Background: the subjective experience of self-harm emerges as an important source of knowledge about the motives of this behavior and as the basis for understanding the dynamics of transitioning from non-suicidal self-injuries to suicide attempts.

The objective: to describe and systematize methods and subjective reasons for self-harm on the basis of qualitative data yielded by a survey in online communities.

Participants and method: the respondents were recruited from online communities focusing on psychological or non-psychological issues. The sample (n = 664, aged 17–35) included 563 (84.4%) women and 101 (15.2%) men. The study utilized a survey developed by the authors.

Results: methods of inicting deliberate self-harm were grouped into three clusters: 1) local self-harm (n = 385) included non-suicidal self-injuries; 2) global self-harm (n = 18) united self-destructive practices aimed at the body on the whole (poisoning, deprivation, drug and alcohol abuse, etc.); 3) local and global self-harm cluster (n = 109) included respondents with both types of self-harm. Local self-harm cluster included more young participants; participants with both local and global self-harm were older and reported mental health problems more often. The analysis of reasons for self-harm yielded 9 topics: 1) emotional experiences; 2) emotion regulation; 3) pain; 4) self-alienation; 5) negative self-image; 6) interpersonal rejection; 7) suicidal tendencies; 8) self-harm urges; 9) age. The topics were closely related; the central topics were the ones related to emotional experiences and their regulation through physical pain.

Conclusion: individual developmental pathways to self-harm can be associated with intolerance of intense mental pain, inability to endure one’s own negative emotions; negative self-image and high dissatisfaction with oneself; feeling alienated from the others, perceived disregard and rejection; and psychopathological symptoms.

Background: the COVID-19 pandemic and associated restrictions may be particularly harmful for adolescents; however, evidence about changes in adolescent mental health during the pandemic is inconsistent.

The aim was to examine changes in levels of Russian adolescent mental health and rates of substance use during the COVID-19 pandemic.

Participants and methods: two cohorts of 11–18-year-old adolescents were recruited from Siberian cities in 2015–18 (n = 1774, 47% male) and in 2020–21 (n = 1747, 43% male). Participants completed identical sets of questionnaires: the Strengths and Difficulties Questionnaire, Body Image and Eating Distress scale and items on tobacco, alcohol and drug use. We examined the effect of cohort, gender and age using linear models.

Results: in the 2020–21 cohort, depression, anxiety and psychosomatic symptoms, total mental health problems and levels of substance use were higher than in the 2015–18 cohort. Increases in emotional symptoms and total mental health problems were similar in both genders, whereas increases in rates of smoking and alcohol use were significant only among girls.

Conclusions: the present findings indicate that the COVID-19 pandemic experience was likely to be stressful for adolescents. Therefore, more research on risk and protective factors of Russian adolescent mental health is needed. The findings also suggest that preventative interventions should be based on gender-specific patterns of adolescent substance use.

Background: the need to develop methods for early diagnostics and preventive interventions in individuals at clinical high-risk state for schizophrenia requires studying the characteristics of the specific symptoms of pre-onset stages. One of such symptoms may be thought disorder, which still have an ambiguous position in the psychopathological structure of schizophrenia.

Aim: correlation analysis of thought disorders in patients with first depressive episode with attenuated symptoms of schizophrenia (ASS).

Patients and methods: the study included 30 young men (mean age 19.2 ± 2.1 years) hospitalized with the first depressive episode (F32.1, F32.2, F32.28, F32.8 on ICD-10), in the structure of which ASS were noted. The severity of thought disorders was assessed using the Thought, Language and Communication scale (TLC) before discharge. Subsequently was performed the search for correlations of scores on the TLC and other characteristics as duration of the current depressive episode, severity of depressive symptoms according to the Hamilton Depression Rating Scale (HDRS), the severity of ASS according to Scale of Prodromal Symptoms (SOPS) and Scale for Assessment of Negative Symptoms (SANS), drug therapy doses.

Results: the median value of the total score on the TLC was 20 [17.3;23.5]. The most important finding is the discovery of only weak correlations of thought disorders with depressive affect and ASS. Indeed, the total score on the TLC correlated only with the total score on the SOPS at admission (r = 0.370, p < 0.05), which refiects the relationship between the thought disorders and the activity of endogenous process in the early stages, and with the SANS subscale “Attention” at discharge (r = 0.388, p < 0.05), which also indirectly refiects the existing thought disorders. The greatest number of correlations was demonstrated by the TLC parameter “Illogicality”.

