Schizophrenic Spectrum Disorders Research Articles

Associations Between Dry Eye Disease and Mental Health Conditions in the All of Us Research Program

To determine the association between dry eye disease (DED) and mental health conditions in a sociodemographically diverse nationwide population of Americans. Cross-sectional study. We used the National Institute of Health's All of Us Research Program database to identify 18257 participants with DED who were propensity score matched in a 1:3 ratio to participants without DED. Univariate and multivariable logistic regression models were used to assess associations between DED and mental health conditions (i.e., depressive disorders, anxiety, bipolar disorder, and schizophrenic spectrum disorder). Participants with DED had a significantly higher prevalence of depressive disorders (31.6% vs. 10.7%; P < .001), anxiety disorders (34.8% vs. 14.7%; P < .001), bipolar disorder (5.5% vs. 2.3%; P < .001), and schizophrenia spectrum disorders (2.3% vs. 0.9%; P < .001) than controls. Adjusted for medical comorbidities (i.e., hypothyroidism, Sjögren's syndrome, systemic lupus erythematosus), participants with DED had higher odds than controls in having a depressive disorder (odds ratio [OR]: 3.47; 95% CI: 3.32-3.62), anxiety (OR: 2.74; 95% CI: 2.63-2.85), bipolar disorder (OR: 2.23; 95% CI: 2.04-2.44), and schizophrenia spectrum disorder (OR: 2.48; 95% CI: 2.17-2.84). The association between DED and mental health conditions was stronger in Black participants than White participants (OR: 3.68 vs. 3.09, P < .001). Participants with DED were significantly more likely to have mental health conditions than matched participants without DED; this association was stronger in Black participants than White participants. Greater efforts should be undertaken to screen DED patients for mental health conditions, particularly in historically medically underserved populations.

Типы нарушений речемыслительной деятельности у пациентов с расстройствами шизофренического спектра

&lt;p&gt;In the study of schizophrenia, special attention is paid to speech disorders. However, the descriptions of linguistic component are usually phenomenological. An objective structure analysis of language is needed, which could be useful to identify additional markers in assessing mental state and clarify criteria for differential psychodiagnostic. The possibility of adapting existing English-language studies is ambiguous, and a method based on the Russian-language sample is required. The study is aimed to identify types of speech characteristics in patients with schizophrenic spectrum disorders related to patopsychological thinking characteristics. The sample consisted of 70 people: 45 schizophrenia patients, 25 conditionally healthy participants. Methods used: expert assessment, experimental methods (tests of thinking, analysis of speech production), content-analysis, statistical analysis. Schizophrenia patients&amp;rsquo; oral and written speech consist of less words, descriptions of feelings and thoughts than healthy participants. Schizophrenia patients&amp;rsquo; speech is grammatically simpler, more formal, more inclusive, low communicative than healthy participants speech. Three types of written speech were found in patients with schizophrenia: Peculiar description of internal experiences, Narrative poverty, Reference to &amp;ldquo;I&amp;rdquo;. Two types of oral speech were also found: Narrative poverty, "Philosophizing". All types of written speech and Philosophizing in oral speech were significantly related to thinking disorders. The 5 speech characteristics that form in connection with thinking disorders characteristic of schizophrenia result in 3 types of speech-thinking disorders.&lt;/p&gt;

The influence of family history of schizophrenic spectrum disorders on the clinical presentation of schizophrenia

Objective: to identify the characteristics of the clinical debut of schizophrenia, as well as clinical aspects related to hereditary aggravation within schizophrenic spectrum disorders.Materials and methods: patients with a confirmed diagnosis of F20.0 “Paranoid schizophrenia” selected according to inclusion/non-inclusion criteria participated in the study. Material was collected through clinical interviewing, analysis of medical records and documentation, and self-questionnaires.Results: a total of 264 individuals participated in the study. Hereditary aggravation with schizophrenic spectrum disorders within two generations was detected in 127 of them (48.1%). Our results showed that having a family history of schizophrenic spectrum disorders correlated with earlier age of schizophrenia debut (p=0.018) and higher scores on the Calgary Depression Scale (p=0.013).Conclusions: the findings may serve as an effective tool for developing more accurate diagnostic strategies in individuals at high risk of developing schizophrenia due to hereditary aggravation, as well as for the subsequent treatment of these individuals.

