Non-psychotic Mental Disorders Research Articles

Trends in the mental health in children and adolescents in Russia

Introduction. Mental health disorders in the world and the Russian Federation pose a serious problem, and their increase in childhood and adolescence is a determining factor in the development of diseases in later life. The purpose of the study is to analyze the follow up data of official sources on the specifics of the incidence of mental disorders in Russia of a children 0–17 year contingent with a differentiation of 0–14 and 15–17 years. Materials and methods. Materials from official statistics of the Ministry of Health of Russia and Rosstat were used in dynamics for various sections of the study as a whole for the 7-year period over 2015–2021, highlighting the years 2019–2021 to potentially identify the impact of COVID-19 on mental health. The analysis was carried out using statistical, analytical, and other methods. Results. The terminology on the problem was discussed. According to the analysis materials, among the reasons for taking in the Russian Federation under observation with a diagnosis for the first time in life (per 100 thousand population) in the “Mental and behavioural disorders” class. The leading reason for the entire population was “psychosis and dementia” — 55.1%; in children (0–14 years old) and in children, especially adolescents — “non-psychotic mental disorders” — 38.5% and 50.2%, respectively. An increase in childhood disability was revealed, both in general and for the studied reasons. Recommendations substantiated. Research limitations. The research materials are limited to the results of the analysis of official statistical information (indicators of morbidity, disability of the population) for the period of 2015–2021. Conclusion. Based on the research materials, we can conclude that the presented characteristics of the incidence of mental disorders and behavioural disorders in the population of Russia, certain negative trends cannot but cause concern, indicating the need for adequate decisions to be made by all levels of the organization and management to provide effective medical care with preventive measures for the adult and child population in Russia.

Suicide risk in patients with a current depressive episode during the COVID-19 pandemic.

The prevalence of major depressive disorder (MDD) increased during the COVID-19 pandemic. Data on suicidality in these patients during the pandemic period remain scarce. The aim of the study was to determine the prevalence and variables associated with serious suicide risk in Russian inpatients with MDD during the COVID-19 pandemic. A cross-sectional cohort study with consecutive sampling was conducted from January 1, 2021 to December 31, 2021. All patients completed the Mini International Neuropsychiatric Interview (M.I.N.I.) (including the suicidality module), the Beck Depression Inventory, and the State-Trait Anxiety Inventory, and underwent a semi-structured interview to collect relevant demographic and clinical data. Effect sizes for all independent variables and covariates were calculated using partial eta-squared (ηp2). Of the 6757 patients with non-psychotic mental disorders assessed, 1605 (23.7%) had MDD confirmed by the M.I.N.I., of whom 17.8% were at serious risk for suicide according to the M.I.N.I. suicidality module. Factors independently associated with serious suicide risk in Russian inpatients with MDD during the pandemic were younger age (ηp2 = 0.021), greater severity of depression (0.038), higher state anxiety (0.003), and nonsuicidal self-injury (NSSI) (0.066). The same variables, except for state anxiety, were independently associated with suicide risk in the subgroup of MDD patients previously infected with SARS-CoV2. In the COVID-19 pandemic, the proportion of patients with MDD at serious risk of suicide was similar to pre-pandemic data. No associations were found between suicidality in patients with MDD and COVID-related factors. Younger age, greater severity of depression, and especially NSSI were the most significant risk factors for suicide in patients with MDD during the COVID-19 pandemic.

A post-traumatic stress disorder in military servicemen and war veterans

Aim. To analyze the characteristics of the incidence of a post-traumatic stress disorder in military servicemen and war veterans in order to search for new methods of diagnosis and treatment. Materials and methods. The analysis of the data of a secret questionnaire of doctors (psychiatrists, neuropathologists) regarding changes in character, complaints about anxiety after returning from the war zone in military servicemen and war veterans was used. Results and discussion. Since the start of russia’s full-scale invasion of Ukraine, there has been a brutal, exhausting war bringing a post-traumatic stress disorder (PTSD) on a par with Ukraine’s leading health problems. By monitoring foreign sources and literature, which more broadly highlight the problems of military personnel and war veterans with experience of working in such harsh conditions, a study on the prevalence of a post-traumatic stress disorder was conducted. Conclusions. Therefore, it is promising to conduct further research to improve understanding of the prevalence of a post-traumatic stress disorder in military servicemen and war veterans, which remains one of the “young” diagnoses in Ukraine and in world psychiatry. In the International Classification of Diseases (ICD-10), it is designated by the code F43. 1 and is included in the section F40-F48 “Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders”.

