Hemostasis System in Patients with Schizophrenia and Schizophrenia Spectrum Disorders.

Hemostasis system in patients with schizophrenia and schizophrenia spectrum disorders was examined using "Fibrinodynamics" technology that allows evaluating the overal coagulation, fibrinolysis, and hemostasis potentials. All indices, except for the parameter characterizing the hemostasis balance, were statistically higher (p<0.0001) in patients than in healthy volunteers (control). In most patients, the hemostasis system remained balanced despite changes in individual coagulation and fibrinolysis parameters. The obtained results have a fundamental importance, expand the understanding of the pathogenesis of endogenous mental disorders, and are useful for the development of personalized approaches to the treatment of these patients.

[Impairments of Neurocognitive Mechanisms of Decision-Making in Depression.]

A multidisciplinary clinical-psychological-neurophysiological study has been performed in 28 depressive patients (females, aged 18-56) and 50 healthy volunteers (females, aged 18-55) in order to analyze the relationships between the impairments of neurocognitive mechanisms of decision-making based on logics and considerations or on emotional experience (emotional learning) in uncertain situation and clinical and neurophysiological signs of depression. The severity of depression was assessed quantitatively using Hamilton's Depression Rating Scale (HDRS-17). Tests "10 words", Wisconsin Card Sorting Test (WCST), and Iowa Gambling Task (IGT) were used for quantitative assessment of cognitive functions. Multichannel resting EEG was recorded in all depressive patients in order to assess the brain functional state. Neurocognitive deficit was observed in all the patients; its pronounce correlated positively with the severity of depression. The ability to make decisions based on both logic and considerations (in WCST), which is associated with EEG signs of hypofrontality, and on emotional learning (in IGT) was impaired. Only in depressive patients reduced ability to make rational decisions based on logics and considerations resulttd in a compensatory shift towards decision-making based on emotions, which led to relatively higher results of emotional learning. The data suggests that hypofrontality causes difficulties in making decisions that requires logical reasoning and the disinhibition of subcortical (including hippocampal) brain structures, the activation of which provides better results of emotional learning.

[Transcranial Magnetic Stimulation in the Combined Treatment of Pharmacoresistant Depression: Dynamics of Clinical, Psychological and EEG Parameters].

In order to investigate the mechanisms of the therapeutic effect of transcranial magnetic stimulation (TMS) of the left dorsolateral prefrontal cortex in patients with depression, we studied the dynamics of clinical parameters, a number of cognitive functions, and the spectral structure of resting EEG in 20 patients with pharmacoresistant depression in the course of combined treatment including TMS. It was shown that short course (10 sessions) of TMS significantly enhanced and accelerated the effect of antidepressants. The course of TMS contributed not only to the reduction of depressive symptoms but also to the improvement of general condition and the recovery of some impaired cognitive functions. The therapeutic effect of TMS seems to be provided by the activation of not only the prefrontal cortex itself but also of some subcortical structures closely linked with it. Thus, TMS appears to be a promising non-drug method for the treatment of clinical conditions and for the correction of brain functional state in patients with depression, including the use in combined treatment of depressive disorders in cases of pharmacoresistance.

[Auditory event-related evoked potentials in dynamics of treatment of affective-delusional conditions].

With the aim to study neurophysiologic correlates and to search for some possible predictors of therapeutic response correlation analysis has been carried out of links between temporal parameters of components of auditory event-related potentials (AERPs) and dynamics of quantitative clinical assessments of mental state conditions in two groups of patients--with depressive-delusional conditions (group 1) and with manic-delusional conditions (group 2) in the frames of attack-like schizophrenia. Statistically significant correlations have been revealed between values of peak latencies of main AERPs components and severity of psychopathologic symptoms before beginning of treatment course, as well as between initial (before treatment course) AERPs temporal parameters and quantitative clinical assessments at the stage of remission establishment. Larger severity of residual positive, negative and common psychopathologic symptoms of schizophrenia (and also of depression and anxiety in group 1) after course of treatment was associated with smaller initial (before treatment course) values of peak latencies of "early" (P1 and N1) and with larger initial values of "late" (P2, N2 and P3) AERPs components in both groups of patients. The data obtained allow to justify basic views on brain mechanisms of affective-delusional disorders, and to reveal possible neurophysiologic predictors of treatment efficacy in such disorders.

