Vol LII, No 4 (2020)

The evolution of terminology related to neurodevelopmental disorders is primarily determined by the need for destigmatization and includes three stages. The ethical unacceptability of the concept of oligophrenia with the identification of its three forms (debility, imbecility and idiocy) became apparent in the second half of the XX century, which led to the adoption of a new term — mental retardation, which was replaced in the DSM-V and ICD-11 by the concept of intellectual disability, and for the first time in the history of medicine, the reason for changes in American and global professional terminology was a special Federal law 111-256, which also received the official synonym “Rosa’s Law”, which can be considered a symbol of destigmatization in psychiatry.

A review of literature is devoted to consideration of the theoretical studies in modern psychiatry as a clinical representative of neurosciences. It discusses the development of a personalized approach in psychiatry, the training of psychiatrists in neurobiology, the prospects for transferring the achievements of psychiatric science into clinical practice, and new principles of systematization of mental disorders.

The purpose of the study was to reveal intercorrelation between personality traits and superstitiousness and paranormal beliefs among patients with neurotic disorders. Empiric methodology included tests and experiment.

Methods. The following tools were used: The Paranormal Belief Scale by J. Tobacyk (adapted D.S. Grigoriev), “Superstitiousness Inventory” by I.R. Abitov, the “Big Five” Inventory (5PFQ) by McCrae & Costa (adapted by A.B. Khromov). For independent samples the Mann–Whitney U-test was used and the Spearman correlation coefficient.

Results. The empiric study showed that the patients with neurotic disorders have higher scores on the Psi (U=927.5; р=0.026) and Superstition (U=755.0; р=0.001) scales of the J. Tobacyk Inventory, higher superstitiousness parameters according to I.R. Abitov Questionnaire (U=943.0; р=0.034), and higher values of the “Big Five” scales “agreeableness” (U=769.0; р=0.001), “conscientiousness” (U=796.0; р=0.002) and “neuroticism” (U=919.0; р=0.022). Experiment revealed that patients with neurotic disorders are more disposed to believe in positive projections than healthy respondents (U=872.5; р=0.007).

Conclusions. In the neurotic sample group agreeableness, neuroticism, extraversion and conscientiousness are directly correlated with superstitions and paranormal beliefs. It was concluded that patients with neurotic disorders are more superstitious, more tend to believe in some people’s superpowers and in favorable astrological forecasts. Probably superstitiousness and paranormal beliefs of patients with neurotic disorders play compensatory role.

The aim of this study was to identify the features of electroencephalograms in patients with depressive disorders and to evaluate correlations with clinical and dynamic parameters.

Material and methods. The study included 74 patients with depressive disorder. The severity of depressive disorder was assessed using the Hamilton depression scale and the General clinical impression scale. To assess the clinical features of the course of depressive disorder, the Hamilton anxiety scale, the Snaith–Hamilton anhedonia scale, and the social adaptation scale were used. Information about the age of depressive disorder was taken from patients’ medical records. In addition to the clinical data, the level of cognitive flexibility was assessed using the Stroop test. The electroencephalogram was recorded and analyzed using the international 10–20 system at rest with closed eyes. The values of the spectral power of rhythms were analyzed. Correlation analysis of clinical and electroencephalographic data of patients was performed.

Results. Analysis of the spectral power of rhythms revealed statistically significant differences between the group of patients with depressive disorders and the control only in the β-frequency range in the frontal (p=0.000001), central (p=0.00028) and parietal (p=0.017) cortex. Direct correlations were found between the level of beta — rhythm spectral power in the frontal cortex and the severity of depressive disorder (r=0.2856; p=0.015), the level of anxiety (r=0.2622; p=0.028), and the degree of cognitive rigidity (r=0.3728; p=0.007). Direct correlations were also found between the spectral power of the β-rhythm in the central cortex and the degree of cognitive rigidity (r=0.3332; p=0.017).

Conclusions. The predominance of high-frequency activity in patients with depressive disorders reflects an increase in cortical arousal in the brain, which is accompanied by a number of clinical features in the form of a more severe course of the disease, the presence of anxiety symptoms and cognitive rigidity. Thus, the results obtained allow us to use quantitative electroencephalogram data to clarify the severity of clinical symptoms of depressive disorder.

The analysis of the literature on the relationship of psychological characteristics with the onset and course of primary dysmenorrhea is carried out. In addition, the relationship of this disease with mental symptoms is discussed, including the likelihood of emergence and comorbidity of the most common mental symptoms against the background of prolonged pain syndrome. The results on the effectiveness of psychotherapy and psychocorrection in the treatment of primary dysmenorrhea are presented.

