Background: the comorbidity of depressive disorders (DD) and alcohol dependence (AD) negatively affects the clinical and dynamic characteristics of depressive disorders, as well as the manifestations of aggressiveness in these patients. The aim was to evaluate the impact of comorbidity of DD and AD on the main clinical and dynamic characteristics of DD and the manifestations of aggressiveness. Patients and Methods: 182 patients were selected in the departments of affective and addictive states of Mental Health Research Institute, Tomsk National Research Medical Center. The study group was divided into a group of patients according to the ICD-10 classification (n = 132) with DD (F32–33, F34.1) and group of patients (n = 50) with DD comorbid with AD (F3 + F10). In the F3 group, women predominated (82.6%), and in the F3 + F10 group, men predominated (68,0%). The median age of patients in the DD group was 45 (33.0; 54.8) years, and 46.5 (39.0; 53.0) years in patients of DD + AD group. Results: data were obtained on the high comorbidity of alcoholism and dysthymia, comparable severity of current depression in the case of “pure” DD and in case of “dual diagnosis”; the formation of alcohol dependence syndrome occurred 7 years earlier than the onset of DD. Multimodal antidepressants and an augmentation strategy were more often used, instability in relation to changing jobs due to illness and less satisfaction with their income was more often noted in the comorbid group. Increase of physical and verbal aggression level as well as suspiciousness was statistically significant (p < 0.001) compared with the same indicators in patients with “pure” DD. Conclusions: in the study sample, the formation of comorbidity of DD and AD has a predominant pattern with the primary occurrence of AD. Such comorbidity affects professional functioning and is accompanied by marked indicators of aggressiveness and hostility, which can be considered as an important clinical vector for assessing the patient’s current condition in the case of isolated DD, as well as in case of DD and AD comorbidity.

Background: a problematic issue in child psychiatry is the differential diagnosis of early childhood schizophrenia and autism spectrum disorders (ASD). Previously, the authors showed that the genomes of children with schizophrenia, like the genomes of adult patients, contain more copies of ribosomal genes than the genomes of children with ASD. For adult patients with schizophrenia, a decrease in the content of satellite III repeat (1q12) in blood leukocytes and a decrease in the average telomere length were also shown. The aim of study was an analysis of the content of three genome repeats (ribosomal, satellite III and telomeric) in DNA samples of blood leukocytes of children with endogenous mental disorders in order to search for a genetic marker that allows for differential diagnosis of early childhood schizophrenia and ASD. Patients, Control groups and Methods: blood samples from 136 patients with ASD (F84.0 and F84.1 according to ICD-10) and childhood-onset schizophrenia (F20.8xx3 according to ICD-10) were obtained from the Department of Child Psychiatry of the Mental Health Research Centre. DNA samples from the healthy control group (93 children and 78 adults) were taken from the collection of samples of Research Centre for Medical Genetics. The selection of patients was carried out using the clinical-psychopathological method. DNA was isolated by extraction with organic solvents. The content of three repeats in DNA was carried out using non-radioactive quantitative hybridization. Data were analyzed using the package “StatPlus2007 Professional software”, “MedCalc”, Excel Microsoft Office, “StatGraph”. Results: patients DNA samples from children with schizophrenia contain more ribosomal genes and less satellite III than DNA from children with ASD and DNA from healthy children (p < 0.001, U test). DNA samples of patients with ASD and schizophrenia contain fewer telomeric repeats than healthy child controls (p < 10⁻¹⁰). The Ksz indicator, equal to the ratio R2/(S·T), which takes into account the increased content of the ribosomal repeat and the reduced content of the satellite and telomeric repeat in the DNA of children diagnosed with childhood schizophrenia, showed the maximum differences between the group of children with schizophrenia and the group of children with ASD (p < 10⁻¹¹, U test; ROC analysis: AUC = 0.88, p < 0.001). Conclusion: the Ksz indicator can potentially be used in practice to confirm the diagnosis of schizophrenia in children with mental pathology.

