[Psychopathological correlates of depression with non-suicidal self-harm in non-psychotic mental illnesses of adolescence]. / Psikhopatologicheskie korrelyaty depressii s nesuitsidal'nymi samopovrezhdeniyami pri nepsikhoticheskikh psikhicheskikh zabolevaniyakh yunosheskogo vozrasta.

OBJECTIVE: To determine the main clinical and psychopathological features of the relationship between depressive states and non-suicidal self-injury (NSSI) in mental illnesses of the non-psychotic register in adolescence. MATERIAL AND METHODS: Clinical data of 128 patients (77 males and 51 females), who presented with depressive states and NSSI in non-psychotic mental disorders during adolescence, were analyzed. The patients were examined at the Clinic of the Mental Health Research Center during the period 2020-2023. The mean age of the patients was 19±4.1 years. RESULTS: Based on the data from studying depression and NSSI in adolescence, we developed a typology, identifying three variants of affect and auto-aggressive activity interactions. The affect-dominant type (25.8%) was characterized by a predominance of affective pathology (p<.05), with the occurrence of impulsive NSSI (45.5%) and demonstrative NSSI (30.3%) (p<0.05). The personality-dominant type (43.0%) was based on pathocharacterological abnormalities (60.0%), where NSSI were represented by impulsive (25.5%), depersonalizing (27.3%), and addictive variants (32.7%) (p<0.05). The reciprocal type (31.3%) exhibited pronounced polymorphism, combining high affect variability with a tendency towards auto-aggressive behavior of varying severity and manifestations of NSSI (p<0.05). In terms of nosological distribution, schizotypal disorder predominated (45.0%) followed by predominantly borderline personality disorder (30.0%) and bipolar affective disorder (25.0%) (p<0.05). In terms of nosological distribution, schizotypal disorder predominated (45.0%), followed by predominantly borderline personality disorder (30.0%) and bipolar affective disorder (25.0%) (p<0.05). CONCLUSION: Three types of correlation between depression and NSSI were identified, the formation of which was due to the pathoplastic influence of the age factor, nosological affiliation and a certain, including pathological personality structure. Statistically significant regularities between variants of NSSI and types of their interrelation were revealed. The results can be considered as differential diagnostic and prognostic markers of their further trajectories and, therefore, contribute to the creation of new therapeutic strategies, timely diagnosis and earlier intervention.

[Borderline personality disorder in young adults: features of psychopathology and patterns of course]. / Pogranichnoe rasstroistvo lichnosti v yunosheskom vozraste: osobennosti psikhopatologii i zakonomernosti techeniya.

OBJECTIVE: To identify the psychopathological features of borderline personality disorder (BPD) in adolescence, determine the trajectory of its further course, and develop criteria for differential diagnosis. MATERIAL AND METHODS: Clinical/psychopathological and psychometric methods were used to study 143 patients. The patients were divided into two groups: a clinical group - 73 patients, who were inpatients or outpatients in the clinical departments of the Mental Health Research Center (MHRC) in 2019-2022, and a follow-up group - 70 patients who were inpatients or outpatients in the MHRC clinic in 2006-2010. RESULTS: The structure of BPD in adolescence was clinically heterogeneous, which allowed distinguishing three typological varieties: with phenomena of «affective storm¼, which was characterized by the dominance of affective disorders, including after completion of adolescence, with some stabilization of personality structure (type I); with the dominance of addictive patterns of the type of «adrenalinomania¼, in which one of the key positions was occupied by craving impairments, with a constant need to search for new extreme hobbies, the use of psychoactive substances, which persisted after the end of adolescence (type II); with the predominance of «cognitive dissociation¼, which was characterized by the most polymorphic picture of disorders, with the predominance of self-identification disorders with dissociative disorders that retain their severity after the end of adolescence (type III). An integrative assessment of outcomes showed that rather favorable results (47.37%) (χ2=23.37, p=0.001) prevailed at type I, type II was characterized by rather unfavorable (59.26%) and unfavorable results (22.22%) (χ2=12.75, p=0.013) and type III by rather unfavorable (79.17%) and unfavorable (8.33%) outcomes (χ2=16.75, p=0.002). In the nosological evaluation of the follow-up group, 80.0% of patients were diagnosed with BPD, in the rest of the patients there was a change in diagnosis: in 14.3% for schizotypal disorder, in 5.7% for an attack-like form of schizophrenia (χ2=13.8, p=0.008; χ2=14.5, p=0.006). CONCLUSION: BPD in adolescence was confirmed in the majority of cases in adulthood. The results confirm that the typological variants of BPD are of prognostic value and can serve to further develop therapeutic and socio-rehabilitation measures.

