Background: the necessity of conceptual understanding of catatonia phenomenon is dictated by a new clinical reality. The matter concerns creating systematics of a wide range of catatonic disorders, based on the data of clinical, neurobiological and psychopharmacological studies. The aim of the study was to present psychopathological systematics of movement disorders, united by the concept of catatonia as transnosological entity (DSM-5, ICD-11 project).

Patients and methods: a total of 38 patients (20 males; 18 females; mean age 24.7 years; average duration of the disease 14.4 years) were studied. The subjects with established diagnoses of schizophrenia (F20), schizophrenic (F21) and schizoaffective (F25) spectrum disorders underwent treatment in the department of borderline psychiatry and psychosomatic disorders of the FSBSI “Mental Health Research Centre”.

Methods: clinical, pathopsychological, psychometric, Bush Fransis Catatonia Rating Scale (BFCRS), The Scale for the Assessment of Negative Symptoms (SANS).

Results: in the range of movement disorders, that combine non-psychotic forms of catatonia, two categories were distinguished, i.e. parakinetic catatonia syndrome (K. Kleist, K. Leonhard) and stereotyped catatonia syndrome (K. Kleist). Manifestations of parakinetic catatonia (polymorphism of motor symptom complexes, covering isolated areas of the body; impulsivity; extreme intensity; expressiveness with the effect of alienation, loss of arbitrariness of sensorimotor acts) are formed according to the mechanism of mental automatism, act as transformers, that modify positive pathocharacterological disorders and complicate the clinical picture of subsequent exacerbations of the process. Symptom complexes of stereotyped catatonia (monotony, general slowness, uniformity of unrelated motor acts/stiffness is out of the scope of patients’ attention/with a feeling of discomfort, alienation of motor sensations) are formed according to the mechanism of evolving dyskinetopathy. In the psychopathology space of the disease they play the role of doublers, amplifiers of negative (abulia, passivity, apathy, emotional fiattening) and cognitive disorders.

Conclusion: the identified non-psychotic catatonic syndromes (parakinetic and stereotyped catatonia) are clinically heterogeneous both in terms of the ways of their formation (mechanism of mental automatism/evolving dyskinetopathy) and functional activity in the psychopathology space of the disease (transformers of positive disorders/doublers of negative changes) and clinical prognosis.

Introduction: the clinical heterogeneity of catatonic disorders, as well as the involvement of various mechanisms (GABAergic and glutamate systems, and neuroendocrine dysfunctions of the hypothalamic-pituitary-adrenal axis (HPA) disorders in the immune system) in the pathogenesis of these conditions served as a basis for the consideration of catatonia from a position of the modern clinical and biological model of schizophrenia, which considers the formation of psychopathological symptoms in this disease in the conjunction with infiammation.

The aim: to establish relationships between immunological processes of sterile infiammation and psychopathological characteristics of catatonic disorders formed on their basis.

Patients: 41 patients with schizophrenia (F20) and schizophrenic spectrum disorders (F21, F25) were examined, among them 26 patients with motor disorders belonging to the category of “non-psychotic” catatonia (12 patients with stereotypic catatonia and 14 patients with parakinetic catatonia), and 15 patients with schizophrenic spectrum disorders without symptoms of catatonia. A control group consisted of 17 healthy people.

Methods: the activity of leukocyte elastase (LE) and α₁-proteinase inhibitor (α1-PI), S-100B and myelin basic protein (MBP) antibody levels in plasma, and leukocyte inhibitor index (LII) were determined.

Results: in all groups, a significant increase in the activity of LE and α₁-PI was revealed in comparison with the control (p < 0.05). LE activity and LII value were significantly higher in patients with stereotypic catatonia and schizophrenic spectrum disorders compared to patients with parakinetic catatonia (p < 0.05; p < 0.01). Cluster analysis revealed two immunological clusters in the general group of patients: the 1^st cluster was characterized by pro-infiammatory status with high proteolytic activity, which corresponded to physiological infiammation. This status was typical for most patients with stereotypic catatonia, as well as for patients with schizophrenic spectrum disorders (75% and 98.3%). The 2nd cluster was characterized by a pro-inflammatory status with low proteolytic system activity, which was a sign of inflammation imbalance presumably associated with functional depletion of neutrophils. This status was predominantly in patients with parakinetic catatonia (66.7%).

