The present review discusses the comorbidity of psychogenic non-epileptic seizures (PNES) with other mental disorders. Data on the prevalence of mood, anxiety, psychotic and personality disorders are presented. The role of traumatic experience in the development of PNES is described. Special attention is given to PNES as an independent nosological entity and its place in the modern classifications of mental disorders.
Mental Disorders , Problem Behavior , Anxiety Disorders/epidemiology , Comorbidity , Humans , Mental Disorders/epidemiology , Mental Disorders/psychology , Seizures/epidemiology , Seizures/psychology
The article provides a review of the literature on changes in views on negative symptoms, from historical aspects to modern research (clinical, neuroimaging), allowing them to be considered within the framework of a transdiagnostic approach.
Neuroimaging , Humans
OBJECTIVE: To investigate psychometric properties of the Russian version of the brief Reasons for Living Inventory (bRFL) in patients with non-psychotic mental disorders (NPMD) and to define its association with current suicide ideation. MATERIAL AND METHODS: Six hundred and 15 consecutive patients with NPMD were included. The median age was 27 (19) years; 403 (65.5%) were female. Cronbach's alpha, Cronbach's alpha coefficient if an item is deleted and corrected item-total correlation were used for the internal consistency evaluation. The internal structure assessment was based on the exploratory and confirmatory factor analysis. To identify an association of bRFL with current suicidal ideation, MANCOVA was used. RESULTS: An internal consistency of bRFL was good (Cronbach's Alpha-0.856). The exploratory factor analysis revealed a 6-factor model, explaining 80.22% of variance. These factors were: «survival and coping beliefs¼, «responsibility to family¼, «child related concerns¼, «fear of suicide¼, «fear of social disapproval¼ and «moral objections¼. The confirmatory factor analysis indicated a good agreement of the 6-factor model with an empirical data (CMIN/DF - 2.98, CFI - 0.956, SRMR - 0.05, RMSEA - 0.057, PNFI - 0.497). Regardless of gender and age, the total scores of bRFL and its subscales were significantly lower in patients with suicide ideation (p<0.01). CONCLUSION: The Russian version of bRFL is a reliable and valid tool for the assessment of the adaptive beliefs and expectations that form an anti-suicidal barrier.
Adaptation, Psychological , Suicidal Ideation , Adult , Child , Factor Analysis, Statistical , Female , Humans , Psychometrics , Reproducibility of Results , Surveys and Questionnaires
The review provides epidemiological data and discuss the associated burden of non-epileptic seizures (PNES). Data on the prevalence, socio-demographic and clinical risk factors for the development of PNES are presented. The hypotheses of the PNES origin, including the contribution of psychological trauma, are considered. We also describe contemporary methods for differential diagnosis of epileptic seizures and PNES, including biomarkers and the use of diagnostic questionnaires. Special attention is given to the issues of the psychiatric comorbidity of PNES.
Electroencephalography , Epilepsy , Comorbidity , Diagnosis, Differential , Epilepsy/diagnosis , Epilepsy/epidemiology , Humans , Seizures/diagnosis , Seizures/epidemiology
OBJECTIVE: To study clinical manifestations of separation anxiety disorder (SAD) in adults with nonpsychotic mental disorders. MATERIAL AND METHODS: Fifty outpatients over 18 years of age with SAD and comorbid non-psychotic mental disorders were assessed for diagnosis by MINI and the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), the Adult Separation Anxiety Self-Report Checklist (ASA-27), HARS, the Experiences in Close Relationship Scale (ECR), the Personality Inventory for DSM-5 (PID-5), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). RESULTS AND CONCLUSION: Two clinical variants of the disorder: affective and cognitive-behavioral as well as two variants of the course: with onset in childhood and in adults are identified. Clinical variants and types differ in the spectrum of comorbidity, objects and styles of attachment, personality characteristics as well as correlations and prognosis.
