Volitional Disorders Research Articles

Primary disablement of the adult population due to schizophrenia: structure, medical and social aspects

Substantiation. The article presents the structure and medical and social aspects of the primary disablement of the adult population of the Altai Region due to schizophrenia for the period from 2015 to 2019. Purpose of the study: to investigate the structure of primary disablement of the adult population of the Altai Region due to schizophrenia (by sex, age, place of residence, the main types, and degree of impairment of body functions and life limitations) and present the medical and social characteristics of patients first recognized as disabled. Material and methods. During the study, statistical data of the Federal State Institution «Main Bureau of Medical and Social Expert Examination for the Altai Region» of the Ministry of Labor and Social Protection of the Russian Federation were used. The material of the study included reporting forms No. 7‑sobes (n=5), protocols for conducting medical and social expert examination in the federal state institution of medical and social expert examination (n=745), and forms No. 088 / u of medical organizations (n=745). The research period was 2015‑2019. Research methods: documentary, data copying, statistical, and analytical methods. Results. The study has indicated that in the structure of primary disablement of the adult population of the Altai Region due to schizophrenia, urban residents predominate, while men prevail in the gender category. More than 90.0 % of the patients first recognized as disabled due to schizophrenia are citizens of working age. The vast majority of the patients did not work at the time of examination, while having a professional education. More than half of the patients,mostly men, were not married, had no children, and lived with their parents. In more than 90.0 % of the patients, the paranoid type of schizophrenia led to disability, and the main maladapting syndrome involved emotional and volitional disorders. More than 60.0 % of the patients had persistent moderate impairment of body functions; life limitations were more frequently detected in the following categories: the ability to work, the ability to communicate, and the ability to control one»s behavior. More often, patients with schizophrenia obtained the third group of disability during the initial examination. Conclusion. The results of the study can be a scientific and practical basis for planning and effective implementation of comprehensive rehabilitation of disabled patients with this pathology.

Obsessions And Compulsions: A Lifespan Perspective.

Freud traced the origin of the obsessional neurosis, which he considered a model condition for psychoanalytic inquiry, to a fixation in the anal phase of psychosexual development. Although many analysts have raised doubts about his account, and while the Sullivanian and Lacanian traditions have proposed alternatives, no approach has accounted for what Freud observed as the dizzying variety of obsessive presentations, which seem to defy a singular explanation. The broader research community has moved on, meanwhile, to genetic, neurological, and cognitive-behavioral explanations of what we now call obsessive-compulsive disorder. I argue that we can best account for the variety of obsessive presentations and meaningfully contribute to this interdisciplinary dialogue by framing obsessive-compulsive symptoms as the result of a disorder of volition, an exaggerated sense of willpower, not tied to any one developmental phase or bodily zone. Such a disorder evolves through the lifespan processes of introjection, identification, and repudiation in relation to an anxious/critical parent or an unpredictable environment. I trace these processes through three major developmental milestones. The implication is that, by looking in depth at how the obsessive person internalizes relationships, psychoanalysis can make a unique contribution to a conversation beyond its own borders.

Leiter-3 Scale as Instrument for Assessment of Children with Emotional-Volitional Disorders

Background : assistance to children with emotional and volitional disorders requires effective methods of psychological assessment. However, using standard diagnostic methods in this regard is often considered problematic. Successful application of a standard Leiter-3 test in the described sample provides a valuable insight into the prospects for standardized diagnostics in this area. Aim : to evaluate the possibilities of using the Leiter-3 battery for examining a group of children with severe emotional and volitional disorders. Patients and methods : the study involved preschoolers and adolescents with emotional and volitional disorders (41 people in total) attending group remedial classes at the Center of Curative Pedagogics (Moscow). A pilot study of non-verbal intelligence was carried out using the Leiter-3 test. Results : we have identified a number of problems that make it difficult to use the technique in this group. They are associated with certain traits of the children involved — difficulties in contact, interaction, communication (both verbal and non-verbal), acceptance of the examination situation, focusing on the task, etc. Many of these problems could be solved by slightly modifying the methodology and maintaining certain conditions during testing. Conclusions: the Leiter-3 method can be successfully used to assess the level of intellectual development of children with severe emotional and volitional disorders. However, in some cases it is advisable to apply an individual approach and modify the examination procedure taking into account the characteristics of the child. Further research is needed to verify results obtained that way.