[First depressive episode in the dynamics of personality disorders in adolescence]. / Pervyi depressivnyi epizod v dinamike rasstroistva lichnosti v yunosheskom vozraste.

OBJECTIVE: To determine clinical and psychopathological specifics of the first depressive episode (DE) in the context of formation of personality anomalies and their dynamics in adolescence. MATERIAL AND METHODS: Two hundred and thirty-seven patients (180 male, 57 female), aged 16 to 25 years, with the first DE and comorbid personality disorder (PD) were clinically observed and psychopathologically evaluated. Later 149 patients from this group participated in the follow-up study. RESULTS: The first DE with PD in adolescence is characterized by psychopathological variety due to PD type and age factor. Diagnosis of PD in adolescence is based on pathological traits, while affective impairment is a separate dimension. PD determines the clinical features of the first DE and all spectrum of affective disorders. The high conjugation of the first DE with autoagressive behavior confirms their suicidal risk. Autoagressive behavior is noted in 201 (84.8%) patients, of which 59 (29.4%) had non-suicide self-injury (NSSI) and 14 (70.6%) had suicidal activity. The follow-up study identified variants of further dynamics of PD with comorbid affective spectrum disorders after the first DE developed in youth that had prognostic value: unipolar major depression in schizoid PD (13 (37.1%) patients), cluster C PD (8 (26.7%)); bipolar affective disorders in borderline (42 (28.2%)) and narcissistic (16 (40.0%)) PD; recurrent depressive disorder in PD of cluster C (14 (46.7%)). CONCLUSIONS: The revealed clinical and psychopathological features will contribute to the creation of a unified model for predicting affective disorders and the formation of therapy standards.

Thiacalixarene based quaternary ammonium salts as promising antibacterial agents.

The search for new antibacterial and antiseptic drugs is an urgent problem due to the resistance of microorganisms to existing drugs. In this work, for the first time, the design of antibacterial and bactericidal agents based on quaternary ammonium compounds on thiacalixarene macrocyclic platform was proposed and implemented. A series of tetrasubstituted quaternary ammonium salts with different nature and length of the substituent (-N+(CH3)2R, R = CH2Ph, CnH2n+1, n = 1, 4, 8, 10) based on p-tert-butylthiacalix[4]arene in cone and 1,3-alternate conformations was obtained with excellent yields. The obtained compounds have a high antibacterial effect against Gram-positive (S. aureus, S. epidermidis, B. subtilis) bacteria comparable with commercial antiseptics chlorhexidine, miramistin and benzalkonium chloride. It was found that quaternary ammonium derivatives of thiacalix[4]arene in 1,3-alternate conformation more effectively inhibit the growth of the tested bacterial strains in comparison with compounds in cone conformation. Cytotoxicity studies on human skin fibroblast (HSF) cells demonstrated that all compounds were less toxic compared to reference drugs. The different type of interaction of the studied compounds with model DPPC lipid membranes explains different antibacterial activity and cytotoxicity of compounds. The compounds in cone conformation are adsorbed on the DPPC vesicles membrane surface, while the incorporation of lipophilic alkyl fragments of macrocycles in 1,3-alternate conformation into the membrane leads to "clumping" of DPPC vesicles. It was shown the saving of antibacterial activity of thiacalixarene derivatives in 1,3-alternate conformation on Gram-positive clinical strains. The obtained results allow viewing the described thiacalixarene based quaternary ammonium compounds as promising molecules in the development of the new antibacterial agents.

[Suicidal behavior in patients with mental disorders in youth]. / Osobennosti suitsidal'nogo povedeniya pri psikhicheskikh rasstroistvakh yunosheskogo vozrasta.

OBJECTIVE: To study suicidal behavior in young adult patients with different mental disorders. MATERIAL AND METHODS: Two hundred and fifty patients (190 men and 60 women) who committed suicide attempts in youth age over the years 2009-2019 were studied. RESULTS: The most common psychological and social characteristics of young adults who attempt suicide, which set prerequisites and define the very mechanisms of suicidal behaviors, are determined. The following psychopathological types of suicidal attempts in this group of patients are identified: 1) Impulsive (30.1%); 2) Demonstrative (20.2%); 3) Overvalued (19.8%); 4) Depersonalization-related (14.9%); 5) Psychotic (10.1%); 6) Self-torturing (4.8%). The types of suicidal attempts correlate with nosologic forms. This finding is important in terms of differential diagnosis and working out therapeutic and socio-rehabilitation strategies. CONCLUSION: The dynamic study of the patients showed that the suicidal risk persists throughout the entire period of youth, including after medical intervention. Therefore, long-term and systemic individual pharmaco- and psychotherapy is required.

