Schizophrenic Spectrum Research Articles

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 < 0.01). There was also a correlation between immediate pleasure experience and errors in the Rey figure test (r = –0.349; p < 0.05). Social anhedonia in these patients was associated with phonetic verbal fluency productivity (r = –0.509; p < 0.01) and performance in visual fluency productivity (r = –0.473; p < 0.01). Patients with schizophrenia spectrum disorders had a correlation between anticipatory anhedonia and the Color-Word Interference Test (r = –0.329; p < 0.05) and the Rey Complex Figure Test (r = –0.307; p < 0.05). Consummatory anhedonia was correlated with verbal fluency test (r = –0.511; p < 0.01) and the Rey Complex Figure Test (r = –0.417; p < 0.01). Social anhedonia was correlated with Color-Word Interference Test (r = –0.656; p < 0.01), verbal fluency (r = –0.523; p < 0.01), and story description (r = –0.421; p < 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.

Microstructural Brain Pathology in Paranoid Schizophrenia (According to Magnetic Resonance Tractography)

Background: inconsistency of the obtained results of research on the pathology of microstructural connectivity in schizophrenia on the basis of tractography, absence of clinical application of special MRI techniques justify the need to continue scientific search in this direction. Objective: to identify the features of microstructural pathology of the brain in paranoid schizophrenia. Patients and methods: 25 patients diagnosed with paranoid schizophrenia (F20.0) were included in the main group, 30 healthy subjects without neurological and somatic diseases made up the control group. Instrumental studies were carried out on a Philips Ingenia magnetic resonance tomograph (magnetic field strength 1.5 T) using a DTI pulse sequence. Subsequent processing was carried out using “DSI Studio” (software for the analysis of tractor data). Results and discussion: the resulting microstructural brain changes demonstrated differences in the microstructural connectivity of the brain in patients with paranoid schizophrenia compared to the control group. Significant connections were revealed (at the given parameters for constructing connectivity matrices) between the hippocampus and the cingulate gyrus, the hippocampus and thalamus, thalamus and structures of the striopallidar system, and the absence of significant connections between the amygdala in the main group compared to the control group. The results of graph theoretical analysis of neural network indicators of the brain demonstrated higher values of indicators of “clustering” and the “small world” coefficient, characteristic path length, transitivity, density, and lower values of the global efficiency indicator of the main group compared to the control group. Conclusion: the obtained results demonstrate microstructural semiotics of neural network changes of brain in paranoid schizophrenia. Changes in the connectivity of the hippocampus, thalamus, and amygdala appear to be important tractographic semiotic features of the microstructural pathology of the brain in paranoid schizophrenia. The study is one of the stages of the search for a method of objectification and detection of disruption of brain neuroplasticity processes in the endogenous pathology of the schizophrenic spectrum.

The relationship of frustration reactions and gender role behavior in patients with schizophrenia and affective disorders

The study of violations of the adaptive-compensatory mechanisms of patients with mental disorders makes it relevant to study the combined characteristics of gender, psychosexual sphere and response to stress in mental pathology. The aim of the study was to identify the relationship between the types and directions of frustration reactions as unconscious components of coping with gender and gender-role behavior. 183 patients with diagnoses of schizophrenia and schizotypal disorder, recurrent depressive disorder, bipolar affective disorder were examined. In the diagnostic groups, men and women were dominated by persons under the age of 30. The «Method of diagnostics of gender role behavior accentuations» and «Drawing Associations test» were used. The data obtained indicate that among patients with schizophrenia, men with cross-gender role accentuation better assimilate socio-normative patterns of behavior than women with cross-gender role accentuation; in women with schizotypal disorder, the presence of cross-gender accentuation of gender-role behavior is associated with a lower level of social adaptation compared to women without accentuation.Women with schizotypal disorder and more pronounced masculine gender role accentuation have a profile of the direction of emotional reactions in frustrating situations, characteristic of men with schizotypal disorder. In ontogenesis, the interrelationships of stereotypes of emotional response and the level of gender role accentuation change. The revealed sex differences in the profiles of frustration reactions among patients on the schizophrenic spectrum may be partially explained by the gender-role characteristics of patients. In conclusion of the analysis, it can be concluded that the stereotypes of a person’s emotional response and their formation are closely related to gender-role behavior. Knowledge of this kind of interrelationships enables the psychotherapist in the course of treatment to achieve the patient’s understanding of his behavior, including its unconscious aspects.