Conclusion: the data obtained indicates the independent nature of thought disorders in youth patients with first-onset of depression, which indicates the need to determine its independent prognostic value for schizophrenia manifestation.

The aim of study: the current study has been caried out in order to find the anxiety-affective symptomatology persistence duration (AASPD) under standard antidepressants therapy and its neurobiological and premorbid personality predictors in different diagnostic groups.

Patients and methods: 191 patients were included into study. Among them 57 patients with organic anxiety affective disorder (OAAD), 41 with endogenous depression (ED), 14 with anxiety neurotic disorder (AND) and 93 with schizophrenia. 

The Munich personality test and Toronto alexithymia scale were used for assessment of premorbid personality, while SCL-90 and MMSE — for the assessment of psychopathology structure. For the assessment of handedness Annett scale has been used. The product moment correlation analysis was performed for the assessment of relationships between premorbid personality, MMSE and Annett scale score and psychopathology persistence.

Results: the symptomatology persistence was maximal in OAAD (21.37 ± 8.33) and smallest in ED (16.27 ± 4.38). Neuroticism correlated positively with AASPD in ED (r = 0.481; р = 0.001). Duration of disorder correlated positively with AASPD (r = 0,286; p = 0.031), while MMSE correlated negatively (r = –0.267; p = 0.045) in OAAD. In AND the negative correlation between MMSE and AASPD (r = –0.585; p = 0.028) and between Annett score and AASPD (r = –0.617; p = 0.032). No stochastically significant correlations were revealed in schizophrenia.

Conclusion: the data obtained are important both for further study of the pathogenesis of these disorders and for the prediction and prevention of affective disorders in clinical practice.

Background: tobacco use is one of the leading risk factors for early death and disability worldwide. Comorbidity of anxiety disorders and nicotine dependence reduces the efficiency of the specialist complex therapy of tobacco dependence. Of significance is a problem of timely detection of such concurrent disorders.

Objective: to study nicotine addiction and severity of anxiety in students of the Tomsk State University (TSU) and Siberian State Medical University (SSMU) of Tomsk City.

Surveyed students and methods: the Fagerström Test for Nicotine Dependence (FTND) and the Hospital Anxiety and Depression Scale (HADS) were usedto recognize nicotine addiction in 323 students (78 males; 24.1% and 245 women; 75.9%).

Results: the findings on nicotine addiction in students were as follows: 59.0% never smoked, 12.4% smoked previously, 21.9% are currently cigarette smokers, 6.7% use tobacco heating systems (THS). The median total score according to the HADS anxiety subscale in current smokers made 7 (6; 9) points, in current THS smokers — 7 (5; 10), in previously smokers — 7 (5; 9), in never smoking —7 (4; 9). The median total score according to the HADS depression subscale in currently cigarette smokers made 6 (4; 8) points, currently THS smokers — 4.5 (2; 5), previously smokers — 4 (3; 7), in never smoking — 5 (3; 7). The study revealed formation of nicotine addiction in 26% of surveyed individuals; age of the regular smoking onset was 16.1 (14.2; 17.5) years, nicotine dependence formed at the age of 17.0 (16; 18) years (p = 0.001).

Conclusions: the availability of direct dependency between indicators of total score of anxiety according to the HADS and the FTND (rs = 0.51; p < 0.05) is an evidence of predictive value of anxiety for nicotine addiction and need of timely preventive intervention.

The aim of the study: evaluation of the impact of long-term effects of repeated courses of Actovegin therapy on indicators of minimal cognitive dysfunction (MCD) in relatives of patients with Alzheimer’s disease (AD).

Study participant: 76 people with signs of minimal cognitive dysfunction objectively confirmed by clinical and neuropsychological examination, who are relatives of the 1st degree of relatives of patients with AD.

Study design: a prospective comparative study of the effects of repeated courses (4 courses in total) of three-month oral therapy with Actovegin (at a daily dose of 600 mg divided into three doses of 200 mg) every 1.5 years in groups of relatives with ApoE4(+) and ApoE4(–) genotypes.