Mental disorders of non-psychotic level during the pandemic of coronavirus infection

The coronavirus infection (COVID-19) is a pressing problem of the 21st century, since in a short period of time the epidemic of this infection rapidly developed into the pandemic with ensuing medical and socio-economic consequences. The impact of the pandemic on the mental health of the population is explained both by the direct biological impact of the virus on the human body and by associated psychosocial factors. The purpose of our work is to study the clinical picture and dynamics of non-psychotic mental disorders caused by the COVID-19 pandemic. Materials. An analysis of 991 archival medical records of the patients who were treated in the Psychotherapy Department, Altai Regional Clinical Psychiatric Hospital named after Yury Karlovich Erdman, for 2021–2022 was carried out. Of these, 246 patients (24.8 %) had a history of COVID-19 or associated the occurrence of mental disorders with this infection. In addition, a clinical study and follow-up of 45 patients was carried out in the same department. Results. COVID-19 is a significant factor in the development of non-psychotic mental disorders. Initial use of mental health care accounts for 42 %. The mean age of the patients was 47 years. It has been found that women are more susceptible to such disorders than men. After suffering from COVID-19 infection, the level of anxiety doubled, and a significant increase in depressed mood (from 57.1 to 85.7 %), sleep disturbances (from 67.8 to 82.1 %), phobias (from 71.4 up to 78.6 %), as well as asthenic symptoms, was noted. At the end of the treatment, a reduction in mental disorders was noted. Conclusion. The study convincingly showed the high prevalence of non-psychotic mental disorders associated with COVID-19. People of working age with pre-existing neurotic disorders are more vulnerable to the effects of the pandemic than others. In the clinical picture, three main psychopathological syndromes were identified: anxious-depressive, asthenic-depressive, and anxious-phobic. Complex treatment (psychopharmacotherapy, psychotherapy) in the psychotherapy department of a 24‑hour psychiatric hospital showed high effectiveness.

Attitude to vaccination against COVID-19 in patients with non-psychotic mental disorders

The COVID-19 pandemic has exacerbated the increasing prevalence of non-psychotic mental disorders and the rise of antivaccination tendencies.The aim of the study was to describe the attitude to vaccination against COVID-19 in patients with non-psychotic mental disorders, as well as in mentally healthy individuals.Materials and methods: a survey was conducted of 100 outpatient patients with psychiatric diagnoses of non-psychotic level: organic mental disorders (14), affective disorders (38), neurotic and stress-related disorders (48), as well as 30 people without mental disorders.Results and discussion. There was no association between the severity of COVID-19 and an adverse reaction to the vaccine. A high incidence of skepticism about vaccination against COVID-19 was noted in women, in the older age group, in people with higher education and highly qualified work, but poorly informed about immunoprophylaxis. Post-vaccination complications (fever, general weakness) after immunization against COVID-19 were more often detected in patients with affective disorders, however, this group of patients showed the most loyal attitude to vaccination. Patients with organic mental disorders shown the lowest degree of approval of vaccination against COVID-19, they cited fear of possible «side effects» and «lack of proven benefit» as the main reason for not being vaccinated.Conclusion. Vaccination of the population of all countries affected by COVID-19 has exacerbated such a phenomenon as doubt about the benefits of immunoprophylaxis. The results of the article can be extrapolated to the future development of new drugs in the field of immunoprophylaxis.