Trait schizotypy and the psychosis prodrome: Current standard assessment of extended psychosis spectrum phenotypes

Schizotypy has become an increasingly important construct for elaborating psychotic disorders that vary along the schizophrenic spectrum. However, different schizotypy inventories vary in conceptual approach and measurement. In addition, commonly used schizotypy scales have been seen as qualitatively different from screening instruments for prodromal schizophrenia like the Prodromal Questionnaire-16 (PQ-16). Our study investigated the psychometric properties of three schizotypy questionnaires (the Schizotypal Personality Questionnaire-Brief, Oxford-Liverpool Inventory of Feelings and Experiences, and the Multidimensional Schizotypy Scale) as well as the PQ-16 in a cohort of 383 non-clinical subjects. We initially evaluated their factor structure using Principal Component Analysis (PCA) and used Confirmatory Factor Analysis (CFA) to test a newly proposed composition of factors. PCA results support a three-factor structure of schizotypy that accounts for 71% of the total variance, but also shows cross-loadings of some schizotypy subscales. CFA of the newly composed schizotypy factors (together with an added neuroticism factor) shows good fit. Analyses including the PQ-16 indicate considerable overlap with measures of trait schizotypy, suggesting that the PQ-16 might not be quantitatively or qualitatively different from schizotypy measurements. Taken together, results indicate that there is good support for a three-factor structure of schizotypy but also that different schizotypy measurements grasp facets of schizotypy differently. This points towards the need for an integrative approach for assessing the construct of schizotypy.

Plasma autoantibodies in patients with Affective and Schizophrenic Spectrum Disorders

Plasma autoantibodies in patients with Affective and Schizophrenic Spectrum Disorders

Pathology of imagination in an adolescent at clinical high-risk for psychosis.

We report a pathological imagination process in an adolescent at clinical high-risk for psychosis, associated with the presence of self-disorders. The subjective experience associated with pathological imagination helped in distinguishing such mental activity from intrusive thoughts of obsessive-compulsive patients; moreover, such anomalous imagination focused on other people may be an adaptive process triggered by negative emotionality against others that appear difficult or impossible to relationally grasp and attune with. In conclusion, anomalies of imaginations may occur within the schizophrenic spectrum since adolescent prodromal stages, associated with self-disorders.

Experience of clinical use of fluvoxamine for the treatment of comorbid depression in childhood and adolescence

To identify the frequency of administration of fluvoxamine, to determine the main targets of the drug and the expediency of its use in depression of various genesis in children and adolescents. To assess the frequency of prescribing fluvoxamine, 195 medical histories of patients who were inpatients in the children's department of the Mental Health Research Center in 2023 were analyzed. To assess the dynamics of depression during treatment with fluvoxamine, a clinical group was formed of 12 patients aged 10 to 15 years (age 13.1±3.6 years) who received fluvoxamine for the treatment of depression with comorbid obsessive-compulsive and anxiety-phobic disorders. Clinical and psychopathological, psychometric (Hamilton Depression Rating Scale - HDRS) and statistical research methods were used. In total, in 2023, fluvoxamine was received by 20% (n=37) of all inpatient patients of child age (from 7 to 16 years). All patients received combination therapy. The therapeutic targets were comorbid depressive, obsessive-compulsive and anxiety symptoms developing in the structure of nosologically heterogeneous states, with the dominance of schizophrenic spectrum disorders. Against the background of the use of the drug fluvoxamine for 4 weeks in the clinical group, there was a significant reduction in depressive symptoms on the HDRS. Adverse events during complex therapy were observed in 20% of patients, but were not severe, did not require discontinuation of therapy and were unreliably associated with the use of fluvoxamine. The use of the fluvoxamine provides reduction of depressive symptoms within the framework of various nosologies, and is characterized by sufficient safety. The variety of therapeutic targets of the fluvoxamine, including antidepressant, anti-anxiety, cognitive effects, is certainly a significant advantage of the studied fluvoxamine for use in childhood.