Background: the need to study and clarify the neurobiological basis of depression is due to the widespread prevalence and heavy socioeconomic burden of this disease. In order to prevent relapses, it is recommended to continue treatment for depression for a long time after the relief of the main depressive symptoms. The study of neurobiological pathways of depression showed a significance of EEG parameters for diagnosis and prognosis. However, delayed EEG changes have been almost completely unstudied. The aim of the study was to analyze the dynamics of spectral-coherent EEG parameters during long-term therapy for endogenous depression in young female patients. Patients and Methods: The study included 20 female patients aged 16–25 years who underwent quantitative clinical (using the HDRS-17 and GAF scales) and neurophysiological (multichannel resting EEG with subsequent analysis of absolute spectral power (SP) and EEG coherence). Examination underwent three times: upon admission to hospital for treatment before the start of the course of therapy (at visit 1), upon discharge from the hospital at the stage of establishing remission (at visit 2) and one year after discharge from the hospital on maintenance therapy (at visit 3). Methods: clinical-psychopathological, psychometric, neurophysiological, statistical. Results: after the course of stopping therapy (at visit 2), there was a significant (p < 0.01) reduction in depressive symptoms with further improvement in the clinical condition (according to the HDRS-17 scale) and social functioning (according to the GAF scale) a year later (at visit 3). This was associated with an EEG slowdown in the form of a generalized increase in the SP of theta-delta activity, which was significant (p < 0.05) in the frontal-central leads, and a significant (p < 0.05) decrease in the alpha2 and alpha3 components of the alpha rhythm in the occipital zones. The same EEG pattern, including a significantly increased SP of theta2 sub-band in the centralparietal-occipital leads, persists a year later (at visit 3). Conclusion: the observed EEG changes are assessed as a reection of a complex restructuring of brain activity into a mode more adequate for these patients, ensuring the suppression of depressive symptoms and restoration of the social functioning of patients.

Background: the professional activity of employees of the Ministry of Internal Affairs of Russia belongs to the extreme, in which there is an increased risk of mental adaptation disorders, the occurrence of stress-related and mental disorders. The aim of study: to assess mental disorders dynamics among employees of the Ministry of Internal Affairs of Russia and use this data for prevention, timely detection, treatment and social rehabilitation. Patients and Methods: we studied the dynamics of mental disorders in employees of the Ministry of Internal Affairs of Russia with special ranks for 16 years from 2008 to 2023. The identified mental disorders should be correlated with groups in the V class of diseases “Mental disorders and behavioral disorders” according to the International Statistical Classification of Diseases and Causes of Death Related to Health of the 10th revision (ICD-10). The total and primary morbidity, labor losses were calculated per 1,000 employees or in ppm (%), due to low values, the need for dispensary supervision, hospitalization and dismissal — per 10 thousand employees or 10^-4. The indicator of chronic morbidity was calculated by comparing the level of general morbidity to the primary one. The development of the indicators was studied using the analysis of dynamic series and a polynomial trend of the 2-nd order. Results: the average long-term level of general morbidity of mental disorders of employees of the Ministry of Internal Affairs of Russia was 7.1%, primary morbidity — 3.7%, the need for dispensary supervision according to the results of preventive examinations — 21,8 × 10^–4, hospitalization — 10.9 × 10^–4, disqualification for health reasons — 1.35 × 10^–4. The dynamics of reduction of the listed types of morbidity is noted. The level of general and primary morbidity of mental disorders in employees of the Ministry of Internal Affairs of Russia was statistically significantly lower (p < 0.001) than in the adult population of working age, and the primary morbidity was higher at the trend level (p > 0.05) than in servicemen of the Armed Forces of Russia. The average long-term level of chronization of mental disorders in the adult population of working age in Russia turned out to be 11.6, among employees of the Ministry of Internal Affairs of Russia — 1.9. The 1st rank of significance of the constructed socio-epidemiological assessment was indicators of neurotic stress-related and somatoform disorders (group 5) with a share of 50.4%, the 2nd rank — organic, including symptomatic, mental disorders (group 2) — 25.6%, rank 3 — schizophrenia, schizotypal and delusional disorders (group 3) — 10.7%. The cumulative proportion 35 of cases of these causes was 86.7%. Conclusions: the structure and dynamics of mental disorders incidence in employees of the Ministry of Internal Affairs of Russia dictates the need to improve approaches to neurotic, stress-related, and somatoform disorders prevention. It seems appropriate to organize systematic monitoring of Ministry of Internal Affairs of Russia employees’ mental health state. 

