[Willingness to expend effort for rewards in individuals at clinical high-risk for psychosis: a relationship with the severity and stability of negative symptoms]. / Gotovnost' prilagat' usiliya v gruppe klinicheskogo vysokogo riska razvitiya psikhoza: svyaz' s vyrazhennost'yu i stabil'nost'yu negativnoi simptomatiki.

OBJECTIVE: To identify the deficit in willingness to expend effort and its association with negative symptoms in the high-risk for psychosis (CHR) group. MATERIAL AND METHODS: The study included young men: 45 patients, who met CHR criteria and were treated for a depressive episode, and 15 controls. All subjects completed a modified version of the Effort Expenditure for Rewards Task (EEfRT). The CHR group was assessed with the SOPS, SANS and HDRS at the beginning and at the end of treatment. EEfRT was performed only at the end of treatment. RESULTS: The CHR group was significantly less likely to choose high effort tasks across reward probability and magnitude levels compared with the control group (all p<0.001). No significant correlations were found between the rate of selecting the high effort task and the negative syndrome domains of amotivation and diminished expression. The subgroups of CHR with stable and transient (i.e., with a reduction >50% during treatment) negative symptoms, which were identified by a cluster analysis, did not differ in the willingness to expend effort. CONCLUSION: The study confirmed a decrease in the willingness to expend effort in the CHR group; however, this deficit was only weakly correlated with negative symptoms and persisted after the symptoms reduction during treatment, which requires future studies to investigate mechanisms underlying impaired effort expenditure for rewards in CHR.

[History of the development of domestic psychiatry: the period 1940-1980]. / Istoriya razvitiya otechestvennoi psikhiatrii: period 1940­1980 gg.

The article briefly presents an analysis of the development of domestic psychiatry (with an emphasis on research in the field of psychopathology and nosology) from the post-war period (the Great Patriotic War) to the era of "perestroika". With the founding of the Institute of Psychiatry of the USSR Academy of Medical Sciences under the leadership of V.A. Gilyarovsky, the study of endogenous diseases was based on a multidisciplinary approach, in which the clinical-psychopathological research method was combined with clinical/biological ones. The most important role of the subsequent school of A.V. Snezhnevsky in describing the syndromes and forms of the course of schizophrenia (G.A. Rotshtein, R.A. Nadzharov, A.B. Smulevich, A.K. Anufriev), its age aspects (E.Ya. Sternberg; M.S. Vrono, G.P. Panteleeva, M.Ya. Tsutsulkovskaya; V.M. Bashina) is reflected. The contribution to psychopathology of other leading Russian psychiatrists, who worked mainly in Moscow and Leningrad research institutions of that period, was noted: students of P.B. Gannushkin - O.V. Kerbikov, V.M. Morozov, D.S. Ozeretskovsky, S.G. Zhislin, as well as G.K. Ushakov, A.E. Lichko, M.M. Kabanov, G.V. Morozov, M.V. Korkina, A.A. Portnov, I.N. Pyatnitskaya and others. The priority of A.V. Snezhnevsky and G.K. Avrutsky with colleagues for the introduction of neuroleptics and other new psychotropic drugs in the treatment of mental illnesses is emphasized. The review ends with the activities of M.E. Vartanyan who headed the country's leading scientific institution in the difficult «perestroika¼ era and developed the biological approach to mental illness further with the creation of international research programs.

[Juvenile depression as at-risk state for psychotic disorders]. / Yunosheskie depressii kak gruppa riska endogennykh psikhozov.