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.

Psychopathologic evidence in the Italian “Trap Music” population

Background and aims: In the last decade, a musical strand has emerged in the Italian national scene that has international roots since the 1990s of the last century: “Trap Music” and younger generations are increasingly fascinated by this genre, for various reasons. The present research hypothesizes the existence of a link between the choice of preference of this musical genre and the psychopathological profile of those who choose their first preference, hypothesizing that such individuals have on average a higher level of dysfunctional traits typical of cluster B (borderline, narcissistic, histrionic and antisocial), according to the PICI model and compared to the population. Materials and methods: Clinical interview, and administration of the battery of psychometric tests. The population sample was selected based on previous clinical contacts and voluntary participation through recruitment in major social networks (Facebook, Instagram, Twitter, TikTok), a total of 4,368 participants, divided into three age groups (18-25, 26-37, 38-46) and two groups (the first “clinical” and the second “control”). SPSS, Anova test (with Bonferroni). Results and discussion: On average, the users selected in the clinical group population sample presented 81% of cases with a psychopathological personality profile (PICI-2) with at least 5 dysfunctional traits afferent to cluster B (bipolar, borderline, histrionic, narcissistic, antisocial, and psychopathic) and at least 4 dysfunctional traits afferent to cluster C (paranoid, delusional, schizophrenic spectrum, dissociative), according to the PICI model, compared to 23.1% of the cases in the control group, which, however, shows traits more oriented toward neurotic tendencies (anxious, phobic-avoidant, obsessive, somatic). The investigation of dysfunctional sexual behaviors then showed, in the clinical group, the marked presence of the clinical condition of the users, with an average of 96.8% compared to 24% in the control group; in particular, the presence of a tendency toward pedophilic (under 13 years old) and pederastic (13-17 years old) paraphilia is noted for the average value between only the markings of the second and third clinical groups equal to 54.3% (with an overall phenomenon slightly more inclined toward the male group). Conclusion: It is concluded, therefore, that the starting hypothesis can be confirmed, as the hypothesized link between the primary preference choice of “Trap Music” and the psychopathological profile afferent to the dysfunctional traits of Cluster B (borderline, narcissistic, histrionic, antisocial and psychopathic), according to the PICI model and compared with the control group (CG) population, which has significantly lower pathological values (57.9% - 72.8%) than the clinical group (CG), appears credible and non-random.

Application of Antipsychotic Medication: Gender Differences in Tolerance and Medication Response

This paper covers the role of gender factor in the efficacy and tolerance of antipsychotic therapy in patients with schizophrenic spectrum disorders. The author describes phenomenology of definitions that characterizes differences between male and female sexes. The authors give the data on biological basis of gender differences, frequency of occurrence and clinical features of neuroendocrine dysfunctions (NED) in patients with schizophrenic spectrum disorders during the therapy by first and second generations antipsychotics. It is shown that female patients are more “vulnerable” for some NED. It is emphasized that the problem of tolerance is now more relevant and significant in comparison with the efficacy of antipsychotics, because intolerance or poor tolerance are one of the most common reasons for non-adherence to therapy up to the complete abandonment of it.

Vogt-Koyanagi-Harada Disease Presenting as a Schizophrenia Spectrum Disorder: A Case Report

Introduction: Numerous autoimmune disorders accompany with psychosis. The Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disease with no reports about its concomitance with psychosis so far. Case Presentation: We report the co-occurrence of schizophrenic spectrum diseases with VKH for the first time. They have common manifestations such as aggression, agitation, and self-talking, subsiding after chemotherapy. Workup evaluation was performed by computed tomography (CT) scan, magnetic resonance imaging (MRI), electroencephalography (EEG), lumbar puncture (LP) study, IQ test, lab tests for hepatitis and other infections, and retinal angiography and sonography. The patient underwent corticosteroid therapy, immunosuppressive therapy, risperidone, propranolol, and trihexyphenidyl. Conclusions: Our results showed the significant role of autoimmunity in the genesis of psychosis. On the other hand, unusual manifestations and slow response to treatment in these patients show that autoimmune disorders with psychosis may worsen the prognosis of psychosis.

