Vol LI, No 3 (2019)

Frontiers papers
Behavior epiphenomenes in the International Classification of Diseases
E.V. Snedkov .
Neurology Bulletin. 2019;LI(3):5-19
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PSYCHOTHERAPY WITHOUT PSYCHOTHERAPIST
Trutneva D.R., Mendelevich V.D., Mendelevich V.D.
Abstract

In article results of the analysis of a problem of expediency and efficiency of digital methods of self-regulation as addition to face-to-face psychotherapy are carried out. On the basis of the review of evidential researches (meta-analyses and systematic reviews) the validity of application of methods of digital psychotherapy is shown. Scientific data on efficiency of a technique of Master Kit intended for independent work of the person with the beliefs, installations, emotional states (fears, touchiness), unaccepted qualities, a self-assessment are provided. It is noted that despite polarity of opinions of professionals and clients/patients on need of more widespread introduction of self-regulation with use of mobile applications, this approach is evidence-based and expedient. It is noted that the considerable number of clients and patients inclines to the self-help choice more and more actively. The conclusion that transition only to techniques of the self-help is similar to self-treatment which not always appears an adequate measure is drawn. Self-regulation not an alternative of face-to-face psychotherapy, but apps are not identical to the qualified psychotherapists. But the choice remains for the consumer of psychotherapeutic services.

Neurology Bulletin. 2019;LI(3):20-27
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Personality, personality disorder, dysregulation of behavior and activities
Gorinov V.V., Korzun D.N., Shekhovtsova E.S.
Abstract

At the present stage, the problem of personality is a key aspect of research in all fields of knowledge. In General psychiatry and psychology, models are created that describe the structure of the individual, taking into account the various individual and personal components (characterological features, basic beliefs, I-concept), that is the most promising in modern science is the study of such variables as the integrity of the individual, the ability to take responsibility for their behavior, to make their own decisions, the flexibility of mental processes and behavior, the ability to develop mechanisms to adapt to stressful situations and the ability to social adaptation.

From a practical point of view, in modern forensic psychiatry the most urgent problem is the definition of disorders associated with personality pathology. This problem is of particular importance in the light of the changing approach to the diagnosis of personality disorders in the light of the new International classification of diseases of the 11th revision.

Also, within the framework of forensic psychiatry and psychology, the most urgent issue is the regulatory violations that affect the behavior of the individual in a criminal situation. So the behavior of persons with personality disorders is most influenced by individual psychological and situational features, which requires a more detailed analysis of motivational, prognostic and volitional disorders, preservation of the ability to self-regulation, purposeful behavior, planning and control of their actions. In this regard, the domestic of forensic psychiatry, the most urgent question of determining the possibility of application of the provisions of article 22 of the criminal code to the persons with personality disorders who have committed socially dangerous deysvtiya formulating criteria for forensic psychiatric evaluation of this pathology, the assessment of their danger to themselves and others in cases of need application recommendations.

Neurology Bulletin. 2019;LI(3):28-31
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Original studies
Prevalence and clinical typology of separation anxiety disorder in adults
Arkusha I.A., Avedisova A.S., Zakharova K.V.
Abstract

Aim: To assess the prevalence of separation anxiety disorder (SAD) in adults on an outpatient psychiatric network, to study clinical and psychological characteristics and comorbidity depending on the age at which the disorder began.

Methods: Using clinical-psychopathological and psychometric methods, 366 outpatients over 18 years of age were examined.

Results: The received data testify to high rates of prevalence and comorbidity of SAD, to essential decrease in quality of life of investigated patients. Among the personality traits, negative affectivity and vulnerability to separation prevailed. It is noted that the childhood onset of SAD is associated with greater severity of separation anxiety in adults, a wider range of comorbid disorders, and lower quality of life enjoyment and satisfaction.

Conclusions: There is a high prevalence of SAD in adult patients in the outpatient network. The results obtained are important for classification, clinical identification, and the development of therapeutic approaches.