Anxiety, Separation , Quality of Life , Adolescent , Adult , Anxiety, Separation/diagnosis , Anxiety, Separation/epidemiology , Comorbidity , Diagnostic and Statistical Manual of Mental Disorders , Humans , Personality Inventory
OBJECTIVE: To investigate the prevalence and symptoms of separation anxiety (SA) and separation anxiety disorder (SAD) in adult outpatients with non-psychotic mental disorders. MATERIAL AND METHODS: Five hundred and fifty-seven outpatients over 18 years of age with nonpsychotic mental disorders were examined. Clinical, psychopathological, psychometric (the Adult Separation Anxiety Questionnaire (ASA-27), the Structured Clinical Interview for Anxiety Symptoms (SCI-SAS), the Mini-International Neuropsychiatric Interview (MINI), the Quality of Life Enjoyment and Satisfaction Questionnaire (QLES-Q) methods were used. RESULTS AND CONCLUSION: SAD and SA accompany a wide range of nonpsychotic mental disorders, predominantly anxious and affective, and are highly prevalent among outpatients (24.8% and 5.4%, respectively). Patients with SAD are characterized by a high level of SA; the symptoms specific to SAD predominate in the structure of the disorder. It has been shown that during the manifestation of the disorder in childhood, the range of attachment objects widens with age, and the quality of life in such patients is lower.
Anxiety, Separation , Outpatients , Adolescent , Adult , Anxiety , Diagnostic and Statistical Manual of Mental Disorders , Humans , Prevalence , Quality of Life
This review focuses on studies of pain threshold and tolerance in individuals with nonsuicidal self-injurious (NSSI) behavior. The data on methods of pain sensitivity studies are presented, with issues in animal modeling of NSSI discussed separately. The results of neuroimaging studies on pain sensitivity in individuals with NSSI are described, along with contribution of genetic factors, psychological variables, and disturbances in opioid and hypothalamic-pituitary-adrenal systems. A critical methodological analysis of the studies on pain sensitivity in individuals with NSSI was performed.
Self-Injurious Behavior , Analgesics, Opioid , Humans , Pain Perception , Pain Threshold , Pituitary-Adrenal System
AIM: To study structural correlates of apathy in patients with late-life depression. MATERIAL AND METHODS: Thirty-five patients (≥60 y.o.) with late-onset depression and 22 age-matched healthy volunteers underwent high resolution brain MRI-scanning, and a comprehensive neuropsychiatric examination including HAM-D and the Apathy Scale. RESULTS AND CONCLUSION: A morphometric analysis showed that apathy was associated with atrophy of the lateral prefrontal cortex and reduced grey matter volume of the caudate nucleus on the right, and the nucleus accumbens on the left. Depression correlated with reduced thickness of the medial orbitofrontal cortex bilaterally, rostral anterior cingulate gyrus on the left, isthmus cingulate gyrus on the right, and larger surface area of the entorhinal cortex. Total grey matter volume, grey/white matter volumes of the cerebellum, and cortical thickness in temporal and occipital regions were negatively correlated with both apathy and depression severity. Thus, atrophy of basal ganglia and lateral prefrontal cortex, well known neuroanatomical correlates of apathy in different psychiatric and neurological conditions, characterized it in late-life depression too. This supports the idea of independent pathophysiology of apathetic syndrome.
Apathy , Depression , Depressive Disorder , White Matter , Brain/diagnostic imaging , Depression/complications , Depression/psychology , Depressive Disorder/complications , Depressive Disorder/psychology , Gyrus Cinguli , Humans , Magnetic Resonance Imaging
This text reviews the evolution of the concept of non-suicidal self-injury (NSSI) and discusses its place in the current classification systems. Data on the prevalence of NSSI are presented in detail and the effects of such variables as, gender, age, sexual orientation on the rate and type of NSSI are analyzed. Finally, the comorbidity of NSSI with affective and personality disorders, as well as eating disorders, is examined.