Непсихотичні психічні розлади у пацієнтів з хронічними соматичними неінфекційними захворюваннями в умовах перманентного стресу: роль метаболічної терапії

bstract. The article discusses the current issues of comorbidity between mental disorders and chronic non-infectious somatic diseases, highlighting the importance of a multidisciplinary patient-centered approach in the treatment of these conditions. Additionally, in light of the negative impact of the Russian military aggression on the mental health of Ukrainians, this paper presents the positive experience of using the dietary supplement Cognitium® in a regimen of 1 ampule twice a day as an additional therapy for non-psychotic mental disorders in adult patients with chronic somatic diseases under conditions of chronic stress. The positive impact of Cognitium® was noted in the reduction of affective, cognitive and somatoform symptoms, specifically: decreasing in the level of anxiety and depression, mood stabilization, improvement of concentration and memorization of new information, increasing energy levels, restoration of sleep and appetite.

The Effect of Lavender Aromatherapy on The Level of Anxiety Level of Laboring Mothers in The Era of New Habits In PMB Bdn. Luh Ayu Koriawati, A.Md.Keb

Anxiety disorders comprise non-psychotic mental disorders, generalized anxiety disorder, phobias, panic attacks, obsessive compulsive disorder, and other disorders that fall under the broader category of "anxiety disorders without other specifications" (American Psychiatric Association, 2013). In general, anxiety disorders are characterized by excessive fear and anxiety, as well as certain behavioral disturbances. While fear is an emotional response to an imminent threat, characterized by acute autonomic system activation, anxiety is also described as the "anticipation of future threats" (Donelli et al., 2019). The design of this study was quasi experimental. This research was conducted at PMB Bdn. Luh Ayu Koriawati, A.Md.Keb with an average maternity population of 90 mothers giving birth at PMB Bdn. Luh Ayu Koriawati, A.Md.Keb. The sample in this study amounted to 30 respondent mothers at PMB Bdn. Luh Ayu Koriawati, A.Md.Keb who met the inclusion criteria. The sampling technique of this research is purposive sampling. Data were collected with the help of an anxiety level questionnaire using the Hamilton Rating Anxiety Scale (HARS) and data analysis was carried out in stages including univariate and bivariate (Wilcoxon Signed Rank Test). Based on the results of the study obtained from 30 respondents (100%), after being given aromatherapy (posttest) there were 18 respondents (60.0%) did not experience anxiety and there were 12 respondents (40.0%) experiencing mild anxiety. The bivariate results show that there is a significant value of 0.000 (p-value <0.05), thus it is concluded that there is a significant effect on the average score of anxiety levels before and after giving lavender aromatherapy at PMB Bdn. Luh Koriawati, S.Tr.Keb

Factors associated with comorbid fibromyalgia in patients with non-psychotic mental disorders

Factors associated with comorbid fibromyalgia in patients with non-psychotic mental disorders

Early Adverse Family Experiences and Elevated Adrenocorticotropic Hormone Predict Non-Suicidal Self-Injury in Females with Non-Psychotic Mental Disorders and Suicidal Ideation.

Nonsuicidal self-injurious behavior (NSSI), prevalent in patients with non-psychotic mental disorders (NPMD), is associated with numerous adverse outcomes. Despite active research into the clinical and psychological aspects of NSSI, the underlying biological mechanisms remain obscure. Early adverse experiences are believed to induce long-lasting changes in neuroendocrine mechanisms of stress control playing a key role in NSSI development. The aim of the study was to evaluate parameters potentially predicting development of NSSI in female patients with NPMD and suicidal ideation. Eighty female patients over 18 years with NPMD and suicidal ideation (40 with and 40 without NSSI) and 48 age matching women without evidence of mental illness (healthy controls) were enrolled. Diagnostic interviews and self-report measures were used to assess childhood maltreatment, presence, frequency, and characteristics of suicidal and self-injurious thoughts and behaviors, the Beck Depression Inventory scale to assess severity of depression. Hypothalamic-pituitary-adrenal axis markers, hormones, and neurotrophic factors were measured in blood serum. The likelihood of developing NSSI in patients with NPMD and suicidal ideation was associated with early adverse family history and elevated adrenocorticotropic hormone levels. Dysregulation of hypothalamic-pituitary-adrenal axis as a result of early chronic stress experiences may represent critical biological mechanism promoting the development of NSSI behaviors in patients with NPMD.