Нейропсихологическая оценка и верификация когнитивных нарушений в практике судебно-психиатрической экспертизы

&lt;p style="text-align: justify;"&gt;In modern clinical psychiatry, there is a tendency to introduce the principle of quasi-dimensional assessment, which can be facilitated by the use of specialized diagnostic methods such as neuropsychological examination. The purpose of the study is to clarify the possibilities of neuropsychological examination during forensic psychiatric examination for persons held criminally responsible. As part of the forensic psychiatric examination of persons brought to criminal responsibility on the basis of the Serbsky State Scientific Center for Social and Forensic Psychiatry Ministry of Health of the Russian Federation, 113 men (age 42&amp;plusmn;13) were examined with established groups of diagnoses, including organic, personality disorders, as well as schizophrenic spectrum disorders, disorders associated with the use of psychoactive substances. Of these, 50 people were declared &amp;ldquo;insane&amp;rdquo; and 63 were &amp;ldquo;sane&amp;rdquo;. A neuropsychological examination was performed using qualitative syndrome and quantitative analysis. In individuals with organic mental disorders (OMD), there were more pronounced disorders of neurocognitive functioning compared to those surveyed with other mental disorders. In addition, persons with OMD who were recognized as &amp;ldquo;insane&amp;rdquo;, compared with persons recognized as &amp;ldquo;sane&amp;rdquo;, had more pronounced disorders in such parameters as: programming, regulation and control, neurodynamic characteristics, auditory&amp;mdash;speech memory, with primary interest - frontal (p=0.004), temporal (p=0.004), and subcortical structures (p=0.005). The results of a neuropsychological examination can be used to verify an expert decision at the level of both medical and psychological criteria, primarily in the examination of persons suffering from an organic mental disorder.&lt;/p&gt;

Quantitative-Qualitative Assessment of Dream Reports in Schizophrenia and Their Correlations with Illness Severity.

Positive symptoms of schizophrenia have been proposed to be an intrusion of dreaming in wakefulness; conversely, psychotic patients' abnormal cognitive and behavioral features could overflow into sleep, so that their dreams would differ from those of healthy people. Here we assess this hypothesis by comparing dream features of 46 patients affected by schizophrenic spectrum disorders to those of 28 healthy controls. In patients, we also investigated correlations of dream variables with symptom severity and verbal fluency. Overall, patients reported fewer and shorter dreams, with a general impoverishment of content (including characters, settings, interactions) and higher spatiotemporal bizarreness. The number of emotions, mainly negative ones, was lower in patients' reports and correlated inversely with symptom severity. Verbal fluency correlated positively with dream report length and negatively with perceptive bizarreness. In conclusion, our data show a significant impoverishment of dream reports in psychotic patients versus controls. Future research should investigate to what extent this profile of results depends on impaired verbal fluency or on impaired mechanisms of dream generation in this population. Moreover, in line with theories on the role of dreaming in emotion regulation, our data suggest that this function could be impaired in psychoses and related to symptom severity.

Treatment adherence rates across different psychiatric disorders and settings: findings from a large patient cohort.

Approximately 50% of patients with psychiatric disorders do not fully adhere to the prescribed psychopharmacological therapy, significantly impacting the progression of the disorder and the patient's quality of life. The present study aimed to assess potential differences in terms of rates and clinical features of treatment adherence in a large cohort of psychiatric patients with different diagnoses attending various psychiatric services. The study included 307 psychiatric patients diagnosed with a primary major depressive disorder, bipolar disorder, anxiety disorder, schizophrenic spectrum disorder, or personality disorder. Patient's adherence to treatment was evaluated using the Clinician Rating Scale, with a cutoff of at least five defining adherence subgroups. One-third of the sample reported poor medication adherence. A lower rate of adherence emerged among patients with schizophrenic spectrum disorder and bipolar disorder. Subjects with poor adherence were more frequently inpatients and showed higher current substance use, a greater number of previous hospitalizations, and more severe scores at psychopathological assessment compared with patients with positive adherence. Poor adherence was associated with symptom severity and increased rates of relapses and rehospitalizations. In addition, substance use appears to be an unfavorable transdiagnostic factor for treatment adherence.