[Basic symptoms in young female patients with depression within the framework of schizophrenia and affective spectrum disorders]. / Osobennosti bazisnykh simptomov u patsientok molodogo vozrasta s depressiyami v ramkakh rasstroistv shizofrenicheskogo i affektivnogo spektrov.

OBJECTIVE: To investigate the structure and severity of basic symptoms in young female patients with endogenous depression. MATERIAL AND METHODS: One hundred and nineteen female patients, aged from 16 to 26 years, were examined. Three groups were identified: patients meeting the criteria of high risk of psychosis (51 patients, mean age 18.55±3.84 years), patients not meeting the criteria of high risk of psychosis(48 patients, mean age 20.12±3.84 years), patients with postpsychotic depression (20 patients, mean age 21.8±4.5 years). The main method of the study was the application of COGDIS (Cognitive Distortions) and COPER (Cognitive-perceptual baseline symptoms) criteria. RESULTS: The baseline symptoms criteria were met by 83.3% of depressed patients without psychosis risk symptoms (mean severity score 24.0±14.7), 96% of depressed patients with high psychosis risk symptoms (38.1±15.9 points), and 50% of patients with postpsychotic depression (15.3±12.9 points). COGDIS criteria were met by 62.5% of depressed patients without psychosis risk symptoms (16.2±10.1 points), 68.6% of depressed patients with high psychosis risk symptoms (22.3±9.6 points), and 25% of patients with postpsychotic depression (9.2±8.4 points). The COPER criteria were met by 77.5% of patients with depression without psychosis risk symptoms (16.2±10.3 points), 92.2% of patients with depression at high risk of psychosis (28.4±14.0 points), and 50% of patients with postpsychotic depression (8.9±9.7 points). CONCLUSIONS: The group with post schizophrenic depression was characterized by lower basic symptom scale scores and percentage of eligible patients. Basic symptoms were common in a group of young female patients with depression who did not meet high-risk criteria. The score differentiates the high-risk group from the group of patients without risk symptoms.

[Prolonged and chronic endogenous manic and manic-delusional states (psychopathology, typology, dynamics, clinic)]. / Zatyazhnye i khronicheskie endogennye maniakal'nye i maniakal'no-bredovye sostoyaniya (psikhopatologiya, tipologiya, dinamika, klinika).

OBJECTIVE: A clinical and psychopathological analysis, nosological differentiation of prolonged and chronic manic and manic-delusional states (PMDS) within the framework of the paroxysmal course of endogenous psychoses, determination of the patterns of their development, diagnostic criteria and prognosis. MATERIAL AND METHODS: The study included 76 female patients (average age 37.2±8.3 years) who were hospitalized for endogenous mental illnesses with a paroxysmal course that occurred with the clinical picture of PMDS. The patients were divided into two groups: clinical (n=43) and follow-up (n=33). Clinical-psychopathological, clinical-follow-up, psychometric, statistical methods were used. RESULTS: A clinical and dynamic typology of PMDS has been developed, according to which 2 groups have been identified: «monomorphic¼ PMDS and «polymorphic¼ PMDS. «Monomorphic¼ PMDS included 2 subtypes - «acute¼ and «chronified¼ and were characterized by the same clinical picture that remained unchanged throughout, while «polymorphic¼, which also included 2 subtypes - «developing¼ and «double mania subtype¼, were characterized by the variability of clinical picture. «Acute¼ and «developing¼ subtypes of PMDS predominantly developed in schizoaffective psychosis and bipolar disorder; the «chronified¼ subtype and the «double mania¼ subtype were more often observed within the framework of the schizoaffective variant of paroxysmal-progressive schizophrenia. CONCLUSION: The clinical and dynamic structure of PMDS is heterogeneous and differs in psychopathological structure, as well as in the level of stability of symptoms and characteristics of its course. The developed clinical typology of PMDS is prognostically significant and provides information about the further dynamics of the disease.

[Proinflammatory activity of monocytes and activity of glutathione-dependent enzymes in red blood cells in women with depressive conditions]. / Provospalitel'naya aktivnost' monotsitov i aktivnost' glutation-zavisimykh fermentov v eritrotsitakh krovi u zhenshchin s depressivnymi sostoyaniyami.