Functions of nonsuicidal self-injurious behavior in Russian patients with suicidal ideation.

Nonsuicidal self-injurious behavior (NSSI) is an important risk factor for future suicide attempts. Previous research has identified a number of motivations for engaging in NSSI. The aim of the present study was to translate the Inventory of Statements About Self-Injury (ISAS) into Russian and then to evaluate its psychometric properties in a sample of patients with non-psychotic mental disorders and suicidal ideation (SI). Other aims were to determine the prevalence of specific NSSI functions in this population and to assess the relationship between different NSSI functions and clinical and psychological parameters. The study was conducted at the largest center for non-psychotic mental disorders in Moscow. All admitted patients with both NSSI and SI completed the Russian version of the ISAS-II, underwent the Self-Injurious Thoughts and Behaviors Interview, and completed the Personality Inventory for DSM-5 and ICD-11 Brief Form Plus-Modified, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. A total of 614 patients were included in the study. 543 (88.4%) patients were assigned female at birth with a mean age of 24.86 (7.86) years. Factor analysis supported a two-factor structure (Intrapersonal and Interpersonal) of the Russian version of the ISAS-II, but in contrast to the original study, the "Marking distress" function loaded more strongly on the Interpersonal factor. In people with non-psychotic mental disorders and SI, Interpersonal functions of NSSI are associated with more severe depressive symptoms (r = 0.34), 12 months history of NSSI (r = 0.30), higher number of NSSI methods (r = 0.41), likelihood of future NSSI (r = 0.35) and psychoticism (r = 0.32). The Russian version of the ISAS-II is a valid and reliable instrument for assessing NSSI functions in a population at high risk for suicide attempts. Interpersonal functions are associated with a number of unpleasant clinical and psychological features.

Sex differences among children, adolescents and young adults for mental health service use within inpatient and outpatient settings, before and during the COVID-19 pandemic: a population-based study in Ontario, Canada

ObjectivesThe pandemic and public health response to contain the virus had impacts on many aspects of young people’s lives including disruptions to daily routines, opportunities for social, academic, recreational engagement...

IMPACT OF THE WAR ON THE MENTAL HEALTH OF UKRAINIANS: FACTORS IN FORMATION OF NEUROTIC AND STRESS-ASSOCIATED MENTAL DISORDERS. CURRENT STATE OF THE ISSUE