Neurology Bulletin. 2019;LI(3):32-35
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PSYCHOLOGICAL CHARACTERISTICS OF THE PERSONALITY OF A MOTHER BREATING A CHILD WITH A PSYCHIC DYSONTOGENESIS
Krasnoshchekova I.V., Kovshova O.S.
Abstract

The birth and upbringing of a child with a mental development condition causes the mother to search for special ways to adapt to a difficult life situation. Mothers of children with mental disorders such as autism spectrum disorder, mental retardation and cerebral palsy are in a situation of many years of crisis. The aim of our study was to consider the characteristics of the psychological characteristics of women mothers raising children with mental dysontogenesis. The study involved 200 women mothers. We used the following methods: a study of personality traits of R. Kettell (16PF) and a study of coping behavior of E.Heim (1988), as well as a mathematical regression analysis of significant differences in psychological characteristics of personality, behavior and attitudes in three groups of mothers depending on type mental dysontogenesis of their children. It was found that in the psychological portrait of all the mothers studied, neurotic and emotional dysfunctions, reduced control of emotions and behavior, the use of non-adaptive coping strategies and impaired mental adaptation are noted. In each group of mothers, distinctive characteristics of personality traits and coping strategies were found, which should be taken into account when working with such mothers. Our study may be useful in preventing emotional and behavioral disorders and psychological support for mothers raising children with mental dysontogenesis. Timely psychological diagnosis of the mothers themselves will help to identify maladaptive personal characteristics, and the provision of psychological assistance to mothers of sick children will help to form a constructive attitude towards the child and his mental defect. This will lead to an understanding of the need to identify constructive models of women's social adaptation and the development of special routes for psychological and pedagogical support for such mothers.

Neurology Bulletin. 2019;LI(3):36-42
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COGNITIVE AND PSYCHOEMOTIONAL FUNCTIONS IN PATIENTS WITH HEALTHY ISCHEMIC STROKE IN COMPARISON WITH MATHEMATICAL ANALYSIS OF THE BIOELECTRIC ACTIVITY OF THE BRAIN
Novikova L.B., Sharapova K.M., Dmitrieva O.E.
Abstract

The aim of the study was to study the relationship and comparison of data from a neuropsychological study and the results of a mathematical analysis of electroencephalography (EEG). The first mathematical analysis of EEG in patients with ischemic stroke in the MCA pool revealed a decrease in alpha rhythm power, an increase in beta, delta and theta rhythms in the affected hemisphere, as well as an increase in hemisphere coherence. There has been established the relationship of cognitive and anxiety-depressive disorders with the degree of power of alpha, beta, theta and delta waves on the affected side. Identified pathological EEG patterns are more significant in the temporal region on the affected side and correlate with neuropsychological findings. As a result of the study, it was found that cognitive and anxiety-depressive disorders are detected already in the acute and acute period of ischemic stroke. The data of a neuropsychological study are comparable with the EEG data, which allows us to assume that there is a possibility of using mathematical analysis to assess the degree of cognitive impairment in patients with ischemic stroke.

Neurology Bulletin. 2019;LI(3):43-50
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Parent-child relationships in families of adolescents with diabetes of the first type, as the factor of formation of attitude to the disease
Kireeva T., Kovshova O.
Abstract

Purpose. Type 1 diabetes mellitus is one of those chronic somatic diseases in which the solution of medical problems is inextricably linked to a whole complex of psychological problems. The main condition for successful treatment and prevention of complications is the constant active involvement of the patient in the treatment process. In this regard, factors such as the immediate social environment, especially the family, are of particular importance. The aim of the study is to identify the features of child-parent relationships in families of adolescents with type 1 diabetes, and their impact on the formation of the adolescent's attitude to the disease.

Methods. The study used tests "Teenagers about parents", "Family sociogram", a questionnaire on the study of parental attitudes, a diagnostic test of the attitude of adult family members to the child's disease, a projective drawing test "My disease".

Results. According to the results of the survey, it can be said that the attitude of adolescents to their disease is generally adequate, except in rare cases of increased anxiety and communication problems. At the same time, teenagers are distinguished by egocentrism, because they are often the center of attention of the whole family and wait for a special attitude. In the case where the mother's excessive control activity of teenagers, they consider their decision-making. High mental tension of the mother in connection with the disease of the child leads to the formation of his emotional-negative attitude to his disease. The mother, unlike the teenagers, the harder it is to adapt to their disease, exhibit excessive emotional concentration and anxiety, and connecting with the child and the fixation on the satisfaction of its needs.

Summary. Adolescents with type 1 diabetes are characterized by egocentrism and expect special care towards themselves, at the same time negatively assessing the strict control of behavior in the case of the disease on the part of the mother. Both positions do not contribute to the formation of such an attitude to the disease, which would be characterized by a high degree of their own activity and responsibility. High neuro-mental tension of the mother in connection with the disease, her experience of stress, anxiety leads to the formation of a teenager emotionally negative attitude to his disease, making it difficult to adapt to the disease. Mothers who demonstrate a pronounced emotional concentration on the child and the satisfaction of his needs, contribute to the formation of fixation of the child on the disease.

