Background: insufficient study of heterogeneous delusional disorders in schizophrenia and the role of inflammation in the development of the disease served as the basis for this study. The aim: to establish the role of immune mechanisms in the processes of the interaction of different forms of delusional symptom complexes in schizophrenia. Patients: 60 patients (mean age 38.4 ± 1.11 years) with the diagnosis “paranoid schizophrenia, continuous progressive course” (F20.00, ICD-10) were included in the study. The state of patients was defined by persistent delusional/hallucinatory delusional disorders. Based on the clinical assessment, patients were divided into three groups: 27 patients (group 1) with interpretative delusion, 22 patients (group 2) with delusion of influence based on the phenomena of mental automatism, and 11 examinees (group 3) with mixed forms of delusions (interpretative and delusions of influence with mental automatism). The control group consisted of 17 mentally and somatically healthy people, comparable with the patients by sex and age. Methods: inflammatory and autoimmune markers leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) activity, leukocyte inhibitor index (LII) and antibody (aAb) level to S100B and MBP were determined in the blood. Results: in all groups of patients, an increase in the activity of LE and α1-PI was revealed compared with the control (p < 0.05). In group 2, an increase in aAb level to S100B was also detected (p < 0.05). Intra-group differences in LE activity served as the basis for dividing patients into three clusters. Cluster 1 was characterized by moderate activation of the immune system and was represented mainly by patients with interpretative delusions (54.5% of patients in the corresponding clinical group). Clusters 2 and 3 were distinguished by a higher level of immune system activation. A distinctive feature of cluster 3 was low LE activity against the background of high α1-PI activity and elevated level of aAb to S100B. Clusters 2 and 3 were represented mainly by patients with delusion of influence (74.1%). Сonclusion: the study confirmed the involvement of inflammation in the pathophysiology of delusional disorders in paranoid schizophrenia and allowed us to identify the relationship between the psychopathological structure of these disorders and the features of the spectrum of immune markers. The highest level of activation of the immune system, as well as immunological features presumably indicating impaired permeability of the blood-brain barrier, were associated mainly with delusions of influence with the phenomena of mental automatism.

The aim: to analyze the current trends in the rational organization of the space of psychiatric medical institutions for the possibility of using these developments in improving the treatment and rehabilitation potential of Russian hospitals. Materials and methods: search for relevant scientific articles on the following keywords in the MEDLINE and PubMed databases. Conclusions: the article reflects modern views on the organization of psychiatric institutions based on the principles of creating a favorable environment. The main attention is paid to the role of architectural and design components of the hospital territory, which have a huge impact on the treatment and rehabilitation of psychiatric patients. The basic rules of the rational organization of the space of the psychiatric department with an emphasis on reducing discomfort from staying in the walls of the hospital are given, examples of successful planning of both individual wards and departments as a whole are given. Special attention is paid to the arrangement of hospital areas, the CHIMES concept is presented in detail, which contains the main principles of creating patient-safe spaces filled with opportunities for various kinds of activities. The creation of a favorable architectural and landscape design of a medical institution contributes to a significant improvement in the prognosis for patients with mental disorders.

The aim of the study was to assess the impact of the coronavirus infection on clinical, neurophysiological and neuroimmunological parameters, as well as on their interrelations in young female depressive patients. Patients: a comparative analysis of quantitative clinical (according to the HDRS-17 scale), neurophysiological (EEG) and neuroimmunological (according to the “Neuro-immuno-test” technology) parameters was carried out in two groups of female depressive patients aged 16–25 years. The first group included 46 patients who recovered from a mild or asymptomatic coronavirus infection (“COVID” group). The second group included 40 patients who were studied and treated before the start of the pandemic (i.e., those who did not have COVID — the “pre-COVID” group) and corresponding to patients of the first group by gender, age, diagnoses, and syndrome structure of disorders. In all patients, prior to the start of the course of therapy, a multichannel EEG was recorded with the measurement of absolute spectral power and neuroimmunological parameters in blood plasma were determined. Methods: clinicalpsychopathological, psychometric, neurophysiological, neuroimmunological, statistical. Results: significantly greater scores of somatic disorders cluster of HDRS-17 scale, and increased amount of slow-wave EEG activity (of delta, theta1 and theta2 subbands) were revealed in the “COVID” group in comparison to patients of “pre-COVID” group. Mean values of neuroimmunological parameters were not differed statistically between two groups, but the values of neuroplasticity markers (levels of autoantibodies to the S100b protein and to the basic myelin protein) in the “pre-COVID” group correlated positively with the spectral power values of the main EEG rhythm (alpha2 and alpha3 sub-bands), and in “COVID” group — with the values of the spectral power of slow-wave EEG activity, reflecting a reduced brain functional state. Conclusion: the results obtained indicate that coronavirus infection, even in mild or asymptomatic forms, affects the clinical, neurophysiological and neuroimmunological parameters, as well as their interrelations in young female depressive patients.