Impact of the COVID-19 pandemic on the manifestation and course of mental illness in elderly

IntroductionCOVID-19 is a multisystem disease affecting not only the respiratory, gastroenterstitial and vascular systems, but also the central nervous system, which leads to a wide range of neurological and mental complications. 3 years of experience in combating the pandemic has shown that elderly people burdened with chronic somatic diseases are the most vulnerable risk group for the development of severe course and complications of COVID-19.ObjectivesTo study the impact of COVID-19 on the onset and course of mental illness in elderly inpatientsMethodsWe examined 67 inpatients aged 50 to 95 years with various mental pathologies, who underwent COVID-19 from February 2020 to December 2021. 46 people had previous history of mentall disease (PHMD), in 21 cases the disease developed for the first time. Statistical analysis was performed.ResultsIn the manifest group of patients, depressive episodes predominated (42.9%), including psychotic episodes (9.5%). In 28.6% of cases, organic disorders were diagnosed in the form of emotional lability, organic depression, mild cognitive impairment and delirium. In 23.8% of patients, neurotic disorders were observed in the form of depressive reactions, panic and generalized anxiety disorder. In one case (4.8%), acute polymorphic psychosis with symptoms of schizophrenia was diagnosed. The PHMD group includes affective disorders - 45.7%; organic disorders, including dementia 26.1%; schizophrenic spectrum disorders -19.6% and neurotic somatoform disorders - 8.7%. In the acute and subacute periods of COVID-19, acute psychotic states (APS) developed in both groups of patients (in 23.3% and 30.4%, respectively) in the form of delirium, psychotic depression, or polymorphic psychosis. APS were more common in PHMD patients with organic (50%) and schizophrenic spectrum disorders (33.3%) with a predominance of delirium. In the long-term period of COVID-19, PHMD patients more often than non-PHMD (60.9% and 38.1%) developed cognitive impairment (CI), especially in schizophrenia-like (77.8%) and organic (83.3%) disorders. CI developed twice as often after APS (89.5% and 39.6%, p&lt;0.001), reaching the degree of dementia in 15.8% of cases. APS were significantly associated (p&lt;0.05) with the development of CI (0.567733), the age of patients (0.410696) and the presence of previous cerebrovascular insufficiency (0.404916).ConclusionsThe age-related features of the mental consequences of COVID-19 are the occurrence of APS in the acute period of infection and the deterioration of cognitive activity at a remote stage. The PHMD patients, especially with disorders of organic and schizophrenic spectrum, were found to be more vulnerable to the effects of COVID-19. In them, the occurrence of APS was a risk factor for the development of dementia, while in primary diseased, and patients with affective and neurotic disorders, CI was reversible or had the character of a mild cognitive disorder.Disclosure of InterestNone Declared

Treatment adherence across different psychiatric disorders: findings from a large patient cohort

IntroductionMedication adherence was defined by the WHO as “the extent to which a person’s behavior coincides with the medical advice given” (WHO, 2003). Existing literature indicates that approximately 49% of patients with major psychiatric disorders do not fully adhere to their prescribed psychopharmacological therapy (Colom et al, 2002). Non-adherence can lead to partial therapeutic responses or treatment resistance, increased risk of relapse, re-hospitalization, elevated suicide risk, and overall poorer functioning, thereby compromising the patient-doctor therapeutic relationship (Garcìa et al, 2016).ObjectivesThe aim of the present study was to assess potential differences in terms of clinical features related to adherence to treatment in a large cohort of psychiatric patients of an Italian psychiatric department.MethodsThe study included 307 psychiatric patients, of any gender or age, diagnosed with unipolar depression (UD), bipolar depression (BD), anxiety disorders (AD), schizophrenic spectrum disorders (SS) or a primary diagnosis of personality disorders (PD), based on DSM-5 criteria. Patients were consecutively recruited from the Department of Psychiatry at Luigi Sacco University Hospital, in Milan. The patient’s adherence to treatment was evaluated using the Clinician Rating Scale (CRS), with a cut-off of ≥ 5 defining adherence subgroups (A+: score ≥ 5; A-: score &lt; 5). Comparative and predictive analysis were performed for the whole sample and the two adherence subgroups.ResultsOverall, nearly one-third of the whole sample reported suboptimal medication adherence. Specifically, rates were approximately 35.3% and 32.7% for BD and SS, respectively, followed by 30.8% for PD, 28% for AD and, 20.3% for UD (see Figure 1). Patients with A- showed significantly higher current substance abuse (17.8% vs 4.5%, p&lt;.001), along with a higher rate of lifetime substance abuse, although with a trend towards significance (31.5% vs 20.5%; p=.057). Moreover, the A- group had a significantly higher number of lifetime hospitalizations (1.35 ± 1.8 vs 0.73 ± 1.11; p&lt;.001) and higher rate of previous psychotropic treatment dropouts compared to the A+ group (90% vs. 36.2%; p&lt;.001, see Figure 2).Image:Image 2:ConclusionsApproximately one-third of the whole sample reported a suboptimal medication adherence, with varying rates across different diagnoses. Current and lifetime substance abuse appears to be an unfavorable transdiagnostic factor. Additionally, severe outcomes such as increased hospitalizations and a more acute disease presentation are linked to poorer adherence. Recognizing the characteristics of adherence patterns within specific diagnostic categories is crucial for designing precise interventions to enhance patient outcomes and optimize the overall effectiveness of treatment.Disclosure of InterestN. Girone: None Declared, B. Benatti Speakers bureau of: Angelini, Lundbeck, Janssen, Rovi., M. Cocchi: None Declared, F. Achilli: None Declared, C. Viganò: None Declared, M. Vismara: None Declared, B. Dell’Osso Grant / Research support from: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova, Speakers bureau of: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova

