[Aggressive behavior of patients with vascular dementia]. / Agressivnoe povedenie bol'nykh sosudistoi dementsiei.

There is a worldwide trend towards an increase in the number of people aged over 60, which in turn leads to an increase in the prevalence of vascular dementia and neuropsychiatric disorders, including the accompanying aggressive behavior. The authors analyze the relationship of neuropsychiatric symptoms with aggressive behavior and assess the impact of the evolution of dementia, socio-demographic factors on the development of aggressive behavior in some subtypes of vascular dementia based on literature data retrieved from Scopus, PubMed, eLibrary databases as well as national guidelines. Analyzing the publication was made by the method of the system analysis and generalization. The analysis of the literature suggests that aggressive behavior in patients with vascular dementia changes their lifestyle and worsens its quality, in addition, it increases the burden on caregivers. Also, this psychopathological process is one of the reasons for frequent hospitalizations of patients in psychiatric hospitals and social institutions, which becomes an urgent economic and medical problem at the state level. Of all the psychopathological symptoms in the clinical picture of vascular dementia, aggressive behavior periodically occurs together with apathy, depression, anxiety, abnormal motor activity and hallucinations. The question of the highest frequency of occurrence of aggressive tendencies in one or another subtype of vascular dementia remains debatable. Research on the relationship between dementia severity, gender, and aggressive behavior has been mixed. The question of the influence of the level of education on the manifestation of aggression in patients with vascular dementia remains completely unexplored. Thus, the above facts dictate the need for further study of these issues.

[An analysis of the relationship between genetic factors and the risk of schizophrenia]. / Analiz svyazi geneticheskikh faktorov s riskom razvitiya shizofrenii.

The etiology and pathogenesis of schizophrenia remain poorly understood, but it has been established that the contribution of heredity to the development of the disease is about 80-85%. Over the past decade, significant progress has been made in the search for specific genetic variants associated with the development of schizophrenia. The review discusses the results of modern large-scale studies aimed at searching for genetic associations with schizophrenia: genome-wide association studies (GWAS) and the search for rare variants (mutations or copy number variations, CNV), including the use of whole exome sequencing. We synthesize data on currently known genes that are significantly associated with schizophrenia and discuss their biological functions in order to identify the main molecular pathways involved in the pathophysiology of schizophrenia.

[Transcranial magnetic stimulation in the treatment of depressive disorder in Parkinson's disease]. / Primenenie transkranial'noi magnitnoi stimulyatsii v lechenii depressivnogo rasstroistva pri bolezni Parkinsona.

The prevalence of affective disorders in patients with Parkinson's disease (PD) is significantly higher than in the general population of people of the same age. It is known that the effectiveness of antidepressants in PD with depressive disorder is lower than in patients with primary depression. For depression resistant to standard treatments, other therapeutic strategies are available. Transcranial magnetic stimulation (TMS) is one of the most popular and safe brain stimulation methods that has been successfully used to treat primary depression. The accumulation of experience in the use of TMS has made it possible to expand the application of the method to other diseases, including PD. The article provides literature data on the use of different TMS protocols for the treatment of depressive disorder in patients with PD.

[Characteristics of student response to pandemic in cross-cultural context]. / Osobennosti reagirovaniya studentov pri pandemii v krosskul'tural'nom kontekste.

OBJECTIVE: Of the work is a cross-cultural analysis of the characteristics of student response in a pandemic situation. MATERIAL AND METHODS: The sample consisted of students of NSMU and the Kazakh National University. Al-Farabi in the amount of 37 people aged 20 to 23; The battery of psychological methods was compiled by Spielberger and Khanina; Mississippi Post-Traumatic Stress Disorder Scale (civil version) and PSM-25 Psychological Stress Scale. RESULTS: 52.7% of respondents showed an average level of stress, 47.3% - a low level, which indicates insufficient psychological adaptation to psychological stress. High rates of personal and situational anxiety were diagnosed in 67.57% of cases; the average level of reactive anxiety - in 29.73% of cases and personal - in 27.03% of respondents. The majority of respondents showed average levels of post-traumatic stress reactions (50%, n=37), while a low level of post-traumatic stress reactions occurs in 11 (14.87%) people, a low level - in 17 (22.97%) people and increased - in 9 (12.16%) people. Stress level indicators tend to have significant differences: the frequency of occurrence of average stress indicators in the sample of students from Kazakhstan is higher (75.6%) compared to Russian students (24.32%) (p<0.05).Adapting to changing academic workloads in a pandemic situation does not contribute to the psychological well-being of students, as evidenced by the results of diagnosing anxiety and post-traumatic stress reactions. The results obtained emphasize the importance of taking into account cultural factors in stressful situations. CONCLUSION: Cross-cultural differences in the level of emotional response of students in a pandemic situation were revealed.