Background: inconsistency of the obtained results of research on the pathology of microstructural connectivity in schizophrenia on the basis of tractography, absence of clinical application of special MRI techniques justify the need to continue scientific search in this direction. Objective: to identify the features of microstructural pathology of the brain in paranoid schizophrenia. Patients and methods: 25 patients diagnosed with paranoid schizophrenia (F20.0) were included in the main group, 30 healthy subjects without neurological and somatic diseases made up the control group. Instrumental studies were carried out on a Philips Ingenia magnetic resonance tomograph (magnetic field strength 1.5 T) using a DTI pulse sequence. Subsequent processing was carried out using “DSI Studio” (software for the analysis of tractor data). Results and discussion: the resulting microstructural brain changes demonstrated differences in the microstructural connectivity of the brain in patients with paranoid schizophrenia compared to the control group. Significant connections were revealed (at the given parameters for constructing connectivity matrices) between the hippocampus and the cingulate gyrus, the hippocampus and thalamus, thalamus and structures of the striopallidar system, and the absence of significant connections between the amygdala in the main group compared to the control group. The results of graph theoretical analysis of neural network indicators of the brain demonstrated higher values of indicators of “clustering” and the “small world” coefficient, characteristic path length, transitivity, density, and lower values of the global efficiency indicator of the main group compared to the control group. Conclusion: the obtained results demonstrate microstructural semiotics of neural network changes of brain in paranoid schizophrenia. Changes in the connectivity of the hippocampus, thalamus, and amygdala appear to be important tractographic semiotic features of the microstructural pathology of the brain in paranoid schizophrenia. The study is one of the stages of the search for a method of objectification and detection of disruption of brain neuroplasticity processes in the endogenous pathology of the schizophrenic spectrum. 

Background: imagination, fantasies, dreams and hallucinations are relatively independent mental processes associated with the operation of images reflecting realistic or non-existent objects and situations. Researchers note the diagnostic potential of the features of experiencing these processes in patients with mental disorders, especially at the early stages. The aim of the study is to examine cognitive representations of the processes of imagination, fantasy, dreams and hallucinations, and the subjective experience of their perception in patients with psychotic and non-psychotic mental disorders. Patients and methods: the study involved respondents aged 16 to 29 years: patients with psychotic disorders (n = 54), non-psychotic mental disorders (n = 50) and conditionally healthy individuals (n = 63). A structured clinical interview and a drawing technique (an example of an image of imagination, fantasy, dreams and hallucinations) were used. Results: it was revealed that 90% of healthy respondents were able to distinguish between the studied mental processes, compared with 77% of patients with non-psychotic and 35% of patients with psychotic disorders. In addition, the respondents’ concepts corresponded to highlighted scientific criteria in 85% of healthy individuals, 34% of patients with non-psychotic and 11% with psychotic disorders. Patients with psychotic disorders, in comparison with other groups, were significantly less able to control their imagination (p = 0.001) and fantasies (p = 0.001) and more often reported negative emotional experiences of imagination (p = 0.001). Patients of both clinical groups were significantly more likely than healthy respondents to report having a negative dream experience (p < 0.005). They used significantly fewer colors when depicting images of imagination and fantasy, compared with the control group (p = 0.001). Conclusions: mentally healthy people distinguish between images of imagination, fantasy, dreams and hallucinations; in patients with non-psychotic mental disorders, the boundaries between these processes are less rigid, and in patients with psychotic disorders they are practically blurred. Patients with non-psychotic disorders associate predominantly positive emotions with imagination, whereas patients with psychotic disorders — predominantly negative emotions. There are no statistically significant differences in emotional response to fantasies, dreams and hallucinations between these groups.