OBJECTIVE: To search for possible connections between the anti-inflammatory activity of monocytes (PAM) and the activity of glutathione metabolic enzymes: glutathione reductase (GR) and glutathione-S-transferase (GT) in patients with depressive states (DS) within various mental pathologies, as well as between the studied biological parameters and clinical condition of patients. MATERIAL AND METHODS: Sixty-one women, aged 18-56 years, with DC were examined before and after treatment. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS) and the Hamilton Depressive Symptom Rating Scale (HDRS-21). The control group included 23 women of the corresponding age without mental pathology. Biological parameters were assessed in the peripheral blood of patients and healthy people. RESULTS: Patients with a high level of PAM compared to the control (p<0.001) (subgroup 1, n=31) and with a low (at the control level) level (subgroup 2, n=30) were identified. In the subgroup 1, the values of GR and GT were significantly lower than in patients of subgroup 2 (p<0.05 and p<0.01, respectively). Negative correlations between the level of PAM before treatment and GR before and after treatment were revealed in patients who responded to treatment (r=-0.67; p=0.0041; r=-0.76; p=0.0001). CONCLUSION: The results may indicate the inverse relationship between the level of PAM and the activity of GR and GT, which are involved in the pathogenesis of DC, and can also serve as criteria for assessing the response of patients to treatment.

[Effectiveness, safety and adherence to therapy with Elicea Q-Tab in real clinical practice]. / Effektivnost', bezopasnost' i priverzhennost' terapii preparatom Elitseya Ku-Tab v real'noi klinicheskoi praktike.

OBJECTIVE: To evaluate the effectiveness and safety of escitalopram in the form of oral dispersible tablets (Elicea Q-Tab) in real-life clinical practice in patients with depressive and anxiety disorders. MATERIAL AND METHODS: The study included 1.892 outpatient patients, 1.860 of whom completed participation in accordance with the protocol and entered the statistical analysis. Most patients were diagnosed with depressive and anxiety disorders of varying severity, as a rule, these diagnoses were established for the first time. The drug was most often prescribed at a dosage of 10 mg/day. The patients were monitored for 90 days and at each of the 3 visits, scales were used to assess the clinical condition (CGI-S and CGI-I), scales «Interaction with people, maintaining relationships (social functioning)¼ and «Availability of work, task completion, school attendance (professional functioning)¼, scales satisfaction with the convenience of admission/appointment and the effectiveness of treatment, various indicators of quality of life (autonomy, social and professional functioning, hobbies and hobbies), as well as the severity of cognitive disorders were measured. RESULTS: Patients treated with escitalopram in the form of oral tablets dispersible in the oral cavity (Elicea Q-Tab) showed an improvement in their clinical condition (a decrease in CGI-S scores from 3.65 at visit 1 to 2.63 by visit 3, by 28%; a decrease in CGI-I scores from 2.39 at visit 1 to 1.57 to visit 3, by 34%), as well as improving the quality of life, social (from 2.74 points on 1 visit to 4.32 on 2 visits, by 58%) and professional functioning (from 2.81 on 1 visit to 4.35 on 2 visits, by 55%), the level of concentration (from 3.28 points on 1 visit up to 4.5 on 3 visits, by 37%). Doctors and patients noted high satisfaction with the effectiveness and convenience of using the drug, the frequency of adverse events was low. CONCLUSION: The study showed that escitalopram in the form of oral tablets dispersible in the oral cavity (Elicea Q-Tab) is an efficient and safe treatment for depressive and anxiety disorders in real-world clinical settings. Patients and physicians have evaluated the drug positively and it can be considered as an effective agent in psychiatric practice.

[Depersonalization depression in young female patients]. / Depersonalizatsionnye depressii u patsientok molodogo vozrasta.