Hair cortisol concentrations in pregnant women with bipolar, depressive, or schizophrenic spectrum disorders

PurposeMaternal cortisol levels in pregnancy may support the growth of or adversely affect fetal organs, including the brain. While moderate cortisol levels are essential for fetal development, excessive or prolonged elevations may have negative health consequences for both the mother and the offspring. Little is known about predictors of altered hypothalamic–pituitary–adrenal (HPA) axis activity during pregnancy. This study examined maternal hair cortisol concentration (HCC) in the 3rd trimester of pregnancy in relation to severe psychopathology.MethodsHair samples were collected from 69 women, 32 with a lifetime diagnosis of severe mental disorders (bipolar I or II disorder, moderate or severe depressive disorder, schizophrenic spectrum disorder), and 37 non-clinical controls. Hair samples were collected during the 3rd trimester, and liquid chromatography tandem mass spectrometry was used for cortisol assessment. Psychiatric diagnosis and current level of symptomatic functioning were assessed using the structured clinical interview from the DSM-5 and the global assessment of functioning scale.ResultsWomen with a lifetime diagnosis of severe mental illness had significantly elevated HCC compared to controls. Poorer current symptomatic functioning was also significantly associated with elevated HCC in pregnancy.ConclusionsThe implications of alterations in HCC on both maternal and infant health need further study.

Ремиссии при периодической кататонии

At the current stage of the formation of concepts of endogenous psychoses, due to the change in the clinical paradigm – the expansion of the boundaries of catatonia to a level involving the inclusion of a wide range of periodically manifesting motor disorders (varying in severity), the study of remissions that form after attacks of periodic catatonia is of particular relevance. The aim of the study is to develop a typology of remissions formed after the onset of periodic catatonia attacks, which occur in the clinical space of schizophrenia and schizophrenic spectrum disorders (RSHS). Research methods: clinical and catamnestic (observation for more than 3 years after the onset of seizures), psychometric (BFCRS, SANS, GAF), statistical. The study material consisted of 30 patients diagnosed with schizophrenia and RSHS (ICD-10; DSM-5) who are under outpatient supervision after inpatient treatment of periodic catatonia attacks in departments 1 and 2 of the Federal State Budgetary Institution of the National Clinical Hospital. Results: within the framework of this study, a new approach to the systematics of remissions has been developed, which is based not only on remissions reflecting a certain stage in the development of the endogenous process (slowing down, stabilization, reduction of symptoms) and social and labor maladaptation, but also remissions, in the formation of which the dynamics of personality disorders participates. In accordance with this, 2 types of remissions are distinguished: 1) remissions with personalized motor phenomena – type of personality development (psychasthenic/hypochondriac circle), prolonged; 2) symptomatic remissions, with signs of ongoing course, with symptoms of catatonia mitis.