Background: assistance to children with emotional and volitional disorders requires effective methods of psychological assessment. However, using standard diagnostic methods in this regard is often considered problematic. Successful application of a standard Leiter-3 test in the described sample provides a valuable insight into the prospects for standardized diagnostics in this area. Aim: to evaluate the possibilities of using the Leiter-3 battery for examining a group of children with severe emotional and volitional disorders. Patients and methods: the study involved preschoolers and adolescents with emotional and volitional disorders (41 people in total) attending group remedial classes at the Center of Curative Pedagogics (Moscow). A pilot study of non-verbal intelligence was carried out using the Leiter-3 test. Results: we have identified a number of problems that make it difficult to use the technique in this group. They are associated with certain traits of the children involved — difficulties in contact, interaction, communication (both verbal and non-verbal), acceptance of the examination situation, focusing on the task, etc. Many of these problems could be solved by slightly modifying the methodology and maintaining certain conditions during testing. Conclusions: the Leiter-3 method can be successfully used to assess the level of intellectual development of children with severe emotional and volitional disorders. However, in some cases it is advisable to apply an individual approach and modify the examination procedure taking into account the characteristics of the child. Further research is needed to verify results obtained that way.

The aim of the review was to analyze published studies on the impact of the COVID-19 pandemic on the health status (mental and physical) of people with mental disorders. Materials and methods: by keywords “COVID-19”, “depressive disorders”, “affective disorders”, “schizophrenia”, “anxiety disorders” search for papers in English and Russian in the databases MEDLINE/ PubMed, Scopus, Web of Science, eLibrary for the period from 2017 to 2022 was carried out. Conclusion: the analysis of published works has demonstrated that factors such as social distancing, isolation, or changing the availability of medical services can have a significant influence on the health of people with mental disorders. It has been established that people suffering from mental illness are at a higher risk of contracting COVID-19, they have less effective post-vaccination immunity and have a more severe course of the disease. The past coronavirus infection can lead to both an increase in pre-existing symptoms of a mental disorder, and the emergence of new ones. Possible physiological mechanisms of mental disorders after past COVID-19 include a wide range of pathogenetic processes: from prolonged systemic inflammation of varying intensity to vascular microthrombosis and neurodegenerative changes. Cognitive impairment during COVID-19, associated with damage to brain structures by the virus, may exacerbate existing psychopathological symptoms. The special features of psychopathological symptoms that develop in response to a pandemic situation are closely related to the structure of the previous mental status of patients, and therefore the types of psychosocial assistance needed is different for people with various mental disorders.

Background: today, the problem of aggressiveness of teenagers and young people is becoming more and more urgent. The evidence confirms that violence in young people is becoming widespread, with negative social and economic consequences. It is known that aggression and aggressive behavior in young people is formed by the complex ontogenetic interaction of a variety of environmental factors, discovering a close relationship with suicide and suicidal tendencies. The development of effective measures to prevent severe forms of aggressive behavior has become a priority for the scientific community. Objective: to analyze the research studies of the phenomenon of aggression in adolescents and young people, to assess the impact of social, psychological and clinical factors on the level of aggressiveness in this age group. Materials and methods: according to the key words “teenage aggression”, “aggression factors”, “aggression psychology”, “aggression and suicide” conducted a search of publications in Medline/PubMed, Scopus, Web of Science, RISC and other sources for the last 20 years. Conclusion: increasing the level of aggression among adolescents and young people is a cross-cutting issue. Individual psychological characteristics, as well as some mental disorders, serve as background for the development of aggressive tendencies. A set of negative socio-economic factors contributes to the direct realization of the aggressiveness of the individual. The importance of environmental influence in the genesis of aggressive behavior indicates the need for integrative interaction of researchers with public organizations and law enforcement agencies in order to reduce the incidence of aggression among adolescents and young people.