Background: the dorsolateral prefrontal cortex (DLPFC) is one of the latest brain structures to mature during the ontogeny, and its structural and functional abnormalities play an important role in the pathogenesis of schizophrenia. As schizophrenia spectrum disorders usually start before the complete brain maturation and their earlier onset is coupled with worse prognosis, we suggested that earlier illness onset is related to more pronounced aberrations of the DLPFC. The aim of study was to analyze the associations of the onset age of schizophrenia spectrum disorders with structural and functional characteristics of the DLPFC that differentiated patients with schizophrenia spectrum disorders from healthy controls. Patients and methods: male patients with a diagnosis of schizophrenia spectrum disorders (n = 82) and healthy controls (n = 86) underwent structural MRI and functional resting-state fMRI. Cortical thickness and whole-brain functional connectivity of the DLPFC as well as local coherence and amplitude of low-frequency fluctuations of haemodynamic signal in the DLPFC were analyzed. Results: patients demonstrated a decreased gray matter thickness in the DLPFC bilaterally along with aberrant (predominantly decreased) functional connectivity of the DLPFC with other brain structures in each hemisphere. These measures were not associated with the age of illness onset. Conclusions: structural and functional abnormalities revealed in this study coincide with conventional view on the DLPFC as one of the key regions in schizophrenia spectrum disorders pathogenesis, however, these aberrations were not related to the age of psychosis onset. Possible interpretations of our results and limitations of the study are discussed in the article.

Background: hospitalization of elderly patients is associated with social and psychological maladaptation, reduced levels of daily functioning, and development of hospitalism. Patients whose status suddenly worsened immediately prior to discharge from psychiatric hospital make up a group that is difficult for diagnostics and treatment and not sufficiently studied. The aim of the study was to analyze changes in patients’ status before planned discharge from hospital to identify clinical patterns of deterioration and factors associated with this adverse event. Patients and methods: study participants were selected from 181 consecutive patients of the Geriatric Psychiatry Department of V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology. The main study methods were history-taking and psychological assessment. Results: predischarge deterioration was observed in 81 patients (44.8%) and was represented by exacerbation of mental disorder in 60 cases (33.2%), development of new symptoms in 12 patients (6.6%), or decompensation of somatic disease in 9 cases (5.0%). The history of patients with predischarge worsening was characterized by longer prior hospitalizations. These patients were more heavily pretreated, and had higher rates of hospitalism and non-compliance. For patients with worsening or development of new symptoms of mental disorder median duration of mental disease was respectively 84 and 204 months. They were more prone to violation of compliance, of the prescribed treatment regime and doses. Somatic decompensation occurred in patients with median duration of mental disorder 36 months and was associated with latent refusal to take medicines. Conclusions: an increased risk of predischarge deterioration in geropsychiatric patients with a history of prolonged hospitalizations needs earlier rehabilitation, psychotherapy, and psychological support when planning hospital discharge.

Background: there is the different susceptibility to viral infections, course of the disease, reaction to stress and quality of life (QoL) in men and women. The aim of this study is to identify the psycho-emotional state and QoL characteristics of women and men in 3 months after COVID-19 pneumonia. Patients and methods: during the cross-sectional study within the framework of the prospective cohort study “Prospective follow-up of patients after COVID-19-associated pneumonia”, 133 patients (54.1% women; mean age 54 ± 9 years) were examined by experimental psychological method (PHQ-9, GAD-7, PSS-10, SF-36). The mental health was assessed by a psychiatrist, the cardiovascular system — by a cardiologist. Results: women were more likely to have psychoemotional disorders (p = 0.011) and symptoms of depression (p = 0.030). All indicators of QoL were higher among men. In women, a decrease in the scores on the vital activity scale increased the frequency of detecting signs of anxiety, depression (p = 0.004) and stress, an increase in the values on the social functioning scale showed an association with severe lung damage in the acute period of the disease (p = 0.024). In men, a decrease in pain intensity indicators is associated with the detection of mental disorders (p = 0.039) and the appointment of psychotropic therapy (p = 0.005). The severity of stress was observed with a decrease in values on all scales of the QoL questionnaire. The older age of the examined was determined with a decrease in the indicators of the physical component of health (p = 0.006) and other physical aspects of QoL. Conclusion: the mental state differs significantly in men and women 3 months after COVID-19 pneumonia. QoL of both sexes is associated with stress. In women, QoL depends on the mental state, in men depends on physical well-being. The results obtained can be applied in the planning of rehabilitation measures taking into account gender characteristics.