Psychoses on the Schizophrenia Spectrum in Adolescence: A Cross-sectional Study of Factors Influencing Neuropsychology, Treatment Outcome, and Negative Symptoms

Psychoses on the Schizophrenia Spectrum in Adolescence: A Cross-sectional Study of Factors Influencing Neuropsychology, Treatment Outcome, and Negative Symptoms Abstract: Objective: The present study evaluated the factors influencing the course of disease of children and adolescents in an inpatient rehabilitation suffering from psychosis within the schizophrenia spectrum. Methods: 33 patients (mean age 19.4 years, SD = 2.3), 12 of (36 %) were female, participated. They were assessed with clinical interviews (IRAOS, SANS/SAPS), neuropsychological tests (WAIS-IV, TMT), and questionnaires (FBB, BSCL). Results: The neuropsychological functioning level and the premorbid cognitive performance were correlated, as were treatment success from the patient's perspective with a good relationship with the therapist, and greater negative symptomatology with a longer duration of untreated psychosis (DUP) and a longer initial hospital stay. Conclusion: Possible approaches to improving the treatment of adolescents with psychosis of the schizophrenic spectrum include a shortening of the DUP and a good therapeutic relationship.

Irony detection in patients with borderline personality disorder: an experimental study examining schizotypal traits, response biases and empathy

BackgroundIn verbal irony we often convey meanings that oppose the literal words. To look behind these words, we need to integrate perspectives of ourselves, others, and their beliefs about us. Although patients with borderline personality disorder (BPD) experience problems in social cognition and schizotypal symptoms, research on irony comprehension mainly focused on the schizophrenic spectrum. Accounting for possible negative biases in BPD, the current study examined the detection of praising and critical irony in a text messaging interface.MethodsThe cross-sectional study included 30 patients and 30 matched controls, who completed measures of cognitive and affective empathy (Interpersonal Reactivity Index, IRI), schizotypal (Schizotypal Personality Questionnaire; SPQ), and borderline symptoms (Borderline Symptom List; BSL-23) and the irony detection task. The irony task contained critical and praising remarks embedded in text messages. Asking for literality (ironic vs. literal) and intention ratings (critical to praising) of the stimuli, it allowed to analyze the sensitivity of literality detection as well as implicit and explicit response biases in a signal detection framework.ResultsBorderline symptoms explained lower sensitivity for the detection of literal and ironic statements across groups. Whereas HC showed a negativity bias when implicitly asked about the literalness of the statement, patients with BPD perceived praising utterances as less praising when explicitly asked about their perceived intention. Neither empathy nor schizotypy explained outcomes beyond borderline symptoms.ConclusionsThis was the first study to show lower detection of verbal irony in patients with BPD. While patients were less biased when asked about the literality of a statement, they perceived praising remarks as less positive on explicit measurements. The results highlight the importance of congruent, transparent communication in promoting epistemic trust in individuals with BPD.

Proteomic profile of serum from patients with schizophrenia spectrum disorders.

This article describes the most likely classes of proteins and molecular processes that specifically characterize schizophrenic spectrum disorders such as simple and paranoid schizophrenia, schizotypal disorder, and acute polymorphic psychotic disorder (APPD). The identification of patients’ serum proteins was carried out using mass spectrometry. For patients with paranoid schizophrenia, the proteins responsible for translation and transcription are characteristic. A significant part of the proteins of patients with simple schizophrenia regulate the cell’s main metabolic and transport processes. These are proteins of the receptor system, vesicular transport, and extracellular matrix, which mainly carry out catabolic processes. The proteins of patients with schizotypal disorder mostly coincided with the classes of other patients, apart from chaperone proteins, which were not found in other studied groups. These proteins are mainly involved in anabolic processes. The main classes of proteins found in patients with APPD are responsible for the metabolism of nucleic acids. Active apoptosis processes were also revealed in these patients. These results from our basic knowledge about the molecular mechanisms of the pathogenesis of these disorders.