Background: the lack of obvious signs of mental disorders available for objective registration is known problems of psychiatry. The study of nonverbal behavior based on the ethological paradigm using automatic detection technologies may be one of the approaches to solving this problem. The aim of study was to compare the facial and pantomimic activity of patients with neurotic disorders and pathology of the schizophrenia spectrum in a controlled ethologovideographic study to search for behavioral biomarkers of these disorders. Patients, Control Group and Methods: 19 patients with schizophrenia spectrum disorders (SSD), 23 with neurotic disorders (ND), and 22 healthy subjects of control group (CG) were examined. The severity of SSD symptoms was determined using the PANSS scale; for ND on used the Hamilton Anxiety (HAMA-14) and Depression (HAMD-17) scales. Analysis of non-verbal behavior was carried out using the biometric video analytics complex “MIX VR-19” based on action units (AU) of the Facial Action Coding System (FACS). Results: according to the frequency and duration of facial and pantomimic reactions, facial mimics in patients with Sch was characterized by greater activity in the areas of the mouth and eyes, with a decrease of mimic activity in the area of eyebrows and head movements. Frontal orientation towards the interviewer was less frequent, while a longer duration of sadness expression and a shorter duration of surprise reactions were revealed in ND patients. Factor analysis showed that AU formed the facial complexes “thoughtfulness”, “remembering”, “lack of negativism”, “lack of distrust” in control; “search for a solution”, “surprise”, “helplessness”, “embarrassment/shyness”, “distrust” characterized NR group while “incredulous surprise”, “experience of failure”, “skepticism/distrust”, “satisfaction/superiority” were found in SSD group. Conclusions: the mimic-pantomimic response of mentally healthy persons reflected cognitive processes and was characterized by emotional neutrality in the structure of behavioral complexes of attention and contact as well as of exploring behavior. A combination of cognitive and affective facial reactions was observed within the framework of avoidant-defensive agonistic behavior and neophobia in ND. Facial reactions of emotionally charged content predominated within the complex of preventive-aggressive agonistic behavior were the most frequent patterns of nonverbal behavior in SSD.

Background: according to the numerous data the complement system (CS) is involved in many mental disorders pathological process development. However, the results are contradictory and require the new methodological approaches being established.
One way of studying CS components impact on the pathological process in schizophrenia development is elaborated by the authors the method of assessing the CS functional activity by the recording the biological objects Tetrahymena pyriformis ciliates death in serum/plasma solutions through the CS cascade formation of the terminal component — the membrane attack complex (MAC) on the protozoa membrane. Aim: to study the specificities of the schizophrenia patients CS functioning by comparing the results of serum/plasma assessing effect on Tetrahymena pyriformis and enzyme immunoassay, which determines the quantitative content of the terminal complement complex in the patients’ blood. Patients and methods: the study included 28 women aged 16–40 years with paranoid schizophrenia (F20 according to ICD-10), examined before the start of psychopharmacotherapy. The functional activity of CS (faCS) was assessed using the BioLaT device, which records the death rate of Tetrahymena pyriformis ciliates. Quantitative determination of the terminal complement complex (TTC) in blood plasma was assessed using the ELISA KIT HK328. Results: the results of the two methods of clarifying CS features were only partially comparable. FaCS in patient plasma is characterized by significant fluctuations: 25% of the examined patients were above the normal rate, 32% — below. The alternative pathway of CS activation was indicated by varying the salt composition of the protozoa incubation medium. The TCC midpoint in the patients’ group was twice as high as in reference group. According to Spearman’s rank correlation, a weak relationship was established between the faCS and TCC parameters, which may be a sign of fluid-phase MAC presence in the terminal complement complex and also the contribution of the classical and lectin CS pathways components to the activation. Conclusion: CS involvement in pathogenesis of schizophrenia, presumably, can serve as a basis for complex treatment using medicine to decrease the terminal CS level.

Background: the economic and political transformations taking place today reduce adaptation, cause a variety of psychological reactions and mental disorders, including organic psychic disorders (OPD). Elderly people are especially susceptible to these reforms and the emergence of various disorders. Some persons resort to drinking alcohol to alleviate various psychological disorders. In connection with the above, the study of the problem of the formation of organic mental disorders and alcoholism is very justified. The aim was: to study risk factors (RF) influencing the development of primary organic mental disorders complicated by alcohol dependence in middle-aged and elderly patients. Patients and Methods: 83 male patients aged 67.5 ± 7.2 years with primary organic psychic disorders (POPD) complicated by middle stage alcohol dependence (AD) were included. Taking into account the age parameter of disease manifestation, patients were divided into 2 groups: the 1st group included 49 people (59%), the 2nd group included 34 (41%), in whom symptoms of POPD appeared at 38.2 ± 2.0 and 46.5 ± 2.2 years, respectively, and AD formed at 53.8 ± 1.2 years and 66.8 ± 0.9 years, respectively. Methods used: survey, clinical follow-up, statistical. Results: as a result of the study using the “Anamnestic Card”, etiological RF for the formation of POPD were identified — internal biophysiological (nonspecific) risk factors (antenatal, intranatal, postnatal, closed TBI, chronic somatic diseases). Conclusion: the formation of POPD is influenced by past closed TBI and other exogenous-organic harms, combinations of RF, hereditary burden of alcoholism in the 1st line of kinship, and childhood chronic somatic diseases. The age of formation of POPD is determined by the quantity, and possibly quality, of childhood somatic chronic diseases and combinations of RF, as well as the age of closed TBI. The progression of alcoholism is combined with the age of onset of TBI, hereditary burden of alcoholism in the 1st line of kinship, the number and age of subsequent somatic pathology.