Cognitive and emotional-volitional disorders in patients with residual schizophrenia

IntroductionStudies show that patients diagnosed with residual schizophrenia are characterized by cognitive and emotional-volitional disorders that increase with age. They can be the main barrier to treatment, psychosocial rehabilitation, and cause disability.ObjectivesTo identify cognitive and emotional-volitional disorders in patients with residual schizophrenia.MethodsThe BACS and the abbreviated MMPI test were used; 20 patients with residual schizophrenia (ICD-10 F.20.5xx) receiving outpatient treatment (mean age 59.65±14.24 years) were examined. Exclusion criterion: scores more 4 on at least one parameter of positive symptoms according to the PANSS.ResultsPatients with residual schizophrenia show an overall decline in cognitive function (BACS composite score = 31.56±14.24) compared with healthy individuals, as well as compared with patients suffering from other forms of schizophrenia spectrum disorders. The greatest deficiency was revealed in the speed of information processing (subtests “Symbol Coding”=28.01±10.06; “Verbal Fluency”=37.56±11.57) and auditory-speech memory (subtest “Verbal Memory”=33.25±6 .02). These parameters showed significant associations (r=0.56 at p≤0.01) with the disability of such patients. However, this deficit could be compensated by the relative preservation of planning processes and executive functioning (subtest “Tower of London” = 14.91±4.57). Among the emotional and volitional disorders, the most important is the subjective feeling of low mood and paranoid tendencies (MMPI scales “Dp” = 56.38±10.74T, “Pa” = 59.06±14.49T), which can reduce the compliance of patients with residual schizophrenia.ConclusionsMethods for leveling cognitive and emotional-volitional disorders should to include in programs of psychosocial rehabilitation of patients with residual schizophrenia.Disclosure of InterestNone Declared

Study of aggressive behavior of primary school age children with psychophysical disorders

The article highlights the categories of children that belong to children with psychophysical developmental disorders and shows their age characteristics. It is noted that these are children aged 6–7 to 10–11 years who have been diagnosed with hearing impairment (deaf, reduced hearing); visual impairment (blind, low vision); intellectual impairment (mentally retarded, delayed mental development); speech disorders; disorders of the musculoskeletal system; a complex form of impairment (mentally retarded blind or deaf; deaf-blind, etc.); emotional and volitional disorders and children with autism.Due to subjective reasons, children of primary school age with disorders of psychophysical development often demonstrate aggressive behavior without understanding its meaning. The nature of this behavior in many cases is determined by their age characteristics. The reasons for such behavior are the influence of both internal and external factors, which are characterized in the article.An analysis of the works of scientists who tried to explain the peculiarities of the development and manifestation of aggressive behavior in children of primary school age with disorders of psychophysical development was carried out. The presence of various assumptions and arguments for the existence of various reasons for the appearance of aggressive behavior in children with disorders of psychophysical development has been confirmed in the scientific literature. However, a lack of scientific publications on researching the levels of aggressive behavior in children of primary school age with disorders of psychophysical development during the period of active hostilities was found. This became the goal of the study, which revealed a high level of aggression in children of this category. In particular, the use of Bassa-Darka, "Non-existent animal" and "Cactus" methods for diagnosing aggressive behavior in children of primary school age with psychophysical developmental disorders made it possible to reveal a pronounced high level of aggression in the respondents.The data obtained as a result of the diagnosis of the level of aggressive behavior in the specified category of children made it necessary to study the specific causes of such behavior and to develop ways and means of correcting the aggressive behavior of elementary school students with psychophysical development disorders.

