Background: as the most common form of dementia, Alzheimer’s disease (AD) is characterized by cognitive deterioration and usually begins with loss of memory of recent events. It is important to search for biological, sensitive and affordable methods that could be used for early diagnostics of AD and determine the severity of the disease.

Objective: to develop machine learning algorithms based on such inflammatory markers as the enzymatic activity of leukocyte elastase (LE) and the functional activity of the α1-proteinase inhibitor (α1-PI) for diagnosing and assessing the severity of AD.

Patients and methods: the study included128 people aged 55 to 94 years (73.7 ± 7.9 years), of which 91 patients were diagnosed with Alzheimer’s disease and 37 apparently healthy people (control). The indicators of LE and α1-PI in blood plasma were used as classifying features for building models. The following algorithms were used to build a machine learning model: Optimal Valid Partition (OVP), logistic regression (LR), support vector machine (SVM), random forest (RF), gradient boosting (GB) and statistically weighted syndromes (WSWS). The predictive performance of the constructed classiers was evaluated by the overall accuracy (accuracy), sensitivity (sensitivity), specificity (specificity), F-measure and ROC-analysis.

Results: the developed machine learning algorithms made it possible to reliably divide the general group of subjects (patients + conditionally healthy), as well as patients with different AD severity, into 4 quadrants of a two-dimensional diagram in the LE and α1-PI coordinates and showed close and fairly high predictive efficiency.

Conclusion: the developed machine learning algorithms have proven close and sufficiently high prognostic efficacy for assessing the severity of AD based on inflammatory markers (enzymatic activity of LE and functional activity of α1-PI) and, probably, can be useful for early diagnostics of the disease and timely administration of therapy.

Background: despite a significant progress of psychopharmacology, treatment-resistant schizophrenia (TRS) remains a challenge for clinicians. The etiology and pathogenesis of TRS probably differ from schizophrenia susceptible to therapy, which underlies the non-respondence to most antipsychotics.

Objective: to establish morphometric gray matter brain structural features in TRS as well as to analyze the association of these parameters with the clinical characteristics of patients.

Patients and methods: 21 right-handed male patients diagnosed with paranoid schizophrenia and meeting criteria for treatment resistance and 21 matched healthy controls underwent MRI and clinical examination. T1-weighted images were processed via FreeSurfer 7.1.1. For each subject average values for the cortex thickness and area, volumes of subcortical structures, brain stem structures, and separately volumes of the amygdala nuclei and hippocampal subregions were obtained. Intergroup comparisons and correlations with clinical scales (PANSS, CDSS) and antipsychotic dosage in chlorpromazine equivalent were calculated. Results: TRS patients showed decreased gray matter thickness in frontal, temporal, parietal, occipital, cingulate and insular regions, volumes of the amygdala, hippocampus and nucleus accumbens, as well as a number of amygdala nuclei and hippocampal subregions bilaterally. The volume of the right globus pallidus, on the contrary, was increased.

Conclusion: the widespread gray matter thinning in TRS confirmed the other researchs, which described resistance as a more severe form of schizophrenia that affects brain structures worse. The increase of globus pallidus volume is a surprising result, which is not yet clearly explained.

Background: comorbidity of somatic and mental pathology is the most common reason that complicates the provision of medical care to the elderly even under the conditions of a specialized somatopsychiatric department (SPD) of a multi-field hospital, which dictates the need for further study of the clinical and epidemiological features of these patients population.

The aim of the study was to investigate the clinical and epidemiological characteristics of a contingent of elderly patients treated over a year in SPD of a multi-field hospital in comparison with similar data from a psychiatric hospital. The objectives of the study were to analyze the demographic structure of this contingent, the distribution of various types (categories) of somatic and mental pathology, routes of admission, time and outcomes of treatment in SPD of a multidisciplinary hospital.

Materials and methods: the research material was the medical documentation of a sample of patients treated during 2019 in the SPD of the City Clinical Hospital № 1 named after. N.I. Pirogov of the Moscow Department of Health Protection (the total number of patients treated was 3379 people, of which 1456 were aged 65 and older). To conduct a comparative analysis, we used data from an epidemiological study in a psychiatric hospital (City Psychiatric Hospital № 13 of the Moscow Department of Health Protection), conducted in the same 2019 year.

Results: it was established that in the SPD of a multi-field hospital, care is provided to a heterogeneous (demographic and clinical-diagnostic) group of patients, predominantly of late age (65 years and older). The most common diagnosis is dementia of various origins, complicated by severe somatic pathology (acute or associated with decompensation of a chronic somatic disease).

Conclusion: elderly and senile patients make up more than half of the contingent of patients treated in the SPD of a multidisciplinary hospital. Significant differences were revealed in the SPD diagnostic distribution of young-middle-aged and elderly patients. Special features of the gender and age distribution of patients in the indicated age groups were established. Data were obtained on a higher mortality rate for those aged 65 years and older. The presence of problems in providing care to patients of older age groups in SPD determines the need for its improvement. For this purpose, it is advisable to consider the issue of creating a model of SPD of geriatric profile in a multi-field hospital to provide emergency psychiatric and somatic care to elderly patients.