Efficacy of nutrition education for the increase of symbiotic intake on nutritional and metabolic status in schizophrenic spectrum disorders: A two-arm protocol.

Background/ObjectivesThe microbiota plays a vital role in the two-way communication between the gastrointestinal tract and numerous neuropsychiatric disorders, such as schizophrenia. Besides, the microbiota modulation through the use of psychobiotics (prebiotics and probiotics with nutraceutical action) is related to the improvement of the physical and psychopathological health. The objective to this study was to test the efficacy of prebiotic/probiotic dietary modulation in patients diagnosed with schizophrenia, attending to the nutritional and cardio-metabolic impact.MethodsTwo-arms, double-blind, randomized in balanced blocks clinical trial of 6 months of intervention, will be developed in a group of 50 individuals. The control group will receive conventional dietary advice individually from specialized mental health nurses. In the intervention group, an individual dietetic-nutritional education program with high prebiotic and probiotic content (dairy and fermented foods, green leafy vegetables, high-fiber fruit, whole grains, etc.) will be developed by these nurses. Data will be collected on the psychopathological state, and blood test (at the beginning, at 3 and 6 months). The estimation of intestinal microbiota and the usual nutritional pattern will also be assessed at the beginning and 6 months, using a stool test. To evaluate the degree of adherence, the intervention group will fill a specific weekly record of the main dishes/food consumed. Anthropometric parameters will also be analyzed monthly.DiscussionThe study is anticipated to establish feasibility an adequate dietary modulation with a high simbiotic content, leads to a significant improvement in the nutritional status and cardio-metabolic. Furthermore, it is presumed to reach a degree of evidence that allows establishing nutritional management as an effective therapeutic intervention in the psychopathological treatment of patients with schizophrenia spectrum disorders.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT04366401].

Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) for adults with Autism Spectrum Disorder: A feasibility study

BackgroundSocial cognitive difficulties in Autism Spectrum Disorder (ASD) can affect the daily lives of people with ASD profoundly, impacting the development and maintenance of meaningful social relations. Social cognition training (SCT) is commonly used for improving social functioning, but lacks ecological validity and the ability to effectively mimic social situations. Development of virtual reality (VR) interventions, focusing on enhancing social cognition, could add to the effectiveness of SCT within ASD care, by offering a safe, interactive and practical training setting, where generalization of knowledge and skills to the real-world are promoted. In this paper, our primary aim is to evaluate the feasibility and acceptance by participants and therapists of the Dynamic Interactive Social Cognition MethodTraining in Virtual Reality (DiSCoVR) protocol as developed for adults with schizophrenic spectrum disorder (SSD), adapted for ASD (DiSCoVR-A). 26 participants, aged 18–63, took part in a pilot study. 22 participants completed baseline and post-assessment, including primary outcome evaluation assessment through a semi-structured interview. Secondary measures focused on social cognition, emotion recognition, mental flexibility, social anxiety, empathy and social responsiveness and were assessed at baseline (T0), post-treatment (T1), and at follow-up (T2) sixteen weeks after completion of the intervention. ResultsOur results show that the majority of participant and therapists found the VR intervention acceptable and feasible, as reported in evaluation questionnaires and interviews. ConclusionThese preliminary findings are promising; however, controlled research is needed to further investigate the effectiveness of VR within social cognition training for adults with ASD.