Attenuated negative symptoms in the structure of youth depression

To detect negative symptoms in adolescent depression, to determine their psychopathological structure and predictive significance. Seventy-one young in-patients (average age 19.5±2.4 years) (main group) and 52 in-patients (average age 19.8±2.7 years) (comparison group) with the diagnosis «Depressive episode» according to ICD-10 F32.1, F32.2 were examined. Inclusion criterion in the main group was attenuated negative symptoms (ANS) in adolescent depression. Clinical-psychopathological and psychometric examination was carried out using HDRS, SOPS, SANS. The statistical analysis was done by Statistica 12. Adolescent depression with ANS was more persistent than depression in the comparison group (27.5±17.2 month versus 7.0±6.3, p<0.001), there was higher level of positive symptoms and disorganization symptoms on the respective SOPS sub-scales (7 [5; 9] and 4.5 [3; 8.75], p=0.002; 8 [6; 10] and 5.5 [3.25; 7], p<0.001, respectively). According to the psychopathological structure of the negative symptoms, patients in the main group were divided into a subgroup (n=38, 53.5%) with the predominance of emotional spectrum disorders and a subgroup (n=33, 46.5%) with the predominant involvement of the volition spectrum. ANS in the negative SOPS sub-scale were significantly higher (p=0.045) in patients of the subgroup with volitional disorders. Also, a total HDRS score, reflecting the severity of depressive symptoms, was significantly higher compared to a subgroup with the predominance of emotional spectrum disorders (p=0.038). The results show that it is possible to clinically verify negative symptoms in the adolescent depression, which makes it possible to assign such patients to the risk group of manifestation of schizophrenia, and to assign depression with ANS to the model of the initial stage of schizophrenic process.

Learning English as a means of stress relief for primary school students with special educational needs in the conditions of war

The reform of the educational system of Ukraine, which involves the establishment of an inclusive paradigm within the New Ukrainian School with an emphasis on educational support, the escaping of women with children abroad made it necessary to consider the study of a foreign (English) language as a means of relieving stress in primary schoolchildren with special educational needs in war conditions. Analyzing the concept of “children with special educational needs”, in the context of inclusive practice, understanding the complexity of educational needs, the breadth of the spectrum of intellectual, psychophysical, emotional and volitional disorders, the need for appropriate diagnosis, followed by the provision of comprehensive support by the support team, the creation of a positive atmosphere and cooperation, individualization educational process, we consider it necessary to focus in our research on the categories of children with special educational needs caused by the influence of the social environment. Studying a foreign language contributes to the development of cognitive activity and the purposeful formation of higher mental functions (cognitive motivation; attention; memory; perception; spatial and temporal representations, sensor-motor coordination; mental activity; the formation of voluntary regulation of activity and behavior, etc. It has been established that the influence of negative factors on learning languages, in particular, related to additional workload, which can worsen health and lead to psychophysical diseases. The article examines certain methods of learning English that reduce the risk of PTSD in children, help overcome stress and have a positive effect on behavior child.

ОСНОВНІ НАПРЯМИ КОРЕКЦІЇ ЕМОЦІЙНО-ВОЛЬОВОЇ СФЕРИ ДІТЕЙ З ПОРУШЕННЯМИ ОПОРНО-РУХОВОГО АПАРАТУ ЗАСОБАМИ ПЛАВАННЯ

The article deals with the main directions of correction of emotional and volitional sphere of children of senior preschool and primary school age with disorders of the musculoskeletal system by means of swimming. Emotional and volitional sphere of a child with musculoskeletal disorders has its own peculiarities and requires a specific approach in the correction of disorders and development. It should be noted that the intellectual development of children with musculoskeletal disorders is directly related to the child's ability to experience complex emotions at different age stages. In this regard, it is appropriate to consider the phenomenon of emotions and the human psyche in general. Disorders of the musculoskeletal system is a complex disease of the central nervous system, which leads not only to motor disorders, but also often leads to mental retardation or pathology, speech impairment, emotional and volitional disorders. The use of water environment for correction of emotional and volitional sphere of children can be based on two methodological bases. Firstly, the acquaintance with a relatively new environment (water), being in it, motor and game activities with adults, peers and toys is a kind of return of the child to its primary natural environment both in the phylogenetic sense (evolution of fish, amphibians, reptiles) and in the ontogenetic aspect (the child's presence in the uterus in the amniotic fluid before birth). This process, reinforced by the method of the atricalization (dosed dramatization) of swimming lessons always fills the child with a capacious spectrum of emotions with the dominance of positive ones (satisfaction, joy, pleasure, elation, interest, etc.). Secondly, being in the water, learning to swim involves the systematic overcoming by the child through his volitional manifestations of various psychologically and physically uncomfortable situations for him: the unknown, anxiety, doubts, uncertainty, fears, fatigue, tactile and muscle discomfort, natural physiological reflexes, etc. This will allow the teacher to form the volitional component of the mental development of children of this contingent. The prospects of research in this direction lie in the search for new opportunities to use swimming equipment in the correction of the emotional and volitional sphere of this category of children. Key words: correction, children, disorders, musculoskeletal system, swimming, emotional-volitional sphere.

