The aim of the study was to investigate chronic inammation and genetic predisposition processes, involved in the formation of psychopathological dimensions of schizophrenia and schizophrenia spectrum disorders on the catatonia model. Method: the analysis of PubMed/MEDLINE, RSCI and other sources databases on genetics and immunology of catatonia in comparison with the results of our own clinical and biological studies of catatonic disorders as a model of clinical heterogeneity of positive disorders, as well as various mechanisms of their formation. Results: the results obtained demonstrate the involvement of inammatory mechanisms and genetic factors, not associated with the process of inammation, in the formation of psychopathological disorders in schizophrenia. In accordance with the developed clinical and biological model of schizophrenia, non-specic pathophysiological inammatory mechanisms determine the development of both positive and negative disorders by different, albeit related, molecular mechanisms. Identication of various psychopathological types of positive disorders (by the example of catatonic disorders) and their comparison with the activity of inammation allows us to differentiate these disorders. Such a comparison makes it possible to identify disorders, that are mainly determined by genetic factors, at the stages of the disease, associated with a low level of inammation (basic disorders). Positive disorders, mainly determined by inammatory mechanisms, can probably be considered as less specic, i.e. “secondary” ones. Conclusion: within the framework of the developed concept a different ratio of inammatory and genetic mechanisms, that are not associated with the process of inammation, determines the formation of psychopathological disorders and their clinical heterogeneity at various stages of the disease. These disorders represent a broad continuum, at one pole of which are disorders determined predominantly by inammatory mechanisms, and at the other pole by predominantly genetic ones. The activation of inammation and its attenuation may be one of the variants of a repeatedly recurring cycle of the disease, in which the ratio of inammatory and genetic mechanisms changes.

Introduction: the heterogeneity of psychopathological manifestations and the high comorbidity of social phobia with other mental disorders require the use the indicators of quality of life in the clinical assessment. Objective: determination of differences in quality of life indicators in patients with social phobia, comorbid with other mental disorders. Patients: 135 patients (78 women, 57 men) were examined with a diagnosis of social phobia (F40.1 according to ICD-10), comorbid with other mental disorders. Methods: clinical, psychopathological, psychometric (Liebowitz social anxiety scale — LSAS; Medical Outcomes Study — Short Form — MOS SF-36), statistical. Results: the structure of mental disorders comorbid with social phobia is presented by next diagnostic categories: F3 — affective disorders (n = 27; 20.0%); F4 — neurotic, stress-related and somatoform disorders (n = 90; 66.7%); F6 — personality disorders (n = 18; 13.3%). Based on cluster analysis, patients were divided into three subgroups depending by severity of fear of social situations and social avoidance (low, medium or high level of social anxiety). It was found that an increasing in the level of social anxiety is associated with a rise in the proportion of comorbid disorders of the depressive spectrum, personality disorders and an greater share of generalized social phobia in clinical manifestations. Differences in the quality of life between subgroups were obtained on the four MOS SF-36 scales, reecting the physical component of health (role- physical functioning, p = 0.0023; general health, p = 0.0428) and the mental component of health (social functioning, p = 0.0076; mental health, p = 0.0106). However, only according to the scales of the mental component of health, an inverse relationship between quality of life indicators and the intensity of social anxiety was established. Conclusion: comorbid mental disorders and the level of social anxiety have a differentiated impact on the assessment of individual components of the quality of life by patients with social phobia. In this regard, it is necessary to analyze the inuence of personality, motivational and other individual psychological factors associated with distortions in the cognitive sphere.