The article provides an overview of the main stressogenic factors affecting the development of non-psychotic mental disorders in Ukrainians during the war. Special attention is paid to statistical data indicating the prediction of prevalence of mental disorders and open sources with statistical data.
 Aim. To investigate and study the modern view of the development and formation of neurotic and stress-related mental disorders during the war.
 Materials and methods. Open scientific sources of the last five years on the impact of war on the mental health of the population were used. Scientific data were analyzed by methods of review, system and content analysis. The material was searched using the Google Scholar, PubMed, and open sources of the World Health Organization (WHO), the Ministry of Health of Ukraine (MOH), International Organization for Migration (IOM), United Nations and other government web portals of Ukraine.
 War is a powerful psychosocial stress factor that affects the mental health of Ukrainians and leads to the formation of neurotic and stress-related mental disorders. There is a trend towards an increase in the number of people who need psychiatric or psychological help. Neurotic and stress-related mental disorders caused by the war in Ukraine are becoming one of the most widespread problems of Ukrainians, which prevent them from fully functioning, adapting to new living conditions, and also constitute significant obstacles for the economic state of the state in connection with the increase in the number of people with temporary disability. The important issue of timely diagnosis, prevention, and correction of neurotic and stress-related disorders are topical issues today. Having analyzed the modern literature on mental disorders among Ukrainians as a result of the full-scale invasion of russia on the territory of Ukraine, we can conclude that this topic requires detailed study and analysis. Since many questions remain open regarding the influence of the war on the formation and development of mental disorders during the russian-Ukrainian war. Statistics from the World Health Organization (WHO) show that as a result of armed conflicts, one in five people who have experienced them may have mental health problems. This amounts to about 9.6 million Ukrainians who are potentially at risk of developing neurotic disorders such as depression, anxiety disorder, and stress-related disorders, including post-traumatic stress disorder.
 The development and formation of mental disorders during the war is influenced by a number of psychosocial reasons, the constant action of stressogenic factors of various nature, psychotraumatization of the population caused by news of a negative nature (a sense of loss of relatives, home, sense of security) and socio-economic difficulties.
 Conclusions. As a result of hostilities, the number of people who need psychiatric or psychological help is increasing. There is a tendency to increase the number of neurotic and stressful mental disorders. Suddenly, the question of changing the socioeconomic status arises: people can satisfy their needs at the minimum subsistence level. The loss of working capacity and the increase in the unemployed population provoke the development of mental and behavioural disorders. Undoubtedly, due to the full-scale invasion of russia into Ukraine, the number of victims of sexual violence is increasing. Factors provoking the development of neurotic and stress disorders are the impact of forced resettlement of people outside their homes and homeland as a result of russian aggression against Ukraine.
 Literary search and scientific studies conducted in this direction claim that the main causes of neurotic and stress-related disorders during war include the impact of loss and grief, forced migration, financial factors and violence. Having analyzed the modern literature on mental disorders among Ukrainians as a result of the full-scale invasion of russia on the territory of Ukraine, we can conclude that this topic requires detailed study and analysis. Since many questions remain open regarding the influence of the war on the formation and development of mental disorders and the ways of their prevention during the russian-Ukrainian war.

Factors associated with lifetime history of eating disorder in non-psychotic patients with suicidal ideation.

Data on the sociodemographic, biographical, and clinical factors associated with a lifetime diagnosis of eating disorders (ED) in patients with non-psychotic mental disorders (NPMD) and suicidal ideation (SI) are scarce. A cohort study was conducted at the Moscow Research and Clinical Center for Neuropsychiatry. The sample consisted of consecutive patients with non-psychotic mental disorders and SI, aged 1845 years. Participants with a lifetime diagnosis of anorexia and/or bulimia (then in remission or recovery) were compared with those without ED in terms of their sociodemographic profile, clinical characteristics, lifetime traumatic events, and some behavioral patterns. All participants underwent the Russian version of the Self-Injurious Thoughts and Behaviors Interview and completed the Brief Reasons for Living Inventory, the State and Trait Anxiety Inventory, and the Beck Depression Inventory. A total of 892 patients with non-psychotic mental disorders and SI were included in the study. The mean age was 25.7 years, and 84% were assigned female at birth. Same-sex experience was more common in the ED group. Patients with an ED were more likely to have a history of physical and sexual abuse and to have witnessed domestic violence. The proportion of participants with piercings, tattoos, or severe body modifications was significantly higher in the ED group. Patients with a lifetime ED were more likely to engage in nonsuicidal self-injurious behaviors and to have a history of suicide attempts. Lifetime ED in NPMD patients with SI is associated with younger age, being assigned female at birth, having an alternative gender identity, having same-sex experience, having more than one psychiatric diagnosis, having been diagnosed with bipolar disorder, experiencing severe depression and anxiety, being exposed to multiple traumatic experiences, having various body modifications, practicing NSSI, and having a lifetime story of suicide attempts.