Conclusion: the study confirmed the role of infiammation in the forming of non-psychotic catatonic disorders in schizophrenia and schizophrenic spectrum disorders and revealed their immunological heterogeneity, as well as the relationship between the clinical features of catatonia and the features of the proteolytic system of infiammation.

More and more data indicate that SARS-CoV-2 infection causes neurocognitive deficits in a significant proportion of patients. The structure, mechanisms, and course of these disorders are currently unknown.

The aim was to study phenomenological characteristics of cognitive impairment in patients with COVID-19.

Patients and methods: a total of 2500 hospitalized patients with COVID-19 were examined by a psychiatrist. Clinical examination revealed cognitive decline of various origins in 540 (21.6%) patients, including disorders due to previous cerebrovascular accidents. Patients and their relatives didn’t observed cognitive impairments in patients before COVID-19 infection in 51 (2.4%) cases. These symptoms appeared only against the background of coronavirus infection. These patients were examined clinically and using MMSE in connection with complaints of “decreased memory”, “fog in the head”, “attention deficit”. In 37 (1.48%) patients, a decrease in MMSE score was not found, despite a clinically detectable slowing of mental activity, worsening of active attention, and signs of exhaustion. Decreased scores of the MMSE were found in 14 (0.56%) patients, among them 5 men and 9 women aged 62.57 ± 14.69 years, 95% confidence interval 54.08–71.05. These patients were included in the analysis.

Results: the severity of cognitive impairment in patients with coronavirus infection varied over a wide range, and there was no parallelism between the severity of cognitive deficit and the severity of COVID-19. On the MMSE scale, at the first examination, an indicator corresponding to the gradation of the scale “mild dementia” was detected in 3, “moderate” — in 9, and “severe dementia” — in 2 patients. The structure of the neurocognitive syndrome was dominated by speech and attention disorders. All patients with cognitive impairment were characterized by the presence of concomitant somatic diseases.

Conclusion: it is possible to identify the neurocognitive syndrome associated with COVID-19 when the following conditions are met: 1) occurrence against the background of coronavirus infection, 2) the absence of neurocognitive disorders before the viral infection, 3) the absence of symptoms of confusion, 4) the absence of parallelism between the severity of the physical state and the MMSE score.

Objective: Since the mid-nineties of the last century, there has been a wide involvement of all segments of the world’s population in computer games. A huge number of the younger generation including children, schoolchildren, teenagers is involved in the process of “computerization”. With prolonged and frequent use of a computer, it is possible to form a computer gaming addiction.

The purpose was to study of the effectiveness of tertiary prevention (TP) of computer game addiction (CGA) in students of General education institutions (GEI).

Patients and methods: the study included 558 students in grades 7–10 of GEI aged 12–17 years (14.6 ± 2.4 years). The main group made up 393 students who received preventive intervention, and 165 persons of the control group didn’t it.

Results: as a result of the TP in the main group, there was a decrease in the interval of time spent by students at the computer (p < 0.05); the number of students decreased (p < 0.05): groups with the stage of CGA; with depressive states and states close to depression and anxiety; the quality of communication improved (p < 0.05). The number of schoolchildren with communication skills with peers has increased (p < 0.05). The control group revealed: an increase in the time interval spent by students at the computer (p < 0.05); an increase in the number of students experiencing affective disorders when abstaining from the computer (p < 0.05). There was a tendency to increase the frequency of problems as well as postponed meetings and personal matters related to spending time at the computer.

Conclusion: tertiary prevention of CGA, including psychotherapy and pharmacotherapy, allowed a significant part (p < 0.05) of students to form remission with the deactualization of pathological attraction to computer games (PACG), to control the time spent.

Background: Evidence from available literature suggests that the problem of postpsychotic conditions qualifi ed as part of “new life” type remissions requires revision.

The aim: to study the structure of postpsychotic residual disorders that determine the clinical picture of late remissions, which form the type of “new life”.

Patients and method: case reports analysis, clinical interpretation and classifi cation of remission type.