[Cognitive impairment in patients with comorbid recurrent affective and panic disorders]. / Osobennosti kognitivnykh narushenii u bol'nykh s komorbidnymi rekurrentnym affektivnym i panicheskim rasstroistvami.

OBJECTIVE: To designate the targets for medical and psychotherapeutic effects in patients with comorbid recurrent affective and panic disorders based on the study of cognitive functions. MATERIAL AND METHODS: A battery of pathopsychological tests («Schulte Table¼, «Corrective Test¼, «Ten Words test¼, «Cube Drawing Technique¼, Binet and Berstein Tests) has been used to assess the neuro-cognitive status of 60 patients with symptoms of recurrent affective (depressive) and panic disorders. According to ICD-10, 27 patients have been diagnosed with recurrent affective disorder with a mild or moderate depressive episode (RAD, F33.0, F33.1) in combination with panic disorder (PD, F41.0). The control group included 33 patients with recurrent affective disorder with a mild to moderate depressive episode (RAD, F33.0, F33.1) without panic disorder. RESULTS: All the patients showed the changes in the cognitive sphere. In patients with recurrent affective disorder in combination with panic disorder, cognitive impairment was more pronounced than that in patients from the control group. Cognitive functions in patients with recurrent affective and comorbid panic disorder were distinguished by their peculiarity, which manifested itself in «left hemisphere¼ disorders in the form of paroxysmal emotional disorders with the predominance of fear and anxiety affect, work dysfunction in a number of neuropsychological factors: successiveness, spatial, inertness-mobility, for which mediobasal and subcortical parts of the brain are responsible. The targets for medical and psychotherapeutic effects in patients with comorbid panic and recurrent depressive disorder are: attention, auditory and verbal memory, thinking components (logical and spatial). CONCLUSION: It is reasonable to use neuropsychological correction of cognitive impairment in this group of patients.

[Peculiarities of affective disorders in residual cerebral insufficiency]. / Osobennosti affektivnykh rasstroistv pri tserebral'noi rezidual'no-organicheskoi nedostatochnosti.

AIM: To determine clinical and psychopathological features of anxiety-depressive disorders in patients with cerebral residual organic insufficiency. MATERIAL AND METHODS: One hundred and fourteen patients with anxiety-depressive disorders and cerebral residual-organic insufficiency were studied. Psychopathological, psychometric, statistical methods were used. RESULTS AND CONCLUSION: Asthenia was identified as a core syndrome in anxiety-depressive disorders developed in patients with cerebral residual-organic insufficiency. Severe anxiety and depression with somatization of symptoms were characteristic of the structure of affective pathology. The somatization of affect, interpersonal sensitivity, marked asthenic and autonomic disorders as well as negative attitudes about their own condition, abilities and activity were main features of affective disorders in patients with cerebral residual-organic insufficiency. Clinical characteristics of cerebral residual-organic insufficiency and the diversity of its manifestations, including the combination with mental disorders, determine the relevance of further research.

[Emotional disorders in patients with controlled hypertension]. / Émotsional'nyi status patsientov s kontroliruemoi gipertonicheskoi bolezn'iu.

AIM: To conduct a comprehensive examination of patients with controlled hypertension, including assessment of the functional state of the cardiovascular system, vegetative and psycho-emotional status. MATERIAL AND METHODS: The study involved 80 patients (51 men, 29 women) divided into 2 groups: 60 patients with essential hypertension (EH) without concomitant severe pathology and normal blood pressure during the preceding 3 months (group 1) and 20 healthy patients without EH (group 2). Anthropometric parameters (height, weight, body mass index), parameters of central hemodynamic (heart rate, systolic and diastolic blood pressure), vegetative status (vegetative Kerdo index), mental and emotional status (SCL-90R, Leonhard questionnaire, HADS, SF-36, MPQ) were assessed. RESULTS AND CONCLUSION: There were significant differences in the psycho-emotional status between patients with hypertension and patients with normal blood pressure. Significant correlations between anthropometric indicators, the state of the autonomic nervous system and psycho-emotional status of patients with hypertension were shown.

[Methodological aspects of a study of medical service satisfaction in patients with borderline mental disorders]. / Metodologicheskie aspekty izucheniya udovletvorennosti meditsinskoi pomoshch'yu patsientov s pogranichnymi psikhicheskimi rasstroistvami.

The authors discussed a methodology of the study of medical service satisfaction and it's factors: moment of assessment, methodology of data collection, format of data, bench-marking, principles of inclusion of questions into a questionnaire, organizing and frequency of conducting studies.

[A comparative analysis of multiple linear models of medical service satisfaction among inpatients with borderline disorders at first-time admission and rehospitalization]. / Sravnitel'nyi analiz mnogofaktornykh modelei udovletvorennosti meditsinskimi uslugami pervichnykh i povtornykh patsientov s pogranichnymi psikhicheskimi rasstroistvami.