Особенности длительной антипсихотической терапии пациентов с расстройствами шизофренического спектра (клинико-статистическое исследование)

Data on 7,236 patients with schizophrenic spectrum disorders (SSD) treated with long-acting injectable antipsychotics were studied, most of whom had paranoid schizophrenia diagnosis (F20.0 – 91.6%), the rest with SSD (F20.1-25.9) observed in 9.4% of patients. In the studied sample, the majority were men (53.9%). Cluster analysis allowed the formation of three cluster groups (CG) of patients, depending on the severity of psychopathological symptoms – positive and negative at the time of remission. The first group (n=4717) included patients with residual productive symptoms and pronounced negative symptoms (CG1); the second (n=1185) – patients with moderately pronounced positive and negative symptoms (CG2); the third (n=1334) – patients with mild positive and negative symptoms (CG3). The largest cohort (CG1) consisted of patients with the most severe register of mental disorders and the lowest social and labor indicators. Patients with CG3 had a mild register of psychopathological disorders and the highest rehabilitation level. Clinically and socially СG2 patients occupied an intermediate position. Thus, a large cohort of seriously ill patients with a predominance of pronounced negative symptoms (СG1) and patients with more favorable clinical and social characteristics and preserved rehabilitation potential (СG3) was identified. A clinical and statistical study has shown that the clinical and nosological heterogeneity of the isolated patients with SSD is dissonant with the approximate homogeneity of the therapy. Regardless of the clinical characteristics of the patients, about a third of them received therapy with prolonged preparations of haloperidol, a third – zuclopentixol, the proportion of long-acting injectable antipsychotics in the groups was also approximately the same and did not exceed 27.4%. It has been established that the subjective perception of psychopharmacotherapy, its direct and side effects is a significant factor influencing the characteristics of long-term antipsychotic therapy. The severity of the clinical course of SSD revealed a relationship with lower compliance, a relatively higher prevalence of episodic therapy intake disorders. It is concluded that pharmacotherapy with prolonged antipsychotics by itself does not determine pronounced shifts in the dynamics of psychopathological disorders and is not determined by clinical and social parameters, which determines the relevance of further catamnestic research of patients of the selected groups after optimizing pharmacotherapy and conducting psychorehabilitation measures taking into account their identified individual characteristics.

Первый психотический эпизод: клинико-диагностические аспекты и терапевтические под¬ходы

Aim. To provide a comprehensive and up-to-date analysis of the clinical, diagnostic, and therapeutic aspects of the first psychotic episode, this scientific review was conducted. The review is based on relevant publications from PubMed/MEDLINE, eLIBRARY.RU, RSCI, Google Scholar, and other databases published over the last five years. Key points In recent decades, there has been an increase in the number of scientific studies that demonstrate the effectiveness of early intervention for the first psychotic episode. Psychosis can be associated with various mental disorders, such as schizophrenic spectrum disorders, bipolar disorder, and depression with psychotic features. The prevalence of these disorders during a person's lifetime is approximately 1.94% for non-affective psychotic disorders and 0.59% for affective psychotic disorders. The first manifestations of psychosis can occur at a young age and can lead to difficulties in personal, family, professional, and social life. Early detection and intervention can improve treatment outcomes and prognosis.. At the same time, lack of timely medical care can affect the effectiveness and duration of antipsychotic therapy. This can lead to increased risk of hospitalizations, decreased quality of life, and an unfavorable outcome for the patient. Conclusion. The social significance of the problem is determined by the fact that, according to the World Health Organization, acute psychosis is in third place among the most disabling diseases, and major psychotic disorders reduce the average life expectancy by 10 years. One of the main directions of modern medicine is preventive and life-saving rehabilitation aimed at preventing repeated hospitalizations and improving the social adaptation of patients. The study of the interaction of various aspects of the occurrence, course and outcome of the first psychotic episode allows us to assess the dynamics, current programs of psychosocial rehabilitation and treatment of the disease. Keywords: first psychotic episode, early intervention, psychosocial rehabilitation, biopsychosocial model.