Background: psychiatrists often face difficulties in selecting appropriate psychopharmacological treatments when patients with Schizophrenia spectrum disorders have been without adequate antipsychotic medication for a long period. This can lead to unforeseen complications and difficulties in case managing. The relevance of this issue is highlighted by numerous clinical and statistical studies that demonstrate the high prevalence of these disorders among psychiatric hospital patients. Additionally, the course of the illness can vary depending on untreated period duration, which has important scientific and practical implications for long-term treatment outcomes, therapy effectiveness, and the timing and quality of remissions. The aim: using a case report as an example to evaluate the impact of long-term nontreatment, we will look at the degree of improvement in psychotic symptoms and the prognosis for paranoid schizophrenia after a long period of untreated psychosis. Patient and Methods: clinicalpsychopathological and clinical-dynamic methods were used to study the clinical manifestations in a patient with paranoid syndrome and deficit symptoms, within the context of a continuous form of paranoid schizophrenia, against the background of a prolonged period of untreated psychosis. Results: the presented clinical case highlights the issue of a poor prognosis after a long period of untreated psychosis. The treatment plan consisted of a combination of traditional first-generation antipsychotics and clozapine, which has been shown to be highly effective and safe in treating paraphrenia in schizophrenia. Conclusion: the clinical observation in question emphasized the significance of timely and appropriate initiation of treatment at the onset of first psychotic episode. Long period of untreated psychosis have been shown to negatively impact the effectiveness of psychopharmacological therapy and the overall outcome of the illness.

Background: mental pathology is widely represented among patients with skin diseases. Psoriasis is of greatest interest as a multifactorial skin disease that has common clusters of genetic risk with those of a number of mental disorders, in particular, the affective spectrum, while the manifestation of one of them can have an impact influence on the implementation of another, increasing the already high risk of decreased ability to work, disability and significant deterioration in the quality of life, characteristic of individual diseases. Studies of the immunological aspects of the relationship between the psoriatic process and mental pathology will allow us to evaluate the possibility of using immunobiological therapy as a pathogenetic therapy for disorders in both the somatic and mental spheres. The aim of this review is to substantiate the methodology and design of a research aimed to study mental disorders comorbid with psoriasis over time, taking into account the use of immunobiological therapy drugs. Materials and Methods: the search was conducted in the PubMed, Mendeley and ScienceDirect databases using a search query on keywords and terms (and their derivatives) for: “comorbidity”, “mental disorders”, “psoriasis”, “immunobiological therapy”, “immunophysiology”. Conclusion: numerous studies confirm the presence of a common pathogenetic link in the development of psoriasis and a number of mental disorders, but at the moment there is an insufficient number of large studies devoted to the study of general immunological parameters in the structure of these conditions. In existing studies aimed at assessing the dynamics of mental pathology during the use of immunobiological drugs, there is virtually no clinical assessment of the mental status of patients with verification of data obtained through the use of psychometric techniques, which also makes it difficult to adequately assess the prospects for using biological therapy in practice.

Background: suicide is one of the significant causes of death in patients with schizophrenia and schizophrenia spectrum disorders (SSD). The development of effective methods for the prevention of suicidal behavior is an urgent scientific and practical problem in psychiatric practice. There is known significant variability in rates of suicidal behavior in patients suffering from these diseases, associated with the ethnic, cultural and economic characteristics of different countries. Despite a number of foreign publications devoted to this problem, there is a shortage of correct and up-to-date data on the situation in the Russian population. As a result, assessing the current situation and making forecasts within the framework of building long-term prevention programs is difficult. The aim was to systematize and generalize published results of Russian scientific studies on suicidal behavior in patients with schizophrenia and SSD. Material and Methods: a search for Russian-language articles was carried out in the eLibrary.ru database. When searching for articles, combinations of keywords “schizophrenia”, “schizophrenia spectrum disorders” and “suicidal behavior” were used. Data from foreign studies used for data comparison were obtained by searching the PubMed electronic database using a combination of keywords “meta-analysis”, “mental disorders”; “schizophrenia”, “suicide” in various combinations. Discussion: the analysis of the scientific publications indicates that there are no large-scale studies at the regional or national level aimed at studying suicidal behavior in patients suffering from schizophrenia and SSD in the Russian Federation. The available data are sparse and contradictory, and the level of agreement with data from other populations is not high. A number of important limitations (small sample sizes, controversial study designs) make it difficult to extrapolate the data obtained to the entire Russian population. Conclusions: the use of the results of foreign studies in the Russian population should be done with caution. It seems necessary to conduct large-scale studies of suicidal behavior in patients suffering from schizophrenia and in Russia. The results of such studies will be important and in demand both for scientific research and for practical purposes, primarily for organizing measures and programs to reduce the risk of suicide among patients with schizophrenia and SSD at the regional and national levels.