Non-psychotic mental disorders in the perinatal period

Special Report: Women’s Reproductive Mental Health—A Clinical Framework

Fibromyalgia (FM) is a chronic pain syndrome associated with significant distress and numerous unpleasant consequences. Mental health problems in people with FM have been reported in many studies. People with mental disorders are thought to be at higher risk of FM than the general population, but the prevalence has not been established. We aimed to investigate the prevalence of FM in a representative sample of inpatients with non-psychotic mental disorders. Additionally, we aimed to assess the psychometric properties of the Fibromyalgia Rapid Screening Tool (FiRST) in the Russian-speaking population of people with mental disorders. Consecutive inpatients admitted to the Moscow Research and Clinical Center for Neuropsychiatry for treatment of non-psychotic mental disorders were evaluated for FM by a neurologist and completed the FiRST, Beck Depression Inventory (BDI), and State and Trait Anxiety Inventory (STAI). Of the 1168 patients evaluated 9.0% met the diagnostic criteria for FM. FM was associated with being female, having a diagnosis of unipolar depression, and having higher total scores on the BDI and STAI. The psychometric properties of the FiRST were good (McDonald's omega 0.79, corrected item-total correlation greater than 0.45). An optimal cut-off point with the highest Yuden's index (J = 0.75) was >3 (AUC of 0.89). FM is a common comorbidity in people with non-psychotic mental disorders, associated with being female, having a diagnosis of unipolar depression, and having more severe anxiety and depression. The FiRST can be used for the FM screening with its cut-off >3 in people with non-psychotic mental disorders. It is the first study to determine the prevalence of FM in people with non-psychotic spectrum mental disorders. The study design included a consecutive sample in a real-life setting to avoid bias. In addition, we evaluated the psychometric properties of the FM screening instrument in a population of people with mental disorders and established the cut-off. The specificity of this subpopulation is explained by both the high prevalence of pain symptoms and the overlap of some psychiatric and FM symptoms.

Recent evidence has suggested that psychosis could develop not only in people at clinical high risk for psychosis (CHR-P) but also in those with clinical risk syndromes for emergent nonpsychotic mental disorders. The proportion of people with these clinical risk syndromes who will develop psychosis rather than to other nonpsychotic mental disorders is undetermined. Electronic databases were searched for studies reporting on clinical risk syndromes for the development of emergent nonpsychotic mental disorders. Incidence of emerging psychotic and nonpsychotic mental disorders defined on the ICD or DSM. Of a total of 9 studies relating to 3006 nonpsychotic at-risk individuals were included. Within prospective studies (n = 4, sample = 1051), the pooled incidence of new psychotic disorders across these clinical risk syndromes was of 12.9 per 1000 person-years (95% CI: 4.3 to 38.6) and that of nonpsychotic disorders (n = 3, sample = 538) was of 43.5 per 1000 person-years (95% CI: 30.9 to 61.3). Psychotic disorders may emerge outside the CHR-P paradigm, from clinical risk syndromes for incident nonpsychotic disorders, albeit at lower rates than in the CHR-P group. The clinical risk syndromes for emerging nonpsychotic disorders may exhibit a pluripotential risk of developing several types of mental disorders compared with CHR-P. If substantiated by future research, the current findings suggest that it may be useful to move beyond the current strategy of identifying individuals meeting CHR-P criteria only.