Results and conclusion: a characteristic of residual states is presented — remissions according to the type of “new life” lasting from 10 to 40 years. A medical model of this group of post-procedural states has been developed. The main — “nuclear” group (remissions limited by the level of in-hospital adaptation) — hypoparanoial with residual delirium of persecution (ideas of attitude, damage, persecution by family members). The formation of residual paranoia as the psychosis progresses backwards is accompanied by alienation of all past life realities (rejection of kinship responsibilities and previous productive activities) and the formation of new autistic occupations. The clinical picture of residual states — remissions on the type of “new life” of the spectrum group is also dominated by ideas of alienation of realities of the past — and the beginning of a “new life” with functioning at the level of new super-valuable hobbies. These residual states show essential differences from the basic “nuclear” group. In the social aspect we are talking about more limited changes of a life stereotype — adaptation in the out-of-hospital space, inthgegration into the structure of closely related interpersonal contacts, implementation of labor activity outside the specialized stationary conditions. Psychopathological characteristics of the phenomenon of “new life” appearing in the clinical space of remissions of the “nuclear” group and the “spectrum” group are heterogeneous and differ rentiated both on the basis of severity level and typological heterogeneity of deficit changes, and different structure of positive (hypoparanoial) disorders. The formation of the phenomenon of “new life” in remissions of the “nuclear” group is associated with negative — predominantly emotional changes. The parameters of the complicity of procedural dimensional disorders (negative — positive disorders), which determine the formation of the “new life” phenomenon in remissions of the spectrum group, shift towards delusional rather than negative symptomatology. The change of work orientation by supercreative hobbies is induced by catathymic ideas of delusions of pretension formed as part of post-procedural paranoia development (delusional symptom complexes and delusional fantasies of the desire paranoia circle, Wunschparanoja E. Kretschmer).

Background: CNS functional impairment is observed even in cases of low radiation doses. The results of epidemiological studies show the relevance of the problem of mental health disorders in persons affected by ecological disasters. Asthenic syndrome is one of the main complex of symptoms in case of both acute and accidental radiation exposures although there are no accurate data about pathway of development, categories of asthenic syndrome and factors determining its course so far.

The objective of the research is to study asthenic syndrome in persons accidentally exposed to radiation.

Patients: the main group included 81 persons (average age 68.9 ± 5.0 y.o.) with clinically pronounced asthenic manifestations and soft tissue dose ≥ 0.07 Gy. The comparison group included 50 persons (average age 65.8 ± 7.0 y.o.) with exposure dose < 0.07 Gy and also pronounced asthenic manifestations.

Methods: psychopathological, clinical, neurophysiological (EEG), psychological (MFI-20 and MMSE scales) and psychophysiological (Simple Hand-Eye Reaction, A.R. Luria “Remembering 10 words”, Schulte table) methods have been used in the study.

Results and conclusion: a significantly pronounced asthenic manifestation was observed in both groups. Autonomous disorders, general asthenia, pre-dement cognitive changes, slow rate of sensorimotor reaction, moderate disorders of the functioning of cortical structures, predominant infiuence of stem structures on the brain bioelectric activity, more frequent changes in the right hemisphere, dysfunction of the reticular formation with its enhanced activation were identified significantly more often in a group of irradiated patients.

Background: cognitive disorders are considered as key disfunctions in schizophrenia spectrum disorders and as risk factors of schizophrenia.

The aim of study was to examine neurocognitive deficit in patients with schizophrenic spectrum disorders, its structure and risk factors of schizophrenia.

Patients and methods: 42 patients were examined with the diagnosis of “schizotypal disorder” (F21.3–21.5 according to ICD-10, n = 20) and “paranoid schizophrenia” (F20.00 according to ICD-10, n = 22). The control group included 20 people who had no signs of mental disorder. Cross-sectional study used methods for cognitive functions assessment.

Results: patients with schizotypal disorder and paranoid schizophrenia are united by a deficit in the speed of processing, in verbal, visual and working memory, executive functions with sufficiently preserved visual-constructive abilities. In patients with the schizotypal disorder, compared with patients with paranoid schizophrenia, sustained attention and taskswitching ability, the effectiveness of long-term memorization and visual-spatial abilities are preserved to a greater extent. We found a correlation between burdened heredity and reduced results of the “Ray–Osterritz figure” technique and between the frequency of seeking medical help and the indicator of the “TMT-B” tracking test. Patients with schizotypal disorder are more likely to received more than one antipsychotic. The cognitive functioning of patients taking first/second generation antipsychotic drugs or their combination does not differ.

Conclusions: patients with schizotypal disorder show similar, but in contrast to patients with paranoid schizophrenia, less pronounced cognitive impairment. There is a link between the degree of visual-spatial ability and the family risk of psychosis. The frequency of seeking medical help (unfavorable course of the disease) is associated with task-switching ability. Antipsychotic polypharmacotherapy, subject to dosages, is not a significant factor in cognitive disorders.