OBJECTIVE: To study psychopathological structure characteristics of depersonalization depression in young women and nonsuicidal autoaggressive and suicidal behavior characteristics in these states. MATERIAL AND METHODS: We studied 36 adolescent female patients (16-25 years) with endogenous depression (F31.3-4; F34.0; F21.3-4+F31.3-4; F60.X+F31.3-4), whose clinical picture was dominated by depersonalization disorders represented by their auto-, allo-, and somatopsychic forms or combinations. RESULTS: Depersonalization depressions in young female patients are characterized by the following features: the dominance of the manifestations of the sensory («hysterical¼) form of depersonalization (83.3%; n=30); the proximity of the phenomenon of somatopsychic depersonalization (77.8%, n=28) to the manifestations of dysmorphic disorders; the specificity of the manifestations of derealization in the form of a feeling of «pretended, staged¼ environment; infrequent manifestations of psychic anesthesia; marked polymorphism of the clinical picture with comorbid obsessive-compulsive, hysteria-conversion, senestopathic, dysmorphic, and attenuated psychotic disorders; high risk of suicide (83.3%; n=30) with the predominance of planned suicide attempts over impulsive ones; significant frequency and variety of nonsuicidal self-harm with the predominance of «depersonalizing¼ motives for its commission. CONCLUSIONS: Depersonalization depression in young female patients is characterized by the clinical specificity manifested both in depersonalization symptomatology and spectrum of comorbid disorders and in the specificity of motives and methods of suicide attempts and nonsuicidal self-harm.

Clinical-Immunological Correlates in Post-COVID-19 Endogenous Psychoses.

Objectives. To carry out a clinical and immunological study of the potential impact of coronavirus infection on the course of endogenous psychoses. Materials and methods. A total of 33 female patients aged 16-48 years with depressive-delusional states (F20.01, F21, F31) developing after coronavirus infections took part; group 1 consisted of 15 people who developed depressive-delusional states 1-2 months after COVID-19; group 2 consisted of 18 people with similar psychoses developing at later time points (2-6 months). The severity of psychopathological symptoms was assessed using the PANSS and HDRS-21 scales. The activity of inflammatory markers leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) was determined in patients' blood. Absolute neutrophil and lymphocyte contents and their ratio (the neutrophil:lymphocyte index) were also evaluated. Standard values for indicators from healthy donors corresponding to patients in terms of age and sex were used as control values. Results. Endogenous psychosis developing at longer intervals after coronavirus infection (group 2) was found to be associated with "typical" inflammatory reactions, with increases in the activity of acute-phase proteins (α1-PI: 43.0 (35.6-49.7) IU/ml, p = 0.001) and neutrophil degranulation activity (LE - 254.8 (238.0-271.0) nmol/min·ml, p < 0.001), which was associated with the development of depressive-delusional states with dominance of manifestations of positive affectivity (anxiety, melancholy) and the extended nature of delusional disorders, which were mostly incongruent to affect. Conversely, development of endogenous psychosis during the first two months after COVID-19 (group 1) was characterized by a spectrum of inflammatory biomarkers with a decrease in neutrophil count ((2.6 ± 0.9)·109/liter, p < 0.05) and low LE activity (196 (172-209.4) nmol/min·ml, p < 0.001). This immunological profile was associated with predominance of manifestations of negative affectivity (apathy, asthenia, adynamia) in the structure of depressive-delusional states and the relatively undeveloped nature of delusional disorders, which were predominantly congruent to affect. Conclusions. The clinical and biological correlates found here presumptively indicate that experience of COVID-19 infection has a modulatory effect on neuroinflammation and the structure of endogenous psychosis.

[Features of the neurocognitive profile of patients with protracted and chronic endogenous manic and manic-delusional states]. / Osobennosti neirokognitivnogo profilya bol'nykh s zatyazhnymi i khronicheskimi endogennymi maniakal'nymi i maniakal'no-bredovymi sostoyaniyami.

OBJECTIVE: To study the neurocognitive profile of patients with protracted and chronic endogenous manic and manic-delusional states (EMDS). MATERIAL AND METHODS: Thirty-two female patients, aged 18 to 55 years (mean age 36.2±10.2 years), with protracted and chronic EMDS were studied. Based on the clinical typology of EMDS, patients were divided into 4 groups of 8 patients each: group 1 - «acute¼ subtype, group 2 - «chronified¼ subtype, group 3 - «developing¼ subtype and group 4 - subtype «double mania¼. Neuropsychological, clinical-psychopathological and statistical methods were used. RESULTS: Disturbances of regulatory and executive functions and a decrease in neurodynamic indicators of mental activity in patients with EMDS are significantly more pronounced compared with the control group (p<0.05). The values of the index of severity of disturbances of regulatory and executive functions in patients with EMDS range from 0.95 points (group 1) to 1.14 points (group 4), without statistically significant differences between the groups. The highest severity of neurodynamic disorders is observed in group 1 (1.88 points), while in other groups the index values range from 0.88 points in group 2 to 1.09 in group 4 (p<0.05). Patients of group 1 have greater severity and wider spectrum of neurodynamic symptoms compared with group 2 (U=45.00; p<0.0021), group 3 (U=30.00; p<0.04), and group 4 (U=45.00; p<0.001). It should be noted that the cognitive impairments identified in patients with EMDS did not reach the level of dementia. CONCLUSION: The most characteristic of EMBS are cognitive impairments associated with a decrease in the parameters of the neurodynamics of mental activity related to the first functional block, as well as with deficiency of executive functions, impaired planning and organization of cognitive activity, due to the weakness of the structures of the third functional block.

