Background: Aripiprazole, among other atypical antipsychotics, is recommended as a drug for maintenance therapy in schizophrenia in cases in which the patient is identified as having depressive symptoms. At the same time, depression in schizophrenia is not listed as a separate indication for Aripiprazole, its antidepressant properties are considered only in the recommendations for the treatment of bipolar depression and augmentation of antidepressant therapy in recurrent depressive disorder. There are no works characterizing the efficacy of the drug in depression in patients with schizophrenia, as well as evaluating the spectrum of its antidepressant action in such conditions.

Objective of the study: to examine the therapeutic efficacy and safety of Aripiprazole (Zylaxera®) in the augmentation therapy of moderate to severe depressive states in patients with schizophrenia.

Patients and methods: the efficacy and safety of Aripiprazole (Zylaxera®) augmentation therapy with 5–20 mg daily dose for 6 weeks was studied in 72 patients aged 18 to 47 years (all women) with depressive states of at least 17 Hamilton Scale scores in remitted schizophrenia, postchizophrenic depression and schizotypal disorder (F20.01 + F32.1–2; F20.04; F21.3–4 + F32.1–2). The HDRS-21, CGI, and UKU scales were used for psychometric assessment.

Results: the effectiveness of augmentation of antidepressant therapy with Zylaxera® was revealed in the majority of patients: the rate of responders as evaluated by the HDRS-21 scale (reduction of severity of depressive disorders by 50% or more) was 67.2% and 71.4% for the CGI scale. At the same time, it was established that the group of responders had a certain similarity in terms of psychopathological structure of depressive states.

Conclusion: it has been established, that in patients suffering from schizophrenia Zylaxera® has a distinct efficacy in augmentation of antidepressant therapy and has a favorable tolerability profile. The maximum efficacy of the drug within the framework of such use is observed in depressive states with predominance of negative affectivity.

Background: neuroleptic malignant syndrome (NMS) is the most dangerous complication of therapy with neuroleptics with high mortality. The publications on MNS are the reviews articles or case reports.

The aim of study: an identification of the frequency of occurrence of NMS harm in patients of the city psychiatric hospital over a 4-year period, a clarification of the clinical manifestations of this complication, an analysis of the effectiveness of the treatment and rate of deaths.

Patients and methods: 19 cases with a confirmed diagnosis of NMS who were treated for 4 years in one of the clinical psychiatric hospitals in Moscow with 1158 beds. All patients met the criteria for the diagnosis of NMS according to DSM-5 (333.92). The severity of extrapyramidal disorders was assessed on the Simpson–Angus Rating Scale (SAS). The Bush–Francis Catatonia Rating Scale (BFCRS) was used to assess the features and severity of catatonic symptoms. All patients underwent a study of the general clinical analysis and biochemical analysis of blood with the determination of the number of leukocytes and the activity of the enzyme creatine phosphokinase (CPK).

Results: the incidence of NMS was 0.035% of all treated patients, mortality— 10.5%. Most often, NMS develops during treatment with haloperidol and much less frequently with the appointment of atypical antipsychotics risperidone and clozapine in patients with schizophrenia, acute polymorphic mental disorder, organic mental disorders, including dementia. The influence of such factors as gender, age, type of disease on the development of NMS has not been established. The age of patients with a fatal outcome was higher than the average for the group. The clinical picture of NMS was characterized by a combination of catatonic, extrapyramidal and somato-vegetative disorders with hyperthermia, leukocytosis and increased activity of CPK.

Conclusion: today NMS remains a relatively rare, but extremely dangerous complication of antipsychotic therapy, with a high risk of death and can develop both in the treatment with first and second generation antipsychotics in patients with schizophrenia and acute polymorphic mental disorder and in organic mental disorders, including dementia.

Background: given the similarity of clinical manifestations of depressive disorder and depressive episodes within the framework of bipolar affective disorder, diagnostic errors are inevitable. Both overdiagnosis and underdiagnosis of bipolar affective disorder are too common, and it may take several years to establish a correct diagnosis. Despite the fact that it is impossible to completely eliminate diagnostic errors, it is important to reduce their likelihood by better understanding diagnostic criteria.

The aim of this study was to study the indicators of frontal EEG asymmetry in patients with unipolar and bipolar depression, as well as to identify possible correlations with the severity of clinical symptoms. Patients and methods: we examined 30 patients with affective disorder in the framework of a single depressive episode or recurrent depressive disorder and 30 patients with bipolar affective disorder, the current episode of mild or moderate depression. The bioelectric activity of the brain was recorded and analyzed with the calculation of the spectral power of beta and alpha rhythm in the frontal cortex and the beta/alpha ratio was calculated.

Results: it was found that patients with bipolar affective disorder had left-sided frontal asymmetry, the beta/alpha ratio was lower on the right than on the left (0.57 [0.41; 0.87] vs. 0.67 [0.43; 1.08], p = 0.007), while patients with unipolar depression had a bilateral pattern of frontal beta/alpha ratio (0.67 [0.45; 1.01] vs. 0.69 [0.45; 0.98], p = 0.441). Statistically significant negative associations were also found between the beta/alpha ratio in the right leads in patients with bipolar affective disorder and the duration of the disease (rs=–0.419, p=0.033).