Background: the range and prevalence of complicating pathologies in alcoholism indicate the need for a thorough examination of patients using modern diagnostic approaches. The aim was to study the indicators of spontaneous electrical activity of the brain in patients with alcohol dependence with comorbid exogenous organic brain damage non-alcoholic nature. Patients and methods: a study of electroencephalograms of 148 men with alcohol dependence using the classification of E.A. Zhirmunskaya (1984) was conducted. Results: based on the hystory data, 85 (57.4%) patients were found to have exogenous organic vascular brain damage (including hypertension in 57 (38.5%) cases, chronic cerebral circulation disorder — in 8 (5.4%), somatoform autonomic dysfunction — in 7 (4.7%)) and traumatic character (mild traumatic brain injury) in 13 (8.8%)) patients. The analysis using Fisher’s exact criterion revealed statistically significant differences between patients with alcohol dependence and alcoholism patients with comorbid exogenous organic brain damage in the frequency of occurrence of various types of electroencephalograms (p < 0.001). The study clearly showed that the presence of exogenous organic brain damage in patients with alcoholism leads to more pronounced functional changes in the brain. Conclusion: early detection of pathological activity on the EEG in patients with alcohol dependence will allow clinicians to carry out appropriate therapeutic and diagnostic measures in a timely manner and will provide additional information necessary for the development of personalized medical rehabilitation programs for patients taking into account their neurophysiological profile.

Background: the need to improve standards, organizational methods and practical scientific approaches to the prevention and treatment of mental pathology and the restoration of mental health of military personnel involved in combat operations determines the importance of developing and implementing effective strategies for correcting the mental state of combatants. The aim: to analyze the results of preclinical online screening of stress-associated disorders in combatants to assess its effectiveness in conducting routine psychoprophylactic examinations of military personnel after returning from the combat zone. Subjects and methods: 176 male employees of the Russian Guard who returned after a business trip of up to 90 days in the combat zone were examined. All combatants underwent preclinical online screening for the detection of stress-associated mental disorders, including methods regulated by the Ministry of Health of the Russian Federation. After testing, the obtained data were processed using cluster analysis by the K-means method. Clinical and psychopathological examination and laboratory studies were conducted, including: the content of carbohydrate-deficient transferrin (CDT), testosterone and cortisol levels, processing of the data obtained using statistical methods. Results: the combination of high levels of evening cortisol and CDT in combatants may indicate a complex interaction of physical stress, psychological trauma and possible alcohol abuse, which may be the result of both specific conditions of military service and a way to cope with post-war stress and trauma. Conclusions: it was found that the data of preclinical screening testing are consistent with clinical and laboratory results. Online screening testing for the detection of stress-associated disorders in combatants, combined with the determination of testosterone, evening cortisol and CDT levels, can serve as markers of the presence of stress-associated disorders.

Background: depression is widespread in the population, and one of the leading causes of disability, reduced life expectancy and mortality. Such a significant effect is based on the high frequency of comorbidity of depression with severe chronic somatic diseases. Genetic studies can provide tools to identify groups with a high level of genetic risk of comorbidity of these diseases in a population for their early specific prevention. The aim of review article was to justify the methodology and design of research directed for joint genetic risk markers for depression and chronic somatic diseases linked with each other in terms of genetic comorbidity. Publication, patients and methods: population cohort of depressive patients examined using international clinical and psychometric instruments. The study will allow: 1) to evaluate the risks of developing chronic somatic diseases in a population of patients with depression; 2) to assess the predictive power of polygenic risk scores of somatic diseases for symptoms of depression and somatic diseases in a population sample; 3) to validate polygenic risk scores for genetic comorbidity of depression and somatic diseases in a qualitatively described sample of patients using modern clinical and psychometric tools. Conclusion: the methodology and results of the study can be used for an evidence-based preventive approach in the field of mental and physical health.