Background: the application of group analysis for the treatment of somatoform disorders requires the substantiation of its clinical and psychological effectiveness in various differential diagnostic groups.

Aim: the investigation of the dynamics of pathological bodily sensations, concomitant psychopathological symptoms, quality of life as well as beliefs about the disease and treatment in patients with somatoform disorders undergoing group analysis, in comparison with patients in the psychoeducation program.

Patients and methods: 100 patients with somatoform disorders were randomized to group-analysis or psychoeducation. Before and after treatment, they filled Screening for Somatoform Symptoms, the Toronto Alexithymia Scale, the Illness Perception Questionnairie revised, Cognitions about Body and Health Questionnaire, Scale for the Assessment of Illness Behaviour, and Quality of Life Enjoyment and Satisfaction Questionnairie-18.

Results: all patients demonstrated a decrease in the severity of somatoform symptoms and an improvement in the quality of life in various spheres of life, which is significantly more pronounced in patients receiving group-analysis compared to psychoeducation. The improvement of subjective state of patients having undergone psychotherapy during treatment was highly associated with a decrease in the severity of the emotional reaction to the disease, somatosensory amplification, beliefs in bodily weakness and intolerance to bodily sensations. The patients of the main group solely demonstrated a decrease in patterns of hypochondriacal behavior such as catastrophization regarding bodily sensations, revisiting general practitioners, and simultaneous distrust of the results of medical tests and prescriptions. When comparatively analyzing the separate diagnostic groups, patients with polymorphic somatoform disorder displayed the most pronounced clinical effect (a decrease in the severity of complaints) in the process of group analysis, and patients with somatized disorder showed the most pronounced psychological effect (an improvement in the quality of life, a decrease in the dramatization of bodily sensations, a decrease in medical retesting and diagnosis verification, the optimization of beliefs about health).

Conclusions: group analysis demonstrated greater clinical and psychological effectiveness, in comparison with psychoeducation, in patients with somatoform disorders.

Background: anorexia nervosa (AN) is the actual issue of medicine due to continued increase of the prevalence and extension of onset age of disease. The efficiency of treatment of this category of patients remains low. One of the main somatic manifestations of AN is severe, life-dangerous malnutrition. The most important component of treatment and rehabilitation is nutritional metabolic intervention to restore the nutritional status of patients.

The aim was to study energy expenditures and daily nitrogen loss in patients with AN to develop recommendations for optimizing their substrate supply during the period of rehabilitative nutrition with a high risk of developing refeeding syndrome and consider the role of psychological correctional measures.

Patients and methods: energy expenditures (indirect calorimetry on the Cosmed Quark RMR apparatus) and daily nitrogen loss were studied in 81 patients with AN, aged from 18 to 55 years, who were treated in the somatopsychiatric department of the Saint-Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine.

Results: the target optimal energy intake is 58.5–73 kcal/kg per day of actual body weight, and protein intake is 1.95–2.39 g/kg per day. An acceptable positive result is achieved a gradual gain in body weight (500–1000 g per week).

Conclusion: nutritional and metabolic therapy of patients with AN should be carried out in the mode of personalized differentiated hyperalimention, considering the initial nutritional status and adequate metabolic tolerance of the gradually increasing substrate load.

Introduction: impulsivity is a maladaptive factor in many mental illnesses which leads to hospitalization more often that other symptoms. Most of researchers consider this symptom as an intrinsic part of the bipolar disorders (BD) in the manic state of the disease. But some of them notice the presence of impulsivity in other periods of the disease, both in depressive state and in remission.

Aims of the study: 1. Assessment of severity of impulsivity in patients with BD in comparison with healthy controls. 2. Assessment of prevalence of BD with comorbid disorders with intrinsic impulsivity.

Materials and methods: we searched three databases GoogleScholar, PubMed, eLIBRARY using the strategy: the words “bipolar disorder impulsivity”, “bipolar disorder impulsivity comorbidity” in the title of the paper in time period of 20 years. Search in database PubMed gave us 147 results, GoolgleScholar — 142 and eLIBRARY — 0. After analysis of the results of search it appeared that only 11 studies met the search criteria “bipolar disorders impulsivity”.