The aim of this work was to assess the main methods for diagnosing lesions of the pudendal nerve and sacral pathways, which include it. A critical analysis of the literature data was carried out with a generalization of the currently available results of original studies on identifying the causes of neurological disorders in diseases of the pelvic organs. Key scientific publications of different years, containing materials on this topic, placed in the PubMed, ResearchGate, eLibrary and other available sources were analyzed. The pudendal nerve is the caudal branch of the sacral plexus and facilitates the processes of urination and defecation, as well as perineal skin sensitivity and sexual function. The complex course of the pudendal nerve and the proximity to many dense anatomical structures contribute to the appearance of conditions for its external compression. Most often, the nerve can be compressed in three places (traps): in the space under the tense piriformis muscle, between the sacrospinous and sacroiliac ligaments, and in the genital canal (Alcock’s canal), formed by the splitting of the fascia of the internal obturator muscle. This article discusses advantages and disadvantages of the main diagnostic techniques used to diagnose damage to the pudendal nerve and the pathways, of which it is a part: bulbocavernous reflex, needle electromyography of the pelvic floor muscles with analysis of motor unit potentials, somatosensory and cutaneous sympathetic evoked potentials, transcranial and translumbar magnetic stimulation. Main attention is paid to the method of electrophysiological study of the bulbocavernosus reflex as the most popular and accessible in clinical practice. But despite the advantages of the described methods, currently there is no one that would allow to accurately determine the level of damage to the structures under study, which is often a very important aspect in the choice of tactics for the management and treatment of patients with neurological disorders of the pelvic organs.

In recent decades psychiatry has increasingly debated issues related to the spectrum of mental disorders. The article analyzes modern classifications of mental disorders from the standpoint of the spectral approach. Various concepts of the addictive disorder spectrum are discussed. The benefits of the spectral approach are discussed in detail: a better understanding of the etiology and pathogenesis, the study of new forms of addictive states/disorders, the expansion of therapeutic approaches, and multidisciplinarity. Alternative points of view are analyzed that the spectral approach leads to anosologism, erasure of the border of norm and pathology, medicalization of non-nosological conditions, relativism of psychopharmacotherapy. In conclusion, the concept is proposed that the addictive spectrum should include disorders that have similar symptoms, similar genetic predisposing factors, similar neurobiological mechanisms, similar psychological mechanisms, similar (effective) pharmacological and psychotherapeutic interventions.

The large amount of clinical data on the efficacy and safety of the sleep deprivation technique and its neurobiological mechanisms of action suggest that this technique can be employed as one of mood disorders treatment strategies and used as a biological method of first-line thymoanaleptic therapy. The aim of using sleep deprivation in the clinical setting is to relieve depressive syndrome and to prevent relapses, especially in the cases when patients are resistant for pharmacotherapy. In the modern society, sleep deprivation represents an alternative to the use of traditional approaches in the treatment of depression. In part I of this review we focus on indications for this method, protocols of therapeutic sessions, and well as on the amount of time spent on sleep deprivation needed for achievement of therapeutic effect.

Purpose. Evaluation of the effectiveness of anticipation-prognostic regulation in rehabilitation training of patients with ischemic stroke, taking into account the levels of movements’ construction and localization of the lesion.

Methods. 17 patients participated in the study (62.3±1.48 years). Based on the localization of the ischemic stroke focus, two groups were formed: the first group included 11 patients with localization of the ischemic stroke focus in the cerebellar structures. The second group consisted of 6 patients with lesions of the basal ganglia. The NIHSS scale was used to assess neurological status. Assessment of severity of motor disorders was carried out with the use of functional neuropsychological tests. The research included three phases: diagnostic phase (pre-diagnosis of gnostic and praxis functions); the stage of the rehabilitation training (using the hardware-software complex “Visual medicine”); the re-identification stage (estimated gnostic and praxis functions after rehabilitation training).

Results. As a result of the study, it was found out that in patients who suffered an ischemic stroke with localization of the lesion in the basal ganglia, the level of voluntary movements’ construction may transform into automated ones (without the possibility of automating motor programs). The implementation of motor programs in such patients is possible only through speech mediation at the level of voluntary movements’ construction.

Conclusions. In patients who have suffered an ischemic stroke with localization of the lesion in the structures of the cerebellum, at the level of voluntary movements’ construction both separate movements and motor programs are restored through speech mediation. In the absence of speech mediation, patients make mistakes mainly when performing separate movements that make up motor programs. This leads to a violation of the motor program. Due to morphological limitations, the automation of both separate movements and complete motor programs requires significantly more time. The implementation of motor programs is also possible for this category of patients at any level of movements’ construction on a basis of speech mediation.

Aim of this study was to evaluate interconnection of anticipatory consistency and coping strategies in patients with mixed anxiety and depression disorder.

Methods. Clinical and psychopathological, experimental- psychological and statistical.

Results. We examined anticipatory consistency and coping strategies of 31 patients with mixed anxiety and depression disorder. It is concluded that with temporary anticipatory failure in patients, the methods of defense “confrontation” and “escape-avoidance” are enhanced, and the temporal and prognostic solvency increase the indicator of general anticipatory solvency.

Conclusion. In a mixed anxiety and depressive state, anticipatory consistency and coping strategies are interrelated and interdependent parameters.

10 декабря 2020 года на 68 году жизни скоропостижно скончался Альберт Вазгенович Погосов – доктор медицинских наук, профессор, академик РАЕН, «Отличник здравоохранения СССР», заведующий кафедрой психиатрии и психосоматики Курского государственного медицинского университета, один из ведущих отечественных ученых в области психиатрии и наркологии.