Vol LI, No 2 (2019)

Frontiers papers
Evidence-based psychotherapy:between the possible and the necessary
Mendelevich V.D.

Polemic article is devoted to the analysis of the reasons of not demand of evidence-based psychotherapy by professional community. The principles of evidence-based medicine and evidence-based psychotherapy are compared. Results of 96 meta-analyses and systematic reviews from Cochrane library devoted to studying of efficiency of various methods of psychotherapy are analyzed. It is noted that so far in 47. 9% of cases the efficiency of psychotherapeutic interventions continues to remain unproven, 27. 1% of reviews note the low level of substantiality, 20. 8% average and only 4. 2% high. The conclusion that the situation which developed in the field of psychotherapy has only two solutions is drawn: either the psychotherapy will try to overcome negative attitude to evidence based and will refuse the confrontation destroying a profession between various schools, or recognizes that psychotherapeutic activity cannot be estimated by means of methods of scientific statistics and will exist out of an evidence based paradigm.

Neurology Bulletin. 2019;LI(2):4-11
Text and diagnosis
Zislin J.

The concept «Pathography» was studied by comparing the biographies of artists written by biographers and physicians. In this article we can use few clusters of the biographies of art figures: a pathobiographies of avant-garde poets D. Harms, V. Khlebnikov, and modern artist P. Pavlensky. Psychiatrists repeatedly described the biographies of these persons previously and established psychiatric diagnoses. Comparison of these biographies makes it possible to identify the core types of diagnostic descriptions used by doctors. It is shown inconsistence of confusing the author and the author’s personality. The same errors occur in the diagnostic process. The second part of the article is devoted to the typological analysis of the figure of the author. There are core six elements described that affect the understanding / misunderstanding of texts interpretation and the process of diagnosis.

Neurology Bulletin. 2019;LI(2):12-29
Original studies
The interaction of the factors of adverse childhood experiences and emotional problems
Каtan Е.А., Каrtets V.V., Коtlyarova S.V., Danilchuk V.V., Коsenko I.A.

The structure and saturation of the factors of adverse childhood experience in narcological patients were studied, their linear relationship between the level of alexithymic and post-traumatic disorders was determined, affective disorders of the anxiety-depressive spectrum were assessed. It is shown that the difficulties of emotion regulation can function as a mechanism connecting traumatic experiences preceding in childhood and subsequent use of surfactants.

Neurology Bulletin. 2019;LI(2):30-35
Cognitive impairment in patients on hemodialysis
Khrulev A.E., Studyanikova S.F., Langraf S.V., Sadyrin R.V., Grigoryeva V.N.

The aim of research was to study cognitive impairment (CI) in patients on hemodialysis (HD): 63 people (25 men and 38 women) aged 38 to 72 years (mean age 54. 2±11. 1 years). The main group consisted of 43 people on HD. The control group consisted of 20 relatively healthy individuals without kidney disease. A clinical neurological examination, MoCA and Mini-Cog tests were conducted. It was found that CI are much more common in patients on HD (according to MoCA, 81. 4%; Mini-Cog, 34. 9%). The inverse dependence of the cognitive status on the duration of dialysis patients was demonstrated (r=-0. 27, p≤0. 05). A weak correlation between MoCA test and the adequacy of the dialysis dose (kt/V index) was detected. The structure of CI in HD patients was dominated by memory impairment, visual-constructive disorders, changes in the executive skills and fluency of speech.

Neurology Bulletin. 2019;LI(2):36-40
The dynamics of the regulatory-adaptive status of the body in the treatment of generalized anxiety disorder
Alexandrova L.A., Boyko E.O., Lozhnikova L.E.

The main parameters of regulatory and adaptive status of the organism in the treatment of the generalized anxiety disorder were identified and considered. The features of these parameters are studied. It was found that with the onset of remission in the treatment of patients with GTRS, the index of regulatory adaptive status (IRAS) increases. More effective treatment corresponds to larger IRAS.

Neurology Bulletin. 2019;LI(2):41-43
Structure and dynamics of the emotional burnout syndrome in medical workers during correction with mindfulness technology
Ovchinnikov A.A., Sultanova A.N., Vinokurov A.V., Sycheva T.Y., Tagiltseva E.V.

The objective of this study is research of structure and dynamics of the emotional burnout syndrome among health care workers in the process of applying the mindfulness technique. It is revealed that in the course of correction the phenomena relating to the emotional sphere – emotional exhaustion, situational anxiety and catastrophization significantly change. Identification of relationships showed a clear structure of the emotional burnout syndrome. This structure contains a catastrophization in addition to the three components. In this structure catastrophization and reduction of professionalism are the coping strategies against emotional exhaustion and depersonalization.

