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Vol LV, No 3 (2023)
- Year: 2023
- Articles: 8
- URL: https://journals.eco-vector.com/1027-4898/issue/view/8011
Editorial
The history of the journal Neurology Bulletin (to the 130th anniversary)
Abstract
The article prepared for the anniversary of the Neurological Bulletin journal, describes the history of the creation and the first years of work of the Society of Neurologists and Psychiatrists and its press edition — the Neurological Bulletin journal. The purpose of the Society was to unite the scientific forces of the Imperial Kazan University for the continuation of complex studies of the nervous system by clinicians together with representatives of the natural sciences (histology, anatomy, physiology), as well as psychologists and lawyers. This determined the theme of the new journal, which published articles on a wide range of issues.
5-11
The concept of a second opinion in psychiatry
Abstract
The article analyses the “second opinion” strategy, which involves providing patients with the opportunity to obtain a second (different) opinion from a qualified specialist in cases where patients are not sure of the correctness of their diagnosis or want to consider other treatment options. The use of “second opinion” in general medicine and in psychiatry is compared. It is pointed out that it is rare to get a “second opinion” in psychiatry, and there is very little scientific research on this issue in both general and forensic psychiatry. It is concluded that the lack of demand for the concept of “second opinion” on the part of psychiatrists is associated with many factors, in particular with the prevalence of diagnostic and therapeutic relativism. It is argued that psychiatrists should reconsider their attitude to the concept of “second opinion”, gain communication skills with patients on the topics of substantiating the correctness of their own diagnostic conclusion and create criteria for an objective assessment of the qualifications of doctors.
12-20
Original study arcticles
Development of a short version of the test of anticipatory solvency
Abstract
BACKGROUND. The Test of anticipatory consistency was developed by V.D. Mendelevich based on the anticipatory concept of neurosogenesis. The technique has been used in numerous studies and has proven itself as a diagnostic tool. At the same time, the substantial volume of questions makes the current version time-consuming for the subjects.
AIM. The purpose of this work was to create a short version suitable for screening studies of anticipation consistency.
MATERIAL AND METHODS. The study involved 315 students and 96 patients treated in the departments of the Republican Clinical Psychiatric Hospital of academician V.M. Bekhterev and Central Clinical Hospital No. 18 with established diagnoses of the heading “Neurotic, stress-related and somatoform disorders”of the International Classification of Diseases of the 10th revision. The development of the test included three stages: the study of the psychometric indicators of the original test, the development of the stimulus material of the short version, the study of the reliability and validity of the short version. To assess convergent validity, adapted Russian-language versions of the questionnaires “Methods of coping behavior”by R. Lazarus and “Melbourne Decision-making Questionnaire”were used.
RESULTS. Confirmatory factor analysis revealed a sufficient level of agreement of compliance with the three-factor structure of the test: CFI=0.909; TLI=0.894; SRMR=0.0672; RMSEA=0.05 (CI 90% 0.0338–0.0648). The short version of the test has sufficient reliability: Kronbach α=0.727, McDonald ω=0.742, the scales correlate with each other, individual statements correlate with their scales. The short version of the test correlates with the results of the original methodology, and retest reliability, criterion and convergent validity are confirmed.
CONCLUSION. A short version is possible for use in screening studies of anticipation viability.
21-30
Coping strategies for residents of the Republic of Karelia with autonomic nervous system
Abstract
AIM. To analyse thе coping strategies leading to psychological maladjustment and the occurrence of autonomic nervous system disorders (ANSD) in residents of the Republic of Karelia (RK).
METHODS. Heart rate variability (cardiointervalography, rhythmography, spectral analysis) and coping strategies (adapted Lazarus coping test) were studied in 104 residents of RK suffering from ANSD (main group — MG; sex index 1:1; mean age 36.8±10.7 years) and in healthy control subjects (CG; n=30; sex index 1:1; mean age 36.1±5.5 years; p=0.761).