Evolution of the Affective Catatonia Concept in XIX–XXI Centuries

Background: the connection of catatonic disorders with affective pathology is noted in publications related to the prenosological stage of research in psychiatry. Numerous publications of the last and the current centuries are devoted to clinical studies of the relationship between affective and catatonic symptoms. At the present stage of scientic development, catatonia is considered as a transnological formation, manifesting in the framework of various nosological units, including affective diseases. Aim: analysis of the affective catatonia construct’s development in the period of the XIX–XXI centuries and development of affective-catatonic states, forming in the clinical space of schizophrenia and schizophrenic spectrum disorder, conceptual model. Conclusion: affective-catatonic disorders represent a continuum of psychopathologically differentiated phase-owing state. At one of the continuum pole there are catatonic disorders manifesting in the structure of affective pathology, which is realized at the level of recurrent depressions; at the other pole — affective-catatonic states of more severe psychopathological register, acting in the clinical space of bipolar affective disorder and schizoaffective psychoses. The role of movement disorders in affective-catatonic attacks and phases, as well as the modus of interaction of catatonic disorders with affective ones, also varies widely. In some cases, motor symptoms replace the affective symptoms, on the basis of which they were formed, and completely determine the clinical picture of the state; in others — they only modify the manifestations of affective disorders without altering their syndromic structure.

Effectiveness of Psychosocial Rehabilitation: Innovative Method of Results Assessment

Background: The main problem of evaluating the effectiveness of psychosocial rehabilitation (PSR) is incorrect methods of processing psychometric data obtained with the help of appropriate tools (scales and questionnaires), which are standard used to measure the effectiveness of interventions within the framework of the implementation of PSR procedures. The purpose of the study: 1) а systematic analysis of the problems of assessing the severity of mental disorders and the effectiveness of subsequent PSR; 2) development of cardinal algorithms for processing the initial expert information in order to obtain appropriate numerical criteria for the effectiveness of the PSR. Material and methods: a systematic analysis of domestic and foreign publications, based on the results of their own research on the problems of assessing patients’ conditions, as well as evaluating the effectiveness of a comprehensive long-term PSR program for people with schizophrenia and schizophrenic spectrum disorders in various forms of care (public organization, day hospital, hospital). As methods of information processing, clinical-psychopathological, psychometric, as well as methods of system analysis and the analytic hierarchy process (AHP) were used. Results: an innovative methodology and algorithms for processing expert clinical, psychopathological and psychometric information based on the AHP apparatus have been developed to develop criteria for the effectiveness of PSR. The cardinal difference between the proposed approach and the rank methods of processing initial information is that the results of processing initial expert information are obtained in the fundamental scale of AHP (numerical scale), which ensures the correct integration of psychometric and psychosocial characteristics of patients when considering diagnostic procedures, psychosocial therapy and rehabilitation. Conclusions: the calculations are based on expert assessments of the weight of areas of impaired functioning of patients and the corresponding changes in psychosocial characteristics. This ensures the universality of the methodology and algorithms for evaluating the effectiveness of any rehabilitation interventions: from psychosocial to physiotherapy.

Dopamine receptor DRD1 expression (mRNA, protein level) in peripheral blood lymphocytes and prognosis of antipsychotic therapy

Introduction. There is a problem in predicting the efficacy and safety of antipsychotic therapy. Dopamine receptor D1 is one of the targets of antipsychotics. Peripheral blood lymphocytes (PBL) are the research object of neurotransmission receptors.The objective was to study DRD1 gene expression (mRNA, protein level) in PBL as a possible biomarker of olanzapine and haloperidol therapy prognosis.Methods and Materials. Sample: 106 patients diagnosed with schizophrenic spectrum disorder. Study design: prospective longitudinal follow-up with drug administration by randomization. Assessment of mental status and development of Parkinsonism: Positive and Negative Syndrome Scale (PANSS) and Simpson-Agnus Scale (SAS), respectively. PBL was study material. DRD1 mRNA level was determined by real-time PCR. DRD1 protein concentration in PBL was measured by enzyme immunoassay.Results. Haloperidol (but not olanzapine) treatment for 28 days, leads to DRD1 protein concentration decrease in PBL in a manner dependent on its initial level. DRD1 mRNA level in PBL remained unchanged during the treatment. Patients with effective therapy by olanzapine had lower DRD1 mRNA levels. Side effects of the therapy (Parkinsonism, weight gain) were not associated with studied DRD1 parameters.Conclusions. Haloperidol treatment leads to a decrease of DRD1 protein concentration in PBL, which depends on the initial protein level. Effective olanzapine therapy is associated with reduced DRD1 mRNA level in PBL before the treatment.