[The impact of depression symptoms on postmorbid adaptation of patients who have undergone SARS-CoV-2 infection (assessment from the position of the multimorbidity model)]. / Vliyanie simptomov depressii na postmorbidnuyu adaptatsiyu patsientov, perenesshikh SARS-CoV-2-infektsiyu (otsenka s pozitsii modeli mul'timorbidnosti).

OBJECTIVE: To evaluate the impact of psychosomatic and anxiety symptoms of depression on the formation of postmorbid adaptation in patients who have undergone SARS-CoV-2 infection. MATERIAL AND METHODS: The data of 54 patients, aged 18-55 years, with a current depressive episode who had outpatient SARS-CoV-2 infection were analyzed. The Hamilton depression rating scale (HDRS) was used and somatic condition was assessed using a general assessment of the patient's function limitation at the stage of reconvalescence. A linear regression analysis was performed to assess the association of psychosomatic and anxiety symptoms with somatic condition in SARS-CoV-2 infection, regardless of other factors. RESULTS: The multimorbidity model took into account, in addition to SARS-CoV-2 caused by organic somatic disorders, psychosomatic manifestations (B=-1.9, p=0.004) and anxiety (B=-3.7, p=0.04) symptoms of depression. Somatic anxiety was significantly correlated with a pronounced impairment of postmorbid readaptation (p<0.05), while mental anxiety did not demonstrate such a relationship (p=0.46). The observed trend seems to be due to the overlap of manifestations of somatic anxiety with the construct of residual somatic symptoms, even though there is no multicollinearity between them. CONCLUSION: Identification of clusters of symptoms associated with reduced opportunities for full recovery in the SARS-CoV-2-postmorbid period can significantly help in providing a high-quality and targeted psychopharmacological care.

[The structure of catatonia in depression and depressive-delusional conditions]. / Struktura katatonii pri depressiyakh i depressivno-bredovykh sostoyaniyakh.

OBJECTIVE: To determine the psychopathological structure of catatonia and its major components in depression and depressive-delusional conditions in affective and schizophrenia spectrum disorders. MATERIAL AND METHODS: Ninety-six patients (67 women and 29 men), aged 16 to 65 years, with depression and depressive-delusional conditions with catatonic features were examined (ICD-10 - F20, F25, F31, F33). Exploratory factor analysis with MLE data extraction and varimax rotation was used to determine the structure of catatonia. Thirty-one catatonic features were selected for the analysis. RESULTS: Heterogeneity of catatonic syndrome in depression and depressive-delusional conditions has been revealed. Four factors of catatonia have been extracted (KMO test=0.782, Bartlett test: χ2=2098, df=465, p<.001): Agitated (eigenvalue 5.64, 18.2% of variance), Hypokinetic (4.88, 15.7% of variance), Parakinetic (3.84, 12.4% of variance), Proskinetic (3.75, 12.1% of variance). The extracted factors can be considered as the subsyndromes of catatonia in depressive conditions. The agitated factor (31 patients, 32.3%) is manifested by an increase in psychomotor activity. The hypokinetic factor (75 patients, 78.1%) reflects a decrease in reactivity combined with negativism. The parakinetic factor (30 patients, 31.3%) is associated with negative symptoms of schizophrenia. The proskinetic factor (20 patients, 20.8%) doesn't occur separately from other catatonic features in depression and depressive-delusional conditions. CONCLUSION: The results are partially consistent with earlier investigations in other groups of patients with catatonic features. Schizophrenia is characterized by the presence of parakinetic manifestations of catatonia, the greater severity of hypokinetic manifestations and a higher degree of catatonia polymorphism, in contrast to affective disorders. The results indicate the heterogeneity of catatonia associated with the manifestations of depression and with concomitant symptoms. Catatonic subsyndromes may differ not only phenomenologically, but also neurobiologically.

[The effect of the serotonin transporter 5-HTTLPR polymorphism on the recognition of facial emotions in schizophrenia].

The 5-HTTLPR SLC6A4 and catechol-o-methyltransferase (COMT) Val158Met polymorphisms are reported to be associated with processing of facial expressions in general population. Impaired recognition of facial expressions that is characteristic of schizophrenia negatively impacts on the social adaptation of the patients. To search for molecular mechanisms of this deficit, we studied main and epistatic effects of 5-HTTLPR and Val158Met polymorphisms on the facial emotion recognition in patients with schizophrenia (n=299) and healthy controls (n=232). The 5-HTTLPR polymorphism was associated with the emotion recognition in patients. The ll-homozygotes recognized facial emotions significantly better compared to those with an s-allele (F=8.00; p=0.005). Although the recognition of facial emotions was correlated with negative symptoms, verbal learning and trait anxiety, these variables did not significantly modified the association. In both groups, no effect of the COMT on the recognition of facial emotions was found.