The aim was to study the impact of late diagnostics of bipolar disorder (BD) on the main clinical and dynamic indicators, suicidal behavior, the subjective evaluation of social adaptation level, and employment status of patients. Patients and methods: 121 in-patients (38 males, 31.4% and 83 females, 68.6%) with a veried diagnosis of bipolar disorder (according to the ICD-10 

criteria) were examined. A comparative evaluation of indicators that could reect the causes and consequences of delayed diagnostics of bipolar disorder was performed. The rst group (n = 46) included patients with BD veried during the initial visit to a psychiatrist, and the second group (n = 75) made up patients with late diagnosis of BD. Clinical, psychopathological, follow- up, psychometric, statistical methods were used. Results: delay in the diagnosis of BD was 38%. Comorbid anxiety disorders were the most signicant confounding factor of late diagnostics of BD. Suicidal attempt incidence and the total SBQ-R (The Suicidal Behaviors Questionnaire-Revised) score were higher in cases of late diagnosis of BD (p < 0.05). In the group with late diagnosis of BD, 17 patients (22.7%) were unemployed due to affective disorder compared to 4 patients (8.7%) with BD diagnosed at the rst visit to psychiatrist (p < 0.05), and a lower level of subjective evaluation of their social adaptation was revealed (p < 0.05). Conclusions: late diagnostics of bipolar disorder increases suicide risk and negative impact on the employment status and reduces social adaptation of patients.

Background: Borderline personality disorder (BPD) in adolescence has a high prevalence and a signicant polymorphism of the psychopathological structure which creates considerable difculties to conduct differential diagnostics and assessing comorbidity with other disorders. To date, special research has not been carried out to explore BPD in adolescents that highlights the relevance of the present study. Objectives: identication of the borderline personality disorder (BPD) clinical features, leading psychopathological syndromes and differential diagnostics criteria in adolescence. Patients and methods: 71 young patients (16–25 years old) with borderline personality disorder were examined by clinical psychopathological and psychometrical methods (PBQ-BPD, TAS, BIS-11). This study includes 28 women (39%) and 43 men (61%) who were examined as inpatient or outpatient in the Mental Health Research Centre in 2019–2021. Results: key symptoms complexes were identied and presented by affective instability, dissociative state with identity disturbance and addictive behavior. Based on the analysis of the clinical picture and the discovered patterns, three types of BPD in adolescents were identied: with an “affective storm” (type I); with a dominance of impulsive and addictive features such as “adrenaline addiction” (type II); with a dominance of “cognitive dissociation” and self-identity disorder (type III). Distinctive features of the clinical pictures of affective and behavioral disorders for each type of BPD in adolescence were found and psychopathological signs and their impact on further dynamics were determined, taking into account an auto-aggressive behavior and a high level of suicidality. Conclusions: the found psychopathological patterns of BPD formation in adolescence help to assess the disorders of personality and social functioning and to predict the risk of auto- aggression and suicidal activity for the diagnostic and prognostic assessment of borderline personality disorder in adolescence.

Background: mental disorders of different origin often begin with affective symptoms. The inuence of adolescence is recognized and concerns psychopathological manifestations following diagnostics difculties. The aim of the study was to investigate the structure of mental disorders with symptoms of affective disorder in adolescents rstly admitted for psychiatric advice. Patients and method: the study involved 120 adolescents (aged 17.1 ± 2.37) who became patients of the psychoneurological dispensary for the rst time in 2020–2021 due to affective register symptoms. The clinical, psychopathological and statistical methods were used in the study. Results: all respondents had initial symptoms before seeking psychiatric help, the average age of occurrence of which was 14.5 ± 33.18 years. Among the initial manifestations, a decrease in mood, irritability, and emotional lability predominated. Symptoms detected at the initial stage, persisted until the moment of seeking psychiatric help, and were the cause of the violation of social adaptation: a decrease in academic performance in 52 cases (42.28%), school absences in 44 patients (35.77%), narrowing of the range of interests in 17 (13.82%) and conicts in 11 (8.94%) cases. At the same time, psychopathological symptoms noticed by the adolescents themselves and their parents were not a reason to seek help and, in most cases, were considered as manifestations of the puberty crisis. At the rst request of teenagers for psychiatric help, mood disorders (F30–F39) — 48,5%, neurotic, stress-related and somatoform disorders (F40–F49) — 25% dominated in the structure of diagnoses, according to ICD-10. Conclusions: mental disorders, including affective pathology, debuting in adolescence, can have a prodromal period and be often misinterpreted as a puberty crisis. The symptoms of affective disorder in adolescence differ in polymorphism and can lead to a variety of diagnoses. Underestimation of initial preclinical manifestations of affective pathology, despite signicant difculties in social adaptation, can result in untimely therapeutic intervention, severe clinical manifestations and conversion of the diseases into a chronic course. The obtained data conrm the need for a thorough differential diagnosis of initial manifestations of mental disorders, subsequent clinical and follow up care and proper treatment.