Personalized system of therapy of stress-related disorders in persons affected by combat actions

According to estimates by the Ministry of Health of our country, 15 million citizens of Ukraine may eventually develop mental disorders, and 3 to 4 million people will need psychopharmacological treatment as a result of the war. In turn, mental disorders can have an exacerbation and affect the course of chronic diseases of the population, such as cancer, cardiovascular diseases, and of course, no one excludes addictions or the development of bad habits. The aim of the study was to develop a personalized system for the treatment of stress-related disorders in people affected by military operations. The study involved 299 patients with non-psychotic mental disorders, both sexes, with an average age of (30.6±4.7) years. We also used the following research methods: anamnestic, clinical and psychopathological, and psychodiagnostic. According to the results of the psychodiagnostic study, the examined patients showed a decrease in anxiety and depression according to the Hamilton Anxiety and Depression Scale and anxiety and depression according to the hospital scale; reduction in the intensity of clinical manifestations on the Mississippi Posttraumatic Stress Disorder Scale and a significant decrease in the intrusion and avoidance scores on the traumatic event impact assessment scale; restoration of social activity and improvement of the quality of life of patients with stress-related disorders. According to the scale for assessing the impact of an Impact of Event Scale - Revised in all three groups (military, volunteers, resettles), the indicators of the subscales "intrusion", "avoidance", "arousal" showed a decrease in the indicators of these subscales. Using the developed program, we noted positive dynamics of the mental state, namely a rapid reduction of anxiety and depressive symptoms, normalization of the sleep-wake cycle, restoration of social activity and improvement of the quality of life of patients. Keywords: anxiety, depression, PTSD, psychotherapy, psychoeducation, pharmaco­therapy.

The impact of COVID-19 quarantine on mental health: an observational study from an outpatient service for non-psychotic patients in Russia (Moscow)

We aimed to compare psychiatric hospital visits during the COVID-19 quarantine period with the same period in 2019, to reveal the predictors of underutilization of mental health services. We then investigated the fluctuation of telemedicine service during the quarantine period. The retrospective study included patients with non-psychotic mental disorders who consecutively visited the Moscow clinic. The number of outpatient visits, inpatient admissions, sociodemographic factors were analyzed. We assessed the sample within two periods - the “quarantine period” (March 30 - June 9, 2020) and “control period” (March 30 - June 9, 2019). Psychiatric visits decreased in older, retired and disabled persons, and increased among the unemployed. In multivariate analysis, the reduction became significant for the number of inpatient admissions. Telemedicine calls gradually increased from the start of the service, but decreased towards the end of the quarantine. In conclusion, referrals to outpatient and inpatient psychiatric services decreased during the quarantine period, with newly established TMS potentially compensating for that decrease. The strongest factor associated with visits during the pandemic is employment status.

Psychometric Properties and Diagnostic Associations of the Short-Form Community Assessment of Psychic Experiences in a Population-Based Sample of 29 021 Adult Men.

Around 5%-7% of the adult population are estimated to have lifetime psychotic experiences (PEs), which are associated with psychosis risk. PEs assessed with Community Assessment of Psychic Experiences (CAPE) are associated with psychosis but also non-psychotic disorders, which could be partly explained by CAPE indirectly capturing emotional symptoms. We investigated the psychometric properties of a shorter version, CAPE-9, and whether CAPE-9 scores are associated with lifetime psychotic or non-psychotic mental disorders after controlling for current anxiety and depressive symptoms. CAPE-9 questionnaire data were obtained from 29 021 men (42.4 ± 5.6 yrs.) from the Norwegian Mother, Father, and Child Cohort Study. We investigated CAPE-9 reliability and factor structure. Logistic regression was used to test effects of current anxiety and depressive symptoms (SCL-12) on associations between CAPE-9 scores and psychiatric diagnoses. CAPE-9 fit a previously reported 3-factor structure and showed good reliability. Twenty-six percent reported at least one lifetime PE. CAPE-9 scores were significantly associated with most psychiatric disorders (schizophrenia, depression, bipolar disorder, substance abuse, anxiety, trauma-related disorders, and ADHD). After controlling for concurrent emotional symptoms, only associations with schizophrenia (OR = 1.29; 95% CI = 1.18-1.38) and trauma-related disorders (OR = 1.09; CI = 1.02-1.15) remained significant. CAPE-9 showed good psychometric properties in this large population-based adult male sample, and PEs were more clearly associated with psychotic disorders after controlling for current emotional symptoms. These results support the use of the short CAPE-9 as a cost-effective tool for informing public health initiatives and advancing our understanding of the dimensionality of psychosis.

