[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.

[Psychopathology of depressive-delusional states with religious content]. / Psikhopatologicheskie osobennosti depressivno-bredovykh sostoyanii s religioznym soderzhaniem.

OBJECTIVE: Identification of psychopathological characteristics of depressive-delusional states with religious content, development of a typology, determination of formation features, nosological assessment. MATERIAL AND METHODS: A total of 79 patients (47 female, 32 male, mean age 27±6.5 years) with depressive-delusional states with religious content within the affective and schizophrenia spectrum disorders were studied. Clinical-psychopathological, psychometric (PANSS, HDRS, S. Huber CRS) and statistical methods were used. RESULTS: Based on the psychopathological structure, specific mechanisms of development of delusions and themes of the religious experiences, three types of depressive-delusional states were identified: type 1 - with a predominance of depressive delusions congruent with affect and delusional ideas of guilt, sinfulness, abandonment of God (14 patients, 17.7%; 6 women, 8 men; mean age 28±4.5 years; HDRS score 33±5.6, the total PANSS score 71±5.3, the PANSS positive subscale score 15.8±3.7); type 2 - with the addition of incongruent delusional constructs, persecutory disorders and acute sensory delusions to the existing depressive religious delusion, with the phenomenon of confessional ambivalence (27 patients, 34.2%; 16 women, 11 men; mean age at attack manifestation 25±9 years; HDRS score 29.6±4.4, the total PANSS score 87±6.2, the PANSS positive subscale score 23.5±4.2); type 3 - depressive-paranoid states with a predominance of Kandinsky-Clerambault syndrome of religious content (38 cases, 48.1%; 20 women, 18 men; mean age at attack manifestation 23.4±2.5 years; HDRS score 32.7±3.7, the total PANSS score 102±7.3, the PANSS positive subscale score 32.5±4.5). CONCLUSION: The study of depressive-delusional states with religious content has shown their clinical-psychopathological heterogeneity. The religious experiences served as a pathoplastic factor, which essentially modified the clinical-psychopathological picture of the disease due to presence of the specific religious phenomena. The identified types of depressive-delusional disorders with religious content had different diagnostic value.

[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.

[Doomsday delusions of religious content (apocalyptic version)]. / Bred kontsa sveta religioznogo soderzhaniya (apokalipticheskii variant).

OBJECTIVE: To define psychopathological and phenomenological characteristics of the apocalyptic variant of end-world delusion with religious content (EWDRC) in schizophrenia, to identify features of clinical dynamics of delusional disorders and their interaction with delusional behavior of patients. MATERIAL AND METHODS: A total of 28 patients with schizophrenia (F20.01, F20.02 according to ICD-10) and EWDRC were examined. Clinical-psychopathological and follow-up methods were used. RESULTS: The development of the end-world delusional ideas occurred in unstructured affective-delusional disorder with acute sensual delusion. Two types of EWDRC were differentiated: with predominance of perception delusion or picturesque delusion. These types differed by acuity and massiveness of psychotic symptomatology, the mono- or polythematic character of delusional disorders, affect type, as well as by the duration and intensity of the development of delusional stages, and in their phenomenological specifics. CONCLUSION: Delusional ideas of the end of the world in schizophrenic patients develop in the structure of the syndrome of acute sensory delusions with a predominance of delusions of perception (type I) or visual-figurative delusions of the imagination (type II), which have different duration, degree of dominance and depth of psychopathological disorders.

[Endogenous depressions with religious experience]. / Endogennye depressivnye sostoyaniya s religioznymi perezhivaniyami.

OBJECTIVE: To identify the specifics of psychopathology and phenomenology of religious experience in depressed patients, for early diagnosis of mental disorders masked by a «religious facade¼, and prevention of suicidal activity. MATERIAL AND METHODS: The study included 115 patients (41 men, 74 women) with depression contained religious distress in affective disorders (38 observations) and schizophrenia (77 observations), F31.3, F31.4, F32.1, F32.2, F33.1, F33.2 and F20.0, F20.4, F21 according to ICD-10. RESULTS: According the psychopathological structure of depressive states, five types of depression were identified. The predominant type was melancholic depression (61%). Based on characteristics of religious experience, types of depressions were distinguished as follows: with congruent religious ideas of guilt and sinfulness; with the loss of «living¼ faith, God-forsakenness; with overvalued doubts about the choice of faith; and with «spiritual hypochondria¼. CONCLUSION: Mental disorders, in particular depressive states, which have a religious «facade¼ often remain unrecognized due to the specific religious content, which often leads to severe and sometimes irreversible consequences as suicidal activity. Thus, these conditions require early diagnosis and specific approaches to the treatment.

[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 influence of religiosity on depressive disorders and suicidal behavior]. / Vliianie faktora religioznosti na depressivnye sostoianiia i suitsidal'noe povedenie.

This review of the literature is focused on the positive influence of religiosity on recovery after depression and on the protective role of religiosity against suicidal activity. Despite the inconsistent results on the role of religiosity in treatment of mental diseases, to date there is a sufficiently large body of literature showing the beneficial effect of religiosity and describing specific therapeutic approaches and suicide prevention programs.

[Psychopathology and phenomenology of religious delusion of possession in schizophrenia]. / Osobennosti psikhopatologii i fenomenologii breda oderzhimosti religioznogo soderzhaniia pri shizofrenii.

AIM: To analyze psychopathological features of religious delusion of possession, determine the place of this phenomenon in psychotic syndrome, and identify the prognosis and dynamics of schizophrenia due to this disorder. MATERIAL AND METHODS: Thirteen patients with religious delusion of possession were examined in 1994-2016 by psychopathological and follow-up methods. RESULTS AND CONCLUSION: Hallucinations of a general feeling are the crucial psychopathological phenomenon of states with religious delusion of possession. Other delusional disorders (delusion of possession itself or metamorphosis - 'reincarnation in a demon', delusions of spoilage, witchcraft or hypochondriacal delusion) and delusional behavior (special forms of defense), haptic, olfactory hallucinations, and affective (depressive) disorders, suicidal activity are connected with this phenomena. Disease course is either continuous or attack-like. The type of disease course in most cases is complied with the development of stereotype of paranoid schizophrenia. A characteristic feature of disease was the combination of psychopathological disorders, reflecting the continuous nature of the endogenous disease (interpretive delusions, overvalued religious constructions) with disorders, that are more representative for the paroxysmal course (the phenomena of acute sensual delusions, expressed affective disorders), at the manifest stage of the disease. However, in most cases, unlike the classical hallucinatory type of paranoid schizophrenia, the disease began with circular bipolar affective disorders. In most cases, outcome of a manifesting psychosis is unfavorable.