Neurology Bulletin. 2019;LI(2):44-48
Cognitive mechanisms of emotions regulation of patients with diabetes type ii with different variants of its course
Solovyova S.L., Koshanskaya A.G.

Purpose. To study cognitive mechanisms of regulation of emotions at patients of the diabetes (D) of the II type with different variants of its course.

Methods. “Scale of the dysfunctional relations” of A. Beck, A. Veysman (adapted by Zakharova M.L.), technique of “Diagnostics of irrational installations” of A. Ellis, questionnaire “Cognitive regulation of emotions” of N. Garnefski and V. Krayga (CERQ) (adapted by Pisareva O. L., Gritsenko A.), “Scales of emotional schemes of R. Leahy” (adapted by N. A. Sirota, Moskovchenko D. V.). The obtained data are processed by means of the statistical SPPS 20 program.

Results. Research showed that patients with type 2 diabetes for regulation of affective experiences use productive cognitive strategy in the form of acceptance of the incident with derivation of thoughts on more pleasant events, reflections over the plan of further actions, decrease in the exclusive importance of an event due to its comparison with other more difficult situations. They use emotional schemes of reaction in the form of “tendency to rationalization of feelings” and “the simplified idea of emotions” more often: rationality is more preferable to these patients, than emotional experience, complex feelings and ambivalent emotions hardly are accepted. At the same time at patients with type 2 diabetes existence of irrational installations with tendency to an assessment of adverse events as catastrophic with excessively high requirements to itself and people around is observed. At persons with non-insulin-dependent diabetes mellitus (NIDDM) the tendency to look for positive sense in the events, unlike patients with insulin-dependent diabetes mellitus (IDDM) as patients with heavier form of a course of a disease at whom tendency to self-accusation and charge of others is revealed, with catastrophic and brighter expressiveness of emotional reaction, with perception of emotions as infinite, disturbing the functioning, arising because of other people who are not able to understand emotional experience of the patient. High expressiveness of the dysfunctional relations is also peculiar to IDDM patients with manifestation of the increased control over the thoughts, feelings and behavior, a pedantry, dependence, self-criticism, tendency to a reflection and depression of mood.

Conclusion. Cognitive distortions in the form of the inadequate, dysfunctional attitudes towards themselves, other people, the occurring events, and also their negative interpretation can be the cornerstone of emotional frustration which have impact on the course of diabetes of the II type, especially at patients with IDDM.

Neurology Bulletin. 2019;LI(2):49-55
Attitude of cancer patients to death in terms of temporal perspectives and level of religiosity
Frolovа A.V.

This article discusses the attitude of cancer patients to death in terms of the temporal perspective and the level of religiosity. An important result of this study was that various parameters of a temporal perspective, reflecting the ability for prognostic competence, performing an adaptive function, programming future constructive behavior and being a marker of psychological health, can serve as indicators of an adequate experience of the fear of death. It is revealed that religiosity does not reduce the fear of death, but may affect the attitude towards death.

Neurology Bulletin. 2019;LI(2):56-60
Emotional disorders in children with breath-holding spells and in their mothers
Polskaya A.V., Chutko L.S.

The aim of the research was to study the emotional characteristics of children with breath-holding spells (BHS) and their mothers. The results of a survey of 80 young children examined for BHS are presented. To assess their emotional characteristics, we used the questionnaire of A.I. Zakharov, the questionnaire of G.P. Lavrentieva and T.M. Titarenko «Level of anxiety of a child», as well as the anxiety test of R. Temml, V. Amen, M. Dorka. The results of this study showed that children with BHS revealed a higher level of anxiety compared with healthy children in the control group. As the methods of research of the mother’s emotional characteristics was used the following: «Questionnaire for detecting signs of autonomic disorders» by A. M. Wayne, Personal scale manifestations of anxiety by A. J. Teylor in the adaptation of T. A. Nemchinova, State-Trait Anxiety Inventory of Ch.D. Spilberger in adaptation of Y.L. Hanin, Toronto Alexithymia Scale (TAS-26), adapted at the Research Institute of Bekhterev (St. Petersburg). According to the results of the research, most mothers of children with BHS had emotional disorders (high level of anxiety, alexithymia), which suggests the presence of a psychosomatic component in the Genesis of this disease.