OBJECTIVE: To establish the risk of psychotic disorders in juvenile depression and to study the role of negative symptoms in its formation. MATERIAL AND METHODS: Seventy-four in-patients (19.6±2.3 years old), who were hospitalized for the first time in the clinic for a depressive episode, were examined. Psychometric scales HDRS, SOPS, SANS were used. The risk of manifestation of psychotic disorders was established in the presence of attenuated positive symptoms (APS) with values of at least one of the points P1, P2, P3 and P4 of the corresponding SOPS subscale more or equal to 3. The overall risk of schizophrenia spectrum disorders was established in the presence of attenuated negative symptoms (ANS) with values of at least one of the points H1-H6 of the negative SOPS subscale is more than or equal to 5. Statistical analysis was carried out using the Statistica 12 program. RESULTS: During the psychometric assessment of patients at admission, four groups were identified based on the presence of APS and ANS: group 1 (APS+ANS), group 2 (APS), group 3 (ANS) and a comparison group without APS/ANS. It was found that the presence of APS and ANS in the structure of depression increased its severity (U=109.0; p=0.009). Assessment of the ANS severity on the negative subscale of SOPS and on the SANS demonstrated quantitative differences with the highest representation of negative symptoms in the corresponding groups (APS+ANS and ANS) with significant differences in total scores in the comparison group (U=93.0; p=0.004 and U=85.0; p=0.002). When studying the structure of negative symptoms according to the SANS subscales, patients with APS differed in a lower degree of severity of negative symptoms only according to the «Avolition-Apathy¼ subscale (U=141.5; p=0.028). Patients from the comparison group, despite significant differences in other psychopathological symptoms, showed lower values only for the SANS subscales «Affective flattening¼ (U=112.0; p=0.02) and, to a greater extent, «Avolition-Apathy¼ (U=84.0; p=0.002). CONCLUSION: Based on the presence of prodromal symptoms in the structure of juvenile depression and their dynamics during therapy, one can assume not only a different degree of risk of endogenous psychoses, but also their nosological affiliation.

[Features of inflammatory reactions in patients with juvenile depression with a clinically high risk of psychosis]. / Osobennosti vospalitel'nykh reaktsii u patsientov s yunosheskimi depressiyami s klinicheski vysokim riskom psikhoza.

OBJECTIVE: To determine the levels of pro-inflammatory and anti-inflammatory cytokines and inflammatory markers such as C-reactive protein, leukocyte elastase, α1-proteinase inhibitor, autoantibodies to neuroantigens in the blood of patients with adolescent depression with clinical high risk for psychosis (CHR-P) and to study the relation of these biological markers to the features of psychopathological symptomatology of the patients. MATERIAL AND METHODS: Eighty young adults, aged 16-24 years, with the first depressive episode (F32.1-2, F32.38, F32.8) were studied. Based on the presence of attenuated positive symptoms in the structure of depression, all patients were divided into two groups: with CHR-P (clinical group, n=58) and without CHR-P (comparative group, n=22). The HDRS-21, SOPS, and SANS were used for psychometric assessment of the patients. Serum levels of cytokines TNF-α, IL-6, IL-8, IL-10, and concentration of C-reactive protein (CRP) were determined. Leukocyte elastase (LE) activity, α1-proteinase inhibitor (α1-PI) activity, and plasma levels of autoantibodies to S100B protein and myelin basic protein (MBP) were assessed. RESULTS: Both groups of patients were characterized by the high levels of inflammation as assessed by LE (250.5 (226.2-280.8) nmol/min·ml vs 248.3 (226.8-284.5) nmol/min·ml) and α1-PI activity (44.4 (37.5-50.1) IE/ml vs 45.2 (36.4-49.9) IE/ml). Higher levels (p<0.05) of IL-6 (1.22 (0.64-2.2) pg/ml), CRP (0.93 (0.18-3.18) mg/l), and TNF-α/IL-10 (0.34 (0.2-0.47)) were detected in the group with CHR-P. This group was also characterized by higher levels of antibodies to the S100B protein 0.78 (0.69-0.84 units of opt.density) compared with the group without CRH-P (p<0.05). In each clinical group, different correlations between clinical, psychometric and biological parameters were revealed. CONCLUSIONS: The results confirm the involvement of inflammation in the development of depression in youth and indicate a different role of the inflammatory markers analyzed in the formation of CHR-P. The differences in the spectrum of inflammatory markers in depressed patients suggest a more pronounced pro-inflammatory potential in the group with CHR-P.

[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.

[Existential youth depressions]. / Ekzistentsial'nye yunosheskie depressii.