[EEG correlates of suicidal intentions in depressive patients who survived and have not been ill with COVID-19]. / EEG-korrelyaty suitsidal'nykh namerenii u bol'nykh depressiei, bolevshikh i ne bolevshikh COVID-19.

OBJECTIVE: To search for EEG correlates of suicidal intentions in young depressive patients who survived and have not been ill with COVID-19. MATERIAL AND METHODS: We studied 46 female patients, aged 16-25 years, with depressive disorders who had previously had a mild or asymptomatic coronavirus infection («COVID¼ group) and 40 female patients with depressive disorders matched in age, syndromic structure of disorders and the initial severity of depression to patients of the «COVID¼ group but who are known not to have COVID-19 («non-COVID¼ group). The severity of suicidal intentions was assessed by the number of points of item 3 of HDRS-17. In all patients, pre-treatment multichannel background EEG was recorded with spectral power analysis in narrow frequency sub-bands. RESULTS: In patients of the «COVID¼ group, the mean number of points of item 3 of HDRS-17 was slightly higher (at the trend level) than in the «non-COVID¼ group (2.1±1.5 and 1.8±1.6 points, respectively), and positively correlated (p<0.05) with the spectral power values of theta2 (6-8 Hz) and delta (2-4 Hz) EEG sub-bands. In the «non-COVID¼ group, the severity of suicidal intentions positively correlated (p<0.05) with the values of the spectral power of alpha2 (9-11 Hz) EEG sub-band. CONCLUSION: Suicidal intentions increased in depressive patients survived from COVID-19, and their severity is associated with EEG signs of a reduced functional state of the cerebral cortex.

[Hostility as a manifestation of attachment disorders in depression]. / Vrazhdebnost' kak proyavlenie narushenii privyazannosti pri depressii.

OBJECTIVE: To analyze the relationship between hostility and attachment disorders in endogenous depression. MATERIAL AND METHODS: The study included 49 patients with a diagnosis of depressive disorder, all of them completed the Simptom Check List-90-Revised (SCL-90R); the Buss-Perry Aggression Questionnaire; the Experiences in Close Relationships-Revised (ECR-R); Ich-Struktur-Test nach Ammon. The patients were assessed using the Hamilton Depression Rating Scale (HDRS-17). RESULTS: At high levels of depression, the indicators of «hostility¼ (p=0.046), «destructive aggression¼ (p=0.04) and «deficit aggression¼ (p=0.005) are significantly higher. The severity of depression significantly correlates with the severity of «anxiety¼ in attachment (close relationships), as well as with pathological «narcissism¼, «destructive external self-delimitation¼, «deficient internal self-delimitation¼ (p<0.05). For the measure of depression, the regression model explains more than 76% of the variance, with the measures of «interpersonal sensitivity¼, «deficit narcissism¼, and «avoidance¼ in attachment making significant contributions. For the «hostility¼ the regression model explains about 62% of the variance, while, as in the analysis of «depression¼, a significant contribution is made by the indicators of «interpersonal sensitivity¼ and «avoidance¼, however, unlike «depression¼, the contribution of the «destructive narcissism¼ is noted in contrast to the «deficit narcissism¼. CONCLUSIONS: With severe depressive symptoms, indicator of hostility are increased. Hostility in depression is associated with factors caused by a violation of early interpersonal relationships (anxious attachment) (which causes increased sensitivity in relations with others, building a barrier between oneself and the external environment perceived as hostile), the narcissistic pathology, problems in emotional regulation.