Сariprazine in the treatment of schizophrenia spectrum disorders in a hospital setting

The aim of the study was to evaluate the possibility of using cariprazine for the treatment of productive and negative symptoms in schizophrenic spectrum disorders in a hospital setting.Materials and methods: A group of 35 patients with leading productive and negative symptoms in patients with schizophrenic spectrum disorders treated in a psychiatric hospital constituted the material of the study. The condition of patients was objectified according to the Clinical Global Impression Scale (CGI-S and CGI-I) and the Positive and Negative Syndrome Scale (PANSS) — at the beginning of the study and in dynamics on the 30th and 60th day of treatment. The mean PANSS score at the beginning of the study was 94.45±14.49 points. After the drug administration, the patients were followed up for up to 60 days.Results: Cariprazine was administered both as first-line treatment and after prior therapy. The dose range was from 1.5 mg to 6 mg daily. In 3 patients (8.57%), cariprazine therapy was discontinued due to the development of adverse events or worsening of the condition. The remaining 32 patients (91.43%) showed positive dynamics.Conclusions: The study showed high efficacy of cariprazine when administered for the treatment of productive and negative symptoms in schizophrenic spectrum disorders in a hospital setting. The drug was well tolerated in the majority of patients.

Clinical and Social Characteristics, Quality of Life, Adherence to Therapy of Out-Patients with Schizophrenic Spectrum Disorders: Cross-Sectional Study

Background: clinical diversity of schizophrenic spectrum disorders determines a variety of long-term management and treatment outcomes of out-patients.Aim of the study: to analyze the interrelationships of clinical and social characteristics, quality of life and adherence to therapy in patients with schizophrenic spectrum disorders.Patients and methods: data of 120 patients observed in a neuropsychiatric dispensary with diagnoses of schizophrenic spectrum disorders (F20, F21, F25 according to ICD-10) were studied.Results: three categories of individuals were identified, taking into account the high degree of intragroup similarity of clinical and social characteristics. Patients of the first group (29%) have a stable-positive characteristics of social adaptation and a high adherence to therapy. They were characterized by a younger age, mainly an attack-like course of the disease with an affective-delusional structure of exacerbations and weakly pronounced personality changes. Significantly more often than patients of other groups, they received therapy with second-generation antipsychotic drugs of prolonged action. Patients of the second group (39%) have the negative dynamic characteristics of social adaptation and a low adherence to therapy. They were characterized by older age, continuous or episodic types of disease course with increasing defect, higher prevalence of moderately and strongly pronounced positive and negative symptoms at the time of remission. Treatment and rehabilitation measures did not give sufficient results, despite the active use of prolonged antipsychotic drugs of the second generation. In this category of patients, there were phenomena of social drift, with the collapse of social ties, loss of work skills. Patients of the third group (32%) were characterized by contradictory characteristics with stable negative characteristics of social adaptation and high adherence to therapy. A significant part of the patients had negative personality changes and often a low-grade course of the disease with a predominance of neurosis-like and depressive symptoms. Receiving for many years mainly therapy with firstgeneration antipsychotics (APP1) and practically not hospitalized in a psychiatric hospital, they found pronounced social isolation, loneliness and feelings of hostility of the surrounding world.Conclusions: the management of out-patients with schizophrenic spectrum disorders represent clinical problems depending of different forms of social adaptation and adherence to therapy, for the effective solution of which it is necessary to optimize complex social rehabilitation measures.

The relationship between bullying and symptom presentation in first-episode psychosis.

Multiple recent studies have indicated that adverse psycho-traumatic experiences are particularly significant, if not the most significant, among the environmental factors that participate in the aetiology of schizophrenic spectrum disorders. The prevalence of bullying in the adolescent population has increased dramatically compared to earlier reports. This may be related to the recent development of communication technology and the use of social media, which have expanded the means by which bullying can be practiced. The present study aims to investigate the association between bullying victimisation and psychotic symptoms in First-Episode Psychosis (FEP) patients, hypothesising that patients who have a bullying history may have increased psychotic symptoms and a more unfavourable early trajectory after treatment as usual compared to patients who do not have a bullying history. Research data were collected from a sample of men and women of the Greek general population aged between 16 and 45 (N=225) who experienced a FEP in the context of the Athens First-Episode Psychosis (FEP) Study. The assessment of bullying was performed using the Retrospective Bullying Questionnaire (RBQ). Assessment of positive and negative psychotic symptoms and general psychopathology was performed using the corresponding subscales of the Positive and Negative Syndrome Scale (PANSS) at baseline and after 4 weeks of treatment as usual. Clinical remission was assessed based on the baseline and follow-up values of the PANSS and on Andreasen's symptomatic criteria. Methodologically, Pearson's chi-square test was used to compare the history of bullying between men and women, while linear and logistic regression models were used to check the correlations between history of bullying and symptom severity at baseline and 4-week follow-up, as well as the correlation between history of bullying and remission. The prevalence of bullying history in our sample of patients (N:225) with a FEP was 51.4% (114/225). Bullying was recorded in our study participants with equal frequency in women and men. According to the analysis results, the patients who had experienced bullying did not present at baseline with significantly increased psychotic symptoms compared to the patients who did not have a history of bullying. In addition, bullying was not associated with reduced remission according to Andreasen's criteria. However, the patients who had experienced bullying were found to have significantly increased negative symptoms (B=1.66; SE=0.70; p=0.018) and increased PANSS total score (B=4.81; SE=2.34; p=0.041) at 4-week follow-up. Our results highlight the persistence of negative and overall symptoms as an impact of bullying on the development of the FEP and align with studies that support the consideration of a history of bullying during both the diagnostic and therapeutic processes.