[Depression in patients with personality disorder in youth]. / Depressiia pri rasstroistve lichnosti v iunosheskom vozraste.

AIM: To define clinical specifics of depression in patients with personality disorders (PD) in youth and work out differential/diagnostic criteria of these states. MATERIAL AND METHODS: One hundred and sixty patients (136 men, 24 women, mean age19.5±3.2 years) were studied. Later 42 patients from this group participated in the follow-up study. RESULTS: The following types of depression were described: 'with overvalued ideas', 'with neurotic disorders', 'with predominant addictions', 'with youth asthenic incapacity' and 'with attenuated psychotic symptoms'. These types clearly correlate with the type of PD. CONCLUSION: Personality abnormality plays a role in the pathogenesis of these states. This finding contributes to the more accurate diagnosis, prognostic and therapeutic solutions.

[Neuropsychological syndromes of non-psychotic mental disorders of youthful age].

Seventy male patients with non-psychotic mental disorders of youthful age (mean age 19.2±3.7), were studied using A.R. Luria neuropsychological syndrome analysis. Patients were stratified into 3 groups by diagnosis: cyclothymia (20 patients), pubertal decompensation of schizoid personality disorder (30 patients) and schizotypal personality disorder (20 patients). It has been shown that the neuropsychological changes indicate the dysfunction of the amygdale/temporal region in patients of the first group and frontal/thalamic/parietal connections in the patients of two other groups. There were interhemispheric differences between patients with personality disorder and schizotypal personality disorder: left hemisphere dysfunction was characteristic of schizotypal disorder and right hemisphere deficit (neurocognitive deficit) was found in patients with personality disorder.

[Characteristics of the pre-manifest stage in young patients with the first episode endogenous psychosis].

A retrospective study of pre-manifest personality traits in 120 young patients (16-25 years old) identified the clinical heterogeneity of the period preceding the first episode of juvenile endogenous attack-like psychosis. Depending on the degree of personality abnormalities, patients were stratified into 3 groups as having accentuated personality traits, personality disorders (psychopathy) or pseudopsychopathy, the latter divided into deficit and degenerative subgroups. Correlations between the degree of personality abnormality and the type of manifest episode and its nosological status were found.

[Main types of depression with the prevalence of overvalued ideas within the pubertal decompensation of personality disorders].

Authors observed 96 patients (81 males and 15 females) with overvalued depressions within the pubertal decompensation of personality disorders. Past medical history and prospective observation showed that those conditions develop over the long period of distimia and pose a high risk of suicide. Such conditions differ mildly in content - metaphysical, dysmorphophobical or hypohondriacal, but far more significantly in a parity of structural components of overvalued symptoms, which consist of an ideational cultivation, an affective filling and a component of inclination. According to prevalence of one of the components three main types of such depressions were described: classical, obsessive and type of overvalued inclination. There was established a correlation between type of depression and patient's personality structure and it influenced on the clinical course of depression, the choice of therapy and on prognosis on personality disorders compensation probability in adulthood.

[Cognitive behavioral therapy of residual symptoms in patients with juvenile depression]. / Kognitivno-bikhevioral'naia terapiia rezidual'nykh simptomov depressii iunosheskogo vozrasta.

There were forty patients (mean age 20.7 years) who met the ICD-10 criteria of diagnosis of affective disorder (items F31-F33)--juvenile depression, successfully treated with antidepressants in psychiatric hospital and later on maintenance therapy for correction of residual symptoms. The duration of follow-up study was 2 years. All the patients were randomised into two groups, the first one receiving psychopharmacotherapy combined with cognitive behavioural therapy and the second--only the former one. In both groups, the antidepressant dosing was continuously decreased up to complete withdrawal. In the first group, patients revealed significantly fewer residual symptoms after antidepressants treatment compared with the second group, which was assigned only to psychopharmacotherapy. Also, depression relapse frequency tended to be lower in the first group than in the second one (15% vs 35%) but the differences were insignificant. The authors emphasize that further studies of cognitive behavioural therapy in depression relapse prevention are needed.