OBJECTIVE: To determine the clinical and psychopathological features of existential depression in youth. MATERIAL AND METHODS: 53 male patients (16-25 years old) with diagnosis F31.3, F31.4, F32, F33 with existential themes of depressive experiences were studied by clinical and psychopathological method. RESULTS: The axial symptom of existential was over-value ideas about the meaninglessness of their own and human life with ideas of self-abasement, insolvency, low value, imperfection of society, which in most of the studied cases (79.2%) was accompanied by various degrees of severity suicidal thoughts and intentions. Three varieties were identified: with the prevalence of reflections on the meaninglessness of life (39.6%); with the prevalence of neurotic religiosity (28.3%); with an existential philosophical interpretation (32.1%). CONCLUSION: As a result of the study, the heterogeneity of existential depressions, a significant role of psychogenic factors in their formation were revealed, as a high suicidal risk. Existential depressive states differed in duration, severity of depressive symptoms, high frequency of non-suicidal self-neglect and suicidal risk.

[Application of the biofeedback method in the therapy of depression]. / Primenenie metoda biologicheskoi obratnoi svyazi v terapii depressii.

In order to systematize the modern literature data on the effectiveness of biofeedback in the treatment of patients with depressive disorders, clinical efficacy and prospects for use in psychiatric practice, publications in the MEDLINE / PubMed, eLibrary databases from 2013 to 2023, as well as relevant references in the reference lists of the analyzed articles, were selected by the keywords «biofeedback¼, «depression¼, «depression therapy¼, «electroencephalogram¼, «non-drug treatments for depression¼. The analysis of data has shown that the biofeedback method demonstrates a certain therapeutic potential in the treatment of depression. It can be used to augment therapy in case of insufficient therapeutic effect, with low patient compliance, as well as poor tolerability of psychopharmacotherapy and in the presence of residual symptoms after pharmacological treatment. The method allows the correction of the psycho-emotional state, improves the balance between the parasympathetic and sympathetic divisions of the autonomic nervous system, and contributes to a more stable clinical effect. At the same time, further studies are needed, with the inclusion of large samples of patients from various nosological groups and with an analysis of the comparability of the effects of various biofeedback protocols.

[Psychopathology of depressive-delusional states with religious content]. / Psikhopatologicheskie osobennosti depressivno-bredovykh sostoyanii s religioznym soderzhaniem.

OBJECTIVE: Identification of psychopathological characteristics of depressive-delusional states with religious content, development of a typology, determination of formation features, nosological assessment. MATERIAL AND METHODS: A total of 79 patients (47 female, 32 male, mean age 27±6.5 years) with depressive-delusional states with religious content within the affective and schizophrenia spectrum disorders were studied. Clinical-psychopathological, psychometric (PANSS, HDRS, S. Huber CRS) and statistical methods were used. RESULTS: Based on the psychopathological structure, specific mechanisms of development of delusions and themes of the religious experiences, three types of depressive-delusional states were identified: type 1 - with a predominance of depressive delusions congruent with affect and delusional ideas of guilt, sinfulness, abandonment of God (14 patients, 17.7%; 6 women, 8 men; mean age 28±4.5 years; HDRS score 33±5.6, the total PANSS score 71±5.3, the PANSS positive subscale score 15.8±3.7); type 2 - with the addition of incongruent delusional constructs, persecutory disorders and acute sensory delusions to the existing depressive religious delusion, with the phenomenon of confessional ambivalence (27 patients, 34.2%; 16 women, 11 men; mean age at attack manifestation 25±9 years; HDRS score 29.6±4.4, the total PANSS score 87±6.2, the PANSS positive subscale score 23.5±4.2); type 3 - depressive-paranoid states with a predominance of Kandinsky-Clerambault syndrome of religious content (38 cases, 48.1%; 20 women, 18 men; mean age at attack manifestation 23.4±2.5 years; HDRS score 32.7±3.7, the total PANSS score 102±7.3, the PANSS positive subscale score 32.5±4.5). CONCLUSION: The study of depressive-delusional states with religious content has shown their clinical-psychopathological heterogeneity. The religious experiences served as a pathoplastic factor, which essentially modified the clinical-psychopathological picture of the disease due to presence of the specific religious phenomena. The identified types of depressive-delusional disorders with religious content had different diagnostic value.