Pathologies of imagination and affectivity: the genesis of the unconscious in Marc Richir.

In their recent work in phenomenological psychopathology, Andreas Rosén Rasmussen and Joseph Parnas argue that there is an expressive relationship between the anomalies of imagination reported in schizophrenic spectrum disorders (SSDs) and an underlying generative self- or ipseity disorder. The authors build their argument on an updated review of the phenomenological model of consciousness, by which each experience articulates itself in ipseity according to its modality. Therefore, they explain imagination as the figuration of an absent object mediated by the imaginary and accompanied by a sense of irreality. Finally, by drawing on patients' descriptions, Rasmussen and Parnas show that SSD imagination disorders testify to the breakdown of this model of consciousness. In this article, I aim to complexify the scenario summarized above by focusing on the contribution made by the phenomenologist Marc Richir in his late masterwork Phantasia, imagination et affectivité (2004). To this end, I examine the genetic analyses of the pathologies of the imaginary that Richir develops through a non-standard interpretation of Husserl's phenomenology of imagination (in particular, Hua XXIII, text n.16, 1912). In my examination, I aim to unfold an alternative model of consciousness that (a) is based on the gap between the architectonic registers of phantasia and imagination (and the corresponding stages of sense-making and the institution of sense), (b) takes account of the role of affectivity in those registers, (c) places the pathologies of the imaginary in the quasi-empathy that characterizes the missed encounter with the other, and (d) links the institution of these pathologies with the psychoanalytic account of the fixation of the phantasm.

Сognitive Functioning in Patients with the Phenomenon of Anhedonia in the Framework of Affective Pathology and Schizophrenia Spectrum Disorders

Background: anhedonia is a transdiagnostic psychopathological phenomenon, which is assessed as “core” for several diseases at once — first of all schizophrenic and affective spectrum disorders. The problem of clinical features differentiation and identification of anhedonia’s neurobiological mechanisms in the structure of the affective and schizophrenic spectrum disorders is still topical and far from being resolved.The aim of the study: to compare the relationship between the features of neurocognitive functioning and the manifestations of anhedonia among patients with disorders of the schizophrenic and affective spectra.Patients: the sample consisted of 40 patients including 17 patients with schizophrenic spectrum disorders (ICD-10 diagnosis codes F20.01, F20.02, F21.3, F21.4, F25.0, F25.1) and 23 patients with affective disorders (ICD-10 diagnosis code F33, F31).Methods: clinical, psychometric, experimental psychological and statistical.Results: patients with schizophrenia spectrum disorders show lower scores on pleasure anticipation ability and ability to experience pleasure in the social sphere. The affective spectrum group showed a correlation between anticipatory anhedonia and phonetic verbal fluency (r = –0.487; p &lt; 0.01). There was also a correlation between immediate pleasure experience and errors in the Rey figure test (r = –0.349; p &lt; 0.05). Social anhedonia in these patients was associated with phonetic verbal fluency productivity (r = –0.509; p &lt; 0.01) and performance in visual fluency productivity (r = –0.473; p &lt; 0.01). Patients with schizophrenia spectrum disorders had a correlation between anticipatory anhedonia and the Color-Word Interference Test (r = –0.329; p &lt; 0.05) and the Rey Complex Figure Test (r = –0.307; p &lt; 0.05). Consummatory anhedonia was correlated with verbal fluency test (r = –0.511; p &lt; 0.01) and the Rey Complex Figure Test (r = –0.417; p &lt; 0.01). Social anhedonia was correlated with Color-Word Interference Test (r = –0.656; p &lt; 0.01), verbal fluency (r = –0.523; p &lt; 0.01), and story description (r = –0.421; p &lt; 0.01).Conclusion: manifestations of different parameters of anhedonia demonstrate the differences in schizophrenia and affective spectrum disorders. Patients with schizophrenia spectrum disorders have greater difficulties in anticipating pleasure and experiencing pleasure in the social sphere. The ability to anticipate pleasure may be associated with executive function, while the ability to experience pleasure immediately may be associated with memory function. Social anhedonia affects a wide range of cognitive functions.