Introduction: central pontine myelinolysis (CPM) is rare neurological condition. The severe symptoms of neurologic and psychiatric disorders accompanying this condition are not sufficiently disclosed in the literature. Most often CPM develops on infusion therapy and forced correction of hyponatremia. The complexity of diagnosis and the lack of certain algorithms for the management of this category of patients cause a high frequency of disability, persistent neurological and psychiatric symptoms, and lethal outcomes.

The aim was to present and analyze clinical picture of psychosis in CPM on the example of non-Hodgkin’s lymphoma case report. Patient and method: clinical analysis of disorders in 14-years old patient with diagnosis of non-Hodgkin’s lymphoma.

Results: clinical polymorphism of psychotic features, catatonic disorders, neurological symptoms at the end stage and development of psychosis associated with CPM during cytotoxic treatment. A year and a half follow-up of the first generation antipsychotics administration is presented.

Conclusion: CPM may occur on cytotoxic infusion therapy in patients with non-Hodgkin’s lymphoma and be accompanied by severe psychotic disorders. Thus, practitioners should be aware of the risks of this condition, its diagnostic and therapeutic options when working with these patients.

Background: effective and safe provision of medical care depends on the well-being of medical workers – problems related to health and quality of life do not allow the clinician to realize his potential fully. A high level of work stress undermines the well-being of medical personnel. One of its most characteristic manifestations is burnout.

The aim was to study the relationship between burnout and quality of life with the construction of a mathematical model for prediction of the quality of life based on information about the degree of psychiatrists’ burnout.

The main hypothesis of this study was that burnout significantly and negatively affects the quality of life.

Participants and methods: 82 psychiatrists, working in Moscow psychiatric clinics, independently filled out the Maslach Burnout Inventory and an abbreviated version of the WHO questionnaire «Quality of Life» (WHOQOL-BREF). The multiple linear regression was used to assess the impact of burnout on the quality of life of physicians. The values of the Maslach Burnout Inventory, the age, and gender of the respondents were used as predictors; the response variables were the values of WHOQOL-BREF.

Results: the value of the domain «emotional exhaustion» is negatively associated with the four dimensions of the WHOQOL-BREF such as «physical health», «psychological health», «social relationships», «environment». The domain «personal accomplishment» positively correlated with respondents’ physical and psychological health. Age affected these indicators negatively but did not affect social relationships and health in the «environment» subscale. The gender of psychiatrists did not have a significant impact on their quality of life. The adjusted coefficient of determination of the models was in the range from 0.1907 to 0.511.

Conclusions: еmotional burnout negatively affects the quality of life of practicing psychiatrists. Prospective, longitudinal studies are still needed to establish causal connections between these constructs.

Background: schizophrenia is a severe mental illness characterized not only by cognitive but also sensory impairments, including the visual system. Research suggests impairments in contrast processing in schizophrenia, but evidence regarding the nature of these impairments is inconsistent. The theory of tremor modulation signal connects contrast sensitivity with the parameters of ocular microtremor – high-frequency and low-amplitude micromovements that are controlled by neurons of the nuclei of the brain stem. The parameters of ocular microtremor in psychopathology, in particular in schizophrenia, have not been described in the scientific literature.

The aim of the study was to study the characteristics of contrast sensitivity and microtremor of the eyes of patients with schizophrenia.

Patients and methods: to register contrast sensitivity, the method of computer visocontrastometry was used. Gabor elements were presented with spatial frequencies of 0.4, 1.0, 3.0, and 10 cycles/deg. Eye microtremor was recorded using a non-contact high-speed video recording method using an original optical system. The study involved 30 patients diagnosed as paranoid schizophrenia and 30 people without psychopathology and neurological diseases.

Results: the contrast sensitivity of patients was reduced in the region of medium and high spatial frequencies compared with conditionally healthy controls, which may be associated with the chronic course of the disease. Ocular microtremor in the patient group was characterized by a lower frequency and a higher amplitude compared to the control group.

Conclusions: contrast sensitivity and ocular microtremor are considered as potential markers for determining the functional state in schizophrenia, which requires further research and accumulation of experimental data.

Background: microRNAs are small non-coding RNAs that play a crucial role in post-transcriptional regulation of gene expression. Recent studies indicate the involvement of microRNAs in the pathogenesis of various psychiatric disorders, which allows to consider them as diagnostic biomarkers and therapeutic targets.

The aim of this literature review is to analyse curren research on the involvement of microRNAs in the formation of psychiatric disorders, focusing on their potential as diagnostic and prognostic biomarkers. Materials and methods: to find relevant publications, we searched eLibrary and PubMed databases using the following keywords and terms: microRNAs, mental disorders, psychological status, biomarkers, diagnosis, prognosis.