Personality Disorders , Self-Injurious Behavior , Sexual Behavior , Comorbidity , Female , Humans , Male , Prevalence , Risk Factors
The review highlights contemporary views on the problem of suicide in patients with epilepsy. The most relevant theories are presented that describe the emergence of suicidal thoughts and the transition to suicidal attempts. Along with a description of risk factors, protective factors, as well as the possible impact of comorbidity, a description of methodological deficiencies in papers on suicide in patients with epilepsy is given. Recommendations for studies related to suicidal behaviour in patients with epilepsy are discussed.
Epilepsy/psychology , Suicide/psychology , Humans , Risk Factors , Suicidal Ideation , Suicide, Attempted
Anxiety separation disorder (SAD) became the subject of increased attention of researchers in recent decades. DSM-5 and project of ICD-11 allow us to treat this disorder as an independent nosological unit without attachment to age. The review provides information on the prevalence, clinical manifestations and diagnosis of SAD in adults, summarizes information on the etiopathogenesis, relations to other psychiatric disorders, and highlights the lack of modern therapeutic approaches to SAD. The purpose of this review is to raise the level of knowledge about SAD and its new positioning in classification systems.
Anxiety, Separation , International Classification of Diseases , Adult , Anxiety Disorders , Diagnostic and Statistical Manual of Mental Disorders , Humans , Prevalence
Advanced age is a significant risk factor for a completed suicide. The review considers the patterns of suicidal behavior of older adults in the context of their gender, ethnicity as well as social and cultural factors. In terms of pro- and antisuicidal variables, special emphasis is made on the role of somatic and psychic disorders. The article looks at the features of committing a suicide peculiar to the older people and debates some specific issues of self-inflicted death by elderly people. The obtained data indicate the involvement of multilevel factors (biological, clinical, cultural, micro- and microsocial) in suicidal behavior in later life.
Mental Disorders , Suicide , Aged , Ethnicity , Humans , Risk Factors , Suicidal Ideation , Suicide, Attempted
The literature of the last decades shows the growing interest to multiple pathologies in medicine including psychiatry and neurology. Multiple pathology is often determined as multimorbidity or comorbidity. Multiple pathology is a common phenomenon, which is the rule rather than the exception. In the medical care system, it is burden for the patient and for the physician in clinical, organizational and economic aspects. The review addresses all these issues in the aspect of terminology and prevalence.
Mental Disorders/epidemiology , Psychiatry , Comorbidity , Humans , Physicians , Prevalence
The article presents a literature review of psychopharmacological methods of treatment of the apathy syndrome, which is common in neurocognitive disorders. The review provides recommendations for the management of such patients, taking into account evidence-based medicine.
Apathy , Dementia , Humans , Neurocognitive Disorders
This review focuses on the role of mental and cognitive disorders in the prognosis for surgical treatment of pharmacoresistant epilepsy. The authors analyze historical aspects of the surgical treatment of epilepsy and present current data on the prognosis of operative intervention with respect to seizure control, cognitive functioning, and psychiatric disorders. The psychiatrist's role in the structure of preoperative and postoperative management of patients is considered.
Cognition Disorders , Epilepsy , Mental Disorders , Cognition Disorders/complications , Epilepsy/complications , Epilepsy/drug therapy , Epilepsy/surgery , Humans , Mental Disorders/complications , Prognosis
This review is devoted to the place of anxiety disorders in the spectrum of psychiatric comorbidity in patients with epilepsy. The authors present general characteristics of anxiety manifestations and current views on the classification and qualification of anxiety disorders in such patients. Recent data show the relationship of anxiety with different forms of epilepsy, demographic and gender characteristics, localization of epileptic focus. The problem of bidirectional relationship of anxiety and epilepsy as well as the temporal relationship between anxiety and epileptic states are considered.