[Augmentation therapy of resistant schizophrenia with rhythmic transcranial magnetic stimulation]. / Augmentatsiya terapii rezistentnoi shizofrenii metodom ritmicheskoi transkranial'noi magnitnoi stimulyatsii.

OBJECTIVE: To identify the clinical efficacy of rhythmic transcranial magnetic stimulation (rTMS) in resistant schizophrenia. MATERIAL AND METHODS: The study included 44 male patients with resistant schizophrenia, divided into 4 groups: with depressive (group 1; n=11, 25.0%), with hallucinatory (group 2; n=12, 27.3%), with negative (group 3; n=11, 25.0%) and with delusional symptoms (group 4; n=10, 22.7%). Patients received rTMS, the parameters of which were determined depending on the typological variety, for 3 weeks (15 sessions). Psychometric assessment was carried with PANSS, CGI-S, CGI-I, SANS, CDSS, AHRS when included in the study (0 day), after stimulation (21 days) and by the end of the study (42 day) that allowed evaluation of both the severity of the therapeutic effect and its duration. RESULTS: By the end of the course of stimulation, patients of the first three groups developed a distinct positive effect corresponding to a significant reduction in the total PANSS score: group 1 - 24.4% (p=0.002), group 2 - 8.3% (p=0.02), group 3 - 11.7% (p=0.001), which remained stable by day 42 in patients of the first (p=0.001) and second (p=0.005) groups. In patients with delusional symptoms (group 4), a subpsychotic state developed with a corresponding increase in the total PANSS score by 9.7% (p=0.007) requiring a course of relief therapy, which showed effectiveness by the end of the observation (day 42), indicating that resistance was overcome. CONCLUSION: The study demonstrated the validity of rTMS as an adjuvant method of treatment in the resistant schizophrenia. To implement the potential of rTMS, it is necessary first of all to take into account the structural features of the condition, as well as to continue improving the stimulation technique itself (increasing the duration of the course, developing supportive courses).

[Structural features of the brain in individuals with youth depression at a clinical risk for psychosis]. / Strukturnye osobennosti golovnogo mozga pri yunosheskikh depressiyakh s klinicheskim riskom manifestatsii psikhoza.

OBJECTIVE: To establish the structural features of the brain (cortical and subcortical) in depressive patients at clinical risk for psychosis. MATERIAL AND METHODS: Nineteen right-handed male patients with youth depression, who were assessed for high risk of psychotic manifestation, and 20 healthy controls underwent MRI and clinical examination. T1-weighted images were processed in FreeSurfer 7.1.1. For each subject average values for the cortex thickness and area, volumes of subcortical structures, and separately volumes of the amygdala nuclei were obtained. Intergroup comparisons and correlations with clinical scales (SOPS, HDRS) were calculated. RESULTS: Patients showed decreased gray matter thickness in the left (p=0.002) and right (p=0.003) postcentral gyri and increased thickness in the right posterior cingulate cortex (p=0.003) and rostral anterior cingulate cortex (p=0.001). CONCLUSION: These findings may reflect cortical changes at early stages of the psychotic process, including the gray matter loss in some areas and the opposite phenomena in others (it cannot be ruled out that the latter may be the result of altered ontogenesis and/or certain compensatory changes).

[Therapeutic drug monitoring of antipsychotic drugs in routine psychiatric practice]. / Terapevticheskii lekarstvennyi monitoring antipsikhoticheskikh preparatov v povsednevnoi psikhiatricheskoi praktike.