Penerapan Art Therapy Terhadap Kemampuan Pasien Mengontrol Halusinasi pada Asuhan Keperawatan Pasien dengan Halusinasi Pendengaran di Rumah Sakit Umum Madani Palu

&#x0D; &#x0D; &#x0D; &#x0D; Background: Mental disorders are psychological or behavioral disorders that occur in a person, generally associated with affective, behavioral, cognitive and perceptual disorders. Schizophrenic patients have symptoms including thought process disorders, affective and emotional disorders, volitional disorders, psychomotor disorders and secondary symptoms in the form of delusions and hallucinations. Hallucinations are one of the symptoms of mental disorders where the client experiences changes in sensory perception, feels false sensations in the form of sound, sight, taste, touch or smell. The client feels a stimulus that is not actually there. Schizophrenia is a major disorder in thought processes and disharmony between thought processes, affect and emotions. Schizophrenia has the main symptom of decreased sensory perception, namely hallucinations. Destination : To apply Art Therapy to the Nursing Care of Patients with Auditory Hallucinations at Madani Hospital Palu. Research methods : Descriptive Research with Case Study approach. Measuring instrument : The measuring instrument used to relieve auditory hallucinations is using an observation sheet. Research result : It was found that the patient's complaint during the assessment was that the patient looked restless, often paced back and forth the patient said he heard whispering sounds like he wanted to scold people, the patient said the voice came when the patient was alone and before going to sleep. with nursing diagnoses Auditory hallucinations. The nursing intervention carried out a strategy for implementing auditory hallucinations, namely training how to rebuke, converse, doing activities, one of which was Art Therapy, taking medication regularly. Suggestion :Conclusion: The application of Art Therapy can control hallucinations at Madani Hospital Palu. Suggestion : It is hoped that nurses can apply Art Therapy to patients who experience hallucinations.&#x0D; &#x0D; &#x0D; &#x0D;

Prerequisites for the introduction of climbing in the recreational activities of primary school age children with emotional and volitional disorders

The article aims to determine the advisability and prerequisites for the introduction of climbing in the recreational activities of primary school age children with emotional and volitional disorders. The following research methods were used: theoretical analysis of professional scientific and methodological literature; comparative analysis; expert assessment; pedagogical, anthropometric, physiological, psychodiagnostic research methods; physical health assessment methods; mathematical statistics methods.&#x0D; Based on the expert assessment, we identified factors limiting the effectiveness of health and recreational activities with this cohort, and determined the organizational and methodological conditions for the introduction of climbing in recreational activities of primary school age children with emotional and volitional disorders. The analysis of the physical development of children with emotional and volitional disorders confirmed and supplemented research conducted by other authors proving that emotional and volitional disorders do not have any fundamental influence on changes in the growth patterns of the child's body. It was found that the indicators of the functional state of the cardiovascular system of primary school children with emotional and volitional disorders did not differ significantly from that of children of the same age with normative development.&#x0D; The analysis of the physical fitness of the studied cohort confirmed the existing trends in the professional literature regarding the insufficient level of physical qualities development in junior schoolchildren. The results obtained in 6 motor tests measuring the development of coordination skills indicate that in younger students aged 9-10 the level of these skills is much lower than in their peers with normative development. The analysis of the emotional and volitional features of junior schoolchildren aged 9-10 years of both sex groups showed the lack or insufficient development of the following studied qualities: discipline, independence, perseverance, endurance, organization, determination, and initiative, which indicates the difference between this cohort of students from their peers with normative development. In the study of the psycho-emotional sphere in this cohort of schoolchildren, we found dominance of medium and high levels of psycho-emotional stress in both boys and girls aged 9-10, which significantly distinguishes them from peers with normative development.

