[Psychological, psychiatric and neurological aspects of COVID-19]. / Psikhologicheskie, psikhiatricheskie i nevrologicheskie aspekty COVID-19.

OBJECTIVE: To analyze neurological, psychological and psychiatric aspects of COVID-19, as well as to study the current state of the problem. MATERIAL AND METHODS: The study included 103 patients with COVID-19. The main research method was clinical/psychopathological. To study the impact of activities related to the care of patients with COVID-19 in a hospital setting, the medical and psychological state of 197 hospital workers involved in the treatment of patients with COVID-19 was assessed. The level of anxiety distress was assessed with the Psychological Stress Scale (PSM-25), distress indicators corresponded to values of more than 100 points. The severity of anxiety and depressive symptoms was assessed using the Hospital Anxiety and Depression Scale (HADS). RESULTS: When considering psychopathological disorders in the context of COVID-19, it is necessary to distinguish between two main groups of disorders: mental disorders during the pandemic, and mental disorders directly caused by the causative agent SARS-CoV-2. The analysis of psychological and psychiatric aspects in various periods of the initial stage of COVID-19 showed that each of them was characterized by specific features depending on the nature of the influence of different pathogenic factors. In the structure of nosogenic mental disorders in patients with COVID-19 (103 patients), the following clinical forms were identified: acute reaction to stress (9.7%), anxiety-phobic disorders (41.7%), depressive symptoms (28.1%), hyponosognosic nosogenic reactions (20.5%). At the same time, the majority of the patients had manifestations of somatogenic asthenia (93.2%). A comparative analysis of neurological and psychological/psychiatric aspects of COVID-19 showed that the main mechanisms of the impact of highly contagious coronaviruses, including the SARS-CoV-2, on the central nervous system are: cerebral thrombosis and cerebral thromboembolism, damage to the neurovascular unit, neurodegeneration, including that induced by cytokines, and immune-mediated demyelinating nerve damage. CONCLUSION: Neurological and psychological/psychiatric aspects of COVID-19 should be taken into account both at the stage of disease treatment and in the post-infection period due to the pronounced neurotropism of SARS-CoV-2 and its effect on the neurovascular unit. Along with helping patients, an important aspect is the preservation of the mental health of medical personnel working in hospitals for infectious diseases, due to special working conditions and a high level of professional stress.

[Some psychiatric and neurological aspects of the asymptomatic and mild course of COVID-19]. / Nekotorye psikhiatricheskie i nevrologicheskie aspekty bessimptomnogo i legkogo techeniya COVID-19.

OBJECTIVE: To study neurological and mental disorders associated with the inapparent and mild course of COVID-19. MATERIAL AND METHODS: The study included 50 patients (mean age 35.2±11.4 years) admitted to a psychiatric hospital due to depressive spectrum disorders. Patients were divided into two groups: patients (n=16) who had IgG antibodies to SARS-CoV-2 (main group) and patients (n=34) without a history of COVID-19 (comparison group). RESULTS AND CONCLUSION: Patients of the main group showed a difference in the structure of asthenic disorders compared with the comparison group. Also, there was a significant predominance of the severity of asthenic symptoms and anxiety in the structure of psychopathological disorders in depressive spectrum disorders. The viral intoxication contributes to the formation of a kind of asthenic «soil¼ (with characteristic manifestations). In the future, in the case of the development of any stress-associated disorder, more pronounced psychopathological disorders are noted compared with patients of the comparison group. The authors describe a variant of the course of COVID-19, in which the development of ischemic stroke was the first clinical manifestation of the disease. These disorders are based on the pronounced neurotropic effect of SARS-CoV-2 and its effect on the neurovascular unit.

Psychological and psychiatric aspects of unusual living conditions caused by the COVID-19 pandemic

The article examines the psychological and psychiatric aspects of unusual living conditions caused by the pandemic of the novel coronavirus infection COVID-19. The features of the formation of psychopathological disorders in the population during an unfavorable epidemiological situation are analyzed. Five periods of their development are identified, which were characterized by their specific features depending on the influence of various factors (patterns of development of the infectious process, the nature of its information support, organizational measures taken, etc.). In the study of the psychological and pathopsychological characteristics of the response under conditions of an unfavorable epidemiological situation, it was established that their structure and clinical features had, along with the general patterns (characteristic for each of the periods of the development of the epidemic situation), a number of specific features. In the course of studying the psychological and psychiatric aspects of unusual conditions of existence (forced self-isolation), three groups of people were identified, according to their age and the nature of their professional activities. It was established that the psychological forms of response and the features of psychopathological manifestations in the conditions of an unfavorable epidemiological situation caused by COVID-19 were characterized by heterogeneity and polymorphism and were determined both by the course of the epidemic process and by the influence of various biomedical, socio-psychological, informational, and professional household pathogenic factors. Of particular importance was the fact that the degree of influence of these factors on the mental health of people was largely determined by the gradually increasing asteniс effect of each of them (the “vicious circle”), with the formation of a “favorable asthenic soil” that promotes the development of more marked and persistent mental and psychosomatic disorders. В статье проведено изучение психолого-психиатрических аспектов непривычных условий существования, вызванных пандемией новой коронавирусной инфекции COVID-19. Проанализированы особенности формирования психопатологических нарушений у населения в период неблагополучной эпидемиологической обстановки. Выделены пять периодов их развития, которые характеризовались своими специфическими особенностями в зависимости от влияния разных факторов (закономерностей развития инфекционного процесса, характера его информационного сопровождения, принимаемых организационных мероприятий и т. д.). При исследовании психологических и патопсихологических особенностей реагирования в условиях неблагополучной эпидемиологической обстановки установлено, что их структура и клинические особенности имели, наряду с общими закономерностями (характерными для каждого из периодов развития эпидобстановки), ряд специфических особенностей. В ходе изучения психолого-психиатрических аспектов непривычных условий существования (вынужденной самоизоляции) выделены три группы лиц в зависимости от их возраста и характера профессиональной деятельности. Установлено, что психологические формы реагирования и особенности психопатологических проявлений в условиях неблагополучной эпидемиологической обстановки, вызванной COVID-19, характеризовались неоднородностью и полиморфностью и определялись как течением самого эпидемического процесса, так и влиянием различных медико-биологических, социально-психологических, информационных и профессионально-бытовых патогенных факторов. Особое значение приобретало то обстоятельство, что степень влияния данных факторов на психическое здоровье людей во многом определялось постепенно нарастающим астенизирующим воздействием каждого из них («порочный круг») с формированием «благоприятной астенической почвы», способствующей развитию более выраженных и стойких психических и психосоматических расстройств.