Methods: psychometric, neuropsychological, molecular genetic, statistical.

Results: in the study, the effectiveness of 4 repeated courses of Actovegin therapy in relatives with manifestations of MСD was established. According to the CGI-I subscale, no deterioration was found over a period of 4 years and 9 months. By the end of the study, in 86.9% of all cases, a pronounced and moderate improvement was achieved.

Conclusion: minimal cognitive dysfunction in first-degree relatives of AD patients, both in carriers of the ApoE4(–) genotype and especially in carriers of the ApoE4(+) genotype, is the basis for special attention to measures to prevent cognitive deficits.

Background: the issues of early diagnosis and therapy of cognitive disorders that do not reach the degree of dementia remain relevant.

The purpose of the research was to study the immediate and long-term effects of course cholinergic therapy (choline alfoscerate, CA) in patients with an amnestic mild cognitive impairment (aMCI).

Patients and methods: in the course of an open comparative prospective study, the dynamics of cognitive functioning indicators were analyzed in 150 patients with aMCI who received infusion or oral course therapy in comparison with the control group (without treatment). All patients were divided into 3 groups. The first group of patients received an infusion course of CA (Gliatilin), the second group received an oral course of the drug (Gliatilin), the third group (control) did not receive treatment. MRI, clinical-psychological, psychometric, statistical methods were used in the study.

Results: it has been shown that course therapy with CA has a positive effect on cognitive functioning in patients with aMCI in both therapeutic groups. The greatest effectiveness was observed in group 1 patients who underwent an infusion course of therapy for a month. In group 2 patients who took CA orally for 2 months, there was also an improvement in cognitive functions, however, in the control group there was a statistically significant decrease in cognitive functioning after 90 days of follow-up, in two cases (4%). This trend continued after a year of follow up. The indicators of improvement of cognitive status compared to the baseline level remained in 41% of cases in patients of group 1 and only in 28% and 2% in patients of group 2 and 3 respectively. Only in group 3 Alzheimer’s disease was diagnosed in 2 patients (4%) after a year of follow-up.

Conclusion: the long-term positive effect of CA on cognitive functioning allows us to consider the drug as a possible model of therapy aimed at preventing the progression of cognitive deficits and the development of dementia in people with aMCI.

Background: hypothalamo-pituitary-adrenal (HPA) axis plays an important role in the pathogenesis of depression. Patterns of HPA functioning depend on both biologic factors and psychological background, which, taken together, may increase the risk of depression later on. Objective: to analyze scientific publications on pathophysiology of depression, linked to HPA disruption, assess causal relationship between hypercorticism and depression, role of hypercorticism in clinical symptoms and course of depressive disorder.

Material and methods: according to the key words “hypercortiсism”, “depression disorder”, “cortisol”, “treatment resistant depression”, “Cushing’s syndrome”, “Сushing’s disease”, a search was conducted for publications in databases Medline/ PubMed, Scopus, Web of Science, RSCI and other resources.

Conclusion: there is a high comorbidity between depressive disorders and HPA axis abnormalities, including endocrine disorders with both increased and decreased cortisol secretion. Hypercorticism related to Сushing’s disease or Cushing’s syndrome is often associated with irreversible mental disorders, especially anxiety and depressive disorders, which persist after normalization of cortisol levels. Depressive patients are characterized by persistently elevated cortisol levels and their non-supression in the 1 mg dexamethasone suppression test (DST); however, sometimes they have reduced cortisol secretion. The possible pathophysiology mechanisms of hypercorticism are discussed. Beside hypercorticism, increased level of adrenocorticotropic hormone (ACTH) and decreased secretion of ACTH after CRH stimulation are demonstrated. It has been demonstrated that elevation of cortisol levels may precede the development of depression and as such can be used as marker of increased depression risk. Hypercorticism in patients with depression may promote its increased severity and transform ation of depressive symptoms. Persistent hypercorticism and non-supression of cortisol in DST are predictors of poor outcomes. HPA dysfunction seems to play an essential role in evolvement of treatment resistant depression. There is data on the efficacy of drugs modifying HPA activity for amelioration of affective disorders and psychotic symptoms in patients with depression. Further research into HPA functioning in patients with depression are needed to clarify pathogenetic mechanisms and development of newer treatment approaches to depression.