OBJECTIVE: To evaluate the relationship between daily doses of antipsychotic drugs, their serum concentrations, and characteristics of patients treated for schizophrenia or schizophreniform disorder in day-to-day clinical practice. MATERIAL AND METHODS: A total of 187 patients were included in the study, 77 (41.1%) patients were on monotherapy, and 110 (58.9%) patients received two or more antipsychotics. Patients age was 27.8±8.1 years, and their body weight was 79.8±15.6 kg. The sample was represented mainly by young men (93.0%). The proportion of smokers was 37.4%. The appropriate HPLC-MS/MS method was used for the simultaneous analysis of 8 antipsychotics and its active metabolites. Serum concentrations of the drugs aripiprazole (ARI), chlorpromazine (CPZ), haloperidol (HAL), zuclopenthixol (ZUC), clozapine (CLO), risperidone (RIS), quetiapine (QUE), olanzapine (OLA), norclozapine (N-desmethylclozapine, NOR), 9-hydroxyrisperidone (9-OH-RIS), dehydroaripiprazole (DGA) were measured. The serum concentration/dose ratio (C/D) was employed as the primary outcome measure, as doses were not kept constant during the study. The active antipsychotic fraction (drug+active metabolite, active moiety - AM) was also evaluated for RIS and ARI. In addition, the metabolite/parent ratio (MPR) was evaluated for RIS and ARI. RESULTS: A total of 265 biological samples were obtained, 421 and 203 measurements of the concentration of drugs and their metabolites were carried out, respectively. Overall, 48% of antipsychotics levels were in the expected therapeutic ranges, 30% were below therapeutic ranges, and 22% were above them. A total of 55 patients underwent dose adjustments or drug changes due to ineffectiveness or side-effects. It has been found that smoking reduces the level of C/D for CLO (p<0.01, Mann-Whitney test). We have established that comedication with CLO significantly increases the C/D ratio of QUE (p<0.05, Mann-Whitney test). We have not revealed any influence of weight and age of the subjects on the C/D. The dose-concentration regression relationships are formalized for all AP. CONCLUSION: Therapeutical drug monitoring (TDM) is an essential tool to personalize antipsychotic therapy. Careful analysis of TDM data can contribute significantly to the study of the impact of individual patient characteristics on systemic exposure to these drugs.

[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.

[Attenuated negative symptoms in the structure of youth depression]. / Attenuirovannye negativnye simptomy v strukture yunosheskikh depressii.

OBJECTIVE: To detect negative symptoms in adolescent depression, to determine their psychopathological structure and predictive significance. MATERIAL AND METHODS: Seventy-one young in-patients (average age 19.5±2.4 years) (main group) and 52 in-patients (average age 19.8±2.7 years) (comparison group) with the diagnosis «Depressive episode¼ according to ICD-10 F32.1, F32.2 were examined. Inclusion criterion in the main group was attenuated negative symptoms (ANS) in adolescent depression. Clinical-psychopathological and psychometric examination was carried out using HDRS, SOPS, SANS. The statistical analysis was done by Statistica 12. RESULTS: Adolescent depression with ANS was more persistent than depression in the comparison group (27.5±17.2 month versus 7.0±6.3, p<0.001), there was higher level of positive symptoms and disorganization symptoms on the respective SOPS sub-scales (7 [5; 9] and 4.5 [3; 8.75], p=0.002; 8 [6; 10] and 5.5 [3.25; 7], p<0.001, respectively). According to the psychopathological structure of the negative symptoms, patients in the main group were divided into a subgroup (n=38, 53.5%) with the predominance of emotional spectrum disorders and a subgroup (n=33, 46.5%) with the predominant involvement of the volition spectrum. ANS in the negative SOPS sub-scale were significantly higher (p=0.045) in patients of the subgroup with volitional disorders. Also, a total HDRS score, reflecting the severity of depressive symptoms, was significantly higher compared to a subgroup with the predominance of emotional spectrum disorders (p=0.038). CONCLUSION: The results show that it is possible to clinically verify negative symptoms in the adolescent depression, which makes it possible to assign such patients to the risk group of manifestation of schizophrenia, and to assign depression with ANS to the model of the initial stage of schizophrenic process.

[Premorbid features of youth depression patients with attenuated schizophrenic symptoms]. / Premorbidnye kharakteristiki bol'nykh yunosheskimi depressiyami s attenuirovannymi simptomami shizofrenii.