Neurology Bulletin. 2019;LI(2):61-65
Residual symptoms and their impact on social functioning in patients with bipolar disorder in remission
Ashenbrenner Y.V., Chumakov E.M., Petrova N.N.

64 patients with Bipolar disorder type I and type II in remission who received treatment in the outpatient department of the St. Petersburg Psychiatric Service in 2017-2018 were examined using the archival and clinical scale methods. 42. 2% of the patients had residual symptoms in this remission, and 70. 3% of the surveyed patients had residual symptoms in remission throughout the disease. Patients with residual symptoms at the time of the study were characterized by lower labour and social adaptation. A statistically significant relationship between specific residual symptoms and changes in professional functioning in patients were not identified. It has been established that as the duration of the disease increases, the frequency of residual symptoms in remission also increases. It is necessary to develop new strategies of therapy and rehabilitation of this group of patients.

Neurology Bulletin. 2019;LI(2):66-71
Review papers
Cerebral amyloid angiopathy and hypertensive cerebral microangiopathy. Differential diagnosis
Novosadova О.А., Grigorjeva V.N.

Cerebral amyloid angiopathy (CAA) and hypertensive small vessel disease (HTN-SVD) have a number of similar clinical manifestations, but the prognosis, treatment and approaches to the stroke prevention in patients with these diseases are different, so the differential diagnosis is of great importance. This review discusses the most discriminative clinical signs of CAA, such as «amyloid spells», convexital subarachnoid hemorrhages, clinical manifestations of lobar hematomas and microbleedings. Important neuroimaging differences of CAA from HTN-SVD are cortical superficial siderosis, convexital subarachnoid hemorrhages, cortical microbleedings, «lobar» lacunes, expansion of perivascular spaces in semi-oval centrum, white matter hyperintensity in posterior brain regions.

Neurology Bulletin. 2019;LI(2):72-79
Type 1 Chiari malformation and cognitive impairment: focus on the cerebellum
Kokurkina R.G., Mendelevich E.G.

Given evidence that cerebellar symptom in MK 1 is not limited to existing ideas. The role of the cerebellum in the control of not only motor but also cognitive functions is considered. The theory of universal cerebellar transformation (UCT) as a mechanism of complex regulation of motor and non-motor functions is discussed. The question is raised about the need for a critical analysis of the cognitive profile of patients with MK 1. The problems that lie in the way of studying cognitive dysfunction in patients with MK 1 are highlighted.

Neurology Bulletin. 2019;LI(2):80-84
Self-damaging behavior of children and adolescents with psychic disorders
Krasilnikova A.M., Pyrkova K.V.

This theoretical study examines the features of self-damaging behavior of children and adolescents with various mental illnesses. The specificity of the course of self-harm in affective disorders: schizophrenia, attention deficit hyperactivity disorder, post-traumatic stress disorder, autism spectrum disorders, eating disorders, borderline personality disorder has been determined.

Neurology Bulletin. 2019;LI(2):85-91
The story of a metaphor
Zobin M.L.

The idea of a “biological interface” as a fundamental discovery leading to a paradigm shift in human science, is considered from a critical point of view. It indicates that computer metaphor has a solely utilitarian nature and limited cognitive value to perception of both philosophical problems of consciousness and mental disorders in general.

Neurology Bulletin. 2019;LI(2):92-94
Enchanted again, this time with evidence-based medicine
Zorin N.A.

The discussion on methodological limitations of quasi-measuring human feelings and sensations continues, started by the author in the journal Neurological Bulletin (2018). The differences between clinical epidemiology and its practical part – evidence-based medicine – are considered. The limitations of medical assessment tools in their cultural, linguistic and semantic aspects are discussed. Another attempt is made to show the inadequacy of their use for group generalizations.

Neurology Bulletin. 2019;LI(2):95-100
Place of fake-diagnosis and functional diagnosis in psychiatry (institutional discourse)
Nosachev G.N.

The article is a statement of the author‘s opinion on discussion in the journal «Neurological Bulletin» on the article of V. Mendelevich «Fake diagnoses in psychiatric classifications».

Neurology Bulletin. 2019;LI(2):101-104
Recommendation for practitioners
Depersonalization disorders in psychiatric and somatic clinic.
Krylov V.I.

The article deals with the clinical features of depersonalization disorders in major mental and somatic diseases. The ratio of depersonalization, asthenic, anxiety, affective, somatoform mental disorders in the clinical picture of the disease is discussed.

Neurology Bulletin. 2019;LI(2):105-111

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