Conclusion: the study clearly showed that quantitative EEG indicators can be used as an additional tool for differentiating bipolar and unipolar depression.

Background: increasing interest in visual disturbances in schizophrenia is connected with the fact that they are a potential biomarker for objectification of a mental condition. The nature of the relationship between visual disturbances and higher-level cognitive functions in schizophrenia remains understudied.

The aim of the study was to investigate differences in visual information processing between individuals with paranoid schizophrenia and healthy individuals, and to analyze the relationship between visual system characteristics with clinical and cognitive factors.

Patients and methods: thirty-three patients with the paranoid form of schizophrenia and 19 healthy subjects were included in the cross-sectional study. Cognitive impairment was assessed using a battery of BACS tests, and the severity of the mental state was assessed using the PANSS scale. Contrast sensitivity characteristics were measured by computer visocontrastometry.

Results: the study found that the visual system of persons with schizophrenia is characterized by hypersensitivity in the high and midrange, but decreased sensitivity in the low-frequency range. Decreased sensitivity in the low-frequency range was associated with better cognitive functioning and less pronounced productive symptoms. Medium frequencies at the trend level correlated with the digit sequencing tests, assessing working memory, and verbal fluency, reflecting speed of information processing.

Conclusions: our findings expand information on the character of the relationship between contrast sensitivity and cognitive function. The results of study will provide the basis for further research on the development of more effective non-medicinal methods to improve cognitive functioning.

Background: anhedonia is a transdiagnostic psychopathological phenomenon, which is assessed as “core” for several diseases at once — first of all schizophrenic and affective spectrum disorders. The problem of clinical features differentiation and identification of anhedonia’s neurobiological mechanisms in the structure of the affective and schizophrenic spectrum disorders is still topical and far from being resolved.

The aim of the study: to compare the relationship between the features of neurocognitive functioning and the manifestations of anhedonia among patients with disorders of the schizophrenic and affective spectra.

Patients: the sample consisted of 40 patients including 17 patients with schizophrenic spectrum disorders (ICD-10 diagnosis codes F20.01, F20.02, F21.3, F21.4, F25.0, F25.1) and 23 patients with affective disorders (ICD-10 diagnosis code F33, F31).

Methods: clinical, psychometric, experimental psychological and statistical.

Results: patients with schizophrenia spectrum disorders show lower scores on pleasure anticipation ability and ability to experience pleasure in the social sphere. The affective spectrum group showed a correlation between anticipatory anhedonia and phonetic verbal fluency (r = –0.487; p < 0.01). There was also a correlation between immediate pleasure experience and errors in the Rey figure test (r = –0.349; p < 0.05). Social anhedonia in these patients was associated with phonetic verbal fluency productivity (r = –0.509; p < 0.01) and performance in visual fluency productivity (r = –0.473; p < 0.01). Patients with schizophrenia spectrum disorders had a correlation between anticipatory anhedonia and the Color-Word Interference Test (r = –0.329; p < 0.05) and the Rey Complex Figure Test (r = –0.307; p < 0.05). Consummatory anhedonia was correlated with verbal fluency test (r = –0.511; p < 0.01) and the Rey Complex Figure Test (r = –0.417; p < 0.01). Social anhedonia was correlated with Color-Word Interference Test (r = –0.656; p < 0.01), verbal fluency (r = –0.523; p < 0.01), and story description (r = –0.421; p < 0.01).

Conclusion: manifestations of different parameters of anhedonia demonstrate the differences in schizophrenia and affective spectrum disorders. Patients with schizophrenia spectrum disorders have greater difficulties in anticipating pleasure and experiencing pleasure in the social sphere. The ability to anticipate pleasure may be associated with executive function, while the ability to experience pleasure immediately may be associated with memory function. Social anhedonia affects a wide range of cognitive functions.

Background: аt the present stage of psychiatry, within the framework of the dimensional paradigm, catatonia is considered as a transnosological entity that manifests within the clinical space of various affective and schizoaffective disorders. In the 21st century studies, devoted to the analysis of motor disorders that appear in the clinical space of postpartum affective and schizoaffective disorders, become increasingly relevant (J.Y. Lai, T.L. Huang, 2004; A. Nahar and et al., 2017; C. Kamau, 2017; L. Csihi and et al., 2022). However, research on this issue is very limited. The objective: the analysis of catatonic phenomenon, manifesting in the postpartum period, based on the observations of three clinical cases.

Patients and methods: 3 clinical cases of patients, undergoing treatment in the clinical department of the FSBSI “Mental Health Research Centre” with established diagnoses of bipolar affective disorder (ICD-10: F31.1; 1 case) and schizoaffective disorder (ICD-10: F25.2; 2 cases) with a predominance of motor disorders in the clinical picture of the disease. The main method was clinical with the use of psychological examination and data from instrumental (EEG) diagnostics.

