[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.

[Peculiarities of treatment with antidepressants in patients with schizoaffective disorder in the interictal period]. / Osobennosti terapii antidepressantami bol'nykh shizoaffektivnym rasstroistvom v mezhpristupnom periode.

OBJECTIVE: To investigate the effect of therapy with various classes of antidepressants on the quality of remission and adherence to therapy in patients with schizoaffective disorder (SAD) in remission. MATERIAL AND METHODS: We examined 87 outpatients, including 29 men (33.33%), 58 women (66.67%) diagnosed with SAD according to ICD-10 criteria (item F25), in whom 341 cases of remission were studied. The average age of the patients was 41.40±12.56 years. Cases of remission in patients receiving therapy with nonselective monoamine reuptake inhibitors (NSMRIs) were included in group 1 (n=228), cases of remission formed on therapy with selective neuronal reuptake inhibitors (SNRI) were included in group 2 (n=113). Clinical follow-up and statistical methods were used. RESULTS: In both groups, mood disorders in remission were represented by subdepression. Delusional disorders at the stage of remission were almost 7 times more common in group 1 (12.28%), compared with group 2 (1.77%). The duration of the interictal period in patients treated with NSMRIs was higher (504.0±60.67 days) compared with patients receiving SNRI (176.46±17.88 days). In group 2, residual affective-delusional symptoms in remission were significantly less common. Cases of refusal from therapy in group 2 were 12 times less frequent, which indicates a greater adherence to therapy in patients receiving SNRI. CONCLUSION: It is possible to recommend treatment with NSMRIs for patients with depressive affect in the structure of SAD to increase the duration of the interictal period. At the same time, for patients with SAD in the presence of delusional and affective-delusional symptoms, it is preferable to prescribe SNRI.

[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.

[Psychopathological characterisitic of infertile women with sexual dysfunctions in assister reproductive technologies programs]. / Psikhopatologicheskie osobennosti infertil'nykh zhenshchin s seksual'nymi disfunktsiiami, uchastvuiushchikh v programmakh vspomogatel'nykh reproduktivnykh tekhnologii.

AIM: To study the psychopathological characteristics of infertile women with sexual disorders in assisted reproductive technologies (ART) programs to develop therapeutic and rehabilitative interventions and improve the quality of life of the couple. MATERIAL AND METHODS: An open continuous comparative descriptive study of sexual health, psychopathological features and personality characteristics of 589 women with infertility seeking treatment using ART was performed in 2013-2017. Clinical-psychopathological, sexological and psychometric methods were used. RESULTS: Non-psychotic mental disorders, predominantly anxiety disorders (28.0%), were identified in 58,9% of patients. Sexual dysfunctions of a disease level, among which prevailed disorder of libido (25.0%), were identified in 18.34% of patients. A high comorbidity of sexual dysfunctions and borderline mental disorders was detected (100% in patients with sexual dysfunctions versus 44.9% in patients without sexual disorders). an analysis of premorbid personality characteristics and severity of psychopathological symptoms based on the results of mpt, scl - 90 showed that patients with sexual disorders scored significantly lower on domains 'extroversion' and 'tolerance to frustration', while scores on 'esoteric tendencies', 'neuroticism', 'obsession', 'sensitivity', 'depression', 'anxiety', 'hostility' and 'psychoticism' were higher; significant positive and negative correlations between domains were noted. Increased or high levels of anhedonia assessed with scale SHAPS were found in 100% of patients, 43.8% had alexithymia according to TAS and 18.19% showed increased and high levels of asthenia (MFI-20). CONCLUSION: Characteristics of the psychopathological structure of sexual dysfunctions in women with infertility in ART programs should be taken into account in the development of treatment and rehabilitation options and improvement of quality of life of the couple.

[Characteristics of personality and psychological aspects of suicidal behavior prevention in medical students]. / Lichnostno-psikhologicheskie aspekty profilaktiki suitsidal'nogo povedeniia studentov.