HEMISPHERE LATERALIZATION IN PATIENTS WITH CHRONIC VENOUS CEREBRAL DYSFUNCTION SYNDROME AND EMOTIONAL-VOLUNTARY DISORDERS.

Relevance: The problem of treatment of cerebrovascular diseases is one of the leading in modern medicine. The combination of this nosology in patients with emotional and volitional disorders acquires a special shade. Features of neurochemical transmission of impulses in different hemispheres of the brain provide greater opportunities for improving the treatment of patients with chronic cerebral venous dysfunction syndrome (SCVD).&#x0D; Objective: To study the features of hemispheric lateralization of the brain in patients with SCVD and indicators of anxiety on the Spielberger-Khanin scale and depression on the Beck scale. Materials and methods: 153 patients tested on the scale of reactive (RT) and personal (LT) anxiety Spielberger-YL Khanin and Beck depression. 125 people with signs of SCCVD and various levels of BP. Mean age of patients: 53.60 ± 10.27 years, 115 women, 38 men. All underwent clinical and neurological examination, testing to determine hemispheric dominance on the scale of NP Rebrova and MP Chernysheva. Statistics were calculated using the Medstat program. The comparison was performed according to the criterion of W. Kruskal-A. Wallis, the criterion of J. Dunn and the chi-square. Results: It was found that the presence of SCCVD did not depend on hemispheric dominance. In patients with SCVD with left hemisphere lateralization, there was a statistically significant increase in personal anxiety on the Spielberger-Khanin scale (p&lt;0.001). The patients with SCVD and right-hemispheric lateralization had a statistically significant increase in depression on the Beck scale (p &lt;0.001). Patients of the control group did not show a statistically significant relationship between the types of hemispheric dominance and indicators of personal anxiety and depression.

Primary and secondary negative disorders in schizophrenia as an actual problem of modern clinical psychiatry

Negative symptoms of schizophrenia represent, at the present stage of their study, a certain group of mental pathology. They include motivation disorders or volitional disorders (anhedonia, abulia, asociality) and disorders of reduced expression or emotional disorders (alogia/poverty of speech and emotional decline/flattening). Negative symptoms are key disorders in schizophrenia, often appear at the pre-manifest stage of the disease, and significantly affect the prognosis and response to therapy. From a scientific and practical point of view, it is important to distinguish between primary and secondary negative symptoms, where the primary symptoms are nuclear, inherent in schizophrenia, and the secondary ones are the result of the influence of positive symptoms (delusions, hallucinations), depression, side-effects of medications, social isolation and hospitalism. Changes in the concept of primary and secondary negative disorders as well as a pathophysiological basis of negative symptoms are considered.

Hypersexuality as a Manifestation of Various Disorders

The article deals with hypersexuality, which can be a manifestation of a wide variety of disorders. These include: consequences of a psychotrauma; premature psychosexual development; borderline personality disorder; submaniac and maniac states in bipolar affective disorder and schizoaffective type of the course of schizophrenia; disinhibition of libido, rough and naked eroticism in the initial stage of schizophrenia; consequence of advanced emotional volitional disorders in simple-type schizophrenia; temporal lobe epilepsy; dementia; mental retardation (oligophrenias); various organic brain lesions (resulting from neuroinfections, injuries, vascular damages, neoplasms) [the temporal and frontal lobes of the brain are indicated as regulators of libido]; consequence of disorders in the hypothalamic area and limbic system. It is reported that a correlation exists between development of hypersexuality and damages in certain cerebral areas in patients with non-traumatic brain damage. It is pointed out that hypersexuality may result from maldevelopment of the right hippocampus, anti-NMDA receptor encephalitis, in patients with disseminated sclerosis, Huntington’s disease, Kluver-Bucy syndrome as well as be caused by various hormonal disorders and consequences of premenstrual changes and effect of virilizing hormones during the childhood or intrauterine period. Numerous clinical illustrations of cases with hypersexuality, caused by various disorders, are given. The author holds the opinion that it is necessary to divide hypersexuality at least into two categories: true hypersexuality and sexual disinhibition, when with the normal or even reduced level of libido manifestation the hypersexual behaviour results from absence or insufficiency of inhibitory mechanisms (for example, in dementia).

