[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.

[Impulsivity and aggression in patients at risk for schizophrenia at the stage of remission after the first depressive episode]. / Impul'sivnost' i agressiya u bol'nykh iz gruppy riska razvitiya shizofrenii na etape stanovleniya remissii posle pervogo depressivnogo epizoda.

OBJECTIVE: To study the phenomenon of impulsivity, its components and aggression in patients at risk for schizophrenia at the stage of remission after the first depressive episode. MATERIAL AND METHODS: Forty-eight male patients (mean age 19.4±2.9 years) with the first depressive episode (ICD-10 F32.1, F32.2) with attenuated positive, negative and/or disorganized symptoms were examined. According to the severity of impulsivity, the patients were divided into the clinical group (n=26) with pathological impulsivity and the comparison group (n=27) without it. The control group consisted of 41 mentally healthy young men, students of higher education of 1-3 courses, (mean age 19.7±1.6 years). HDRS, SOPS, SANS, Barratt Impulsiveness Scale (BIS-11) and Buss Perry Aggression Questionnaire (BPAQ) were used. Statistical analysis was carried out using the Statistica 12 software. RESULTS: The differences between the clinical group and the comparison group were determined by the total score of the subscale of general symptoms of SOPS at admission (53 [41.75; 56] and 45.5 [41.75; 51.25], respectively) (U=187.5; p=0.037) and at discharge (28 [19; 37] and 25 [17.75; 29.25] points respectively) (U=166.5; p=0.012), according to the total HDRS score at admission (35 [31; 38] and 29 [26; 34.25]) (U=191.0; p=0.046). In the clinical group, the motor component of impulsivity and the factor of general impulsivity on the BIS-11 correlated with the severity of aggression on the BPAQ (r=0.395, p<0.05 and r=0.635, p<0.05, respectively). Significant differences were revealed in the clinical group depending on the presence of negative symptoms on the corresponding SOPS subscale according to the total BPAQ score (p=0.01). Correlation analysis showed numerous connections: positive between the total aggressiveness score and the duration of depression (p<0.05), negative between the factors of self-control, consistency, attention, and total scores on the SANS and SOPS (p<0.05). CONCLUSION: We identify the differences in the structure of impulsivity in patients at risk of developing schizophrenia at the stage of remission after the first depressive state, the comparison group and the control group, as well as the relationship of impulsivity factors with individual clusters of psychopathological disorders.

[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.