Vol LIV, No 4 (2022)

The article is devoted to the analysis of the psychopathological consequences of the COVID-19 epidemic. Particular emphasis is placed on assessing the fact of increased mortality from COVID-19 in patients with schizophrenia and affective disorders. It is concluded that this was influenced by the irrational use of antipsychotics, which contributed to the appearance of diabetes and overweight in patients.

BACKGROUND. Currently, the study of the cognitive sphere in COVID-19 is an urgent problem.

AIM. To determine the presence of cognitive dysfunction using valid scales MoCA, FAB, clock drawing test and their subscales in patients in the acute period of coronavirus infection, to compare the data of cognitive impairment in different epidemiological waves.

MATERIAL AND METHODS. Two groups of subjects were included in the present study. Groups No. 1 and No. 2 are patients infected with COVID-19 in the acute period, complicated by pneumonia. Group No. 1 was hospitalized in the period December 2020 — March 2021. Group No. 2 was hospitalized in the period November 2021 — January 2022. To study the neuropsychological status, the neuropsychological scales MoCA, FAB, the clock drawing test and their subscales were used. Screening for anxiety and depression and depression was performed using the valid HADS scale. Quantitative data on the normality of the distribution of the sample was tested using the Shapiro–Wilk test. The Mann–Whitney test was used to compare unrelated groups. Quantitative data are presented as median and interquartile range — Me [P25; P75]. Differences were considered statistically significant at p <0.05.

RESULTS. Statistically significant differences were found in the acute period of coronavirus infection complicated by pneumonia and cognitive impairment in both group No. 1 and group No. 2, respectively. In group No. 1 (observation period from December 2020 to March 2021), cognitive impairments were more severe than in group No. 2 (observation period from November 2021 to January 2022). When comparing the subscales of the MoCA test of groups No. 1 and No. 2 upon admission to the hospital, and at discharge in group No. 1, the results of MoCA testing were worse than in group No. 2 according to subscales: attention, speech, memory, indicators were statistically significant (p <0.05). According to the FAB data, in group No. 1, the indicators on admission to the hospital and at discharge were also worse than in group No. 2, highly significant differences were according to the data: fluency of speech, dynamic praxis, simple and complicated choice reaction, grasping reflex study (p < 0.001). Anxiety and depression were not found in the study groups.

CONCLUSION. With the help of such valid scales as: the clock drawing test, MoCA, FAB and their subscales, the presence of cognitive dysfunction in young and middle-aged patients at different time intervals of observation was proved; in the first group, the violations were more severe than in the group No. 2.

The scientific literature analysis on a magical thinking problem was conducted. A review of studies in a historical perspective on this problem was given (English anthropological and French sociological schools, psychoanalysis views), various descriptions of magical thinking structure and possible causes of its development were discussed. A brief review of experimental studies of magical thinking of people without mental pathology is described as well as a specificity of magical thinking in children’s mind. The study of magical thinking in various mental pathologies is considered as one of the forms of “psychosis-like experiences”, as well as the phenomenon of “thought action fusion”.

Following the writer and publicist S. Sontag the opportunities of demetaphorization and demythologization of mental disorders (schizophrenia spectrum) are discussed here. Some specific methods are suggested based on trichotomous concept of human (spirit-soul-body).

In this paper we carried out a critical analysis of М.М. Reshetnikov’s article. The invalidity of the arguments and the inappropriate form of presentation are pointed out.

The DSM-5, adopted in 2013, presents an updated list of affective disorders, which opens with a fundamentally new psychiatric diagnosis of a disruptive mood dysregulation disorder. Disruptive mood dysregulation disorder is diagnosed in children and adolescents aged 6 to 18 years and is manifested by chronic severe and persistent irritability or anger, as well as outbursts of anger disproportionate to the cause. It is obvious that the condition of a significant part of children and adolescents with a disruptive mood dysregulation disorder before the appearance of this diagnosis was mistakenly regarded as manifestations of bipolar disorder. The criterion of the fundamental difference between disruptive mood dysregulation disorder and bipolar disorder is the absence of manic or hypomanic in the first of them. Disruptive mood dysregulation disorder is characterized by high comorbidity and is often combined with oppositional defiant disorder, conduct disorder and attention deficit with hyperactivity, as well as anxiety. The course and prognostic significance of a disruptive mood dysregulation disorder, as well as the choice of the most effective methods of pharmacological treatment and psychotherapy require numerous further studies.

The article describes the case of Daria D., 23 years old, who has been using various drugs (LSD, marijuana, mephedrone) for a number of years and independently abandoned using drags with the transition to the use of microdoses of red fly agaric (Amanita Muskaria). Her mental and addictive status is analyzed. It is concluded that, despite the systematic use of drugs, there are no grounds for making Darya D. a psychiatric or addiction diagnosis.