Gelotophobia, or the fear of being laughed at, has been described as an inability to enjoy humour and laughter in social interaction. A number of studies have shown its increased levels under various mental disorders. Gelotophobia in psychiatric patients may appear either as a primary syndrome, or as a secondary disorder connected to the patient’s reaction to their social position (self-stigmatization). In turn, self-stigmatization is closely related to the personality of the patient and, in particular, to their attitudes to illness. Since the fear of being laughed at has been studied within both the clinical concept and the continual model of individual differences, the question of differentiation between normal and pathological fear of being laughed at is topical, while borderline groups are of particular interest. The aim of the present study was to examine the relationship between gelotophobia, attitudes to illness, and self-stigmatization in patients with minor, non-psychotic mental disorders, as well as those with brain injuries, who also had mild mental disorders, without having the status of psychiatric patients. The sample consisted of 73 patients with non-psychotic mental disorders, and 30 patients with brain injuries. The methods used included PhoPhiKat-30, ISMI-9 (Internalized Stigma of Mental Illness Inventory), and TOBOL (Types of the Attitudes to Disease). The results revealed at least a slight level of gelotophobia in 31% patients with non-psychotic mental disorders, and 20% in those with brain injuries. Gelotophobia correlated with certain types of attitude to illness in each group. Subjects displaying high levels of gelotophobia were in general characterized by disadvantageous attitudes to illness. In the group of psychiatric patients, gelotophobia was associated with self-stigmatization, whereas in the group of neurological patients it was not. Thus, in this study gelotophobia was examined for the first time in patients with non-psychotic mental disorders, as well as in those with brain injuries. Different mechanisms of gelotophobia development were suggested for the two groups.

In this paper, the complex rehabilitation program for patients who are hospitalized with a diagnosis of pancreatitis is given. The results of a comprehensive examination and treatment of patients suffering from pancreatitis with non-psychotic mental disorders are obtained. The clinical and psychosocial risk factors for pancreatitis are provided.Objectives With the help of clinical and psychopathological examination to develop rehabilitation programs for patients with non-psychotic mental disorders in patients with pancreatitis.Materials and methods Socio-demographic research method was used to obtain objective data on the age of patients with non-psychotic mental disorders in patients with pancreatitis, as well as gender, marital status, education, employment. Clinical and psychopathological research method used in patients with non-psychotic mental disorders in patients with pancreatitis on the basis of generally accepted approaches of psychiatric examination of patients. Diagnosis of mental disorders was performed according to the clinical criteria of ICD - 10 by standardized interviews and observations.Results In the dynamics of complex treatment of 67 patients showed a stable trend (p <0,001) a decrease in the severity of both situational and personal anxiety (Table. 1). The number of patients with a high level of reactive anxiety decreased from 57 (85.1%) and 21 (31.3%), personal anxiety - from 52 (77.6%) and 24 (35,8%) (p <0,001 criterion Mac Nemara). Patients who refuse treatment for this time of observation severity situational anxiety decreased (p <0,05), and the personal - did not change (p> 0.05).Conclusion Based on these data it is developed a phased differentiated rehabilitation program that include drug treatment, non-drug therapies (herbal medicine, physiotherapy), psychotherapy, and social events

Long-term validity of the At Risk Mental State (ARMS) for predicting psychotic and non-psychotic mental disorders

Aim. Study of clinical and psychopathological characteristics in women with sexual dysfunctions and mental disorders of the psychotic level.
 Material and methods. Clinical-psychopathological and sexological methods were used in the work. The results were processed using the licensed program Statistica 10.0 for Windows. At the first stage, 134 women (mean age 43.115.3 years) were examined who had inpatient treatment in the department for persons with non-psychotic mental disorders. At the second stage, the study involved 89 women (mean age 35.212.2 years), who were diagnosed with sexual dysfunctions.
 Results. Clinical and psychopathological indicators were studied, clinical, psychopathological and sexological analysis of sexual dysfunctions in women with non-psychotic mental disorders was carried out, taking into account the diagnostic criteria of the International Classification of Diseases-10. Three groups of patients were identified: (1) a group of women with sexual dysfunctions caused by non-psychotic mental disorders; (2) a group of patients in whom non-psychotic mental disorders were formed against the background of primary sexual pathology; (3) a group of patients in whom non-psychotic mental disorders accompany sexual dysfunctions.
 Conclusions. Sexual disorders in the studied groups are characterized by the predominance of libido disorder in the first group and the second group, as well as the predominance of dyspareunia in the third. There were no significant differences in the duration of sexual dysfunctions in the groups, which must be taken into account when choosing therapeutic and rehabilitation measures.