Conclusion: numerous studies suggest that microRNAs are involved in the regulation of critical molecular pathways associated with psychiatric disorders, including neurotransmission, neurodevelopment, and synaptic plasticity. Dysregulation of certain microRNAs has been observed in various psychiatric disorders such as major depressive disorder, schizophrenia, bipolar disorder, anxiety disorders, autism spectrum disorders, attention-deficit/hyperactivity disorder and addictive disorders. It is highlighted that the investigated microRNAs have a high potential to be used as diagnostic biomarkers, opening up possibilities for early detection and personalised treatment strategies. The identification of specific microRNAs associated with different psychiatric disorders offers new opportunities to develop innovative diagnostic approaches and targeted therapeutic interventions. However, a number of challenges remain, including differences in microRNA expression levels and profiles due to the heterogeneity of psychiatric disorders, the need for standardisation of microRNA analysis protocols and their further validation in large-scale studies on different patient populations. Collaborative efforts between basic genetics researchers and clinicians are needed to harness the full potential of microRNA analysis for the diagnosis and treatment of psychiatric disorders.

The aim was to compare «hierarchical» and «modular» models of the mental functions and psychopathological syndromes.

Material and method: a historical analysis is undertaken in the narrative review the works of thinkers of different times who put forward the concepts of mental deviations from the norm. Discussion and conclusion: hierarchical models go back to the concepts of the ancient Greek philosopher Plato, modular models – to the concepts of the German doctor F. Gall. The most famous hierarchical model of «circles» of positive and negative general psychopathological syndromes in Russian psychiatry by A.V. Snezhnevsky was preceded by the hierarchical model of M.O. Gurevich – M.Ya. Sereisky, in turn, based on the model of «levels» of the psyche of the English neurologist J.H. Jackson and E. Kraepelin’s «organ registers» model. In German psychiatry also K. Jaspers cited the «onion» model in the first edition of General Psychopathology, substantiating the complication of psychopathological symptoms depending on the nosology of mental disorders. Later, the American psycholinguist and philosopher J. Fodor proposed a «modular» model of the psyche, according to which the human psyche consists of relatively independent «modules» («encapsulated») that are specific to a certain area of stimuli, are genetically determined, correlate with certain neural structures and are «computationally autonomous». The concept of modular construction of the psyche was further developed in the works of psychologists and psychiatrists of the «evolutionary» direction (models of «massive modularity», which denied the «encapsulation» of modules according to J. Fodor), based, among other premises, on the modular construction of the brain of many animal species. Diversity turns out to be inherent not only in modular models of the psyche, but also in hierarchical ones, for example, the sequence of general psychopathological positive syndromes in A.V. Snezhnevsky’s model of «circles» differs from the correlation of psychopathological syndromes in the model of «registers» by E. Kraepelin, who at the final stage of his scientific activity postulated the principles of «comparative psychiatry», in many respects similar to the principles of the subsequent direction of «evolutionary» psychiatry.

Background: the role of glutamate receptor dysfunction in mental disorders, neurological, autoimmune, and oncological pathology has been intensively investigated in the past decade. The development of drugs that target glutamatergic receptors has also been a focus of research.

The aim was to describe modern concepts of neurodevelopmental disorders (according to the International Classification of Diseases 11th revision, L1-6A0) that are associated with genetically induced alterations of the structure of glutamatergic receptors.

Material and method: a search for descriptions of cases with impaired neuropsychiatric development associated with genetic defects of ionotropic and metabotropic glutamate receptor subunits was performed in the MEDLINE/Gene database, MEDLINE/PubMed scientific library, Online Mendelian Inheritance in Man (OMIM), UniProt, ClinGen and eLibrary. Genetically induced structural abnormalities of most known ionotropic (GluA, GluN, GluK, GluD) and a number of metabotropic glutamate receptors (mGluR1, 5, 7) are associated with severe variants of neuropsychiatric disorders that manifest in infancy and early childhood.

Conclusion: the considerable variation in the clinical presentation of these cases demands a transnosological approach to diagnosis and management of patients, under cooperation of specialists in pediatrics, child psychiatry, neurology, genetics, and medical and social rehabilitation.

Scientific and Practical Conference with international participation «Mental Health of the Family: Russian Traditions and Modern Approaches to Assistance»м тир, held FSBSI «Mental Health Research Centre» on January 26, 2024 in Moscow as part of the XXXII International Christmas Educational Readings «Orthodoxy and Domestic Culture: Losses and Gains of the Past, the Image of the Future». The conference comprehensively covered the traditional values of families in Russian society, as well as the problems that arise in families whose members suffer from mental disorders and behavioral disorders. The achievements and possibilities of helping family members with mental and behavioral disorders, as well as the provision of psychiatric, psychological, social and spiritual assistance by various institutions through the prism of biopsychosocial, spiritual and family-oriented approaches were discussed. The issues of volunteer participation in rehabilitation programs for families, the contribution of public organizations and their interaction with state and religious institutions in the aspect of psychosocial rehabilitation of patients with mental disorders and behavioral disorders, as well as issues of multidisciplinary interaction of specialists in the field of family prevention of mental disorders were considered. The exchange of scientific and practice-oriented achievements of domestic and foreign psychiatry in the field of family prevention of mental disorders, behavioral disorders and addiction diseases, the introduction of new technologies of assistance allows to improve the quality and effectiveness of psychiatric and narcological care provided to families that include persons with mental disorders and behavioral disorders.