NEGATIVE IMPACTS OF PSYCHOLOGICAL PROBLEMS ON THE PROTAGONIST IN FAYE BIRD’S NOVEL MY SECOND LIFE

The objective of this study is to find out the psychological problems on the protagonist and the negative impacts caused by the psychological problems in Faye Bird’s novel My Second Life published in 2014. Psychological problem are disorders of cognitive, volition, affective, and psychomotor generating to psychological disorders characterized by abnormal thoughts, feelings, and behaviors. The two aspects of the problems are in reality get into the corridor of psychology, a study about human’s soul or mind, either about its symptoms, processes, or its background. As literature is a reflection of society, all the characters are also members of literary community leading to a concept that psychology and literature are closely related. This novel is about a teenager who experiences various psychological problems after finding out that in her first life she has been the cause of someone’s death. This study is conducted to give an overview to all people about the negative impacts of psychological problems experienced by the protagonist. This study applies qualitative method going through social phenomena and the data are collected from the novel. The results show the psychological problems are depression, anxiety and trauma causing negative impacts in the forms of insomnia, lack of concentration and truancy.

Роль характеристик личности и социальной активности в академической адаптации студентов университета с хроническими заболеваниями

The study of personal and behavioral factors of academic adaptation of students with chronic diseases is necessary for the development of a strategy for the socio-psychological and psychological-pedagogical support of such individuals at the university. The purpose of the study is to investigate the role of personality characteristics and social activity in the academic adaptation of conditionally healthy students and students with chronic diseases. The study involved 419 undergraduate university students aged 17–26 years, average age M=19,6, SD=2,8 (men 18,4%), 34,8% of them have chronic diseases (visual system, combined disorders, disorders of the musculoskeletal system, emotional and volitional disorders, etc.). The samples were balanced by gender, age, and academic level. The following questionnaires were used: 5PFQ by R. McCrae and P. Costa in the adaptation of A.B. Khromov (2000), the Scale of academic adaptation (R.M. Shamionov et al., 2020), the Scale of commitment to various forms of social activity (Shamionov R.M. et al., 2018). It was found that students with chronic diseases are characterized by a weaker expression of extraversion and a stronger emotional instability. The relationship between the components of academic adaptation and personality traits attachment–isolation, self- control–impulsivity, emotional stability–instability is universal regardless of the state of health. Socio-political and Internet search activities are associated with the adaptation of students with chronic diseases. Emotional stability–instability is a moderator of the directed connection of age and chronic diseases with academic adaptation, weakening the direct causal relationship. The obtained data allow us to outline the ways of socio- psychological and psychological-pedagogical support of students with chronic diseases at the university.