[Clinical-neurobiological correlations in young depressive patients with a history of suicidal attempts]. / Kliniko-neirobiologicheskie korrelyatsii u bol'nykh depressiei molodogo vozrasta s suitsidal'nymi popytkami v anamneze.

The processes of neuroinflammation play an important role in the pathogenesis of endogenous mental disorders, including in patients with autoaggressive behavior. OBJECTIVE: Is to identify the relationships of quantitative clinical, EEG and neuroimmunological parameters in young female patients with depression and a history of suicidal attempts in order to clarify the role of neuroimmune interaction in the pathogenesis of suicidal behavior. MATERIAL AND METHODS: In 35 female patients aged 16-25 years the pre-treatment severity of the depressive state was quantitatively assessed (according to the HDRS-17 scale), and immunological parameters - markers of neuroinflammation (activity of leukocyte elastase and of α1-proteinase inhibitor) in blood plasma using the laboratory technology «Neuro-immuno-test¼ and the EEG absolute spectral power in narrow frequency sub-bands were measured. The relationships between clinical, neuroimmunological and EEG parameters was determined by correlation analysis (according to Spearman). RESULTS: The values of immunological markers of neuroinflammation correlated with EEG signs of increased activation of the cerebral cortex and with the severity of the anxiety component of the depressive state. CONCLUSION: The structure of clinical-neurobiological correlations in the examined patients indicates the involvement of neuroinflammation processes in the pathogenesis of their condition. The results make it possible to clarify the neurobiological factors of the pathogenesis of suicidal behavior in young depressive patients.

[Hysteroform depressions in young female patients]. / Isteroformnye depressii u patsientok molodogo vozrasta.

OBJECTIVE: To study the features of the psychopathological structure of depression in young women with hysteroform symptoms, as well as the features of auto-aggressive non-suicidal and suicidal behavior in these conditions. MATERIAL AND METHODS: The results of a clinical/psychopathological examination of 50 female adolescent patients, aged 16 to 25 years, with endogenous depressions with one of the following ICD-10 diagnosis: (F31.3-4, F34.0, F21.3-4 + F31.3-4, F60.X + F31.3-4) and prevail of hysteroform symptoms in the form of conversion/dissociative disorders in their clinical picture were analyzed. RESULTS: Depression was characterized by an acute onset due to a traumatic situation represented by difficulties in personal or family relationships (36%, n=18), bereavement reactions (28%, n=14) and problems in school/work (22%, n=11). The depressive triad had an erased character, the thymic component was represented by a variable character of affect with a predominance of dysphoria (38%, n=19) and anxiety (32%, n=16). The ideational component of the triad was detected in 50% of cases (n=25), while in 38% (n=19) there was ideational acceleration. In 44% of cases (n=22), dissociative disorders were noted in the form of delusional fantasizing, represented by symptoms close to the «multiple personality¼ phenomenon. Often there were obsessional disorders (58%, n=29), anxiety-phobic symptoms in the form of panic attacks (46%, n=23), isolated phobias (28%, n=14), social phobias (30%, n=15). In 40% of cases (n=20) the formation of overvalued hypochondriacal ideas was noted. Non-suicidal self-harm occurred in 41 patients (82%), in 42% of cases (n=21) the patients made suicide attempts that were distinguished by a low danger to life. CONCLUSION: Hysteroform depressions in girls are characterized by polymorphism of the psychopathological structure, erosion of the depressive triad, originality of the clinical picture of dissociative disorders, presence of comorbid disorders, and frequent, but with a low danger to life suicidal attempts.

[Clinical-neurophysiological correlations in female adolescents with heboid depression]. / Kliniko-neirofiziologicheskie korrelyatsii u patsientok molodogo vozrasta s geboidnoi depressiei.

