Background: impaired energy metabolism, glutamate and glutathione metabolism contribute differently to the development of late-life depression. The aim was to study the clinical features of depression in groups of elderly patients identi ed by the activity of platelet enzymes of energy and glutamate metabolism and the antioxidant system of glutathione. Patients and Methods: the study included 52 hospitalized patients (40 women and 12 men) aged 60–86 years with a depressive episode of recurrent depressive disorder (RDD), bipolar disorder (BD) and a single depressive episode (DE) on ICD-10 criteria. The study used clinical, psychometric, biochemical and statistical methods. Psychometric assessments were performed before therapy using the Hamilton Depression and Anxiety Scale (HAMD-17, HARS) and the Mini-Mental State Examination (MMSE). At the same day blood samples were taken to determine the activity of cytochrome c-oxidase (COX), glutathione reductase (GR), glutathione S-transferase (GST), and glutamate dehydrogenase (GDH). Results: patients with decreased activity of energy and antioxidant metabolism enzymes (COX, GR, and GST) were characterized by a predominance of shallow apathetic depressions of a “seasonal” nature with mild cognitive impairment, a later age of manifestation, and a high frequency of cerebrovascular pathology. Patients with different changes in enzyme activity (increased COX, decreased GDH and GST) were characterized by an early onset of the disease, its longer duration, more severe and complex depressions with a pronounced anxiety component. Patients with enzyme activity within control values were more likely to have typical melancholy depressions and the lowest frequency of severe cerebrovascular pathology. Conclusion: a relationship was established between the clinical features of late-life depressions and changes in the activity of enzymes of energy, antioxidant, and glutamate metabolism. It was found that patterns of reduced and different enzyme activity correspond to the clinical parameters of late and early-onset depressions. Thus, clinical heterogeneity of late-life depressions is closely related to different biochemical types of metabolism.

Background: disclosure of specific environmental and personality factors of depression development was an object of many studies, but without consensus on their importance. The aim was to study the role of personality and environmental factors in the formation of subtypes of depressive disorders. Patients and Methods: the study made up in-patients treated from May 2021 to April 2024. Diagnostic verification and typology of depressive disorders were performed according to the DSM-5 diagnostic criteria (melancholic, anxious, atypical type). The severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale (HDRS). Questionnaire data were used to determine socio-demographic data and features of early development. The SCID-II Personality Disorder Traits Structured Personality Questionnaire (SCID-II-PD) was used to analyse the personality characteristics of the patients. Results: a total of 120 patients (n = 120) were divided into three groups by type of depression: melancholic (n = 40; 33%), anxious (n = 44; 37%), and atypical (n = 36; 30%). In patients with melancholic depression, accentuations of cluster A (schizoid, schizotypal; n = 17; 43%) and C (avoidant, dependent; n = 18; 45%) more often prevailed, with anxious depression — accentuations of cluster C (avoidant; n = 29; 66%), with atypical depression — accentuations of cluster B (histrionic; n = 29; 81%). There was a correlation between type of depression and scores on the Holmes- Rahe Stress Scale (Social Readjustment Rating Scale, SRRS), (χ² = 7.981, p = 0.018), number of marriages (χ² = 7.530, p = 0.023), patient's age when their family became incomplete (χ² = 8.193, p = 0.017), and the number of their own children (χ² = 4.818, p = 0.09). Conclusion: the identified accentuations of personality traits highlight the specifics of patients' emotional and behavioural reactions depending on the subtype identified. Socio-demographic variables such as family structure and number of children, living alone, birth trauma and smoking have also been found to be associated with type of depressive disorder. These factors may serve as indicators for clinicians to develop more effective intervention and personalised support strategies for patients with depressive disorders.