AIM: To study the formation and dynamics of development of suicidal behavior (SB) in medical students based on a personality/psychological approach. MATERIAL AND METHODS: Two hundred and seventy-two students with- (n=75) and without SB (n=197) were examined. Psychopathological and psychological methods, and several questionnaires and scales were used. RESULTS AND CONCLUSION: Personality and environmental characteristics as well as family loading were the leading factors of SB formation. Based on the results obtained, the authors developed a complex of preventive measures in the frames of three types of prevention (common, selective and indicative).

[Sexual functioning and sexual dysfunction in women with infertility]. / Seksual'naia funktsiia i disfunktsiia pri besplodii u zhenshchin.

AIM: To study sexual dysfunction and assess the need in sexological care to improve quality of life of women with infertility. MATERIAL AND METHODS: Sexual functioning was studied in 329 women with infertility and 722 women who underwent an outpatient gynecological examination using a clinical interview and the Female Sexual Function Index (FSFI). RESULTS: In 24.01% of women with infertility, the total FSFI score was correlated with the presence of clinically relevant disorders. Sexual dysfunction was identified in 16.1% of women with infertility including libido disorder (84.9%), dyspareunia (30.2%) and orgasmic dysfunction (13.2%). The latent forms of sexual dysfunction were identified as well. CONCLUSION: The study showed a high need for curative and preventive sexological care to improve quality of life of women with infertility.

[Clinical features of exogenous organic mental disorders in patients with HIV infection]. / Osobennosti kliniki ekzogenno-organicheskikh psikhicheskikh rasstroistv u bol'nykh VICh-infektsiei.

AIM: To specify clinical/dynamic features of organic mental disorders in patients with HIV and to characterize the formation and course of psychoorganic syndrome. MATERIAL AND METHODS: The study included 250 HIV-infected patients with mental disorders and 50 injection drug users (166 men and 84 women, mean age 30.6±6.3 years). Clinical, psychological methods and laboratory instrumental examinations were performed. RESULTS AND CONCLUSION: Course of the infection process and premorbid personality play an important role in the development of exogenous organic mental disorders in patients with HIV infection.

[Mental disorders in patients with HIV infection: systematics and features of development].

OBJECTIVE: To identify and systematize characteristics and patterns of formation and development of mental disorders in HIV-infection. MATERIAL AND METHODS: Two hundred and fifty patients with HIV-infection and 50 injection drug users, aged 18-50 years, were examined. Most of HIV-infected people were aged from 21 to 40 years. In addition to clinical and psychopathological methods, clinical laboratory instrumentation and experimental psychological method were used. RESULTS AND CONCLUSION: Mental disorders in HIV-infected patients include psychogenic-reactive, exogenous organic and personality disorders. The dynamics of these disorders depends on the combined effects of somatogenic, nosogenic and premorbid personality factors.

[The use of mood stabilizers in preventive treatment of patients with schizoaffective disorders].

OBJECTIVE: To study an effect of combination therapy consisting of mood stabilizers on the quality of remission in patients with schizoaffective disorders. MATERIAL AND METHODS: Authors examined 56 outpatients with ICD-10 diagnosis of schizoaffective disorder (F25). Patients in remission received anti-relapse therapy with antipsychotics and were not treated with mood stabilizers for at least two years, and then they received a combined anti-relapse therapy, including both antipsychotics and mood stabilizers. RESULTS AND CONCLUSION: The combined use of pharmacotherapy creates a better remission. No statistically significant differences in the effect of different groups of mood stabilizers on the average duration of remission are identified. The inclusion of mood stabilizers in the scheme of preventive treatment has no effect on the average duration of subsequent hospitalization. Mood stabilizers are effective in the prevention of suicidal behavior in patients with schizoaffective disorder, they reduce the risk of disability in patients with schizoaffective disorder and increase compliance.