OBJECTIVE: To determine EEG markers of depression severity and clarify the brain mechanisms of heboid depression by identifying relationships between clinical and neurophysiological parameters in female adolescents with heboid depression. MATERIAL AND METHODS: A clinical-neurophysiological study of 25 female adolescents, aged 16-25 years, mean age 18.7±2.6 years, with heboid depression (ICD-10 items F31.3-F31.4, F34.0) was carried out. The severity of depressive disorders during hospitalization varied from mild to severe - the HDRS-17 total score ranged from 12 to 37 points (average 26.4±6.5 points). To assess the functional state of the brain, a multichannel EEG recording was performed in a state of calm wakefulness with closed eyes (for 2-3 minutes). EEG was recorded in 16 leads: F7, F3, F4, F8, T3, C3, Cz, C4, T4, T5, P3, Pz, P4, T6, O1 and O2. Data analysis was carried out using descriptive and nonparametric statistics programs from the IBM SPSS Statistics, v.22 package. RESULTS: Differences in the EEG of patients from the norm were detected in the alpha frequency range, SpM values of the alpha2 subrange (9-11 Hz) were statistically significantly lower in the frontal areas (in the left frontal lead F3 p=0.021, in the right frontal lead F4 p=0.006). The patients did not have «highly coherent¼ (Coh >0.80) interhemispheric connections between the frontal-central-anterotemporal regions of the left and right hemispheres in the frequency range of the alpha-rhythm (8-13 Hz). The following correlations (p≤0.05) were revealed: the values of the HDRS-17 total score were positively correlated with the spectral power values of theta1 (4-6 Hz) and theta2 (6-8 Hz) EEG frequency subranges only in the frontal, central and midtemporal leads from the right hemisphere (F4, C4, T4). CONCLUSION: In patients with heboid depression, there is a functional «uncoupling¼ of the frontal-central-anterior-temporal areas of the right and left hemispheres of the brain. It is possible that such a «dissociation¼ and a relatively large activation of the anterior parts of the left rather than the right hemisphere play a role in the weak control of impulsive delinquent behavior in patients with heboid depression. The identified atypical features of the EEG spatial organization and correlations of the EEG frequency structure with clinical parameters are consistent with the atypical clinical picture of heboid depression.

[Clinical and immunological correlates in endogenous psychoses developed after COVID-19]. / Kliniko-immunologicheskie korrelyaty pri endogennykh psikhozakh, razvivshikhsya posle perenesennogo COVID-19.

OBJECTIVE: The clinical and immunological study of the potential impact of coronavirus infection on the course of endogenous psychosis. MATERIAL AND METHODS: Thirty-three female patients, aged 16 to 48 years, with depressive-delusional conditions (ICD-10 F20.01, F21, F31) developed after coronavirus infection, of whom 15 people (group 1) had depressive-delusional states 1-2 months after COVID-19 and 18 people (group 2), who developed similar psychoses in later periods (2-6 months). The severity of the psychopathologic symptoms was evaluated with PANSS and HDRS-21 scales. The activity of inflammatory markers - leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) in the blood was determined. The absolute neutrophil count, the absolute lymphocyte count and the neutrophil/lymphocyte ratio were calculated. As a control, we used standard values of indicators of age - and sex-matched healthy donors. RESULTS: The endogenous psychosis that developed later after a coronavirus infection (group 2) is associated with a "typical" inflammatory reaction with an increase in the activity of acute phase proteins (according to α1-PI) and degranulation activity of neutrophils (according to LE), which is associated with the development of depressive-delusional states in patients with the dominance of manifestations of positive affectivity (anxiety, melancholy) and the extended nature of delusional disorders, which were predominantly incongruent to affect. On the contrary, the development of endogenous psychosis during the first two months after COVID-19 (group 1) is characterized by a spectrum of inflammatory biomarkers with a decrease in the number of neutrophils and low activity of LE. This immunological profile is associated with the predominance of manifestations of negative affectivity (apathy, asthenia, adynamia) in the structure of depressive-delusional states and the relatively undeveloped nature of delusional disorders, which were predominantly congruent to affect. CONCLUSION: The clinical and biological correlates presumably indicate the modulating effect of the coronavirus infection (COVID-19) on neuroinflammation and the structure of endogenous psychosis.

[Cinnabarinic acid as a potential prognostic marker of schizophrenia]. / Tsinnabarinovaya kislota kak potentsial'nyi prognosticheskii marker shizofrenii.