Prospects of using event-related potentials in medical examination of military mental disorders

Relevance. Considering the demand for additional efficient methods among clinicians to assess military mental health, instrumental methods, including psychophysiological and neuropsychological tools, providing objectifying detection of mental disorders (MD) are of particular importance. Event-related potentials (ERP) are a promising additional method of objectification of psychopathological manifestations, allowing to obtain neurophysiological parameters for processes associated with arbitrary attention, identification and decision-making.Objective. The study provides a generalized analysis of contemporary investigations and research outcomes regarding event-related potentials as a diagnostic tool for mental disorders, its diagnostic and prognostic potential in medical examination of military mental disorders.Methods. To assess the ERP diagnostic informative value, we analyzed over 40 scientific studies published within the last 10 years dealing with event-related potentials and their implementation in MDs, various brain structure damages and associated functional disorders. We also summarized the results of applying this method to study patients’ cognitive abilities and integrative functions.Results and discussion. Our analysis of scientific studies shows that the ERP value differs significantly for various MDs, such as: schizophrenic spectrum disorders, affective disorders, or addictive pathology. The conclusion suggests that the assessment of the parameters associated with various ERP modifications can improve objectivity of diagnostic and prognostic outcomes in military mental disorders.Conclusion. Event-related potentials is a promising method of diagnostic significance to assess severity of perception, attention, short-term memory damage, as well as cognitive disorders. ERP can help determine the boundary values and diagnostic criteria, as well as evaluate treatment efficiency and outcomes in military mental disorders. Moreover, ERP could be a promise as an additional research method to objectify MDs in mental state assessment of the military at military medical examination.

Plasma autoantibodies in patients with Affective and Schizophrenic Spectrum Disorders

Plasma autoantibodies in patients with Affective and Schizophrenic Spectrum Disorders

Реорганизация психиатрической службы и антипсихотическая терапия больных шизофренического спектра

The article discusses the trends in the use of antipsychotic drugs in the treatment of patients with schizophrenic spectrum disorders (RSHS) in the context of the reorganization of the psychiatric service on the example of Moscow. The reform of the psychiatric service (2012-2020) has radically changed the structure of psychiatric care, the system for evaluating its effectiveness and the economic basis. While the number of inpatient beds decreased by more than 3 times, the number of places in day hospitals increased by more than 2 times, the number of visits to a psychiatrist in the outpatient network increased by 2.5 times during the year. During the period under review, the number of repeated hospitalizations of patients with RS in psychiatric hospitals has also significantly decreased. At the same time, stable indicators of the incidence of RS during the considered period of time remain. Simultaneously with the reform of the psychiatric service, there was an increase in the consumption of antipsychotics from 7.6 million Defined Daily Dose (DDD) in 2013 to 12.3 million DDD in 2021, including conventional (KA) and atypical antipsychotics (AA) from 17% to 30% with an outstripping increase in the use of prolonged injectable antipsychotics (primarily AA). If in 2013-2016 AA of prolonged action made up an insignificant part of the total array of prolonged drugs (5-9%), then there was a consistent increase in their use. In 2021 they accounted for 36% of the total volume of prolonged-acting drugs (an increase of 400%), with a general increase in the use of prolonged forms by about 3 times. There was a sevenfold increase in the proportion of injectable forms from the total volume of AA – from 3% (2016) to 23%, and a twofold overall increase in the volume of AA use from 2.5 million DDD (2013) to 5.8 million DDD (2021). It is stated that there has been a stabilization of the system of providing psychiatric care to patients with RSHS with a shift of emphasis to the outpatient link and the widespread introduction of prolonged AA. To the greatest extent, these trends are found in the increasing use of risperidone-const and prolonged forms of paliperidone. It is concluded that the psychiatric service is on the threshold of a new stage of development, which represents a way of personalizing psychiatric care based on an individual approach to the patient.