Conclusion: in all studies patients with BD in active phase (manic or depressed) differed from controls in terms of impulsivity. Concerning patients in remission data were not consistent. To check the hypothesis that impulsivity in BD patients is a part of comorbid disease the search with criteria “bipolar disorders impulsivity, comorbidity” was performed. Thirty-eight studies were selected. Only the studies with comorbid disorders with prominent role of impulsivity in nature of the disease were included in the analysis (ADHD in adults, eating disorders, alcohol and drug abuse and addiction and non-chemical behavior addiction). In all types of diseases the rate of comorbidity was higher in BD patients than in control. It remains unclear whether impulsivity is an intrinsic characteristic of BD or a consequence of the comorbid diseases. In any case the diagnostics of impulsivity in BD patients is an important task as it has to be considered in development of the treatment and rehabilitation strategies.

Objective: to present different views on the etiology and pathogenesis of idiopathic infertility in women.

Material and methods: according to the key words “idiopathic infertility”, “psychogenic infertility”, “unspecified infertility”, “psychosomatics:”, “psychoendocrinology”, a search was conducted for publications in the databases Medline/PubMed, Scopus, Web of Science, RSCI and other resources from the first half of the twentieth century to the present.

Conclusion: there are two approaches to the problem of idiopathic infertility: from obstetric-gynecological and psychological-psychiatric positions. The reproductive function and the development of infertility are influenced by premorbid personality traits, psychogenic factors, emotional stress, mental illnesses. In recent decades, studies of the relationship and mutual influence of a woman’s mental state and her reproductive function have been updated.

Background: The study of secular trends in child and adolescent mental health is a relatively new research direction in world psychiatry. Preliminary summary of recent publications on this topic is necessary for understanding of overall tendencies and further study of problem.

The aim: to evaluate studies of secular trends in child and adolescent mental health examining changes in the prevalence and levels of psychiatric problems during the past decades.

Methods: search for scientific articles using the keywords “secular trends”, “time trends”, “child and adolescent mental health” and similar terms in PubMed/Medline, Scopus, Web of Science and other databases. The findings on the prevalence and persistence of child and adolescent psychiatric disorders in different countries are summarised, as well as the impact of child and adolescent mental health problems on health and well-being across the life course. The methodological aspects of research on secular trends are highlighted; widely used standardised measures for assessing child and adolescent mental health are presented. The findings on secular trends in child and adolescent competencies and levels of mental health problems in different countries are summarised along with possible causes of identified changes.

Conclusion: over the last two decades, there was a decrease in adolescent antisocial behavior and substance use in many, but not all, countries worldwide. In developed countries, the prevalence of affective problems increased along with associated help seeking from mental health services. If key conceptual and methodological challenges can be addressed, research on secular trends may shed light on the mechanisms involved in the development of mental health, identify possible causes of disturbance and provide important pointers for the development of intervention programmes that focus on promoting child and adolescent mental health.

The aim was to study a history of creation and interpretation of term «depersonalization» in French psychiatry.

Method: a narrative review.

Conclusion: as it was elucidated by the analysis of the texts of postmortem published diaries of Swiss philosopher H.-F. Amiel is encountered for the first time not in the notes dated from the 8th of July 1880, as it had been mentioned by Englishspeaking researchers of this phenomenon M. Sierra and G. Berrios, but much earlier in the notes from the 27^th May 1857 concerning the impression that the “depersonated” music of Rihard Wagner made on the author of the diaries during the presentation of Tangeiser opera. The French psychologist L. Dugas firstly united déjà vu phenomenon with the experience of the alienation of mental acts (1894), but in four years (1898) when he used the term “depersonalization” for this experience considered depersonalization and déjà vu as different phenomena. L. Dugas put forward the hypothesis of affective origins of depersonalization, underlined psychological defensive sense of the phenomenon, but marked that the explanation of the alienation of mental acts by emotional apathy was not fully convincing. He did not agree with the position of Th. Ribot and P. Janet who ascribed depersonalization to the kind of obsessive disorders. For P. Janet the depersonalization was a characteristic stigma of psychasthenia, because of that firstly the psychasthenic premorbid character of the patients with depersonalization was described more comprehensively. Although P. Janet understood depersonalization as an affective disorder he considered it as a demonstration of psychasthenia, and predominantly explained the phenomenon by the abstract notion of “fundamental” disorder: “decreasing of the psychic tension”. L. Dugas and F. Moutier considered not only constitutional psychasthenics but also asthenics and other personalities whose emotions accidentally “dropped below the ordinary level” as predisposed to depersonalization.