OBJECTIVE: To establish the premorbid features in youth depression patients with attenuated symptoms of schizophrenia (ASS) and in a comparison group, with an analysis of the course of age crises, signs of personality disorders, level of premorbid functioning and their relationship with the level of functioning after five-year follow-up. MATERIAL AND METHODS: Two hundred and nineteen youth depression patients with ASS (according to ICD-10: F32.1, F32.2, F32.28, F32.8) (main group) and 52 patients with «pure¼ adolescent depression without ASS (comparison group) were examined. A total of 124 patients from the main group and 27 patients from the comparison group were examined in 5-year follow-up. The Perceptual Awareness Scale (PAS) was used to assess premorbid functioning and the Personal and Social Performance (PSP) scale was used to determine function at the time of the follow-up. The method of χ2 was used to analyze qualitative data. The correlation analysis was performed with Spearman's rank correlation coefficient. Results are presented as median values [Q1; Q3]. RESULTS: The main group of patients with ASS have worse psychopathological symptoms compared with the comparison group (χ2=4.74; p=0.029). Premorbid functioning was also lower in the period 12-15 years (0.4 [0.33; 0.5]) and 16-18 years (0.47 [0.385; 0.585]) than in the comparison group (0.3 [0.23; 0.43] and 0.37 [0.23; 0.462], respectively, (p<0.05)). Negative correlation has been established between average PAS scores in the age of 12-15 and 16-18 years and the five-year follow-up on the PSP scale (r=-0.276, p<0.05 and r=-0.359, p<0.05 respectively). CONCLUSION: Similar characteristics of the premorbid period in childhood and an increase in differences starting from the pubertal period reflect the pathogenetic significance of the pubertal crisis and suggest compensatory mechanisms that, in patients with youth depression with ASS, are able to restrain the development of the endogenous process for a certain time, but subsequently become exhausted, which leads to persistence of psychopathological symptoms in intercrisis periods and serves as the first clinical marker of the onset of schizophrenia.

[Clinical features of schizotypal disorder in childhood and adolescence]. / Klinicheskie osobennosti shizotipicheskogo rasstroistva v detsko-podrostkovom vozraste.

OBJECTIVE: To identify psychopathological features, patterns of formation and course of schizotypal disorder (STD) in childhood and adolescence, to develop criteria for differential diagnosis. MATERIAL AND METHODS: A total of 151 patients, aged 7 to 16 years (mean age 12.3 years), with a diagnosis of schizotypal disorder were included in the study. Of these, 48 (31.8%) were women and 103 (68.2%) were men. Psychopathological, pathopsychological, psychometric and statistical methods were used. The Schizotypal Personality Questionnaire (SPQ) was used as a formalized tool for assessing the clinical symptoms of STD. RESULTS: Based on the prevailing symptoms, the clinical sample of patients was divided into 3 groups. The 1st group consisted of 56 (32.5%) patients with a predominance of neurosis-like disorders, the 2nd group - 50 (37.7%) patients with a predominance of behavioral disorders, the 3rd group included 45 (29.8%) patients with the dominance of stable personality anomalies. Significant differences between the groups were found in the frequency and severity of psychopathological symptoms, the structure of deficient (negative disorders), the age of onset of disorders, the characteristics of social activity and adaptation. According to the SPQ scale, positive disorders prevailed in group 1 compared to group 3: ideas of attitude (3.3 and 2.7 points respectively), unusual sensations and perceptions (3, 1 and 1.7 points respectively). CONCLUSION: STD is a spectrum of disorders, on one end of which there are variants with a predominance of positive disorders, on the other negative ones. The predominance of certain psychopathological symptoms is due to the age of onset of psychopathological disorders, age at the time of the current exacerbation, and the duration of persistence of the disease. The predominance of neurosis-like, psychopathic-like disorders and persistent personality anomalies makes it possible to classify STD as one of the identified types, which allows us to substantiate differentiated therapy and prognosis.

Thermal Balance of the Brain and Markers of Inflammatory Response in Patients with Schizophrenia.

In patients with schizophrenia, the thermal balance of the cerebral cortex was studied by means of microwave radiothermometry method and compared with the markers of systemic inflammation and clinical features of the disease course during therapy. Low temperature heterogeneity of the cerebral cortex was associated with an increase in the activity of inflammatory markers in the blood and, in most cases, with a positive response to therapy. High temperature heterogeneity of the cerebral cortex was typical of patients with insufficient activity of the inflammatory proteolytic system, high levels of antibodies to brain antigens, a more severe course of the disease and, in most cases, with resistance to therapy. A conclusion was made about the diagnostic value of the study of the thermal balance of the brain in patients with schizophrenia.