Common mental health problems (particularly depression and anxiety) are common among adolescents during the perinatal period. Previous research has identified the distinctive needs of this group and called for contextually appropriate psychosocial interventions. The current study conducted in Malawi aimed to explore risk and protective factors for common mental health problems, and barriers to accessing mental health care, among perinatal adolescents, to develop a contextually relevant intervention for preventing and treating perinatal depression and anxiety. An exploratory qualitative study was conducted in antenatal and postnatal clinics in Zomba district, Malawi in January-March 2022. In-depth individual interviews were completed with perinatal adolescents aged ≤19 (n = 14); their family members (n = 4); and healthcare workers (n = 8). Interview data were subjected to thematic framework analysis. Data were organised around two themes: "psychosocial risk and protective factors" (potential causes of common mental health problems among adolescents); and "health care services" (maternal and mental health services available, and adolescents' experiences of using these services). Interventions need to go beyond targeting symptoms of depression and anxiety to addressing the wider contextual risk factors and barriers to care at the different socioecological levels. Common mental health problems, particularly depression and anxiety among adolescents in the perinatal (prenatal and postpartum) period, are major public health concerns with several detrimental outcomes for both the adolescent and the foetus or infant. The prevalence rates are particularly higher in low-and middle-income countries (LMICS), including Sub-Saharan Africa. However, interventions addressing these conditions in this region are scarce. This study investigated the risk and protective factors, and barriers to addressing perinatal depression and anxiety among adolescents in Malawi. It is the first phase of a larger programme of study aimed to develop a contextually appropriate psychosocial intervention for perinatal depression and anxiety among adolescents in Malawi. The findings of the study, drawing on qualitative interviews with 26 participants from three stakeholder groups (perinatal adolescents, their family members, and healthcare workers), have important practice implications. First, interventions need to go beyond targeting symptoms of depression and anxiety to address the wider contextual risk factors while enhancing protective factors at the different socioecological levels. Also, considering the scarcity of mental health specialists, current healthcare systems need to be strengthened by training non-specialist health workers to detect and manage perinatal mental health problems among adolescents.

Cannabis and non-psychotic mental disorders

The individual and societal effects of non-psychotic serious mental disorders on earnings in Belgium

Based on the reporting forms No. 10 "Report on diseases of persons with mental and behavioral disorders" for the period from 2000 to 2017, a clinical-statistical analysis of the dynamics of the prevalence of organic non-psychotic mental disorders in the rural population of Ukraine is presented, as well as changes in the structure of the incidence of non-psychotic mental disorders. The data presented indicate signifi cant fl uctuations in the incidence and prevalence rates. A significant proportion of organic nonpsychotic mental disorders in the structure of the incidence of nonpsychotic mental disorders in rural residents requires the adoption of appropriate organizational measures to optimize the system of assistance and prevention of mental health disorders in the rural population. Key words: mental and behavioral disorders, organic non-psychotic mental disorders, incidence, prevalence, villagers, psychiatric care