EVALUATION OF COGNITIVE FUNCTIONS IN NEURODEGENERATION

Cognitive functions and their disorders in patients with neurodegenerative diseases are an urgent problem of modern neurology. Such functions include memory, attention, praxis, gnosis, language, thinking, control functions. The study of the neuropsychological profile allows a more accurate picture of the involvement in the pathological process of various brain structures and thus facilitate the differential diagnosis. The aim of the research: on the basis of studying of cognitive features of patients with neurodegenerative (demyelinating) pathology to consider possibilities of their psychoneurological adaptation. Materials and methods. The survey data of 104 patients with remitting type of multiple sclerosis, who were treated at the state institution “Institute of Neurology, Psychiatry and Addiction of the National Academy of Medical Sciences of Ukraine” are presented. To study the disorders of verbal memory, the method of A. R. Luria “Memorization of 10 words” was used, which allows to estimate such parameters as the amount of direct memory and the strength of delayed memory (i.e. indicators of short-term and long-term memory). The Schulte Table method was used to study arbitrary attention disorders. This technique allows you to evaluate such characteristics of random attention as volume, functions of concentration distribution and switching of attention. Results. The data obtained indicate that, depending on the severity of relapses, there are significant differences in the course of mnestic processes. It was found that in severe variants of remissions in women with relapsing-remitting multiple sclerosis (RRMS) more pronounced than in men, there is a lack of ability to work and exhaustion. Conclusions. It is concluded that the assessment of cognitive deficit out of connection with personal characteristics and emotional and volitional disorders significantly reduces the informativeness and ability to correct cognitive dysfunction. Timely detection of cognitive and emotional-personal changes can not only improve the quality of life of patients with neurodegenerative diseases, but also act as an independent part of the psychoneurological model of adaptation of this category of patients.

Long-term mental activation activities in the practice of social and psychological ssistance gerontological patient

The problem of psychological assistance to the elderly continues to be relevant due to the peculiarities of the personal sphere and mental processes in patients of this age group. When providing medical and social assistance to an elderly patient, psychological support is required, which allows for more effective rehabilitation measures. The purpose of this work is to present modern approaches to psychological care that contribute to the long-term activation of mental activity of elderly patients. The results of the empirical study revealed violations of the dynamic and regulatory nature of all components of mental activity, emotional and volitional disorders in most patients. Therefore, normalization of indicators of mental processes in participants is a necessary condition for positive dynamics of changes in mental processes. Psychological assistance activities in a gerontology center allow you to use a variety of methods and tools that can help activate the mental activity of older people. As a rule, this effect is carried out only in the conditions of the gerontology center and is not long-term. Consequently, the activation of mental activity of elderly patients, achieved by specialists of the institution, may begin to decrease when the patient is discharged. In this regard, the institution introduces innovative forms of psychological and pedagogical influence, which allow the patient to be involved in prolonged projects, in which he can participate after discharge from the institution. The novelty of the work consists in the introduction of a long-term psychological and pedagogical project "Ecoletie", the purpose of which is to implement measures aimed at activating the mental activity of patients by increasing the level of their environmental culture and introducing environmental practices in the further daily activities of the elderly.

COGNITIVE IMPAIRMENT IN NEURODEGENERATIVE PATHOLOGY AS INDEX OF NEUROPLASTICITY IN PSYCHONEUROLOGICAL MODEL OF ADAPTATION OF PATIENTS

Today, cognitive function and their impairment in patients with neurodegenerative diseases is an urgent problem of modern neurology. The study of the neuropsychological profile makes it possible to more accurately present the picture of involvement in the pathological process of different brain structures and thereby facilitate differential diagnosis. In order to study the cognitive features of patients with neurodegenerative (demyelinating) pathology and the possibility of their psychoneurological adaptation, 104 patients with remitting type of multiple sclerosis were examined. To investigate verbal memory disorders, we used the method of "Remembering 10 words", which allows to evaluate such parameters as the amount of direct memory and the strength of delayed memory (ie indicators of short and long−term memory). The Schulte Tables technique was used to investigate arbitrary attention disorders, enabling the evaluation of arbitrary attention as volume, concentration distribution functions, and attention switching. It is concluded that the assessment of cognitive deficits as for personal characteristics and emotional, volitional disorders significantly reduces the informativeness and the ability to correct cognitive dysfunction. Thus, in severe remission multipple slerosis in women was more pronounced than in men, as well as a lack of ability to work and attention deficit.The revealed neurodynamic and operative disorders make it possible to draw conclusions about the severity of the neurodegenerative process and its prognosis.Timely detection of cognitive and emotional−personality changes can not only improve the life quality of patients with neurodegenerative diseases, but also act as an independent link in psychoneurological model of adaptation of these patients. Key words: neuroplasticity, adaptation, neurodegenerative pathology, demyelination, cognitive dysfunction.

Benzodiazepines for catatonia in people with schizophrenia or other serious mental illnesses.