[The course of postpsychotic depressions in adolescence]. / Dinamika postpsikhoticheskikh depressii v yunosheskom vozraste.

OBJECTIVE: To identify psychopathological features of postpsychotic depressions formed within the achievement of remission after the first psychotic episode in adolescence. MATERIAL AND METHODS: Fifty-six male patients of adolescent age (average age 19.7±2.5 years) with postpsychotic depression (F20, F25) were enrolled. The study used clinical-psychopathological, psychometric and statistical methods. HDRS-21 was used for psychometric assessment of depressive symptoms, and suicidal risk was assessed using SSI. RESULTS: There were two types of post-psychotic depression: type 1 with a positive affectivity (58.93%, n=33) and type 2 with negative affectivity (41.07%, n=23). Significant differences in the structure of the first psychosis were found (χ2=7.8; p=0.02). In the case of depression type 1, the HDRS-21 score was 17.49±7.49 points with the largest number of points on the sub-scales «low mood¼ (2.81±0.83) and «mental anxiety¼ (2.88±0.45). The SSI average score was 7.81±6.46. Anti-vital thinking was noted by 75.76% (n=25). In the case of depression type 2, the HDRS-21 average score was 23.68±9.24 points (the largest number of points was fixed in the sub-scales «low mood¼ - 2.44±0.73, «work and activity¼ - 3.19±0.89). The SSI average score was 12.30±8.47. CONCLUSION: The study showed the heterogeneity of the course of postpsychotic depressions that occur after a manifest psychotic episode of adolescence. Differences in the structure of depression were identified, which are important for therapeutic tactics and prognosis of the disease.

[Neurocognitive functioning in young patients with chronic endogenous depression]. / Neirokognitivnoe funktsionirovanie u patsientov yunosheskogo vozrasta s khronicheskimi endogennymi depressiyami.

OBJECTIVE: To identify the specific features of cognitive functioning in patients with youth chronic endogenous depressions (YCED). MATERIAL AND METHODS: Fifty-one male patients with YCED (duration 36.5±12.5 month) and 18 patients with youth depression without chronic course as a comparison group were examined. A neuropsychological battery of the following techniques was used to assess cognitive functioning: the Rey - Osterrieth complex figure test, the Design Fluency Test, the Verbal Fluency Test, the 20-question Test, the Color-Word Interference Test, arithmetic problem solving, compilation of stories based on Bidstrup's cartoons, SDMT, the Digit span. RESULTS: Based on the heterogeneity of psychopathological features of YCED, two types were identified: unitary depressions (type 1) and supplementary depressions (type 2). Among type 2 depressions, two subtypes were distinguished: with neurosis-like disorders (subtype 2.1) and with psychopathic-like disorders (subtype 2.2). The following significant differences between different types of YHED and comparison groups were revealed: on the scale «Copying¼, «Simultaneity « and points when reproducing the Rey-Osterritz figure (p=0.049, p=0.024 and p=0.043); performing the second series in the Digit Span (p=0.022); in the switching test (p=0.004) and the number of errors (p=0.046) in the Color-Word Interference Test; «expansion of the utterance program¼ when solving arithmetic problems (p=0.012). The total number of patterns in the «Visual Fluency¼ test and the execution time of the «Encryption¼ method were significantly lower in the YHED group (p=0.049 and p=0.046). CONCLUSION: Patients with YCED show signs of neurocognitive dysfunction. The patients of supplementary and unitary types of YCED demonstrate the differences in the neurocognitive profile. The revealed peculiarities show the perspective of YCED research and typification of chronic depression in adolescence due to the differences in the neurocognitive profile.

[Suicidal risk in depressions with religious content]. / Suitsidal'nyi risk pri depressiyakh u patsientov s religioznym mirovozzreniem.

The review highlights the main issues of positive and negative religious coping in depression with suicidal behavior. The number of clinical and psychological factors related to suicide risk (age, gender, clinics of depression, internal and external religious orientation, the role of religious community, social support and ethical assessment of suicide) is discussed. To develop personalized approaches to the complex therapy of suicidal behavior, it is advisable to devote further research to studying the influence of the religious factor on depressive states with different levels of severity of psychopathological disorders.