Background: quality of life (QoL) is a multidimensional concept refiecting subjective assessments of physical, psychological, and social well-being. QoL studying in patients, especially in psychiatry, remains a significant challenge due to its marked reduction in persons with mental disorders. The aim was to assess the QoL of psychiatric in-patients and identify differences compared to control groups of healthy individuals from different countries. Patients and Control Groups: the study included 60 patients (46 women and 14 men) aged 60 ± 1.73 years, hospitalized in a psychiatric hospital. Most patients were rural residents (80%). Concomitant somatic diseases were detected in 90%, including cardiovascular pathologies, endocrine disorders and diseases of the musculoskeletal system. Patient data were compared with indicators of control groups of individuals without mental and somatic disorders from the USA (n = 60) and the results of population studies in the Russian Federation and New Zealand. Methods: Clinical-epidemiological, clinical, and anthropometric data were obtained from medical records. A cross-sectional observational study was conducted using the SF-36 questionnaire to assess QoL. Correlation analysis and statistical methods (t-test, Mann-Whitney test) were used for data analysis. Results: in-patients demonstrated significantly lower QoL scores across all SF-36 scales, except for Physical Functioning (PF), which was higher due to the participation of younger patients. Correlations were identified between age and QoL indicators, such as PF, General Health (GH), and Vitality (VT). No significant differences between genders were found. Conclusion: the study confirms reduced QoL in psychiatric in-patients, highlighting the need for integrating the treatment of comorbid somatic diseases to improve overall health and well-being.

Background: previously, the authors found ultrastructural pathology of oligodendrocytes in contact with microglia in the white matter of the prefrontal cortex in attack-like progressive schizophrenia. Aim of the study: to determine ultrastructural changes in microglia and oligodendrocytes in contact with each other and to analyze correlations between ultrastructural components of microglia and oligodendrocytes in the caudate nucleus of attack-like-progressive schizophrenia compared to controls. Material and Methods: an electron microscopic morphometric study of microglia and oligodendrocytes in contact with each other was performed in autopsy head of the caudate nucleus from the left hemisphere in 10 cases of attack-like progressive schizophrenia and 20 controls without mental pathology. Group comparisons were made using ANCOVA and Pearson correlation analysis. Results: we found decreased volume fraction (Vv) and the number of mitochondria in microglia and oligodendrocytes, decreased area of microglia and increased Vv of heterochromatin and area of vacuoles of endoplasmic reticulum in oligodendrocytes in schizophrenia compared to controls. The area of microglia correlates positively with the areas of oligodendrocyte cytoplasm and mitochondria in oligodendrocytes in the schizophrenia group but not in the control group. The areas of oligodendrocytes, microglia and of their nuclei correlate positively with age at onset of disease. Vv and number of mitochondria in microglia correlate positively with the same parameters in oligodendrocytes in the control group, but not in the schizophrenia group. Vv and number of mitochondria in microglia correlate negatively with the perimeter of heterochromatin in oligodendrocytes in the schizophrenia group. Conclusion: The obtained results showed reduced microglial reactivity in the caudate nucleus in attack-like progressive schizophrenia. Dystrophy of oligodendrocytes in schizophrenia is associated with a decrease in the size of microglia, a deficiency of mitochondria in microglia and oligodendrocytes, and disrupted bioenergetics coupling between microglia and oligodendrocytes. Dystrophic changes in microglia and oligodendrocytes in the caudate nucleus in attack-like progressive schizophrenia may be associated with dysontogenesis.

Background: the combined form of psychopathologic diathesis is a special personality structure, capable of to transform into various manifest forms of psychiatric disorders. Neurophysiological features of this form of diathesis practically not studied from the point of view of interdisciplinary research methods research. The aim of study is to determine the neurofunctional basis underlying the clinical phenomenology of the indicated form of psychiatric diathesis. Participiants and methods: 2433 students (mean age 21,1 ± 3,9 yrs) were examined. Two main groups of 74 and 107 students were formed on the basis of the Abraham- Ferenczi-Szondi theory, each of them including a certain variant of the combined form of psychopathological diathesis. EEG recordings of 330 subjects (mean age 21,3 ± 3,7) from the normative HBI Database were used as a control group (CG). The main indicators studied were quantitative evaluation and comparison of the spectral power of the EEG of the respondents both between the main and control groups and with the indicators of neurofunctioning of individuals with various psychiatric pathologies obtained from the literature. Results: the main indicators of changes in the bioelectrical activity of the brain of the examined persons in comparison with the control group were a decrease in the power of practically all frequency ranges in the posterior regions of brain and an increase in the power of the high-frequency alpha rhythm in the associative zones of the cerebral cortex. Comparison of the bioelectrical activity indices of the two main groups of respondents among themselves allows us to characterize their EEG patterns as different, due to the fact that the brain systems providing their manifestations belong to the reciprocally functioning parts of the brain. Conclusions: the mentioned features of bioelectrical activity of the brain are the neurofunctional basis underlying the characteristic mental disorders, which are the manifest form of the combined psychopathological diathesis and determine the distinctive features of the phenomenology of its clinical picture. The division of the group of investigated persons into two subgroups according to the neuropsychoanalytic concept allows a more differentiated approach to the study of the combined form of psychopathological diathesis. This approach can be used in further scientific c research and allows expand diagnostic capabilities and therapy of this form of mental diathesis