OBJECTIVE: To develop a method for determining cinnabarinic acid (CA) and its immediate precursor 3-hydroxyanthranylic acid (3HAA) in blood plasma and to study their concentrations in patients with schizophrenia before and after treatment. MATERIAL AND METHODS: The study was carried out on a sample of 23 female patients with an attack-like progredient schizophrenia (F20.01). The levels of CA and 3HAA in blood plasma were measured using liquid chromatography with tandem mass spectrometry. RESULTS: We found an inverse statistically significant correlation of the sum of CA and 3HAA concentrations before treatment with the total PANSS score after treatment (R=-0.50; p<0.05). There was also an inverse correlation of the CA concentration of before treatment with the total PANSS score after treatment (R=-0.41, p=0.052), statistically significant at the trend level (0.05

[Clinical and psychopatological features of endogenous depressions in young women]. / Kliniko-psikhopatologicheskie osobennosti endogennykh depressii u patsientok molodogo vozrasta.

OBJECTIVE: To study the features of psychopatological structure of endogenous depression in young women and to identify correlations between various clinical types of depression and their nosological affilation. MATERIAL AND METHODS: The results of clinical/psychopathological examination of 107 female patients, aged 16 to 25 years, with endogenous depression with one of the following ICD-10 diagnosis: (F34.0; F31.3-F31.5; F21.3-F.21.4+F31.3-F31.5; F60.X+F31.3-F31.5) were analyzed. RESULTS: Several types of endogenous depression were identified: 1) hysterical depression with hysterical-conversions, and also the phenomena of delusional fantasies; 2) dysmorphic depression with predominance of over-valued ideas of physical disability, self-inferiority and eating disorder; 3) depersonalization depression with depersonalization-derealization symptoms; 4) psychopath-like depression with exaggerated behavior, opposition and impulsivity; 5) existential depression with a feeling of losing the life meaning and often pessimistic worldview; 6) psychasthenic depression with the low self-esteem and exaggerated introspection combined with obsessive-phobic disorder; 7) anxious-melancholic depression with anxiety, melancholy and ideas of self-accusation and self-inferiority; 8) depression with symptoms of adolescent asthenic insolvency with difficulties of understanding information, increasing intellectual exhaustion. We revealed differences in motives for committing non-suicidal self-harm behavior and suicidal behavior in typological variants of depressions. CONCLUSION: Hysteroform and psychopathic depressions prevail in personality disorders, while psychosthenic-like, anxious-melancholic and existential depressions are more frequent in affective disorders. Depersonalization depressions are more common in schizotypal disorder. When comparing the types of depressions in boys as reported in previous research with those in girls, the prevalence of hysteroform and anxious-melancholic variants in girls is revealed.

[The decrease in procoagulant activity of blood during combined therapy with antidepressants and antipsychotics in patients with endogenous mental disorders]. / Snizhenie prokoagulyantnoi aktivnosti krovi u bol'nykh s endogennymi psikhicheskimi rasstroistvami pri kombinirovannoi terapii antidepressantami i antipsikhotikami.

OBJECTIVE: To compare the changes in thrombodynamics indices in two groups of patients with endogenous mental disorders before and after combined treatment with antipsychotics and antidepressants (AD + group) and those who did not receive antidepressants (AD-group). MATERIAL AND METHODS: The study included 110 patients, aged from 16 to 60 years (median age [Q1; Q3] 29 years [22; 35]), admitted for inpatient treatment at the clinic of Mental Health Research Center with the following mental disorders: schizophrenia with attack-like/attack-progressive/continuous type of course (F20.00-2), schizotypal disorder with affective fluctuations (F21.3-4), affective disorder (F 31.1-5; F 32.0-3; F 33.0-3). The thrombodynamics test (TD) was carried out on a T-2 thrombodynamics device according to the manufacturer's instructions (Hemacore LLC, Moscow, Russia). RESULTS: In patients with endogenous mental disorders after combined therapy with antidepressants and antipsychotics, a statistically significant decrease in the procoagulant activity of plasma and procoagulant spontaneous clots is observed, which indicates a decrease in the severity of systemic, immune inflammation. In patients with endogenous mental disorders after antipsychotic therapy without the addition of antidepressants, for most thrombodynamic parameters, there is no statistically significant decrease in procoagulant plasma activity and spontaneous clots formation. It indicates the persistence of acute systemic, immune inflammation in this group. CONCLUSION: The statistically significant positive change in plasma and platelet hemostasis may testify that combined treatment with antipsychotics and antidepressants in patients with endogenous mental disorders may be a biological, pathogenetic link that promotes augmentation (extended action) of antipsychotic therapy.