Individual-psychological characteristics and the state of psychosocial adaptation of combatants with non-psychotic mental disorders who have experienced COVID-19

The relevance of the studied subject lies in the importance of investigating the individual-psychological characteristics, coping behaviour, and the state of psychosocial adaptation of combatants who have recovered from COVID-19, to develop personalised therapeutic and rehabilitation measures The purpose of the study was to determine the pathocharacterological characteristics, coping repertoire features, and psychosocial maladaptation in individuals who participated in combat operations, have non-psychotic mental disorders, and have experienced the coronavirus infection, in a comparative aspect. A total of 132 male combatants with non-psychotic mental disorders who did not have COVID-19 and 120 military personnel with the same mental disorders who had experienced the coronavirus infection were examined using Standardised Multifactor Personality Inventory, questionnaire “Methods of coping behavior”, and the Social-Psychological Adaptation Diagnostic Method. It was found that combatants who had experienced COVID-19 exhibited specific personality characteristics that can be considered pathocharacterological transformations and signs of neuroticism. The core pathocharacterological changes included stable anxious-depressive and hyposthenic traits, while the auxiliary psychopathological constructs included stable emotionally labile, asthenic, hypochondriacal, and dysphoric manifestations. They also exhibited changes in coping repertoire with a predominance of non-constructive strategies of escape-avoidance and confrontation, along with a deactualisation of constructive coping strategies such as problem-solving planning, seeking social support, self-control, and positive reappraisal. Furthermore, pronounced manifestations of psychosocial maladaptation were observed in all key domains. COVID-19 acts as a complicating factor, exacerbating psychopathological symptoms, contributing to the formation of pathocharacterological traits, and deepening the psychosocial maladaptation of combatants with non-psychotic mental disorders. The obtained data provide an opportunity to personalise therapeutic, rehabilitation, and preventive measures, considering the pathocharacterological individual-psychological characteristics and coping behaviour, and to improve existing programmes of social-psychological adaptation for combatants

Actual problems of practical psychiatry: will the new Order of medical care for mental disorders and behavioral disorders solve them?

The article contains examples of the impact of changes in the legislative provision of psychiatric care on the performance indicators of the psychiatric service and the mental health of the population. We analyze optimization of psychiatric care for patients with severe mental disorders, enabled by the legislation of hospital substitution, as well as existing barriers of providing care to patients with non-psychotic mental disorders. Such barriers include the stigmatization of psychiatry, on the one hand, and the lack of legislative support for the provision of medical care to patients with nonsevere mental disorders by non-psychiatrists, on the other hand. Such legislative peculiarities lead to a constant decrease in the detection of mental disorders, while the level of disability due to mental disorders remains stable in the population. In addition, the article provides a brief overview of the key changes in the Order of medical care for mental disorders and behavioral disorders implemented in 2022.

Features of Representations and Subjective Experience of the Images of Hallucinations, Fantasies, Dreams, and Imagination in Patients with Mental Disorders

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.

NEUROIMAGING (RESTING-STATE fMRI) AND NEUROPSYCHOLOGICAL CHARACTERISTICS OF NON-CONVERTERS WITH CLINICAL HIGH RISK FOR PSYCHOSIS

Based on the concept of clinical high risk for psychosis, we aimed to reveal characteristics of brain functioning (resting-state fMRI) and neurocognition in 27 patients with non-psychotic mental disorders with attenuated schizophrenia symptoms who did not transit to psychosis for a long period of observation, in contrast to 24 patients with first-episode schizophrenia and 27 mentally healthy subjects. The main group was characterized by higher local coherence of BOLD signal in the right visual cortex and higher functional connectivity between the occipital component of the visual network and the right prefrontal component of the salience network (as compared to patients with schizophrenia). In both patient groups, a decreased productivity in verbal fluency tests was found. The neuroimaging and neuropsychological findings in the main group can be considered via the dichotomy of protective and pathological mechanisms in patients with high risk for psychosis.