Background: catatonia is the focus of neurophysiological research as a syndrome with unspecified pathogenesis. Modern neuroimaging techniques contribute to the understanding of the pathophysiological mechanisms of this disorder. The aim was to conduct a systematic review of the scientific literature to confirm that catatonia is associated with structural and functional changes in the brain. The analysis made up researches using diffusion MRI for judgement on indirect measure of changes in white or gray matter density using a fractional anisotropy (FA) and resting state functional MRI for assessment a measure of connectivity. Materials and methods: PubMed, ScienceDirect and Mendeley databases were searched using the search terms (and their derivatives) for: “catatonia”, “resting state functional magnetic resonance imaging” and “catatonia”, “diffusion weighted magnetic resonance imaging”. The search yielded 147 publications for preliminary screening, of which 96 were on fMRI of catatonia and 51 on dMRI. During the screening stage, duplicates and articles that could not be accessed were removed. This left 21 fMRI articles and 18 dMRI articles. After which the articles were checked for compliance with the inclusion criteria: 1) original full-text articles; 2) identification of catatonia not caused by a somatic disease and verified using the Bush–Francis and/or Northoff psychometric scales; 3) age of the examined 18 years and over. 3 fMRI and 3 dMRI articles were included. Conclusions: aberrations of FA indicators were found in catatonia, which may be associated with the density of the white matter of the brain. Changes in connectivity in the somatosensory network have been identified, which allows to consider these disorders as potential markers of catatonia. To confirm the hypothesis and results obtained, further research is required due to the small number of publications on this topic.

Background: the need for remote delivery of diagnostic, treatment and correctional care has increased significantly due to the COVID-19 pandemic. At the same time, at present, remote forms of care in psychiatry cause ambiguous attitudes among representatives of the medical community, and many organizational, legal and clinical-methodological issues of the use of telemedicine technologies in the provision of medical care, especially in the “patient–doctor” format, remain insufficiently developed. The purpose of this review is to analyze the scientific publications on the organization and legal regulation of telemedicine consultation in the “doctor–doctor” and “patient–doctor” formats when providing assistance to children and adolescents with mental disorders in the Russian Federation. Material and method of review: according to keywords “child psychiatry”, “health care”, “telemedicine technologies”, “regulatory acts” Russian scientific studies published between January 2016 and September 2023 presented in the databases eLibrary and PubMed were selected and analyzed. An analysis of the organizational and regulatory parameters of telemedicine consultations in the “doctor — patient (legal representative)” format and in the “doctor — doctor” format was made based on the practical activities of the Center named after G.E. Sukhareva of the Moscow Department of Health. Conclusion: the review of scientific articles confirmed the validity of telecommunication technologies use to make accessible the children’s psychiatric care, as well as for destigmatization and improvement the quality of medical care. It was shown the need to optimise the regulatory framework, to eliminate conflicting regulatory requirements for primary telemedicine consultation.

On March 28, 2024, a Scientific and Practical Conference with International Participation “Bipolar Affective Disorder: Spring Fever” was held at the FSBBI “Mental Health Research Centre”. The event was organized on the eve of World Bipolar Disorder Day, which is traditionally timed to coincide with the birthday of the famous Dutch post-impressionist artist Vincent Van Gogh, whose whole life from a psychopathological point of view was overshadowed by this mental illness. However, the artist’s example also shows that Bipolar disorder (BD), under certain conditions, can contribute to creative uplift and high productivity. The conference comprehensively covered the epidemiological, etiological, pathogenetic, clinical, diagnostic and therapeutic features of the BD from a clinical and biological perspective. A vector was set for further study of this disease using the latest technologies, modern diagnostic techniques and therapeutic interventions. Programs have been proposed to raise public awareness of the BD in order to carry out preventive measures. In general, the conference was designed for a wide range of specialists in the field of psychiatry to expand, deepen and systematize their professional knowledge in this field.