method: keywords “biomarkers”, “post-traumatic stress disorder”, “pathogenesis” have been used to fi nd in PubMed articles published in 2010–2020. Conclusion: research methods for elucidating the mechanisms of PTSD are actively developing, however, the identifi cation of specifi c biomarkers (biochemical, molecular, genetic, epigenetic, neuroimaging, psychophysiological) is a complicated task. This complexity is associated with numerous pathogenic mechanisms of PTSD and frequent comorbidity with mental disorders (depression, anxiety) and somatic diseases, as well as lack of specifi city of detected biomarkers.

The origin of the term and notion of “coenaesthesis” of German-speaking medical school was analyzed. Whereas in Germany the term “Coenaesthesis” was presumably fi rst used by J. Reil’s pupil Ch.F. Huebner (1794) in his written in Latin dissertation and the concept that considered the changes in “general feeling” as a ground for some psychiatric disorders was elaborated by J. Reil (1799, 1805), in Russia the similar ideas were expressed by A.F. Solnzev (1825) in his also written in Latin dissertation as D.D. Fedotov and V.G. Ostroglazov indicate. It may be assumed that the Scotch doctor A. Crichton (Alexander Kreiton in Russian transcription) contributed to the propagation of the concept of “Coenaesthesis” from Germany to Russia, due to his account of German concept of “General feeling” in his “Inquiry into the nature and origin of mental derangement” (1798) and succeeding fi fteen years work in Russia. In German-speaking psychiatry the Reil’s concept of “Coenaesthesis” was farther developed by Austrian doctor and psychiatrist E. von Feuchtersleben (1845), who underlined its meaning not only in hypochondrial but also in hysterical disorders and actively used the term “Coenaesthesis” along with the German term “general feeling”; the concept of general feeling is also refl ected in the famous W. Griesinger’s “Pathology and therapy of mental diseases”. In connection with the following separation from general feeling the muscular, temperature and pressure feelings its notion got narrowed as also the circle of mental disorders that was considered as determined by the different changes in general feeling. That is noticeable in German-speaking psychiatry in the concepts of R. von Kraft-Ebing and E. Kraepelin; while H. Schuele did not use the notion of general feeling at all. In Russia A.F. Solnzev’s concept of Coenaesthesis was for a long time forgotten, but in France in the second half of the XIXth century psychologist and philosopher Th. Ribot opened “cenesthesie” anew. In anglo-saxon psychiatry the disorders of general feeling were never considered as a special psychopathological syndrome (with the exception of its presentation by A. Crichton).

The aim of the paper was to provide an overview of the reports presented at the congress on the main problems of clinical and biological psychiatry. Discussion and conclusion: A representative forum of domestic psychiatrists and narcologists, psychotherapists and psychologists, organizers of psychiatric care and the leading scientists in the fi eld of clinical and biological psychiatry was held together with the Regional Congress of the World Psychiatric Association (WPA). The thematic diversity of the reports corresponded to the main problem, refl ected in the title of the congress. The opportunity to review and discuss achievements in scientifi c and practical activities of colleagues and to present their own data was the basis for summing up and identifying the prospects for protecting the mental health of the population at the current level of knowledge and using effective technologies.