Results: movement disorders registered in the structure of apathoanesthetic depressions within the exacerbation of bipolar affective disorder are represented by the phenomena of hypokinetic catatonia and act as an amplifier of affective disorders. Catatonic symptoms within the clinical space of schizoaffective disorders, are limited by manifestations of parakinetic catatonia, do not have a direct correlation with the structure and severity of affective disorders, and indicate an increase in the progredient endogenous process.

Conclusion: the analysis of clinical observations testifies in favor of the heterogeneity of affective-catatonic states not only in terms of the structure of motor phenomena, but also in terms of the psychopathological profile of affective disorders.

Background: the problem of diseases of the thyroid gland (TG) remains relevant. The clinical picture and prevalence of diseases, as a rule, is analysed depending on the nosological form and severity of endocrinopathy. However, the estimated cases of morbidity syndrome on the basis of modern systemic diseases, the alleged reasonable appointment of endocrinopathies with places — the outcome of the syndromic/functional situation of thyroid disease, are divided into suspected either hypo- or hyperthyroidism.

Objective: analysis of publications on the birth of diseases in hypo- and hyperthyroidism with the earliest possible search depth (publications since 1835), aimed at identifying current problems and relevant characteristics.

Material and method: according to the key features “hypothyroidism”, “hyperthyroidism”, “mental disorders”, “depression”, “anxiety”, “psychosis”, literary sources in the MEDLINE/PubMed Scopus, Google Scientist databases were significant and studied.

Conclusion: as a result of the analysis of the literature, it was revealed that the number of studies of the prevalence of diseases among the population in thyroid diseases compared to other somatic diseases is small, and many questions about the relationship between mantal diseases and diseases of thyroid glands that are currently unresolved. The thyroid gland is limited to affective and anxiety symptoms/syndromes, and genetic belonging to certain categories (nosogenic, somatogenic, endoform) is not qualified. At the same time, a number of significant aspects of the problem are discussed: “common symptoms” of mental affiliation and thyroidopathy, duplicating/ imitating each other; psychopathological prodromes and “masks” of thyroid diseases; stress induction, such as in Graves’ disease; psychopathological disorders, such as non-psychotic and psychotic registries, with analysis of the characteristics of limb features for the use of the thyroid gland.

Background: the elaboration of problems of clinical psychiatry in Russia had already begun in the end of the XVIII — beginning of the XIX centuries by professors of internal medicine and of other branches of medical academic institutions, and from the thirties years of XIX century gradually moved to the hands of the doctors who were specialized in psychiatry (V.F. Sabler, A.I. Gerzog, I.F. Rjul, I.P. Malinovskiy and others).

The aim was to analyze the history of the formation of scientific concepts in Russian psychiatry in comparison with the relevant German and French psychiatric concepts at that time.

Method: narrative review.

Conclusion: the author of the first domestic textbook of psychiatry “Diseases of the soul” (1834) was Professor of department of surgery and mental diseases of Kharkov’s University P.A. Butkovskiy. Creating his textbook P.A. Butkovskiy grounded on the textbook of one of the founders of german “school of psychics” J.Ch. Heinroth (1818) and took as a basis of classification of mental diseases Heinroth’s systematics. The forms of mental diseases according to P.A. Butkovskiy and J.Ch. Heinroth were distinguished by two principal signs: predomination of affection of the one among three areas of psyche: imagination, intellect and volition, and due to the changes in its functions: amplification or weakening. Wherein P.A. Butkovskiy connected with the affection of the brain only the group of “paranoiс” diseases (general paranoia, ecnoia, paraphrosyne, moria) and acquired stupidity (anoia) that were explained by exaggeration or weakening of the brain functioning respectively. P.A. Butkovskiy also introduced in Russian psychiatry the notion of “dynamics” and “psychosomatic” that were borrowed from J.Ch. Heinroth, and the concept of “general feeling” (coenesthesis) of J. Reil. The forms of mental disorders distinguished by J.Ch. Heinroth represented the next progressive step in the differentiation of syndrome pictures of mental diseases (but not in psychiatric nosology as the author considered), and the fact that P.A. Butkovskiy, the author of the first Russian Textbook on Psychiatry, created the similar systematics on the same principles, contributed to the building of mutual understanding between national psychiatric schools that were in the process of being formed.

The article is devoted to the 125th anniversary of Zalkind Emil Moiseevich — doctor of medical sciences, professor of the Department of Psychiatry and head of the psychiatric clinic of the Perm Medical Institute. In 1922 he graduated from the Medical Faculty of Don University, and later entered as a resident of the neuropsychiatric clinic of the North Caucasian Medical Institute in Rostov-on-Don, where he served until 1932. He is the author of more than 100 scientific papers devoted to the problem of mental disorders in diseases of the brain. Initiator of the creation of the Ural Research Psychoneurological Institute. He was awarded the Order of the Badge of Honor. In addition to medicine, he was fond of music, graduated from the Saratov Philharmonic with a piano class from the composer Glier, having received a higher musical education. For his great achievements in the field of medicine, Zalkind was awarded the title of Honored Scientist of the Russian Soviet Federative Socialist Republic.