Vol LV, No 2 (2023)

The article is devoted to an analysis of the terminology used to support a psychiatric diagnosis. Using linguistic approaches, the author draws attention to the presence in psychiatry of “semantically filled” and “semantically empty” terms that denote certain psychopathological symptoms/signs.

It is concluded that for a number of terms used in the diagnosis of schizophrenia spectrum disorders, a revision should be revised and those that are vague, ambiguous, not included in international diagnostic systems and recognised as archaic should be removed from the psychiatric lexicon. In particular, we are talking about symptoms such as emasculation of emotions, pretentiousness, paradoxicality, eccentricity, ambivalence.

Parkinson’s disease (PD) is an age-related neurodegenerative disease associated with the loss of dopamine-producing neurons in the substantia nigra. The disease is manifested by motor disorders and a variety of non-motor symptoms (NMS). NMS may reduce the quality of life (QoL) of people with Parkinson’s disease (PD) more than motor manifestations, but their ultimate contribution has not been fully established.

AIM. To determine the impact of motor, cognitive and affective disorders and social factors on the quality of life of patients with PD in the Republic of Sakha (Yakutia).

MATERIAL AND METHODS. The study included 35 patients with PD, Hoehn–Yahr stage 1–3 (60% women and 40% men), mean age 64.4±2.0 years. We used scales: UPDRS, MoCA, HADS, NMSQuest, Epward Sleepiness Scale, PDQ39. The analysis of clinical signs and social factors in the studied group of patients was carried out.

RESULTS. The decrease in QoL was moderately associated with disease stage (r=0.56, p=0.009), the severity of motor manifestations (r=0.65, p <0.001) and the total number of NMS (r=0.46, p=0.008). Age and disease duration did not affect on QoL. The decrease in QoL was influenced by the presence of depression (r=0.83, p <0.001), anxiety (r=0.69, p <0.001) and cognitive decline (r=–0.46, p=0.008). Low levels of QoL were found in individual PD patients and in people with disabilities. QoL was not influenced by ethnicity, gender, employment or education. Three groups of patients with PD were identified: those with mild, moderate and severe decrease in QoL. Their clinical and social portraits are presented.

CONCLUSION. The dependence of the quality of life of patients with PD on the form of the disease, the stage of the disease, the severity of depression, social factors has been demonstrated, which requires attention not only from neurologists, but also from psychotherapists and social workers.

BACKGROUND. Inadequate coping strategies are associated with affective disorders and poor quality of life in stroke survivors. Although coping strategies are determined by several non-modifiable factors they have been shown to change over time.

AIM. Longitudinal assessment of coping strategies and associated factors in patients with first-ever stroke.

MATERIAL AND METHODS. This study was a part of prospective observational study of a cohort of patients with first-ever stroke. Patients underwent standard psychiatric, neurological and cognitive assessment and CT. Patients without aphasia, severe fatigue, eye problems fulfilled the coping strategies indicator (Amirkhan J.H., 1990): 87 patients in the first week after stroke, 45 patients in the second week, 20 patients in 3 months, 21 patients in 6 months, 33 patients in 1 year after stroke. Non-parametric statistics were used.

RESULTS. Different coping strategies were not determined by age, gender and severity of neurological deficit; there were some correlations with educational level, work status, cognitive dysfunction, stroke volume and lesion location. There were differences in the use of coping strategies in the groups with different depression manifestations: in the group with depression manifestations in the early recovery period and later, coping strategies did not differ from the control group in the acute stroke period, but since the manifestation of depression the amount of avoidance strategies increased. In the group with pre-stroke depression, a significant increase in avoidance strategies was observed in the first week after the stroke.

CONCLUSIONS. The longitudinal study of coping strategies revealed that the use of coping strategies is a dynamic process determined by several modifiable and non-modifiable factors in combination. Coping strategies were not predictors of depression; on the contrary, depression seems to influence the choice of coping strategies.

The article presents materials from foreign and domestic literature, that indicate the relationship between ophthalmic pathology and mental disorders. The most common mental disorders are depression and anxiety among patients with visual impairment. The prevalence of comorbidity of ophthalmic and mental pathology was considered, as well as factors contributing to the progression of these diseases.

This article discusses the features of categorical and dimensional approaches to diagnosing personality disorders. The application of the ICD-10 and ICD-11 classifications is demonstrated using a clinical case of a patient with a personality disorder with mixed dissociative symptoms. The advantages and disadvantages of both approaches are considered, as well as the need to implement validated tools for assessing the severity of personality disorders in clinical practice.

Anorexia nervosa and bulimia nervosa are the main forms of eating disorders that characterized by both obvious similarities and certain differences between each other. The commonality of the two disorders is determined by the predominant occurrence in adolescent and young women, deterioration of physical health, significant psychiatric comorbidity and high suicidal risk. Psychotherapy is the principal treatment for both anorexia nervosa and bulimia nervosa. At the same time, unlike anorexia nervosa, the pharmacological agents with proven clinical efficacy for the treatment of bulimia nervosa exist. Patients with bulimia nervosa are more motivated and adherent to treatment.

The discussion on the methodological limitations of the quasi- measurement of human feelings and sensations, started by the author in the journal Neurology bulletin, continues. There are a number of reasons for accepting/rejecting and understanding the principles and limitations of clinical epidemiology/evidence-based medicine (EBM) to the point of deliberate distortion. It is shown that the ideas of “freedom” and “creativity” in medicine, are ways of avoiding control and the realization of biopower. A concrete example, the study of the efficacy of antidepressants, shows how it is possible, either unintentionally or intentionally, to obtain a false result without following the principles and tenets of EBM.