Epilepsy , Anxiety Disorders/complications , Comorbidity , Epilepsy/psychology , Humans
AIM: To study apathetic depression first diagnosed at late age and identify its relation to cognitive and social dysfunction as well as to morphological and functional changes in the brain. MATERIAL AND METHODS: Thirty-two patients at the age above 60 years with newly diagnosed depressive episode and 15 healthy age-matched volunteers were included in the study. All patients were divided into two groups by the score on the Apathy scale (AS): >14 - depression with apathy (n=21), <14 - depression without apathy (n=11). Patients were examined using psychometric methods (HAMD, GDS, AS, SHAPS, SF-36, MoCA-test), neuroimaging (MRI scanner with a magnetic field strength of 1.5 Tesla - EXCEL ART Vantage Atlas-X, Toshiba, Japan) and statistical data analysis. RESULTS AND CONCLUSION: Apathy component in clinical depression reflects a tendency towards the increase in depression severity and cognitive deterioration that results in the substantial lowering of quality of life and correlates with cerebrovascular changes, decrease in gray and white matter volume and mean cortical thickness of large hemispheres.
Apathy/physiology , Cognition Disorders/diagnosis , Depression/diagnosis , Depressive Disorder/diagnosis , Aged , Brain/pathology , Brain/physiopathology , Cognition Disorders/pathology , Cognition Disorders/physiopathology , Cognition Disorders/psychology , Depression/pathology , Depression/physiopathology , Depression/psychology , Depressive Disorder/physiopathology , Depressive Disorder/psychology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Quality of Life , Severity of Illness Index
AIM: To evaluate the efficacy and tolerability of rac-hopantenic acid (pantogam activ) in patients with mixed anxiety-depressive disorder and anxiety-depressive disorder with chronic cerebral ischemia. MATERIAL AND METHODS: A total of 50 patients were examined (30 patients in the main group, 20 patients in the control one). All patients received standard therapy with SSRI antidepressants. Rac-hopantenic acid at a daily dose of 1200 mg was included in the complex therapy of patients of the main group. Duration of the therapy with rac-hopantenic acid was 21 days. Psychopathological, psychometric and detailed somatic examinations were performed. RESULTS: In the main group, the combination of pantogam activ and antidepressants promoted distinct balanced nootropic, antidepressant and anxiolytic effects, as well as the improvement of health outcomes. The reduced total number of adverse events (less frequent drowsiness and headaches) was noted as well. CONCLUSION: The rapid and reliable reduction of anxiety, depression and cognitive impairment during concomitant therapy with antidepressants and pantogam activ was identified.
Antidepressive Agents/therapeutic use , Anxiety Disorders/drug therapy , Brain Ischemia/complications , Depressive Disorder/drug therapy , Pantothenic Acid/analogs & derivatives , gamma-Aminobutyric Acid/analogs & derivatives , Anti-Anxiety Agents , Anxiety Disorders/complications , Humans , Nootropic Agents , Pantothenic Acid/therapeutic use , Psychometrics , gamma-Aminobutyric Acid/therapeutic use
The review deals with the background and current state of the relationship between schizophrenia and epilepsy. The author presents results of recent epidemiological, neuropsychological, neurophysiological and genetic studies, indicating that these diseases may be different clinical variants of a common etiologic process (neurodevelopmental brain abnormalities), while epilepsy with chronic psychotic symptoms can be considered as an experimental model of schizophrenia pathogenesis.
Epilepsy/complications , Schizophrenia/complications , Brain/abnormalities , Brain/physiopathology , Humans , Psychotic Disorders
Based on current clinical and classification concepts of suicidality, the biological parameters characteristic of suicidal behavior, completed and uncompleted suicides reported in the last few decades are discussed. The results obtained in the studies of neurotransmitter and other brain systems, immune system, lipid and other types of metabolism as well as data of neuroimaging brain studies and post-mortem investigation of brain structures are presented.
Brain/pathology , Suicidal Ideation , Female , Humans , Suicide