Neurology Bulletin. 2019;LI(3):51-56
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Clinical and neurophysiological features of comorbidity of alcohol dependence and affective disorders
Galkin S.A.
Abstract

The assessment of mental and neurophysiological parameters in patients with comorbidity of alcohol dependence and affective disorders in comparison with patients with alcohol dependence was carried out. It was found that the comorbid course of alcohol dependence and affective disorders is accompanied by an increase in the level of anxiety. Patients with comorbidity of alcohol dependence and affective disorders have reduced overall health compared to patients with alcohol dependence only. Patients with comorbidity of alcohol dependence and affective disorders are characterized by electroencephalographic changes in the form of a significant increase in alpha and beta rhythm in the occipital parts of the brain and a decrease in theta rhythm in the right anterior - temporal lead compared to patients with alcohol dependence only.

Neurology Bulletin. 2019;LI(3):57-59
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Postoperative dynamics of syringomyelia associated with Chiari Type 1 malformation and its predictors.
Nurullina C.S., Mendelevich E.G.
Abstract

The main treatment for syringomyelia associated with Chiari Type 1 malformation is surgery – decompression of posterior cranial fossa, in order to eliminate the cerebrospinal fluid flow block at the craniovertebral transition level.  However, successful surgical treatment does not always lead to regression of syringomyelia symptoms.  The literature presents controversial data about factors affecting the postoperative outcome. We examined 44 patients, who underwent decompression of the posterior cranial fossa, in order to assess the postoperative dynamics of syringomyelia associated with Chiari Type 1 malformation and to identify predictive factors.  Analysis of clinical and neurovisual parameters before surgery and at the distant postoperative stage (2 years or more after treatment) made it possible to determine the frequency of the dynamics of spinal symptoms and symptoms of the large occipital foramen and identify the main factors affecting the postoperative outcome.

Neurology Bulletin. 2019;LI(3):60-65
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Risk factors for mental health problems in chemical workers
Svetlana V. Kuzmina, Raila V. Garipova .
Neurology Bulletin. 2019;LI(3):66-72
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Review papers
THE SEVERITY OF DEPRESSIVE DISORDER AND THE RATIO OF PHARMACO-AND PSYCHOTHERAPY: THE RATIONALE FOR MEDICAL CHOICE
Petrova N.N.
Abstract

The aim of the work was to review the literature on the problem of assessing the severity of depression in the light of changes in the systematization of mental disorders. The relevance of the correct assessment of mental disorders on the example of depressive disorder is substantiated. New approaches to determining the severity of disorders in DSM-V are presented, their variability is noted. The influence of the severity of depression on the choice of therapy, preference for psychopharmacotherapy or psychotherapy is analyzed. It is concluded that the prospect of assessing the severity of depression on the basis of dimensions.

Neurology Bulletin. 2019;LI(3):73-76
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SELF-STIGMA IN PATIENTS WITH SOMATOFORM DISORDERS: HISTORICAL ASPECTS, PARADOXES OF MISDIRECTED VISIT TO THE PRIMARY MEDICAL FACILITY
Pogosov A.V., Bogushevskaya Y., Petrova M.
Abstract

A recent analysis of factors preventing patients with somatoform disorders from timely visit to a psychiatrist showed that along with clinical, socio-demographic, psychological and other causes, self-stigma phenomenon holds a specific place in the formation of a psychiatrist escape behavior. The article deals with the analysis of some historical aspects of stigma in psychiatry, manifestations of self-stigma attitude in patients with border psychic disorders deserve special attention.  The importance to introduce destigma psych-educational programs into the primary health care settings is emphasized.

Neurology Bulletin. 2019;LI(3):77-87
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Discussions
How to consider the scientific nature of psychotherapy
Zislin Y.M.
Abstract

 The letter addresses critically the debate about the scientific nature of psychotherapy. It is shown that psychotherapy per se as a kind of activity cannot be the subject of scientific analysis.

Neurology Bulletin. 2019;LI(3):88-90
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PASSION ACCORDING TO EVIDENCE BASED MEDICINE (IN CONTINUATION OF DISCUSSION)
Zobin M.
Abstract

The discussion continues about the place of instrumental assessment approaches in evidence-based medicine. The position of the validity of psychometry to objectify the assessment of treatment outcomes, including in group generalizations and in transcultural studies, is being defended. The selection of criteria for evaluating the effectiveness of antidepressant therapy is discussed.

Neurology Bulletin. 2019;LI(3):91-96
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Recommendation for practitioners
Paramnesias (psychopathological features, systematic and diagnostic value).
Krylov Vladimir I., Voronova Elena .
Neurology Bulletin. 2019;LI(3):97-104
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