Background: The main problem of evaluating the effectiveness of psychosocial rehabilitation (PSR) is incorrect methods of processing psychometric data obtained with the help of appropriate tools (scales and questionnaires), which are standard used to measure the effectiveness of interventions within the framework of the implementation of PSR procedures. The purpose of the study: 1) а systematic analysis of the problems of assessing the severity of mental disorders and the effectiveness of subsequent PSR; 2) development of cardinal algorithms for processing the initial expert information in order to obtain appropriate numerical criteria for the effectiveness of the PSR. Material and methods: a systematic analysis of domestic and foreign publications, based on the results of their own research on the problems of assessing patients’ conditions, as well as evaluating the effectiveness of a comprehensive long-term PSR program for people with schizophrenia and schizophrenic spectrum disorders in various forms of care (public organization, day hospital, hospital). As methods of information processing, clinical-psychopathological, psychometric, as well as methods of system analysis and the analytic hierarchy process (AHP) were used. Results: an innovative methodology and algorithms for processing expert clinical, psychopathological and psychometric information based on the AHP apparatus have been developed to develop criteria for the effectiveness of PSR. The cardinal difference between the proposed approach and the rank methods of processing initial information is that the results of processing initial expert information are obtained in the fundamental scale of AHP (numerical scale), which ensures the correct integration of psychometric and psychosocial characteristics of patients when considering diagnostic procedures, psychosocial therapy and rehabilitation. Conclusions: the calculations are based on expert assessments of the weight of areas of impaired functioning of patients and the corresponding changes in psychosocial characteristics. This ensures the universality of the methodology and algorithms for evaluating the effectiveness of any rehabilitation interventions: from psychosocial to physiotherapy.

Background: according to WHO, mental disorders that occur in childhood account for the largest share of child disability among all diseases. Special attention is paid to the problem of autism spectrum disorders, the growth of which in the world over the past 10 years has amounted to 1300%, and the disability rate has increased by 107.1% in 5 years. The purpose of the study: identication of risk factors for the formation of early disability in children with autism spectrum disorders. Patients and methods: the study made up 518 children diagnosed with autism spectrum disorder, divided into 2 groups: disabled children and non-disabled children. Clinical-psychopathological, clinical-catamnestic, psychometric, and statistical methods were used in the work. Results: the inuence of a signicant number of disabling risk factors in children with ASD was revealed, while the strength of their impact varied in a very wide range. For practical application, 3 main groups of disability risk factors are identied (organizational, reproductive health of parents, factors of pregnancy and childbirth) and the strength of their total inuence on the formation of disability is established statistically. Discussion: the obtained data showed that the power of the total inuence of “organizational” factors on the formation of disability in autism spectrum disorders is 2 times greater than the power of factors “reproductive health of parents” and more than 5 times the power of the impact of pregnancy and childbirth, which corresponded to a high statistical signicance (p < 0.001). Hereditary factors did not have a signicant impact on the formation of disabling mental disorders. Conclusion: the system of prevention, early diagnostics and comprehensive rehabilitation based on interdisciplinary interaction contributes to improve adaptation and quality of life of children with autism spectrum disorders and their families.

Background: sleep disorder is one of the important factors that may lead to an increase in the risk of relapse for people in the early phases of recovery from alcohol addiction. Despite the relevance of this problem, little is known about the sleep features in people with co-occurring alcohol and nicotine use. The aim of study was to investigate the inuence of the smoking factor on the dynamics of sleep characteristics in patients with alcohol dependence. Patients and methods: the 24-week prospective cohort study in 67 smokers (mean age 41 ± 9.2; 23.9% women) and 33 non-smokers (mean age 44 ± 8.2; 21.2% women) admitted to the addiction clinics to receive alcohol withdrawal treatment (ICD-10 code F10.2, dependence syndrome; F10.30, withdrawal syndrome). Sleep characteristics were assessed by self-report (Insomnia Severity Index, Pittsburgh Questionnaire) and by actigraphy watch. Results: a group of smokers experienced greater difculty in sleep initiation compared to non-smokers (61.2% vs 39.4%) (p ≤ 0.05). 

