[Existential youth depressions]. / Ekzistentsial'nye yunosheskie depressii.

OBJECTIVE: To determine the clinical and psychopathological features of existential depression in youth. MATERIAL AND METHODS: 53 male patients (16-25 years old) with diagnosis F31.3, F31.4, F32, F33 with existential themes of depressive experiences were studied by clinical and psychopathological method. RESULTS: The axial symptom of existential was over-value ideas about the meaninglessness of their own and human life with ideas of self-abasement, insolvency, low value, imperfection of society, which in most of the studied cases (79.2%) was accompanied by various degrees of severity suicidal thoughts and intentions. Three varieties were identified: with the prevalence of reflections on the meaninglessness of life (39.6%); with the prevalence of neurotic religiosity (28.3%); with an existential philosophical interpretation (32.1%). CONCLUSION: As a result of the study, the heterogeneity of existential depressions, a significant role of psychogenic factors in their formation were revealed, as a high suicidal risk. Existential depressive states differed in duration, severity of depressive symptoms, high frequency of non-suicidal self-neglect and suicidal risk.

[Suicidal risk in depressions with religious content]. / Suitsidal'nyi risk pri depressiyakh u patsientov s religioznym mirovozzreniem.

The review highlights the main issues of positive and negative religious coping in depression with suicidal behavior. The number of clinical and psychological factors related to suicide risk (age, gender, clinics of depression, internal and external religious orientation, the role of religious community, social support and ethical assessment of suicide) is discussed. To develop personalized approaches to the complex therapy of suicidal behavior, it is advisable to devote further research to studying the influence of the religious factor on depressive states with different levels of severity of psychopathological disorders.

[Family history of mood disorders may weaken the link between adverse childhood experience and suicidality in patients with depression]. / Svyaz' semeinoi otyagoshchennosti rasstroistvami nastroeniya s neblagopriyatnym detskim opytom i suitsidal'nost'yu u patsientov s depressiei.

OBJECTIVE: To study the impact of family history of mood disorders (FHMD), comprising genetic factors associated with depression, on the association between adverse childhood experience (ACE) and suicidality in depression. MATERIAL AND METHODS: This multicenter cross-sectional study included 200 in- and outpatients (64% (n=128) women, mean age - (M (SD)) 36.21 (15.09) yrs.) with depression. Self-reports about FHMD and lifetime suicide attempts were obtained in clinical interview. The lifetime intensity of suicidal ideas and behavior was assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS), ACE - by the Adverse Childhood Experience International Questionnaire (ACE-IQ). RESULTS: FHMD did not affect the prevalence of ACE, suicide attempts and C-SSRS scores. We found that FHMD weakens the link between ACE and the risk of suicide attempt. The emotional neglect itself increased the risk of suicide attempt (p=0.001, OR=4.428, CI 95% [1.797-10.911]), but reduced it in patients with FHMD (p=0.03, OR=0.128, CI 95% [0.018-0.893]). GLM analysis revealed that FHMD significantly affected the association between suicidal ideas and domestic violence (p=0.045) and between suicidal behavior and emotional neglect (p=0.015) and abuse (p=0.044). CONCLUSION: FHMD may weaken the link between ACE and suicidality in patients with depression. Suicidality in these patients may be underlined by mechanisms not involved in the response to ACE although more studies are needed.

[The pre-manifest stage in the first psychotic attacks with religious content in juvenile age]. / Domanifestnyi etap pri pervykh psikhoticheskikh pristupakh s religioznym soderzhaniem v yunosheskom vozraste.

OBJECTIVE: To identify the conditions for the formation of religious delusions in adolescence, to analyze the correlations between religiosity at the pre-manifest stage and subsequent manifest psychotic episode with religious delusion. MATERIAL AND METHODS: With the clinical-psychopathological, statistical, and psychometric methods, 51 male patients of adolescent age (16-25 years) with manifest psychotic attack with delusions of religious content (F20, F25 according to ICD-10) - delusions of sin, delusions of devil possesion, antagonistic and messianic delusions, and oneiroid with religious content were studied. RESULTS: The majority of patients were not traditionally religious before the first symptoms of a mental illness, and the religiosity itself differed from the traditional one in many respects. The most important factors in the formation of psychotic attacks with religious content are hereditary burden, premorbid personality structure and high scores on the Premorbid Adjustment Scale. CONCLUSION: Further studies of pre-manifest stages on a larger sample of patients are needed to confirm the results of the study.