I n t r o d u c t i o n . Non-psychotic mental disorders are most prevalent mental disorders with the high relapse rate and onset in the early adulthood the most active period of life, psychosocial factors play essential role in their ethiopathogenesis. Psychotherapy as method influencing one’s mind and through the mind affecting ones organism is considered to play an essential role in the treatment system of this patients group as well as in medico-psychological support of the patients with somatic illnesses.Obj e c t i v e definition of the modern psychotherapy content as independent medical specialty based on the modern data base of its efficacy research systematization, evaluation of its further perspectives development for the provision of the healthcare for the targeted population of the patients with non-psychotic mental disorders as well as organization of the medico-psychological support for the patients with somatic illnesses, taking into account the possibilities offered by digital technologiesМ e t h o d s . WHO, PubMed, Scopus, Pubmed, Medline, Web of Science, Russian Science citation index Science Citation Index search was conducted on non-psychotic mental disorders epidemiology, COVID-19 pandemic impact on mental health, psychotherapy efficacy and psychotherapeutic treatment settings, possibilities of digital technologies implementation in modern psychotherapy.R e s u l t s . The prevalence of non-psychotic mental disorders is constantly growing in the las years, they make a serious impact in the non-communicable diseases burden, with the increase of the treatment costs. The COVID-19 pandemic is characterized by decrease of mental health well-being, growth of the anxiety and depressive disturbances, also because of the somatogenic disorders included in the post-covid syndrome.The recent studies persuasively demonstrated the efficacy of psychotherapy in the non-psychotic mental disorders treatment, combination of psycho- and pharmacotherapy is defined as the golden standard treatment, the ratio of them should be determined personalized in each individual case. Digital technologies active development, computerized psychotherapeutic programs implementation open new possibilities for the research of the psychotherapeutic treatment mechanisms as well as make psychotherapy more available for the different population groups and can substantially decrease treatment costs in the future.Mental health care provision optimization should be aimed at the greater psychotherapists involvement as the main specialists for diagnostic and complex treatment of non-psychotic mental disorders treatment, development of psychotherapeutic offices network, they could be a center of this patient group healthcare system, as well as for patients recovering from novel coronavirus infection with psychoneurological complains, and can be used for the medico-psychological support of the patients with somatic illnesses.Conclusion. Psychotherapy today is recognized as an effective non-psychotic mental disorders treatment method, in the future it can be used as an epigenetic modulator in the personalized medicine framework, it can be considered as an essential part of the medical-psychological support of the patients with somatic illnesses.

Management of Psychiatric Disorders during the Perinatal Period.

Background : imagination, fantasies, dreams and hallucinations are relatively independent mental processes associated with the operation of images reflecting realistic or non-existent objects and situations. Researchers note the diagnostic potential of the features of experiencing these processes in patients with mental disorders, especially at the early stages. The aim of the study is to examine cognitive representations of the processes of imagination, fantasy, dreams and hallucinations, and the subjective experience of their perception in patients with psychotic and non-psychotic mental disorders. Patients and methods: the study involved respondents aged 16 to 29 years: patients with psychotic disorders ( n = 54), non-psychotic mental disorders ( n = 50) and conditionally healthy individuals ( n = 63). A structured clinical interview and a drawing technique (an example of an image of imagination, fantasy, dreams and hallucinations) were used. Results: it was revealed that 90% of healthy respondents were able to distinguish between the studied mental processes, compared with 77% of patients with non-psychotic and 35% of patients with psychotic disorders. In addition, the respondents’ concepts corresponded to highlighted scientific criteria in 85% of healthy individuals, 34% of patients with non-psychotic and 11% with psychotic disorders. Patients with psychotic disorders, in comparison with other groups, were significantly less able to control their imagination ( p = 0.001) and fantasies ( p = 0.001) and more often reported negative emotional experiences of imagination ( p = 0.001). Patients of both clinical groups were significantly more likely than healthy respondents to report having a negative dream experience ( p < 0.005). They used significantly fewer colors when depicting images of imagination and fantasy, compared with the control group ( p = 0.001). Conclusions: mentally healthy people distinguish between images of imagination, fantasy, dreams and hallucinations; in patients with non-psychotic mental disorders, the boundaries between these processes are less rigid, and in patients with psychotic disorders they are practically blurred. Patients with non-psychotic disorders associate predominantly positive emotions with imagination, whereas patients with psychotic disorders — predominantly negative emotions. There are no statistically significant differences in emotional response to fantasies, dreams and hallucinations between these groups.

Persistence or recurrence of non-psychotic comorbid mental disorders associated with 6-year poor functional outcomes in patients at ultra high risk for psychosis