Background: the Perceived Devaluation and Discrimination Scale (PDDS) is an important instrument for diagnosing stigmatization in the practice of clinicians and researchers. This study was aimed to adapt the Russian version of the PDDS. Participants and Methods: a total of 1,303 volunteers completed the PDDS and the Mental Health Knowledge Questionnaire (MHKQ). Results: psychometric analysis of the adapted instrument confirms its discriminativeness, reliability and validity. Discrimination has been proven by adequate discrimination indexes. Internal reliability ensures adequate McDonald's ω coefficient (ω = 0.752). Factor validity was determined by identifying the bifactor structure of an adapted instrument. Convergent validity was confirmed by negative correlations between stigmatization and mental health knowledge. Conclusion: the Russian version of the Perceived Devaluation and Discrimination Scale (PDDS) is psychometrically justified. The prospects of psychometric analysis of the Russian version of the PDS are reduced to its validation in persons with mental disorders and modification for the diagnosis of stigmatization of patients with somatic diseases.

Background: many congenital metabolic disorders affect the functioning of the central nervous system, leading to cognitive deficits and intellectual disability in the child. Hypophosphatasia (HF), a rare inherited disorder caused by mutations in the tissue-nonspecific alkaline phosphatase (TNSAP) gene, is one of such diseases. Mutations in the TNSAP gene, the ALPL gene, result in decreased activity of this enzyme. HF is a progressive disease with onset at any age with a wide range of symptoms. The main symptom is disorder of bone mineralization. The diversity of clinical manifestations of HF affects various organs and tissues, and the severity of the disease can range from mild, virtually asymptomatic, to severe, including lethal forms. The milder the course of the disease, the more variable and atypical the symptoms of HF can be, making timely diagnosis difficult. Patient and Method: this article describes a clinical case of HF with predominantly neurologic and psychopathologic symptoms in a child of 8 years old. Discussion: this clinical case, characterized at the clinical, biochemical and molecular genetic level, is interesting from the point of view of the atypical course of the disease with the predominance of neuropsychiatric disorders. Among all the manifestations of the disease, intellectual disability and cyclic unmotivated vomiting were the most significant and impaired adaptation. The vomiting led to a life-threatening somatic condition of the child and prolonged hospitalization in the gastroenterology department of a somatic hospital with parenteral nutrition using, where a decrease in the levels of TNSAP was randomly detected. Conclusion: it seems advisable to increase the level of awareness and alertness of neurologists and psychiatrists regarding congenital metabolic disorders, as well as to conduct laboratory screening of TNSAP levels in children.

Background: the domestic approach to working with mental disorder postulates the impossibility of treating the disease without taking into account the personality and its environment. While the concept of identity has been widely studied in sociology and social psychology, there is little empirical research on this topic in clinical psychology. The aim was to provide an overview of various theoretical concepts of identity, to present the results of empirical research, to analyse the tools used to assess identity in different approaches, to show the limitations of frequently used tools that create difficulties in their application in the clinic. Materials and Methods: using the keywords “identity”, “diffuse identity”, “identity diagnostics”, “depression”, “schizophrenia”, “mental disorders”, articles in English and Russian in MEDLINE/PubMed, Scopus, Web of Science, and e-library databases were searched. Conclusion: analysis of published works shows that most of the available studies study either the development of identity in adolescence, or one of the aspects of identity, namely the feeling of belonging to a group on one or more grounds (ethnic identity, gender identity, professional identity). At the same time, an analysis of approaches and studies of identity within the framework of a psychiatric clinic shows that the approach closest to the tasks of clinical psychology and psychiatry is an approach that considers identity from the point of view of personality structure, its characteristics and pathology. The use of the identity construct in clinical psychology seems useful, since it allows for the formalization of the normative and different conditions in pathology when assessing and classifying mental disorders. It suggests available methods for evaluating various aspects of identity in the clinic of mental disorder. This makes it possible, when describing mental health disorders, to take into account the factors that cause the lack or violation of certain states and features of mental functioning that are not the explicit causes of the observed dysfunctions.