[The relationship between psychiatry and religion in the works of Russian psychiatrists]. / Religiia i psikhiatriia: problema vzaimootnoshenii v trudakh otechestvennykh psikhiatrov.

This review analyzes the works of Russian psychiatrists on the relationship between religion and clinical psychiatry. Beginning from the first half of the 19th century a lot of Russian psychiatrists in their writings dealt with the issues of religiosity and mental health as well as with psychopathology and clinical studies of mental states with a religious delusion. They studied psychopathological features of the phenomenon of 'hysterics', the syndromes of religious metaphysical intoxication and demon possession. One of the founders of social psychiatry D.E. Melekhov considered religious faith as the most important personal resource for rehabilitation activities. Differentiation of non-pathological religious experience from mental illnesses with a religious plot remains understudied in the literature. The analysis of the literature on the relationship between religion and psychiatry makes clear that psychiatrist's accurate understanding about the peculiarities of the religious life of patients is necessary for a successful therapeutic alliance.

[Endogenous episodes of juvenile psychosis with religious delusions]. / Religioznyi bred pri iunosheskom éndogennom pristupoobraznom psikhoze.

AIM: To identify clinical and psychopathological features, conditions of formation and prognostic significance of delusions with religious content in endogenous psychotic states in adolescence. MATERIAL AND METHODS: Fifty-three male patients, aged from 16 to 25 years, with juvenile endogenous psychosis, with a psychotic episode with religious content of delusion were examined. Clinical, psychopathological, psychometrical (The Dawkins scale) and statistical methods were used. RESULTS AND CONCLUSION: General psychopathological features of psychotic states with religious delusions, according to the specificity of adolescent age, were identified. Common types of religious delusional episodes, forming by primal interpretive (delusion of sin, delusion of demonic possession) and sensual (messianic and antagonistic delusion, religious oneiroid) mechanisms were distinguished. A role of the previous religiosity, including overvalued religious ideas, was clarified. It was found out that the duration of the pre-manifest stage, hospitalization and the period of 'untreated psychosis', was longer in patients with religious delusions compared to patients with other types of delusions. Patients with interpretive mechanism of delusion formation demonstrated the subsequent intensification of religiosity that was not common for psychotic episodes with the sensual mechanism of delusion formation.

[Endogenous episodes of juvenile psychosis with hypochondriac delusions].

Authors studied 57 young patients, aged from 16 to 25 years, with hypochondriac delusions in a psychotic episode. Four psychopathological types of psychotic episodes with hypochondriac delusions were singled out: depressive-hypochondriac, cenestho-hypochondriac, paranoid and polymorphic. An analysis of these types allowed to consider different mechanisms of the formation and relation of cenesthopathy with hypochondriac delusion. In episodes with the interpretative mechanism of delusion formation, the high frequency of psychasthenic and sensitive schizoids and the long preceding stage with dysmorphophobic, senesthopathic, depressive and overvalued hypochondriac disorders as well as somatic/autonomic pathology were observed. In episodes with mixed mechanisms of delusion formation, the presence of dysmorphophobic and cenestho-hypochondriac symptoms were not characteristic of the initial stage.

[Attitude to disease and psychotherapeutic strategies in youths with the first psychotic episode].

To study attitude to disease in patients with the first episode of juvenile endogenous psychosis (ICD-10 items F20, F25, F30.21 and F32.3), authors examined 89 male patients. There were common patterns in attitude to disease caused by the pathoplastic effect of juvenile age and some differences that were correlated with premorbid personality features and the psychopathological structure of the psychotic episode. Normonosognosic, hyponosognosic, hypernosognosic and disnosognosic types of attitude to disease were singled out. Hyponosognosic type was the most common in patients with the first episode of juvenile endogenous psychosis. Its were elaborated recommendations for differential use of psychotherapeutic strategies which took into account attitude to disease and age of the patient.