[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.

[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.

[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.

[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.

[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.

[Chronic endogenous depression of youth]. / Khronicheskie endogennye depressii yunosheskogo vozrasta.

OBJECTIVE: To identify psychopathological features of chronic endogenous depression that develops in youth and determine most significant diagnostic and prognostic criteria. MATERIAL AND METHODS: Sixty-two male inpatients were examined who had suffered from a chronic depressive state over 2 - years in their youth (16-25 years old) and were treated at FSBSI MHRC clinic in 2008-2010. The exclusion criteria were the presence of psychotic episodes, severe deficiency symptoms, as well as clinically significant somatic, neurological and mental disorders that complicated the study. Clinical-psychopathological, psychometric (HDRS, SANS and SOPS) and statistical methods were used. RESULTS AND CONCLUSION: Youth chronic endogenous depression is characterized by the dominance of symptoms of negative affectivity in their structure. In addition, there are disorders that differ from those of an affective spectrum. Based on the analysis of psychopathological characteristics of youth chronic endogenous depressions, two typological varieties are identified: unitary depressions (type I) and supplementary depressions (type II). Among type II depressions, 2 subtypes are distinguished: with neurosis-like and with psychopathic- like disorders. The presence of psychopathic disorders in the structure of depression is a prognostically unfavorable sign.

[Clinical and pathopsychological features of youth depression with attenuated schizophrenic symptoms]. / Klinicheskie i patopsikhologicheskie kharakteristiki yunosheskikh depressii s attenuirovannymi simptomami shizofrenicheskogo spektra.

OBJECTIVE: To determine the clinical and pathopsychological features of youth depressions with attenuated schizophrenic symptoms (ASS), and their significance for early differential diagnostic and nosological assessment. MATERIAL AND METHODS: Twenty young patients (19.7±3.7 years) with the first depressive episode with attenuated schizophrenic symptoms (ASS) (ICD-10 items F32.1, F32.2, F32.3) (basic group) were divided into subgroup 1 with attenuated positive symptoms - APS (19.3%) and subgroup 2 with attenuated negative symptoms - ANS (45.1%). Eleven young patients (19.4±2.9 years) with the classic depressive episode without ASS (ICD-10 items F32.1, F32.2) were included in a control group. Psychometric scales HDRS, SOPS, SANS, pathopsychological methods and Adult Personality Traits Questionnaire (APTQ) were used. RESULTS: Statistically significant differences in the severity of depression were not found. A higher SOPS total score (p=0.006) and a greater severity of negative symptoms on SANS (p=0.006) were detected in patients of clinical groups compared with the comparison group. Distortion of the generalization process was detected in 60% of cases, impairments of immediate memorization were found in 30%, and the non-constructive nature of associations in 10%. Indirect data on greater emotional integrity of patients from the comparison group was obtained. CONCLUSION: The presence of similar clinical and psychological abnormalities in the youth depressions with ASS allows us to attribute these phenomena to the possible risk factors for the development of schizophrenia.