The duration and the quality of sleep increased over time of observation in both study groups (p < 0.001). Throughout the study sleep quality was poorer in smokers compared to non-smokers (17.3 vs 15.9 scores on the Insomnia Severity Index at the rst measurement and 2.6 vs 0.5 scores at the last assessment) (p < 0.001). The multivariate regression analysis revealed that the smoking was signicantly associated with poor sleep quality (F = 5.348, p = 0.021). Conclusion: smoking can predict poorer sleep quality during early remission in patients with alcohol dependence.

Background: quality of life (QOL) considered an integral characteristic of patient’s physical, psychological, emotional and social functioning. An improvement of QOL is one of the tasks of therapeutical intervention in patients with Multiple Sclerosis (MS). The aim was to study QoL of patients with MS and depression, using different instruments of QoL assessment. Patients and Methods: the study made up 203 MS-patients (56 males and 147 females) aged from 15–60 years (mean age 39.7 ± 10.91). The diagnosis of MS established on criteria of W. McDonald (2010, 2017). There were 113 patients with MS and depression. One group of comparison included 90 MS-patients without depression. The other compared group consisted from 70 depressive patients without neurological disease. The mean age of 52 healthy persons was 29.25 ± 5.12. QOL was assessed using The Short Form-36 (SF-36) and Multiple Sclerosis Quality of Life-54 (MSQOL-54). The study presents comparative assessments of the conducted SF-36 and MSQoL-54 questionnaires, which show that their use helps to assess the quality of life of patients with health disorders in MS patients with depression. Each of methods supplements information about the condition of patients, depending on the purpose and nosology. Conclusion: both questionnaires could be used for dynamic monitoring of changes in the quality of life in patients with MS with depression, as well as to determine the impact of the disease on a person and to seek for adequate ways of social and psychiatric care and rehabilitation of patients. 

Background: Mental disorders associated with the female reproductive cycle (premenstrual period, pregnancy, lactation, infertility, perimenopause) have been a clinical reality throughout the history of the study of psychosomatic health factors in women. The most recent ICD-11 classication distinguishes an independent categories, “Mental or behavioral disorders associated with pregnancy, childbirth and the puerperium, with/without psychotic symptoms”. The clinical and etiological variety of mental disorders associated with female reproductive cycle (MDFRC) requires an integrated approach to diagnostics and choice of treatment methods. Objective: to analyze the results of the main scientic studies concerning pathogenetic and clinical characteristics of MDFRC. Material and methods: the key words “mental disorders, premenstrual syndrome, pregnancy, infertility, lactation, perimenopause, involution” were used to search the databases of articles of domestic and foreign authors (PubMed, eLibrary, Scopus and ResearchGate) published over the past 25 years. Conclusion: The presented review analyzed the results of studies showing that a variety of psychoemotional stresses and endocrinological abnormalities at different stages of the female generative cycle are risk factors for the development of psychiatric disorders. MDFRC include heterogeneous and polymorphous anxiety, affective, dysmorphic, and psychotic symptom complexes. However, the lack of a clear understanding of their pathogenesis leads to persistent disagreement as to whether MDFRC (postpartum psychosis, involutionary melancholia/hysteria, etc.) are independent psychiatric disorders or provoked exacerbations of other psychiatric diseases in predisposed women. The presented review allows to improve understanding of MDFRC, their risk factors and clinical variants, which has important practical value in diagnostics and choice of treatment methods.