AIM: To find out the factors of satisfaction with psychiatric help in inpatients with neurotic and depressive disorders depending on the moment of satisfaction evaluation and patients' treatment experience. MATERIAL AND METHODS: The sample included 266 first-time admission inpatients (satisfaction was evaluated at the moment of discharge) and 134 rehospitalized inpatients (satisfaction with previous treatment was evaluated at the moment of discharge; satisfaction with current treatment was evaluated at the moment of rehospitalization). The survey was performed using a questionnaire designed for this study. Statistical analysis was performed using multiple regression. RESULTS AND CONCLUSION: Satisfaction with nursing care was the key factor of satisfaction at the moment of discharge among both groups of inpatients (first-time admission and rehospitalization). Psychiatrist's empathy was the 2nd factor by importance. The structure of factors of medical service satisfaction of these 2 groups was different. General satisfaction with psychiatrist's work was the key factor of satisfaction with medical service during previous hospitalization while nursing care was twice less important. In whole, there were major differences in the structure of factors of medical service satisfaction during previous and current hospitalizations. The shift of importance from nursing care to psychiatrist's work and other differences in the structure of factors of satisfaction of rehospitalized patients with medical services can be explained by belonging of medical services to credible goods - patient is able to evaluate results of treatment only some period after discharge.

[Factors of psychiatric treatment satisfaction in inpatients with neurotic and depressive disorders].

OBJECTIVE: Factors of patients' satisfaction with medical care vary depending on the level of care and medical specialty. Patient's satisfaction with psychiatric care is understudied. An aim of the present study is to find out the factors of satisfaction with psychiatric care in inpatients with neurotic and depressive disorders. MATERIAL AND METHODS: The sample included 356 inpatients suffering from neurotic or depressive disorders. The patients were questioned using PAPI questionnaire designed for this study. Statistical analysis was performed using multiple regression. RESULTS AND CONCLUSION: Key factors of satisfaction with medical care included quality of work of nurses and psychiatrists, hospital ward comfort, the number and quality of psychotherapeutic sessions, psychiatrists' empathy and aptitude to provide the patient with information about the disease and treatment. Multiple regression equation explained 81% of the variance of patients' satisfaction.

[The approaches to investigation of factors impacting satisfaction of patients with medical care (according international publications' data].

The publications review analyzes factors impacting satisfaction with medical care. The principles of development of questionnaire are substantiated. The sociological instrument is targeted to detect such factors impacting satisfaction with medical care as flexibility in selection of patients, carrying out of focus-groups of in-depth interviews with patients and literature analysis, possibility to combine qualitative and ordinal attributes as well as open questions, comfortability of respondent at the choice of ordinal scale and analysis of inner validity of questionnaire.

[Antipsychotic drugs and their influence on the carbohydrate metabolism in patients with schizophrenia-spectrum disorders].

The effect of antipsychotic drugs, typical and atypical neuroleptics, is described in the following sections of this paper: antipsychotic drugs and carbohydrate metabolism, prevention and risk factors, pharmacoepidemiology, treatment. It is concluded that neuroleptic treatment increases the risk of metabolic impairment. Mechanisms of this effect are not clear so far. Ethnicity, sex, age and features of the therapy may play a role. Clozapine, olanzapine, ziprasidone, sertindole and some typical neuroleptics are risk factors as well. Common glucose-reducing drugs as well as prevention of metabolic impairment and special behavioral training,including the control over the level of glycemia, are used in treatment of diabetes mellitus induced by neuroleptics.

[Impairment of attention and executive functions in patients with paranoid schizophrenia].

To study changes in attention and executive functions during psychopharmacotherapy in patients with paranoid schizophrenia, we have examined 120 patients with a first episode of paranoid schizophrenia treated with typical and atypical neuroleptics. Clinical and statistical analyses have revealed the heterogeneity within treatment groups that allowed to define two subgroups. These subgroups were characterized by a differed disease course (favorable or poor type). Before remission was achieved, the effect of atypical neuroleptics on cognitive performance was higher compared to typical neuroleptics. After remission, when doses of neuroleptics were decreased, a type of disease course played a main role. At 6 months after remission, attention and executive functions have improved in subgroups with favorable course of disease regardless of treatment.

[Cerebral venous disorders in young patients with neurotic depression].

Authors examined 143 patients with neurotic depression using ultrasonic Doppler method. Disorders of the cerebral venous hemodynamics associated with clinical symptoms of the disease were found. It is recommended to use ultrasonic Doppler method for the diagnosis and objectification of functional changes in the cerebral blood circulation and for increasing treatment efficacy.

[Cerebral blood flow in neurotic depression: results of ultrasonic dopplerography].

Using the method of ultrasonic dopplerography, authors have investigated the cerebral blood flow in main arteries of the head on extra- and intracranial levels in 83 patients, aged from 20 to 50 years, with depression (ICD-10 codes F32-F33). Different clinical presentations, duration and severity of depression were described. Correlations between these characteristics and the state of cerebral blood flow and changes of sympathoadrenal system were found.