Catatonia is a debilitating disorder of movement and volition associated with schizophrenia and some other mental illnesses. People with catatonia are more likely to require hospitalisation and highly supervised care than those without the disorder. They also have an increased risk of secondary complications such as pneumonia, malnutrition and dehydration. The mainstay of treatment has been drug therapies and electroconvulsive therapy. To compare the effects of benzodiazepines with other drugs, placebo or electroconvulsive therapy for catatonia in people with schizophrenia or other similar serious mental illnesses (SMIs). We updated our previous search (28 February 2007) by searching the Cochrane Schizophrenia Group's Study-Based Register of Trials (9 November 2016; 6 February 2019). This register is compiled by systematic searches of major resources (including CENTRAL, MEDLINE, Embase, AMED, BIOSIS, CINAHL, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings, with no language, date, document type, or publication status limitations for inclusion of records into the register. We also manually searched reference lists from studies selected by the search. All controlled clinical trials that randomised people who have schizophrenia or other similar SMI and experiencing catatonia to receive benzodiazepines or another relevant treatment. We included studies that met our inclusion criteria and reported usable data. We excluded those not meeting our inclusion criteria or those not reporting usable data. We contacted authors when we required further information; and if we received no response, we put those studies aside as 'awaiting assessment'. Review authors extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis using a fixed-effect model. We completed a 'Risk of bias' assessment for the included study and generated a 'Summary of findings' table using GRADE. The searches found 130 citations, from which we could identify 22 possibly relevant studies. From these, we could only include one study. This study had a relatively small sample size of 17 participants who received lorazepam or oxazepam and were drug free for one week before the trial started. The only usable data reported by this study were clinically important change in symptoms of catatonia measured as 50% improvement on the Visual Analogue Scale (VAS). There was no difference in the numbers of participants showing a clinically important change in their catatonic symptoms (RR 0.95, 95% CI 0.42 to 2.16; participants = 17; studies = 1; very low quality evidence).No data were reported for other important outcomes of hospital stay, clinically important change in satisfaction with care, global state, adverse effects or general functioningWe did find a few studies meeting our inclusion criteria but they reported no usable data. We had to exclude these. Although poorly reported, these studies do illustrate that relevant studies have been undertaken - they are not impossible to design and conduct. Analysis of the results from this review, which was a head-to-head comparison of two benzodiazepine monotherapies, does not show a clear difference in effect. No data were available for benzodiazepines compared to placebo or standard care. The lack of usable data and very low quality of data available makes it impossible to draw firm conclusions and further studies with a high-quality methodology and reporting are required in order to determine more definitively the outcomes associated with benzodiazepine use in the clinical management of catatonia in persons with schizophrenia and other SMI.

Carrying On Like a Madman

Melissa J. Ganz, “Carrying On Like a Madman: Insanity and Responsibility in Strange Case of Dr. Jekyll and Mr. Hyde” (pp. 363–397) This essay reads Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde (1886) alongside medico-legal debates about the nature and scope of insanity, arguing that the novel seeks to shore up the idea of individual responsibility in Victorian society. The cognitive test of insanity that emerged from the M’Naghten case of 1843 deemed a person legally irresponsible for his acts if, due to a defect of reason resulting from mental disease, he was unable to perceive the nature and quality of his acts or to know that they were wrong. Alienists such as James Cowles Prichard and Henry Maudsley, however, argued that this test failed to acknowledge the existence of affective and volitional disorders such as moral and impulsive insanity. In their treatises, they urged judges to adopt a more permissive standard—an “irresistible impulse” test—that deemed accused criminals “mad” if they could not control their actions, even if they knew what they were doing was wrong. While the novel appears to be sympathetic to the position articulated by Prichard and Maudsley, I argue, it ultimately shows the dangers of broadening the definition of insanity. To recognize the idea of irresistible impulse as the basis of an insanity defense, Stevenson suggests, is to confound the distinctions between freedom and compulsion, deviance and disease. Contesting the use of emotional insanity to acquit educated professionals like Jekyll, Stevenson holds the doctor guilty of murder.