Background: Bipolar disorder (BD) is a complex psychiatric condition characterized by alternating episodes of mania and depression. Neuroendocrine factors, including thyroid function, play a crucial role in the pathogenesis of BD. Thyroid dysfunction, associated with abnormalities of the hypothalamic-pituitary-thyroid axis, disrupts the balance of key neurotransmitters such as noradrenaline, serotonin, and dopamine which contributes to the development of affective states. Genetic and immuneinfiammatory mechanisms also play a significant role in the pathophysiology of both BD and thyroid disorders. The aim of the review is to evaluate current evidence on the relationship between thyroid dysfunction and BD, focusing on neurochemical, genetic, and immune mechanisms, as well as the potential therapeutic applications of thyroid hormones in BD treatment. Materials and Methods: a literature review was conducted for the years 2000–2023, including publications available in PubMed, the Cochrane Library, and the e-Library databases. The search was performed using the keywords: bipolar disorder, thyroid dysfunction, thyroid hormones, infiammation, GWAS. Original studies, meta-analyses, randomized controlled trials, and cohort studies were included in the analysis. Discussion: Genetic studies, particularly genome-wide association studies (GWAS), have identified shared genetic loci associated with immune regulation and infiammation, which increase the risk of both BD and thyroid dysfunction. The presence of thyroid peroxidase antibodies in patients with BD and their relatives suggests a potential genetic predisposition and an autoimmune component underlying both conditions. Furthermore, clinical trials have demonstrated the efficacy of high-dose L-thyroxine in alleviating depressive symptoms in patients with BD who are resistant to standard therapy. However, further investigation is needed to determine the factors infiuencing response to hormone therapy, including genetic predisposition, coexisting thyroid disorders, and disease duration, to optimize treatment strategies. Conclusion: а deeper understanding of the relationship between BD and thyroid dysfunction, including neurochemical, genetic, and immune mechanisms, will facilitate the development of personalized therapeutic approaches. This, in turn, may improve diagnosis, prevention, and overall quality of life for affected patients.

Background: comorbid depressive and anxiety disorders are the most common combination in clinical practice. These states require a careful approach when choosing treatment methods. The abilities to adapt psychotherapeutic interventions to the needs of patients studied insufficiently. The aim of review was to analyze scientific publications on modern treatment methods, such as cognitive behavioral therapy (CBT) and person-centered (reconstructive) psychotherapy (PCP). Materials and Methods: using keywords “depression”, “stressful disorders”, “comorbidity”, “person-oriented reconstructive psychotherapy”, “cognitive behavioral therapy”, “personalized therapy”, “targets of psychotherapy” a search for articles has been conducted in PubMed, MEDLINE, RSCI, e-Library The purpose of analytical study is to identify the targets of psychotherapeutic interventions for comorbid depressive and stressful disorders in each of the methods. Discussion: the difficulties arising from the comorbidity of depressive and anxiety disorders, as well as their impact according to the choice of therapeutic approach are discussed in most of articles under consideration in connection with the tasks of improving the quality of therapeutic intervention through the selection of a personalized approach to treatment. The characteristics and results of the use of CBT and LORP in the treatment of comorbid conditions are examined, and the targets to which psychotherapeutic interventions should be directed, taking into consideration comorbidity, are identified. The effectiveness of these methods in reducing symptoms and improving the general condition of patients with combined depressive and anxiety disorders is shown. Conclusion: the formation of nosospecific psychotherapeutic strategies can solve problems of increasing the effectiveness of the chosen treatment and improving patients' quality of life

For the anniversary of Andrey Fedorovich Iznak

For the 75th anniversary of Igor I. Miroshnichenko