Background: the connection of catatonic disorders with affective pathology is noted in publications related to the prenosological stage of research in psychiatry. Numerous publications of the last and the current centuries are devoted to clinical studies of the relationship between affective and catatonic symptoms. At the present stage of scientic development, catatonia is considered as a transnological formation, manifesting in the framework of various nosological units, including affective diseases. Aim: analysis of the affective catatonia construct’s development in the period of the XIX–XXI centuries and development of affective-catatonic states, forming in the clinical space of schizophrenia and schizophrenic spectrum disorder, conceptual model. Conclusion: affective-catatonic disorders represent a continuum of psychopathologically differentiated phase-owing state. At one of the continuum pole there are catatonic disorders manifesting in the structure of affective pathology, which is realized at the level of recurrent depressions; at the other pole — affective-catatonic states of more severe psychopathological register, acting in the clinical space of bipolar affective disorder and schizoaffective psychoses. The role of movement disorders in affective-catatonic attacks and phases, as well as the modus of interaction of catatonic disorders with affective ones, also varies widely. In some cases, motor symptoms replace the affective symptoms, on the basis of which they were formed, and completely determine the clinical picture of the state; in others — they only modify the manifestations of affective disorders without altering their syndromic structure.

Background: lithium carbonate salts are used in psychiatry for agitated states reduction and, above all, to prevent recurring manic and depressive episodes, as well as for the treatment of aggressive behavior. The pharmacological characteristics of lithium carbonate have not been fully studied. Recently, there has been an increasing interest in the wider use of Lithium carbonate, in particular, in the treatment of neurodegenerative diseases, and even in viral infections. Objective: to present an overview of the earliest and late foreign studies covering the biomedical and potential therapeutic aspects of lithium off-label use as follows for Alzheimer’s disease and viral infections. Material and methods: the keywords “lithium carbonate, neuroprotection, toxicity, Alzheimer’s disease, coronavirus infection” were used to search for scientic publications in the databases MEDLINE, PubMed, Scopus for the period 1970–2021. Conclusions: lithium carbonate can have signicant effects on pathogenesis of Alzheimer’s disease, which may be a good prospect in the treatment of this currently incurable disorder. It is also important to note the antiviral properties of lithium carbonate. Lithium carbonate is able to mitigate the immune-inammatory activation observed during episodes of bipolar disorder, including the normalization of cytokine levels. It is also important to note the antiviral capabilities of lithium carbonate. The most interesting is the direct impact of lithium carbonate on some members of the coronavirus family, which is especially important in connection with the real problems a global public health crisis associated with the SARS-CoV-2 virus.

The aim was to establish the rst authors of the notion and the conception of depersonalization in psychiatry, to analyze the criteria (signs) of normal and disordered consciousness in its “primary” concept. Method: the analysis of scientic works of G.E. Berrios, M. Sierra, A.A. Megrabjan, W. Maier-Gross, K. Haug, K. Oesterreich, P. Schilder, K. Jaspers, H. Dagonet, Th. Ribot, P. Janet, J. Reil and some other authors. Conclusion: although G.E. Berrios mentioned only two priority “schools” of the ΧΙΧ century developing phenomenology of consciousness and self-consciousness: French and English, we discovered that already in 1803 German physiologist, anatomist and psychiatrist J. Reil presented the original concept of self-consciousness (Selbstbewusstsein) and its deviations that in his psychopathological subtlety of elaboration did not yield to the originated much later concepts of H. Dagonet (1884, 1894) and K. Jaspers (1913). J. Reil highlighted the following properties of self-consciousness: 1) “belonging to oneself”; 2) connection of impressions in unity; 3) demarcation of “I and not I”. According to J. Reil, the nervous system compounds all parts of our body in unity in one main focal point: the brain, similarly the soul strives to processing of various impressions in unity. The state of consciousness is changeable, J. Reil marked its changeability according to ve signs: the loss of ability with necessary clarity for differentiation of subject and object; the predominance of the object with plunge into semi- darkness of the subject; the excessive lighting of the subject with corresponding shading of the external world; I-orientation in time and space; “consciousness of the past”, or continuity of “I”. Concerning the disorders of the state of self-consciousness J. Reil slightly modied these signs in: 1) the disorders of self-consciousness of “objectivity”; 2) the disorders of “subjectivity and own personality”, as a special kind of disorders of subjectivity J. Reil decribed the phenomena that later were designated by the term “depersonalization”; 3) the disorders of the soul and body unity; 4) disorders of continuity of self-consciousness (corresponding to the criterion of “I-identity” of K. Jaspers); 5) wrong reection of place and time.