RESULTS. It was found that the residents of RK with ANSD are statistically significantly (p <0,05) characterised by sympathicotonia in combination with high tension of such emotionally oriented coping strategies as “escape-avoidance” (in men — 47,52±7,05/40,27±5,04%; in women — 47,46±9,47/46,13±8,68% in persons of the MG/CG, respectively) without gender differences (p >0,05). Women used more often (p <0,05) use “distancing” (50,67±10,09/43,07±7,56%; p=0,009) and “taking responsibility” (46,65±7,8/40,27±5,04%; p=0,002); whereas men underestimated (p <0,05) the coping strategy “planning” (49,88±8,2/56,4±6,31% in MG and CG; p=0,004).
CONCLUSIONS. For the primary and secondary prevention of ANSD in RK residents, it is advisable to take into account the specifics of heart rate variability (sympathicotonia) and coping strategies (emotionally oriented), which will optimise psychological adaptation to the disease through personalised rehabilitation programmes based on a biopsychosocial approach (a combination of pharmacological and psychological — psychotherapeutic correction).
31-39
Reviews
Pediatric multiple sclerosis: pathogenesis, clinical and radiological features, diagnosis and treatment
Abstract
Data on the epidemiology, clinical features, diagnosis and treatment of paediatric multiple sclerosis (PMS), as well as characteristics of the immune and endocrine status of children compared with the population with multiple sclerosis (MS) were analysed using the Scopus, Web of Science, MedLine, The Cochrane, EMBASE, Global Health and RSCI databases. The MS course in children and adults has a number of important differences, which may require the development of different treatment approaches than in adults. At the same time, despite the large number of studies on PMS, the pathogenesis of these above differences remains unclear. PMS is characterised by a more active course than in the adult population and by greater severity of exacerbations; in addition, a more rapid increase in lesion volume and early brain atrophy are observed in the absence of effective treatment. Despite a more rapid and complete regression of the neurological deficit after exacerbations and, consequently, a slower rate of its accumulation, conversion to SPMS and achievement of disability occurs at an earlier age. The characteristics of subsets and functional differences of lymphocytes revealed by immunological studies suggest possible differences in the choice of disease-modifying therapies in children and adults. However, the number of studies on the immune and endocrine status of patients with PMS compared with the adult population is limited and the results are often conflicting. PMS is therefore an important medical and social problem that requires further research to optimise approaches to disease-modifying therapies.
40-54
Case reports
Progressive vision loss as part of Munchausen’s syndrom on the example of the clinical case
Abstract
The article presents a case of Munchausen’s syndrome featuring complaints of progressive vision loss not previously reported in Russian literature. Within the research scope, we performed psychopathological enquiry, analysed the medical examination records of the involved specialists, as well as review of modern literature. Existing obstacles in the diagnostics of the syndrome in question were investigated including particularities of ophthalmological practice and it is concluded that alertness of doctors of all specialties in respect of feigned symptoms cases should be increased to properly manage such patients and prevent prescription of unnecessary potentially harmful medical interventions.
55-67
Discussions
68-72
The evolution of psychiatry as the disappearance of cysts (Response to the article by V.D. Mendelevich “Semantic void” of a number of psychiatric terms used in the diagnosis of schizophrenia)
Abstract
Current diagnosis in psychiatry is primarily based on formalised criteria used in diagnostic classifiers — ICD and DSM. Diagnostic classifiers, as well as related professional terminology, change periodically. The updating of the medical (including psychiatric) lexicon is driven both by the accumulation of new scientific data and by increasing ethical requirements that do not allow the use of stigmatising terms. V.D. Mendelevich in his article, the commentary of which is the present publication, justifiably questions the appropriateness of the traditional use of archaic and meaningless terms from psychiatry of the rather distant past in the diagnosis of schizophrenia. According to the author of this comment, the diagnostic approaches criticised by V.D. Mendelevich are not only irrational, but also ethically unacceptable.
73-77
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