[Hypersomnia in mental disorders]. / Gipersomniya pri psikhicheskikh rasstroistvakh.

Hypersomnia is a group of diseases that share the main symptom - excessive daytime sleepiness, not caused by disturbances in nocturnal sleep or circadian rhythms. Excessive daytime sleepiness is present in 15.6% of adults in the world, a Russian study showed a prevalence of 39.2%. It is associated with a wide range of comorbidities, including obesity and mental disorders, on the other hand, the presence of hypersomnia increases the likelihood of mental illness. People with hypersomnia are more likely to take medications, have a decreased quality of life, spend more health care resources, and more often receive social benefits. The heritability is estimated to be about 40% for sleep duration and 17% for excessive daytime sleepiness. Hypersomnia in mental disorders is secondary. It most often occurs in patients with depression or bipolar disorder. To assess the severity of daytime sleepiness, self-observation and objective methods, including the multiple sleep latency test, actigraphy, polysomnography, are used. In the differential diagnosis of hypersomnia in psychiatric disorders, it is necessary to make a differential diagnosis with hypersomnia caused by taking medications or other substances and insufficient sleep syndrome. The etiology of prolonged sleep in psychiatric disorders is complex, and includes biological and psychological causes. The relationship between self-reported hypersomnia and sleep actually obtained is still unclear. Results of daily polysomnography show a significant increase in time in bed during the day and night (clinophilia). Therapy of hypersomniac syndromes should be done taking into account the etiology of the disease. In cases of secondary nature, the main efforts should be directed to the treatment of the underlying mental disorder causing somnolence.

[Optimization of treatment of depression with administration of ethylmethylhydroxypyridine succinate (Mexicor)]. / Optimizatsiya lecheniya depressii naznacheniem etilmetilgidroksipiridina suktsinata (Meksikor).

OBJECTIVE: To investigate the therapeutic efficacy and tolerability of Mexicor as an adjuvant in the treatment of depression with SSRI antidepressants. MATERIAL AND METHODS: The study included 100 patients, aged 18-50 years, with verified depression of mild (n=32) or moderate (n=68) severity. Patients (n=50) of the main group, along with basic antidepressant therapy with SSRIs, received Mexicor at a dose of 600 mg/day, in the comparison group (n=50) - only SSRIs. Clinical-psychopathological, psychometric, using the HDRS-21 scale, CGI, HADS, fluency test of speech responses and the Stroop test, statistical research methods were used. RESULTS: The reduction of depressive symptoms on the HDRS-21 scale, starting from the fourth week, was statistically significantly superior to that in the comparison group (p<0.001), the reduction in the severity of the condition on the CGI scale in the main group was also significantly greater than in the comparison group (17.3% and 9.6% respectively, p<0.05). A significant improvement in speech fluency was found in the main group (p<0.05). Adverse events in the main group were significantly less common (p<0.001). CONCLUSION: Administration of Mexicor together with SSRIs leads to improved efficacy and tolerability of antidepressant therapy, and in the future, Mexicor may be recommended as an adjuvant in SSRI therapy for depression.

[Astenic disorders within the framework of post-covid syndrome]. / Astenicheskie rasstroistva v ramkakh postkovidnogo sindroma.

The direct neurotropic and neurotoxic effect of the SARS-CoV-2 virus on the central nervous system, as well as the stressful effect of various factors of the COVID-19 pandemic, contribute to the development of the so-called post-COVID syndrome. The clinical picture of the syndrome includes asthenic, anxiety-asthenic, and depressive manifestations. When prescribing psychopharmacotherapy to patients who have undergone COVID-19, it is recommended to assess the potential benefits and risks in the aspect of using drugs not only with therapeutic antiasthenic and anxiolytic properties, but with minimally expressed undesirable effects and adverse drug interactions.

[Features of cognitive remediation in patients with affective disorders]. / Osobennosti kognitivnoi remediatsii u patsientov s affektivnymi rasstroistvami.

The article presents a literature review on the problem of cognitive deficit in patients with affective disorders. Cognitive deficit in patients with bipolar affective disorder and recurrent depression affects cognitive and executive functions, information processing, and has certain specific features. Specifics of cognitive deficit in patients with affective disorders hampers the use of rehabilitation programs. Consequently, the topic evokes increased interest of specialists and the need for further research.